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1. Applications of basophil activation test in paediatric allergic diseases

Author

Dodi Giulia, MD, Di Filippo Paola, MD, Di Ludovico Armando, MD, Simeone Pasquale, PhD, De Bellis Domenico, MSc, D'ascanio Francesca, MSc, Di Pillo Sabrina, MD, Chiarelli Francesco, PhD, Lanuti Paola, PhD, and Attanasi Marina, PhD

Subjects
Basophil activation test, Pediatrics, Allergic disease, Venom allergy, Spontaneous chronic urticaria, Immunologic diseases. Allergy, RC581-607
Abstract

Basophilic granulocytes, containing and releasing histamine after a specific allergy stimulation, are directly involved in IgE-mediated allergic reactions. CD63 is a transmembrane protein of secretory lysosomes of basophils and its upregulation is related with the release of histamine to the extracellular space during IgE-mediated allergic reactions. Basophil activation test (BAT) measures the activation of circulating basophils upon the in vitro stimulation of living blood cells with specific allergens. Such a test is particularly safe and reproducible and has recently emerged as a new promising diagnostic tool for allergic diseases.BAT can be used to diagnose food allergy and represents a promising alternative to oral food challenge tests, especially in children as it is less invasive, safer, and cheaper than the gold standard tests. As a biomarker of tolerance and reactivity, it is also useful to monitor natural resolution and clinical response to immune-modulatory treatments. Regarding drug allergies, BAT is even the only possible applicable diagnostic tool for allergy reactions to some drugs, because of the lack of alternative test, or given that those commonly used are unreliable, or equivocal. Additionally, BAT allows to screen patients with more active urticarial and identify Hymenoptera-allergic patients with negative venom-specific immunoglobulin (Ig)E. In respiratory allergic diseases, BAT can facilitate the diagnosis of local allergic rhinitis and evaluate basophil allergen sensitivity in allergic asthma. Although IgE-sensitization in allergic asthma is usually demonstrated by skin prick test and specific IgE, those tests do not predict the clinical allergy contribution to asthma pathogenesis. To date, the potential of BAT in the diagnostic work-up of allergic diseases is well established, but a better standardization of its use is needed. This narrative review summarizes the state-of-the-art BAT technology and applications in pediatric allergic diseases, focusing on immune-related mechanisms and the BAT real clinical utility.

Published
2024
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2. Acute Respiratory Failure in Children: A Clinical Update on Diagnosis.

Author

Panetti, Beatrice, Bucci, Ilaria, Di Ludovico, Armando, Pellegrino, Giulia Michela, Di Filippo, Paola, Di Pillo, Sabrina, Chiarelli, Francesco, Attanasi, Marina, and Sferrazza Papa, Giuseppe Francesco

Subjects
LUNG physiology, RESPIRATORY organ anatomy, RESPIRATORY insufficiency, ARTIFICIAL intelligence, COMPUTED tomography, LUNGS, CHEST X rays, MAGNETIC resonance imaging, AIRWAY (Anatomy), PATIENT monitoring, BIOMARKERS, CHILDREN
Abstract

Acute respiratory failure (ARF) is a sudden failure of the respiratory system to ensure adequate gas exchanges. Numerous clinical conditions may cause ARF, including pneumonia, obstructive lung diseases (e.g., asthma), restrictive diseases such as neuromuscular diseases (e.g., spinal muscular atrophy and muscular dystrophy), and albeit rarely, interstitial lung diseases. Children, especially infants, may be more vulnerable to ARF than adults due to anatomical and physiological features of the respiratory system. Assessing respiratory impairment in the pediatric population is particularly challenging as children frequently present difficulties in reporting symptoms and due to compliance and cooperation in diagnostic tests. The evaluation of clinical and anamnestic aspects represents the cornerstone of ARF diagnosis: first level exams (e.g., arterial blood gas analysis) confirm and evaluate the severity of the ARF and second level exams help to uncover the underlying cause. Prompt management is critical, with supplemental oxygen, mechanical ventilation, and the treatment of the underlying problem. The aim of this review is to provide a comprehensive summary of the current state of the art in diagnosing pediatric ARF, with a focus on pathophysiology, novel imaging applications, and new perspectives, such as biomarkers and artificial intelligence. [ABSTRACT FROM AUTHOR]

