High Speciality Acardarelli Hospital

Napoli, Italy

High Speciality Acardarelli Hospital

Napoli, Italy
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PubMed | Marche Polytechnic University and High Speciality Acardarelli Hospital
Type: Letter | Journal: European annals of allergy and clinical immunology | Year: 2015

Although this highly refined diagnostic approach has been used in several fields of allergy diagnosis, we noticed the scarcity of data on the role of CDR in detecting current sensitization to the allergens of common pets (cat / dog) and, especially, its potential usefulness in predicting the risk of sensitization to other furry animals. Reported data suggest that cross-reacting mechanisms might play an important role in a significant proportion of allergic sensitizations to furry animals (common pets and unusual / exotic mammals) especially in the absence of any possible direct / indirect contact. In this context an evaluation of specific IgE by using the micro-array technique ImmunoCAP ISAC (Thermofisher Scientific - Immuno-Diagnostics, Sweden) for lipocalins (Can f 1, Can f 2, Equ c 1, Fel d 4, Mus m 1) and albumins (Bos d 6, Can f 3, Equ c 3, Fel d 2) might be very useful to evaluate the possibility of cross-reactions between the allergens of different animals. In fact, allergic sensitization without animal exposure is a relevant risk for patients, because they are not aware about the possibility that even severe respiratory symptoms may develop after an occasional animal contact. This aspect should be taken into account by susceptible individuals before acquiring new pets, after removal of common pets or beginning a contact for working / leisure activity with a common as well as uncommon animal.


D'Amato G.,High Speciality Acardarelli Hospital | Corrado A.,Hospital Careggi Florence | Cecchi L.,Allergy and Clinical Immunology Section | Liccardi G.,High Speciality Acardarelli Hospital | And 3 more authors.
European Annals of Allergy and Clinical Immunology | Year: 2013

Thunderstorm-related asthma is a dramatic example of the allergenic potential of pollen antigens. Pollen allergic patientswho encounter the allergenic cloud of pollen during a thunderstorm are at higher risk of having an asthma attack. Relapse is also possible and we describe here the first case of relapse of near fatal thunderstorm-asthma occurred in a 36 years old, 20 weeks pregnant woman affected by seasonal asthma and sensitized to allergens released by Parietariapollen. Patients suffering from pollen allergy should be alerted of the danger of being outdoors during a thunderstorm in the pollen season and if they experienced an episode of severe thunderstorm-related asthma could be at risk of a relapse during a heavy precipitation event.


D'Amato G.,High Speciality Acardarelli Hospital | D'Amato G.,University of Naples Federico II | Vitale C.,University of Naples Federico II | De Martino A.,Directorate General for Health Prevention | And 8 more authors.
Multidisciplinary Respiratory Medicine | Year: 2015

The major changes to our world are those involving the atmosphere and the climate, including global warming induced by anthropogenic factors, with impact on the biosphere and human environment. Studies on the effects of climate changes on respiratory allergy are still lacking and current knowledge is provided by epidemiological and experimental studies on the relationship between allergic respiratory diseases, asthma and environmental factors, like meteorological variables, airborne allergens and air pollution. Epidemiologic studies have demonstrated that urbanization, high levels of vehicle emissions and westernized lifestyle are correlated with an increased frequency of respiratory allergy, mainly in people who live in urban areas in comparison with people living in rural areas. However, it is not easy to evaluate the impact of climate changes and air pollution on the prevalence of asthma in general and on the timing of asthma exacerbations, although the global rise in asthma prevalence and severity could be also considered an effect of air pollution and climate changes. Since airborne allergens and air pollutants are frequently increased contemporaneously in the atmosphere, enhanced IgE-mediated response to aeroallergens and enhanced airway inflammation could account for the increasing frequency of respiratory allergy and asthma in atopic subjects in the last five decades. Pollen allergy is frequently used to study the interrelationship between air pollution and respiratory allergic diseases such as rhinitis and bronchial asthma. Climatic factors (temperature, wind speed, humidity, thunderstorms, etc) can affect both components (biological and chemical) of this interaction. Scientific societies should be involved in advocacy activities, such as those realized by the Global Alliance against chronic Respiratory Diseases (GARD). © 2015 D'Amato et al.


