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Panetta V.,Laltrastatistica srl | Bergmann R.L.,Paediatrics and Obstetrics | Illi S.,Ludwig Maximilians University of Munich | Bergmann K.E.,Robert Koch Institute | And 8 more authors.
Journal of Allergy and Clinical Immunology | Year: 2012

Background: IgE sensitization against grass pollen is a cause of seasonal allergic rhinitis. Objective: We sought to investigate the evolution at the molecular level and the preclinical predictive value of IgE responses against grass pollen. Methods: The German Multicentre Allergy Study examined a birth cohort born in 1990. A questionnaire was administered yearly, and blood samples were collected at 1, 2, 3, 5, 6, 7, 10, and 13 years of age. Grass pollen-related seasonal allergic rhinitis (SARg) was diagnosed according to nasal symptoms in June/July. Serum IgE antibodies to Phleum pratense extract and 8 P pratense molecules were tested with immune-enzymatic singleplex and multiplex assays, respectively. Results: One hundred seventy-seven of the 820 examined children had SARg. A weak monomolecular/oligomolecular IgE response to P pratense was observed very frequently before SARg onset. These initial IgE responses increased in concentration and molecular complexity during the preclinical and clinical process. A typical progression of IgE sensitization was observed: Phl p 1 (initiator in < 75% of cases); then Phl p 4 and Phl p 5; then Phl p 2, Phl p 6, and Phl p 11; and then Phl p 12 and Phl p 7. At age 3 years, IgE sensitization predicted SARg by age 12 years (positive predictive value, 68% [95% CI, 50% to 82%]; negative predictive value, 84% [95% CI, 80% to 87%]). At this preclinical prediction time, the number of recognized molecules and the serum levels of IgE to P pratense were significantly lower than at 3 or more years after SARg onset. Conclusions: The IgE response against grass pollen molecules can start years before disease onset as a weak monosensitization or oligosensitization phenomenon. It can increase in serum concentration and complexity through a "molecular spreading" process during preclinical and early clinical disease stages. Testing IgE sensitization at a preclinical stage facilitates prediction of seasonal allergic rhinitis at its molecular monosensitization or oligosensitization stage. (J Allergy Clin Immunol 2012;130:894-901.) © 2012 American Academy of Allergy, Asthma & Immunology.


Dello Iacono I.,Fatebenefratelli Hospital | Tripodi S.,Sandro Pertini Hospital | Calvani M.,S Camillo Forlanini Hospital | Panetta V.,Laltra statistica srl | And 2 more authors.
Pediatric Allergy and Immunology | Year: 2013

Background: Treatment of severe egg allergy is avoidance of hen's egg (HE) and carrying self-injectable epinephrine. Specific oral tolerance induction (SOTI) seems a promising alternative treatment. However, some aspects of SOTI are still considered experimental. Methods: We evaluated the efficacy and safety of an original 6-month SOTI protocol in children with very severe HE allergy using raw HE emulsion. Twenty children (age range: 5-11yr) were randomized equally into a SOTI treatment group and a control group. The treatment group started SOTI and underwent a second challenge 6months later. Control children were kept on an egg-free diet for 6months and then underwent a second challenge. Results: After 6months, 9/10 children of the SOTI group (90%) achieved partial tolerance (at least 10ml, but <40ml of raw HE emulsion, in a single dose) and 1 (10%) was able to tolerate only 5ml (no tolerance). After 6months, nine control children tested positive to the second challenge at a dose ≤0.9ml of raw HE emulsion, and one reacted to 1.8ml (SOTI vs. control group p<0.0001). All children in the SOTI group had side effects, but no child had a grade 5 reaction according to the Sampson grading. Conclusion: Six months of SOTI with raw HE emulsion resulted in partial tolerance, with regular intake, in a significant percentage of children with severe egg allergy. © 2012 John Wiley & Sons A/S.