Published
2024
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9. A 52-week multicenter retrospective real-world study on effectiveness and safety of dupilumab in children with atopic dermatitis aged from 6 to 11 years

Author

Patruno, Cataldo, primary, Fabbrocini, Gabriella, additional, Lauletta, Giuseppe, additional, Boccaletti, Valeria, additional, Colonna, Cristiana, additional, Cavalli, Riccardo, additional, Neri, Iria, additional, Ortoncelli, Michela, additional, Schena, Donatella, additional, Stingeni, Luca, additional, Hansel, Katharina, additional, Piccolo, Vincenzo, additional, Di Brizzi, Veronica, additional, Potenza, Concetta, additional, Tolino, Ersilia, additional, Bianchi, Luca, additional, Manti, Sara, additional, De Pasquale, Rocco, additional, Di Lernia, Vito, additional, Caminiti, Lucia, additional, Galli, Elena, additional, Coppo, Paola, additional, Chiricozzi, Andrea, additional, De Simone, Clara, additional, Guerriero, Cristina, additional, Amoruso, Fabrizio Giuseppe, additional, Provenzano, Eugenio, additional, Leonardi, Salvatore, additional, Licari, Amelia, additional, Marseglia, Gian Luigi, additional, Palermo, Antonino, additional, Di Pillo, Sabrina, additional, Russo, Daniele, additional, Moschese, Viviana, additional, Patella, Vincenzo, additional, Peduto, Tiziana, additional, Ferreli, Caterina, additional, Zangari, Paola, additional, Veronese, Federica, additional, Berti, Samantha Federica, additional, Gruber, Michaela, additional, Pezzolo, Elena, additional, Termine, Stefania, additional, Satta, Rosanna, additional, Dragoni, Federica, additional, Esposito, Maria, additional, Fargnoli, Maria Concetta, additional, Chiodini, Paolo, additional, Vallone, Ylenia, additional, di Vico, Francesca, additional, Picone, Vincenzo, additional, and Napolitano, Maddalena, additional

Published
2023
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11. Long COVID in Children: A Multidisciplinary Review

Author

Sansone, Francesco, primary, Pellegrino, Giulia Michela, additional, Caronni, Antonio, additional, Bonazza, Federica, additional, Vegni, Elena, additional, Lué, Alberto, additional, Bocci, Tommaso, additional, Pipolo, Carlotta, additional, Giusti, Giuliano, additional, Di Filippo, Paola, additional, Di Pillo, Sabrina, additional, Chiarelli, Francesco, additional, Sferrazza Papa, Giuseppe Francesco, additional, and Attanasi, Marina, additional

Published
2023
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12. Long COVID in Children: A Multidisciplinary Review

Author

Sansone, Francesco, Pellegrino, Giulia Michela, Caronni, Antonio, Bonazza, Federica, Vegni, Elena, Lué, Alberto, Bocci, Tommaso, Pipolo, Carlotta, Giusti, Giuliano, Di Filippo, Paola, Di Pillo, Sabrina, Chiarelli, Francesco, Sferrazza Papa, Giuseppe Francesco, Attanasi, Marina, Sansone, Francesco, Pellegrino, Giulia Michela, Caronni, Antonio, Bonazza, Federica, Vegni, Elena, Lué, Alberto, Bocci, Tommaso, Pipolo, Carlotta, Giusti, Giuliano, Di Filippo, Paola, Di Pillo, Sabrina, Chiarelli, Francesco, Sferrazza Papa, Giuseppe Francesco, and Attanasi, Marina

