European annals of allergy and clinical immunology最新文献

Summary: Background. Understanding the reason for the decrease in atopic dermatitis risk in preterm patients may be crucial for the development of prophylaxis and therapeutic measures. The hypotheses include a change in T-helper1/T-helper2/T-helper17 balance, thymus development, and intestinal colonization. This study was designed to compare these parameters between preterm and term patients.  Methods. The investigated population comprised 28 preterm and 19 term-born patients. On the 7^th day of life, T-helper1/T-helper2/T-helper17 cytokine concentrations were assessed, thymus ultrasonographic examination was performed, and the stool was examined for the presence of pathogenic bacteria. The last two procedures were repeated at 37 weeks of post-menstrual age in the preterm group. Results. There were no significant differences in the concentrations of interferon-γ, tumour necrosis factor-a (TNFa), interleukin (IL)-2, IL-6, or IL-10 after mitogen stimulation between the preterm and term groups. A negative correlation was found between IL-2 and the week of gestation at birth (r_s= -0.466, p=0.038) and thymus/weight ratio and week of gestation at birth (r_s= -0.592, p=0.006). IL-6 was negatively correlated with birth weight in preterm group (r_s -0.694, p=0.008), whereas IL-10 positively with birth weight in term group (r_s 0.775, p=0.041). Correlations of other investigated cytokines were statistically insignificant. The levels of IL-2 and interferon-γ after phytohemagglutinin stimulation were greater in the subgroup with pathogenic bacteria in the stool at birth (381.38 (148.7-727.4) vs. 13.23 (7.98-197.8) pg/ml; p=0.049; 17.49 (6.53-30.54) vs. 3.37 (1.03-9.82) pg/ml; p=0.037), whereas no significant differences were found between the levels of IL-6, IL-10 or TNFa. Conclusions. The observed associations may indicate an altered pattern of immunological development in preterm and term children.

Summary: Background. Many physicians believe delivering medications for asthma exacerbation via nebulizers is more efficacious than using a metered dose inhaler (MDI) with spacer. This study aimed to evaluate pediatricians and allergists' chosen method in children under 5 years: MDI with spacer or nebulizer. Methods. A brief survey was sent via electronic mail to a randomly selected group of pediatricians and allergists. There was a 15.8% (430/2718) total response rate. We divided respondents into 2 groups. Group A comprised 289 primary care pediatricians, and Group B included 141 practicing allergists. Results. In Group A, 68.5% (196/286) respondents indicated an MDI with spacer as their method of choice to deliver bronchodilator therapy during an asthma exacerbation; 64.7% (187/289) reported an MDI with spacer is an effective method; and 48% (135/281) believe delivering medication through a nebulizer will produce increased adverse effects than MDIs with spacers. In Group B, 55% (77/140) of respondents indicated MDI with spacer as their method of choice; 48.9% (69/141) reported a nebulizer is an effective method; and 65.7% (90/137) believe delivering medication through a nebulizer will produce increased adverse effects. Conclusions. Contrary to evidence-based recommendations, most allergists, compared to pediatricians, are not only prescribing nebulizers as their first choice for delivering bronchodilator therapy, but also half of these asthma specialists consider nebulizers to be an effective mode of delivery. As far as safety is concerned, ironically, almost two-thirds of allergists believe more side effects are associated with delivering bronchodilator therapy through a nebulizer.

Summary: Background. Platinum compounds (PC) and taxanes (TX) are drugs frequently administered for the treatment of several cancers. In recent years, their increased use has been accompanied by a relatively high prevalence of hypersensitivity reactions (HSRs). In this study, we report our comprehensive experience of allergy skin test (ST) evaluation in 276 patients who experienced HSRs to PC and/or TX. Primary objectives were to determine the clinical characteristics of HSRs, and to assess the role of STs in the diagnosis and prevention of HSRs in order to address the subsequent treatments. Secondary objective was to evaluate any cross-reactivity between PC (cisplatin, oxaliplatin and carboplatin) and among TX (paclitaxel and docetaxel). Methods. A monocentric, retrospective, observational, cohort study including patients who experienced one or more HSR during PC and/or TX chemotherapy was conducted from May 2018 to July 2023 in the Allergy and Clinical Immunology Unit at the "Fondazione Policlinico Universitario A. Gemelli" IRCCS, Rome. Results. A total of 114 patients with positive ST were identified: 102 for PC, 11 for TX and one for both. 162 patients were tested negative. Patients with HSR to PC were found to be allergic in 64%, compared to 9,9% of patients with HSR to TX (p < 0.0001). Patients who experience more serious reactions have a higher chance to have a positive result on STs (p < .01). Conclusions. STs to investigate sensitization to TX or PC is a highly valuable diagnostic tool in selecting the appropriate therapy when a hypersensitivity reaction occurs.