PubMed | Vittorio Veneto Hospital, University of Turin, Candiolo Cancer Institute, National Institute of Metrological Research and 2 more.
Type: Journal Article | Journal: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery | Year: 2016

The aim was to investigate telephonic voice intelligibility in patients treated for laryngeal cancer using different approaches. In total, 90 patients treated for laryngeal cancer using different approaches and 12 healthy volunteers were recruited. Each patient and each healthy control read a list of words and sentences during a telephone call. Six auditors listened to each telephonic recording and transcribed the words and sentences they understood. Mean intelligibility rates for each treatment were assessed and compared. Regarding words, the poorest intelligibility was noted for type II open partial horizontal laryngectomies, followed by total laryngectomies. The best intelligibility was found for transoral laser microsurgery, followed by radiotherapy alone. For sentences, the poorest intelligibility was noted for type II open partial horizontal laryngectomies, followed by chemoradiotherapy. The best intelligibility was found for radiotherapy alone and transoral laser microsurgery. More aggressive surgery as well as chemoradiotherapy correlated with significantly poorer outcomes. Transoral laser microsurgery or radiotherapy alone ensured the best telephonic voice intelligibility. Intermediate-advanced T stages at diagnosis also showed significantly poorer intelligibility outcomes, suggesting that T stage represents an independent negative prognostic factor for voice intelligibility after treatment.


PubMed | University of Turin, Martini Hospital, Laltrastatistica srl and Vittorio Veneto Hospital
Type: | Journal: Head & neck | Year: 2016

Cancer of the larynx in the intermediate/advanced stage still presents a major challenge in terms of controlling the disease and preserving the organ. Among therapeutic options, open partial horizontal laryngectomy is proposed as a function-sparing surgical technique.We analyzed the clinical outcomes of 555 patients with laryngeal cancer staged pT3 to pT4a who underwent open partial horizontal laryngectomy.Five-year overall survival (OS), disease-free survival (DFS), locoregional control, local control, laryngectomy-free survival, and laryngeal function preservation rates were 84.6%, 84.2%, 86.3%, 90.6%, 93.3%, and 91.2%, respectively. DFS, locoregional control, and laryngeal function preservation rates were significantly affected by pT4a staging (68.1%, 71.7%, and 78.0%, respectively), whereas pN+ influenced only DFS (72.6%) and locoregional control (79.6%).Open partial horizontal laryngectomy with a modular approach can be considered effective in terms of prognostic and functional results in intermediate-stage and selected advanced-stage laryngeal cancers, even with subglottic extension. 2015 Wiley Periodicals, Inc. Head Neck 38: E649-E657, 2016.


Calvani M.,S Camillo Forlanini Hospital | Arasi S.,Messina University | Bianchi A.,Mazzoni Hospital | Caimmi D.,Montpellier University | And 6 more authors.
Pediatric Allergy and Immunology | Year: 2015

The diagnosis of IgE-mediated egg allergy lies both on a compatible clinical history and on the results of skin prick tests (SPTs) and IgEs levels. Both tests have good sensitivity but low specificity. For this reason, oral food challenge (OFC) is the ultimate gold standard for the diagnosis. The aim of this study was to systematically review the literature in order to identify, analyze, and synthesize the predictive value of SPT and specific IgEs both to egg white and to main egg allergens and to review the cutoffs suggested in the literature. A total of 37 articles were included in this systematic review. Studies were grouped according to the degree of cooking of the egg used for OFC, age, and type of allergen used to perform the allergy workup. In children <2 years, raw egg allergy seems very likely when SPTs with egg white extract are ≥4 mm or specific IgEs are ≥1.7 kUA/l. In children ≥2 years, OFC could be avoided when SPTs with egg white extract are ≥10 mm or prick by prick with egg white is ≥14 mm or specific IgE is ≥7.3 kUA/l. Likewise, heated egg allergy can be diagnosed if SPTs with egg white extract are >5 and >11 mm in children <2 and ≥2 years, respectively. Further and better-designed studies are needed to determine the remaining diagnostic cutoff of specific IgE and SPT for heated and baked egg allergy. © 2015 John Wiley & Sons A/S.