Abstract

Long COVID syndrome has emerged as a long-lasting consequence of acute SARS-CoV-2 infection in adults. In addition, children may be affected by Long COVID, with potential clinical issues in different fields, including problems in school performance and daily activities. Yet, the pathophysiologic bases of Long COVID in children are largely unknown, and it is difficult to predict who will develop the syndrome. In this multidisciplinary clinical review, we summarise the latest scientific data regarding Long COVID and its impact on children. Special attention is given to diagnostic tests, in order to help the physicians to find potential disease markers and quantify impairment. Specifically, we assess the respiratory, upper airways, cardiac, neurologic and motor and psychological aspects. Finally, we also propose a multidisciplinary clinical approach.

Published
2023

16. Use of lung ultrasound in school-aged children with wheezing

Author

Attanasi, Marina, primary, Sferrazza Papa, Simone, additional, Porreca, Annamaria, additional, Sferrazza Papa, Giuseppe F., additional, Di Filippo, Paola, additional, Piloni, Francesca, additional, Dodi, Giulia, additional, Sansone, Francesco, additional, Di Pillo, Sabrina, additional, and Chiarelli, Francesco, additional

Published
2023
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21. Drug-Induced Enterocolitis Syndrome in Children.

Author

Di Filippo, Paola, Venanzi, Annamaria, Ciarelli, Francesca, Panetti, Beatrice, Di Pillo, Sabrina, Chiarelli, Francesco, and Attanasi, Marina

Subjects
ENTEROCOLITIS, DRUG side effects, SYNDROMES in children, HYPOVOLEMIC anemia, PHYSICIANS, NEUTROPHILS
Abstract

Drug-Induced Enterocolitis Syndrome (DIES) is a drug-induced hypersensitivity reaction non-IgE mediated involving the gastrointestinal system that occurs 2 to 4 h after drug administration. Antibiotics, specifically amoxicillin or amoxicillin/clavulanate, represent the most frequent drugs involved. Symptoms include nausea, vomiting, abdominal pain, diarrhea, pallor, lethargy, and dehydration, which can be severe and result in hypovolemic shock. The main laboratory finding is neutrophilic leukocytosis. To the best of our knowledge, 12 cases of DIES (9 children-onset and 3 adult-onset cases) were described in the literature. DIES is a rare clinically well-described allergic disease; however, the pathogenetic mechanism is still unclear. It requires to be recognized early and correctly treated by physicians. [ABSTRACT FROM AUTHOR]

Published
2023
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24. Lifelong Lung Sequelae of Prematurity

Author

Di Filippo, Paola, primary, Dodi, Giulia, additional, Ciarelli, Francesca, additional, Di Pillo, Sabrina, additional, Chiarelli, Francesco, additional, and Attanasi, Marina, additional

Published
2022
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27. Emergency Department Visits for allergy related-disorders among children: experience of a single Italian hospital during the first wave of the COVID-19 pandemic

Author

Attanasi, Marina, Porreca, Annamaria, Papa, Giuseppe Francesco Sferrazza, Di Donato, Gulia, Cauzzo, Chiara, Patacchiola, Roberta, Di Filippo, Paola, Di Pillo, Sabrina, and Chiarelli, Francesco