Liccardi G.,High Speciality Acardarelli Hospital | Salzillo A.,High Speciality Acardarelli Hospital | Piccolo A.,High Speciality Acardarelli Hospital | Foglia M.,High Speciality Hospital A Cardarelli | And 7 more authors.
European Annals of Allergy and Clinical Immunology | Year: 2012

No data on the relationship between allergic sensitization to animal dander and milk allergens are available in literature in adults. Considering the high rate of allergic sensitization to mammals in atopic adults living in Naples area, we aimed to evaluate if sensitization to milk allergens could be a risk factor for these subjects. From 755 consecutive outpatients examined between May 1 2009 and December 31 2010, we selected those with an immediate skin reaction to animal dander and milk. A clinical history including evaluation of pet exposure, the results of skin-prick tests (SPTs) and specific IgE antibodies for milk allergens were recorded. Among three hundred sixty SPT- positive patients, 140 were sensitized to animal dander (38.9%) and 9 to milk allergens (6.4%). Among one hundred forty patients sensitized to animals only one was sensitized also to milk allergens; among 9 milk- sensitized individuals 5 were allergic also to animal allergens (only one to cow dander) while 4 were not sensitized to mammals. Our results suggest that relationship between allergic sensitization to milk and animal allergens is negligible in adult atopic individuals living in urban area of Naples and that high rate of sensitization to animals is likely to be due to other mechanisms such as direct / indirect exposure, and allergen cross-reactions.


Liccardi G.,High Speciality Acardarelli Hospital | Salzillo A.,High Speciality Acardarelli Hospital | Sofia M.,University of Naples Federico II | Piccolo A.,High Speciality Acardarelli Hospital | And 5 more authors.
European Annals of Allergy and Clinical Immunology | Year: 2012

Background: Until now no data on allergic sensitization to rodents allergens in Western Europe and Italy are available. The aim of this report was to investigate clinical significance and characteristics of IgE-mediated sensitization to mouse/rat (M/Rt) allergens in atopic subjects not occupationally exposed to these animals and living in urban area of Naples. Methods: In 1765 consecutive outpatients, we selected all subjects with an immediate skin reaction toM/Rt dander. Clinical history including a careful evaluation of the modality of exposure, the results of skin-prick tests (SPTs) and specific IgE antibodies were recorded. Results: Among 1185 SPT-positive patients, 22 were sensitized to M/Rt dander (respectively 1.60% and 0.59%). No patient was mono-sensitized. Only three of 22 patients reported indoor conditions suggesting presence of rodents allergens at home. All patients exhibited low degree of SPT positivity and low levels of circulating IgE antibodies to M/Rt.High frequency of concomitant allergic sensitization to pet (and other animal) dander has been found. Conclusions:Our results suggest that role of allergic sensitization to rodents is negligible in atopic subjects without occupational exposure living in urban area of Naples. However, highly atopic individuals especially those already sensitized to common pet dander should be tested by SPTs/evaluation of serum specific IgE to rodents in the case they could begin an occupational exposure toM/Rt or keeping these animals as pets.


Liccardi G.,High Speciality Acardarelli Hospital | Passalacqua G.,University of Genoa | Salzillo A.,High Speciality Acardarelli Hospital | Piccolo A.,High Speciality Acardarelli Hospital | And 4 more authors.
Journal of Investigational Allergology and Clinical Immunology | Year: 2011

Background: Patients sensitized to common pets (cat, dog) frequently display an immunoglobulin (Ig) E-mediated response to allergens from other animals. Objective: To evaluate whether individuals sensitized to common pets might be at higher risk of developing allergic sensitization to other mammalian allergens. Methods: The study population comprised 900 consecutive patients (300 individuals sensitized to different allergens including those of cat and dog [group A], 300 sensitized to allergens other than those derived from cat and dog [group B], and 300 nonsensitized individuals [group C, controls]). All patients underwent a physical examination, an interview (clinical history, pet ownership, possible exposure data), and skin prick test (SPT) with a standard panel of allergens including cat, dog, horse, rabbit, rat, mouse, guinea pig, hamster, and cow. Results: A significant difference in allergic sensitization to mammalian allergens was observed in group A compared with group B (respectively, 244 vs 17). No sensitization was found in group C. Conclusion: Since sensitization to pet allergens increases the risk of developing allergy to other furry animals, we suggest performing SPTs with several mammalian allergens to identify allergic sensitization and thus prevent future exposure in individuals who are highly sensitized and environmentally exposed to common pets. © 2011 Esmon Publicidad.


Liccardi G.,High Speciality Acardarelli Hospital | Emenius G.,Karolinska Institutet | Merritt A.-S.,Karolinska Institutet | Salzillo A.,High Speciality A Cardarelli Hospital | And 2 more authors.
Current Allergy and Asthma Reports | Year: 2012

Most studies on the sensitization to horse allergens in populations without professional exposure have been carried out in geographical areas where the rate of horse ownership is high and horse riding is popular. Very few studies have been carried out in populations living in large urban areas. This gap in the literature probably reflects the widespread view that prevalence of horse-related allergy is low in urban populations because the latter are not regularly exposed to horses. On the contrary, we suggest that urban areas constitute a model useful to study potential modalities of exposure and sensitization to horse allergen by other routes of exposure than horse-riding. In this article, we describe the risks related to various modalities of exposure to horse allergen, clinical aspects of airway sensitization to horse allergens in patients living in urban areas, and non-occupational exposure to horse allergen. In addition, we illuminate some aspects related to dispersion of horse allergens from sources such as stables to indoor environments. © Springer Science+Business Media, LLC 2012.