Eleni C.,Instituto Zooprofilattico Sperimentale delle Regioni Lazio e Toscana | Panetta V.,Laltrastatistica S.r.l | Scholl F.,Instituto Zooprofilattico Sperimentale delle Regioni Lazio e Toscana | Scaramozzino P.,Instituto Zooprofilattico Sperimentale delle Regioni Lazio e Toscana
Veterinaria Italiana | Year: 2014

Dogs share with humans several zoonotic diseases as well as some important determinants of degenerative syndromes and tumours. For this reason, systematic surveillance on small animal disease carried out through the collection and analysis of necropsy records could be helpful to public health. To describe the causes of death in dogs from the province of Rome (Italy) submitted to the Istituto Zooprofilattico Sperimentale del Lazio e della Toscana for necropsy during 2003-2007, a retrospective study was conducted on diagnostic data of 870 dogs. The final diagnosis was established by anatomo-histopathological examinations and, when needed, by ancillary laboratory tests. The most common causes of death were 'infectious disease' (23%) and 'poisoning' (17%). In 5% of the cases, the cause remained undetermined. The frequency of 'poisoning' was higher (39%) in stray dogs, while 'infectious disease' was more frequent (49%) in dogs from breeding farms. Parvovirosis was the most frequent infectious disease (33%) while anticoagulants accounted for 30% of the cases involving toxicity. Death by neoplastic lesions was quite infrequent (7%). Findings from this study provide veterinarians with an overview of the causes of death in dogs and it could provide public health authorities with new data about both novel and re-emerging threats.


PubMed | Christian Doppler Laboratory, Charité - Medical University of Berlin, Heinrich Heine University Düsseldorf, University Medicine Mainz and 4 more.
Type: | Journal: The Journal of allergy and clinical immunology | Year: 2016

The evolution of the IgE response to the numerous allergen molecules of Dermatophagoides pteronyssinus is still unknown.We sought to characterize the evolutionary patterns of the IgE response to 12 molecules of D pteronyssinus from birth to adulthood and to investigate their determinants and clinical relevance.We investigated the clinical data and sera of 722 participants in the German Multicenter Allergy Study, a birth cohort started in 1990. Diagnoses of current allergic rhinitis (AR) related to mite allergy and asthma were based on yearly interviews at the ages of 1 to 13years and 20years. IgE to the extract and 12 molecules of D pteronyssinus were tested by means of ImmunoCAP and microarray technology, respectively, in sera collected at ages 1, 2, 3, 5, 6, 7, 10, 13, and 20years. Exposure to mites at age 6 and 18months was assessed by measuring Der p 1 weight/weight concentration in house dust.One hundred ninety-one (26.5%) of 722 participants ever had IgE to D pteronyssinus extract (0.35 kUParental hay fever and early exposure to D pteronyssinus allergens promote IgE polysensitization to several D pteronyssinus molecules, which in turn predicts current mite-related AR and current/future asthma. These results might inspire predictive algorithms and prevention strategies against the progression of IgE sensitization to mites toward AR and asthma.


PubMed | Charité - Medical University of Berlin, Heinrich Heine University Düsseldorf, University Medicine Mainz, University of Rome La Sapienza and 3 more.
Type: Journal Article | Journal: The Journal of allergy and clinical immunology | Year: 2016

Studies of a limited number of allergens suggested that nonsensitized children produce IgG responses mainly to foodborne allergens, whereas IgE-sensitized children also produce strong IgG responses to the respective airborne molecules.We sought to systematically test the hypothesis that both the route of exposure and IgE sensitization affect IgG responses to a broad array of allergenic molecules in early childhood.We examined sera of 148 children participating in the Multicentre Allergy Study, a birth cohort born in 1990. IgG to 91 molecules of 42 sources were tested with the ImmunoCAP Solid-Phase Allergen Chip (ISAC; TFS, Uppsala, Sweden). IgE sensitization at age 2 and 7years was defined by IgE levels of 0.35 kUThe prevalence and geometric mean levels of IgG to allergenic molecules in nonsensitized children were lower at age 2years than in IgE-sensitized children, and they were extremely heterogeneous: highest for animal food (87%13%; 61 ISAC Standardized Units [ISU], [95% CI, 52.5-71.5 ISU]), intermediate for vegetable food (48%27%; 13 ISU [95% CI, 11.2-16.1 ISU]), and lowest for airborne allergens (24%20%; 3 ISU [95% CI, 2.4-3.4 ISU]; P for trend<.001 [for percentages], Pfor trend<.001 [for levels]). IgGThe childrens repertoire of IgG antibodies at 2years of age to a broad array of animal foodborne, vegetable foodborne, and airborne allergenic molecules is profoundly dependent on the route of allergen exposure and the childs IgE sensitization status and only marginally involves the IgG