Subjects
allergic diseases, children, COVID-19, Letter to the Editor
Abstract

Introduction: The aim of this study was to compare the number of the Pediatric Emergency Department (PED) visits for young allergic patients with respiratory or cutaneous symptoms during the first wave of the coronavirus disease 19 (COVID-19) pandemic in 2020 with the same period in 2019, evaluating the percentage of positive cases to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). We carried out a retrospective analysis using data from young patients who visited the PED with cutaneous or respiratory symptoms in the period from 20th February to 12th May of the years 2020 and 2019. Data on allergy and COVID-19 nasal swab were also collected. We observed eleven (28.2%) PED visits for allergic patients with respiratory or cutaneous symptoms for the period from 20th February to 12th May of the year 2020 and ninety-three (31.8%) PED visits for the same time frame of the year 2019 (p=0.645). Only a two-month-old child out of 39 patients with non-allergic respiratory or cutaneous symptoms resulted positive for SARS-CoV-2. Specifically, we found for all the PED visits: 21 (7.2%) in 2019 vs 2 (5.1%) in 2020 for patients with urticaria/angioedema or atopic dermatitis (p=0.634); 3 (1.0%) in 2019 vs 3 (7.7%) in 2020 for patients with anaphylaxis (p=0.003); 19 (6.5%) in 2019 vs 2 (5.1%) in 2020 for those with asthma (p=0.740); 11(3.8%) in 2019 vs 1(2.6%) in 2020 for those with lower respiratory diseases, excluding asthma (p=0.706); 39(13.4%) in 2019 vs 3 (7.7%) in 2020 for those with upper respiratory diseases (URDs) (p=0.318). We also showed a substantial decrease (~80%) in all PED visits compared with the same time frame in 2019 (absolute number 263 vs 1,211, respectively). Among all the PED visits a significant reduction was mostly found for URDs [155 (12.8%) in 2019 vs 17 (6.5%) in 2020; p=0.045)]. The total number of PED visits for allergic patients with respiratory or cutaneous symptoms dropped precipitously in 2020. It is very tricky to estimate whether it was a protective action of allergy or the fear of contagion or the lockdown or a reduction in air pollution that kept children with allergy from visiting the PED. Further studies are needed to better understand the impact of underlying allergies on COVID-19 susceptibility and disease severity.

Published
2021

28. A 5-Year-Old Child with a Deep Neck Abscess Complicated by Laryngeal Obstruction.

Author

Di Ludovico, Armando, Raso, Massimiliano, Di Filippo, Paola, Di Pillo, Sabrina, Zappacosta, Roberta, Parruti, Giustino, Zingariello, Pasquale, Chiarelli, Francesco, and Attanasi, Marina

Subjects
NECK surgery, PHYSICAL diagnosis, CEFTRIAXONE, PHARYNGEAL diseases, FEVER, NECK pain, INTRAVENOUS therapy, ABSCESSES, VITAL signs, DEGLUTITION disorders, DIFFERENTIAL diagnosis, MAGNETIC resonance imaging, RESPIRATORY obstructions, LARYNGEAL diseases, NECK, BLOOD testing, MEDICAL drainage, VOICE disorders, CHILDREN
Abstract

Deep neck space infections (DNSI) are defined as infections in the potential spaces and fascial planes of the neck. We show the clinical case of a retro and para-pharyngeal abscess in a healthy 5-year-old child complicated by compression and dislocation of the larynx with marked airway caliber reduction and potentially fatal extension up to the mediastinal aditus. DNSI can occur at any age and, due to its rapid progression, requires immediate treatment in children. In healthy children, concurrent abscesses in separate neck spaces are rare. DNSI recurrence should alert the physician to the possibility of a congenital problem, and if imaging fails, laryngoscopy may be the best diagnostic technique. [ABSTRACT FROM AUTHOR]

Published
2023
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31. An underestimated cause of chronic cough: The protracted bacterial bronchitis

Author

Di Filippo, Paola, Scaparrotta, Alessandra, Petrosino, Marianna, Attanasi, Marina, Di Pillo, Sabrina, Chiarelli, Francesco, and Mohn, Angelika

Subjects
Antibiotics -- Health aspects -- Dosage and administration, Bronchitis -- Health aspects -- Diagnosis -- Care and treatment, CAT scans -- Usage, Bronchoscopy -- Usage, Health
Abstract

Byline: Paola. Di Filippo, Alessandra. Scaparrotta, Marianna. Petrosino, Marina. Attanasi, Sabrina. Di Pillo, Francesco. Chiarelli, Angelika. Mohn Chronic cough in childhood is associated with a high morbidity and decreased quality [...]