Liccardi G.,High Speciality Acardarelli Hospital | Bilo M.B.,University Hospital | Mauro C.,High Speciality Acardarelli Hospital | Salzillo A.,High Speciality Acardarelli Hospital | And 4 more authors.
Multidisciplinary Respiratory Medicine | Year: 2013

Oxytocin (Sintocynon) is considered an uncommon cause of severe allergic reactions during delivery. We have recently shown that allergic sensitization to latex might constitute an important predisposing risk factor for anaphylaxis after the first infusion of oxytocin during delivery. Some oxytocin cardiovascular activities such as lowering blood pressure, negative cardiac inotropy and cronotropy, parasympathetic neuromodulation, vasodilatation etc. can induce significant side effects mimicking cardiac anaphylaxis, and constitute an additional differential diagnostic problem in delivering women with suspected or real allergic background. Finally, some ex vivo models have shown that oxytocin, under pro-inflammatory cytokines stimulation, such as those occurring in asthma, may induce contraction of smooth muscle and airway narrowing. This background suggests that allergic sensitization to latex allergens constitutes a significant but underestimated risk factor for triggering severe systemic reactions after the infusion of oxytocin and, consequently, there is a need of particular attention in managing delivering women suffering from latex allergy and bronchial asthma. An accurate anamnestic, clinical and diagnostic evaluation, latex-free anesthesiological setting, use of oxytocin-alternative agents and, if necessary, a drug premedication are likely to reduce the risk of anaphylactic/broncho-obstructive reactions in these women. © 2013 Liccardi et al.; licensee BioMed Central Ltd.


Liccardi G.,High Speciality Acardarelli Hospital | Liccardi G.,University of Rome Tor Vergata | Salzillo A.,High Speciality Acardarelli Hospital | Calzetta L.,University of Rome Tor Vergata | And 3 more authors.
Respiratory Medicine | Year: 2016

Recently, we studied occurrence and role of non-respiratory symptoms (n-RSs) before a worsening of asthma symptoms. Some n-RSs such as anxiety, reflux, heartburn, abdominal pain, which appeared within 3 h before the onset of an asthma attack, are the likely result of an imbalance between sympathetic/parasympathetic systems with an increase in cholinergic tone. Therefore, it is likely that some of these n-RSs induced by the increased cholinergic tone might be present related with specific parasympathetic-associated respiratory symptoms such as those elicited by airway narrowing. It is likely that, at least in some categories of asthmatics, an increased cholinergic tone, rather than other well-known factors, might play a prevalent role in triggering bronchospasm. If this is the case, it is possible to speculate that the use of anticholinergic agents (mainly those with long-acting activity) in patients suffering from asthma should be more beneficial in individuals characterized by a higher degree of cholinergic tone that, consequently might be the ideal target for the use of long-acting anticholinergics and, possibly, represent a novel asthma phenotype. The presence of parasympathetic-associated n-RSs might help the physician to identify this type of patients, although this might be followed by a more detailed assessment. © 2016 Elsevier Ltd.


PubMed | University of Rome Tor Vergata, High Speciality Acardarelli Hospital and The Second University of Naples
Type: | Journal: Respiratory medicine | Year: 2016

Recently, we studied occurrence and role of non-respiratory symptoms (n-RSs) before a worsening of asthma symptoms. Some n-RSs such as anxiety, reflux, heartburn, abdominal pain, which appeared within 3h before the onset of an asthma attack, are the likely result of an imbalance between sympathetic/parasympathetic systems with an increase in cholinergic tone. Therefore, it is likely that some of these n-RSs induced by the increased cholinergic tone might be present related with specific parasympathetic-associated respiratory symptoms such as those elicited by airway narrowing. It is likely that, at least in some categories of asthmatics, an increased cholinergic tone, rather than other well-known factors, might play a prevalent role in triggering bronchospasm. If this is the case, it is possible to speculate that the use of anticholinergic agents (mainly those with long-acting activity) in patients suffering from asthma should be more beneficial in individuals characterized by a higher degree of cholinergic tone that, consequently might be the ideal target for the use of long-acting anticholinergics and, possibly, represent a novel asthma phenotype. The presence of parasympathetic-associated n-RSs might help the physician to identify this type of patients, although this might be followed by a more detailed assessment.

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