PubMed | S Camillo Forlanini Hospital, Primary Care Pediatrics, Montpellier University, Mazzoni Hospital and 6 more.
Type: Journal Article | Journal: Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology | Year: 2015

The diagnosis of IgE-mediated egg allergy lies both on a compatible clinical history and on the results of skin prick tests (SPTs) and IgEs levels. Both tests have good sensitivity but low specificity. For this reason, oral food challenge (OFC) is the ultimate gold standard for the diagnosis. The aim of this study was to systematically review the literature in order to identify, analyze, and synthesize the predictive value of SPT and specific IgEs both to egg white and to main egg allergens and to review the cutoffs suggested in the literature. A total of 37 articles were included in this systematic review. Studies were grouped according to the degree of cooking of the egg used for OFC, age, and type of allergen used to perform the allergy workup. In children <2 years, raw egg allergy seems very likely when SPTs with egg white extract are 4 mm or specific IgEs are 1.7 kUA /l. In children 2 years, OFC could be avoided when SPTs with egg white extract are 10 mm or prick by prick with egg white is 14 mm or specific IgE is 7.3 kUA /l. Likewise, heated egg allergy can be diagnosed if SPTs with egg white extract are >5 and >11 mm in children <2 and 2 years, respectively. Further and better-designed studies are needed to determine the remaining diagnostic cutoff of specific IgE and SPT for heated and baked egg allergy.


PubMed | Johannes Gutenberg University Mainz, Charité - Medical University of Berlin, Heinrich Heine University Düsseldorf, St Josefs Hospital and 2 more.
Type: Journal Article | Journal: The Journal of allergy and clinical immunology | Year: 2015

The route and dose of exposure are believed to be relevant factors in the sensitization process. Pathogenesis-related group 10 protein (PR-10) molecules are a family of allergenic proteins shared by many pollens (eg, birch and alder) and foods (eg, apple, peach, and soy). Children are exposed to both pollen-derived (inhaled) and food-derived (ingested) PR-10 molecules.We sought to investigate the role of route and dose of exposure in the evolution of IgG and IgE responses to recombinant PR-10 molecules.The German Multicentre Allergy Study examined a birth cohort born in 1990. Blood samples were collected at the ages of 1, 2, 3, 5, 6, 7, 10, and 13 years. Participants were included in the present analysis if they had (1) at least 1 serum sample at each of the 4 age periods or time points (1-3 years, 5-7 years, 10 years, and 13 years) and (2) IgE responses to birch (children with birch atopy) or no IgE response at all to 9 common aeroallergens and food allergens (nonatopic children). Therefore serum IgE antibodies to a panel of 4 airborne and 5 foodborne extracts, as well as to Bet v 1, were measured in singleplex assays, whereas IgG and IgE antibodies to a panel of 3 airborne PR-10 molecules (rBet v 1, rAln g 1, and rCor a 1.0101) and 7 foodborne PR-10 molecules (rCor a 1.0401, rMal d 1, rPru p 1, rGly m 4, rAra h 8, rApi g 1, and rDau c 1) were tested by using a multiplex microarray.In the present analyses we included 28 children with birch atopy and randomly selected 28 nonatopic children from the 190 children fulfilling the inclusion criteria. Two different patterns of IgG responses to PR-10 molecules were identified. Among nonatopic subjects, a default IgG response was directed mostly against foodborne PR-10, started often before age 2 years, stayed weak, and was mostly transient. Among all atopic subjects, the default IgG response at age 1 year was overwhelmed after age 2 years by an pre-atopic IgG response, which started with or shortly before the IgE response and was intense and persistent. This atopic IgG response, as well as the IgE response, involved progressively more foodborne PR-10 proteins with frequencies and levels related to their homology with Bet v 1.The results suggest that children have a default antibody response to PR-10 molecules, which is early, weak, and transient; does not involve IgE; and is initiated by foodborne PR-10. By contrast, an atopic antibody response to PR-10 molecules is delayed, strong, and persistent; involves both IgG and IgE; and is initiated by airborne PR-10.

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