Published
2018

34. Additional file 1 of Evaluation of sleep quality and anxiety in Italian pediatric healthcare workers during the first wave of COVID-19 pandemic

Author

Di Filippo, Paola, Attanasi, Marina, Dodi, Giulia, Porreca, Annamaria, Raso, Massimiliano, Di Pillo, Sabrina, and Chiarelli, Francesco

Abstract

Additional file 1. Survey administered to our study sample. The questionnaire was composed of six sections: A socio-demographic characterization of respondents and definition of their expertise in the clinical management of COVID-19 patients during the first wave of pandemic; B evaluation of the participants’ sleep quality; C evaluation of anxiety after traumatic events; D measurement of anxiety levels; E participants’ feelings of self-efficacy; F participants’ perceived social support.

Published
2021
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35. Additional file 2 of Evaluation of sleep quality and anxiety in Italian pediatric healthcare workers during the first wave of COVID-19 pandemic

Author

Di Filippo, Paola, Attanasi, Marina, Dodi, Giulia, Porreca, Annamaria, Raso, Massimiliano, Di Pillo, Sabrina, and Chiarelli, Francesco

Abstract

Additional file 2. Multivariable Linear Regression Model to evaluate the association between the type of professional figure (pediatric secondary care vs primary care staff) and health mental outcomes.

Published
2021
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40. Inpatient Care during the COVID-19 Pandemic: A Survey of Italian Physicians

Author

Attanasi, Marina, Pasini, Simone, Caronni, Antonio, Pellegrino, Giulia Michela, Faverio, Paola, Di Pillo, Sabrina, Cimino, Matteo Maria, Cipolla, Giuseppe, Chiarelli, Francesco, Centanni, Stefano, Sferrazza Papa, Giuseppe Francesco, Attanasi, M, Pasini, S, Caronni, A, Michela Pellegrino, G, Faverio, P, Di Pillo, S, Maria Cimino, M, Cipolla, G, Chiarelli, F, Centanni, S, and Francesco Sferrazza Papa, G

Subjects
Adult, Critical Care, Pneumonia, Viral, Clinical Investigations, Cardiology, Azithromycin, Acute respiratory failure, Antiviral Agents, Betacoronavirus, Mechanical ventilation, Physicians, Surveys and Questionnaires, Internal Medicine, Pulmonary Medicine, Cannula, Humans, Protease Inhibitors, survey, Practice Patterns, Physicians', Lung, Pandemics, Referral and Consultation, Steroid, Aged, Noninvasive Ventilation, Continuous Positive Airway Pressure, Pandemic, SARS-CoV-2, Rehabilitation, Anticoagulants, COVID-19, Pneumonia, Heparin, Low-Molecular-Weight, Middle Aged, Respiration, Artificial, Anti-Bacterial Agents, COVID-19 Drug Treatment, Hospitalization, Intensive Care Units, Italy, Coronavirus Infections, Respiratory Insufficiency, Tomography, X-Ray Computed, Hydroxychloroquine
Abstract

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a potentially fatal disease that is of great global public health concern. OBJECTIVE: We explored the clinical management of inpatients with COVID-19 in Italy. METHODS: A self-administered survey was sent by email to Italian physicians caring for adult patients with COVID-19. A panel of experts was selected according to their clinical curricula and their responses were analyzed. RESULTS: A total of 1,215 physicians completed the survey questionnaire (17.4% response rate). Of these, 188 (15.5%) were COVID-19 experts. Chest computed tomography was the most used method to detect and monitor COVID-19 pneumonia. Most of the experts managed acute respiratory failure with CPAP (56.4%), high flow nasal cannula (18.6%), and non-invasive mechanical ventilation (8%), while an intensivist referral for early intubation was requested in 17% of the cases. Hydroxychloroquine was prescribed as an antiviral in 90% of cases, both as monotherapy (11.7%), and combined with protease inhibitors (43.6%) or azithromycin (36.2%). The experts unanimously prescribed low-molecular-weight heparin to patients with severe COVID-19 pneumonia, and half of them (51.6%) used a dose higher than standard. The respiratory burden in patients who survived the acute phase was estimated as relevant in 28.2% of the cases, modest in 39.4%, and negligible in 9%. CONCLUSIONS: In our survey some major topics, such as the role of non-invasive respiratory support and drug treatments, show disagreement between experts, likely reflecting the absence of high-quality evidence studies. Considering the significant respiratory sequelae reported following COVID-19, proper respiratory and physical therapy programs should be promptly made available.