Summary: Background. The aim of this study is to translate and validate the Italian Version of the Anaphylaxis Quality of Life Scale for Adults (A-QoL-Adults), made up of the three subscales Social impact (SQoL), Emotional impact (EQol) and Limitations on Life (LoL) to measure the impact of the risk of anaphylaxis from any cause on patients' quality of life (QoL). Methods. The study involves 30 patients with a history of anaphylaxis who were prescribed epinephrine self-injectable, who compiled the Italian translation of A-QoL-Adults, World Health Organization Quality of life (WHOQoL)-Brief edition, Hospital Anxiety and Depression Scales (HADS-A, HADS-D) and Perceived Stress Scale (PSS) questionnaires to validate the Italian version. Results. The A-QoL-Adults administered in the Italian version had good internal structural validity and internal consistency reliability: Cronbach alpha levels of 0.972 for AQoL, 0.942 for SQoL, 0.939 for EQoL and 0.910 for LoL, and a strong correlation with other generic QoL and psychological scales. A large significant correlation (p<0.005) was found with PSS (r=0,722), HADS-A (r=0.685) and Environmental QoL (r=-0.528). A medium significant correlation (p<0.05) was found with HADS-D (r=0.455), Physical QoL (r=-0.376) and Psychological QoL (r=-0.425). Anxiety, depression, and stress levels in participants were accurately predicted by anaphylaxis-related QoL scores (p<0.001). Conclusions. The Italian version of A-QoL-Adults is a trusted instrument for evaluating the QoL of adults with anaphylaxis at any trigger. It may be used in research and clinical practice. The Italian version values match the original version and accurately predict anxiety, depression, and stress levels..

Summary: Background. Hen's egg allergy is one of the most common pediatric food allergies, requiring accurate diagnosis and management strategies. Oral food challenges (OFCs) are critical in evaluating food allergies; however, limited research has focused on the outcomes of challenges involving egg yolks. This retrospective study aims to assess the outcomes and characteristics of pediatric patients who underwent oral challenges with boiled egg yolk. Methods. We evaluated patients diagnosed with egg allergy who underwent an OFC with egg yolk between 2019 and 2022. Results. The study included 123 patients with a median age of 12 months. The first presentation of symptoms occurred at a mean age of 6 months. Initial symptoms included eczema flare-ups (70%), urticaria (13.8%), and anaphylaxis (8.9%). The median age of the first egg yolk OFC was 12 months. For the first egg white OFC to assess the tolerance, the median age was 16 months.  Of the 123 egg yolk OFCs, 115 (93.4%) patients were tolerant and consumed egg yolk at home. In the egg yolk-tolerant group, the mean duration of egg white tolerance was 4 months post-OFC; for non-tolerant patients, this extended to 11 months. The egg yolk non-tolerant group had higher egg white-specific IgE levels than the tolerant group (28 kU/L [IQR: 2.4-85.9] vs. 4.2 kU/L [IQR: 0.9-8.8], p<0.01). Conclusions. Though mild symptoms may occur, most children with egg allergies can safely consume boiled egg yolk. Consuming hen's egg yolk after a negative OFC could expand dietary options and improve quality of life.

Summary: Chronic rhinosinusitis (CRS) is a complex heterogeneous disease of the nose and paranasal sinuses that presents different phenotypes and endotypes. CRS is a common health problem associated with significant morbidity, as well as with high health care expenditure. As our knowledge on inflammation, tissue remodeling and pathophysiological mechanisms develops, both diagnosis and therapeutic approaches to CRS improve. This review outlines key drivers in the pathogenesis of CRS with and without nasal polyps, current diagnostic tools clinicians can rely on in clinical practice, and current and future treatment options, while providing a general overview of up-to-date guidelines for CRS diagnosis and management. A better understanding of CRS can pave the way for the optimization and development of novel therapies, benefiting patients who suffer with more severe phenotypes and allowing a personalized approach to the disease.