Published
2020

41. Peripheral effector memory regulatory T cells are incremented and functionally enhanced in successful mite monomeric allergoid sublingual immunotherapy

Author

Petrarca, Claudia, primary, Lanuti, Paola, additional, Petrosino, Marianna Immacolata, additional, Di Pillo, Sabrina, additional, Mistrello, Gianni, additional, Compalati, Enrico, additional, Otzuki, Takemi, additional, Marchisio, Marco, additional, Pierdomenico, Laura, additional, Paganelli, Roberto, additional, and Di Gioacchino, Mario, additional

Published
2020
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46. Peripheral effector memory regulatory T cells are incremented and functionally enhanced in successful mite monomeric allergoid sublingual immunotherapy.

Author

Petrarca, Claudia, Lanuti, Paola, Petrosino, Marianna Immacolata, Di Pillo, Sabrina, Mistrello, Gianni, Compalati, Enrico, Otzuki, Takemi, Marchisio, Marco, Pierdomenico, Laura, Paganelli, Roberto, and Di Gioacchino, Mario

Subjects
REGULATORY T cells, SUBLINGUAL immunotherapy, MITES
Abstract

Changes in HLA-DR expression on Regulatory T cells after mite allergoid SLIT significantly correlates with changes in VAS (C). The beneficial effects of Allergen-Specific Immunotherapy (AIT) rely on the induction of allergen-specific Regulatory T cells (Tregs).1 Tregs, a subpopulation of CD4 SP + sp CD25 SP + sp T cells expressing the specific transcription factor Foxp3, are not functionally homogeneous and their detection is complex and uncertain due to FoxP3 intracellular localization. [Extracted from the article]

Published
2021
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47. Montelukast versus inhaled corticosteroids in the management of pediatric mild persistent asthma

Author

Scaparrotta Alessandra, Di Pillo Sabrina, Attanasi Marina, Rapino Daniele, Cingolani Anna, Consilvio Nicola Pietro, Verini Marcello, and Chiarelli Francesco

Subjects
Childhood asthma, Inhaled corticosteroids, Leukotriene receptor antagonist, Montelukast, Diseases of the respiratory system, RC705-779
Abstract

Abstract International guidelines recommend the use of inhaled corticosteroids (ICSs) as the preferred therapy, with leukotriene receptor antagonists (LTRAs) as an alternative, for the management of persistent asthma in children. Montelukast (MLK) is the first LTRA approved by the Food and Drug Administration for the use in young asthmatic children. Therefore, we performed an analysis of studies that compared the efficacy of MLK versus ICSs. We considered eligible for the inclusion randomized, controlled trials on pediatric populations with Jadad score > 3, with at least 4 weeks of treatment with MLK compared with ICS. Although it is important to recognize that ICSs use is currently the recommended first-line treatment for asthmatic children, MLK can have consistent benefits in controlling asthmatic symptoms and may be an alternative in children unable to use ICSs or suffering from poor growth. On the contrary, low pulmonary function and/or high allergic inflammatory markers require the corticosteroid use.

Published
2012
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50. Reply

Author

Sferrazza Papa, Simone, primary, Attanasi, Marina, additional, Di Pillo, Sabrina, additional, Mohn, Angelika, additional, Chiarelli, Francesco, additional, and Pelliccia, Piernicola, additional

Published
2019
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