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Background Although the preventive efficacy of allergen immunotherapy (AIT) in the onset of new allergen sensitizations has been asserted by many reviews, position papers, and consensus conferences, the evidence available is from only 3 studies. The objective of this work was a systematic review to evaluate the preventive efficacy of AIT in the onset of new allergen sensitizations. The end-point was the risk difference (RD) in the onset of new allergen sensitizations between patients treated with AIT and pharmacotherapy. Methods Computerized bibliographic searches of MEDLINE, EMBASE, and the Cochrane Library (until November 30th, 2016) were done. Random-effects and fixed-effects model meta-analyses were performed. Randomized controlled trials or observational studies comparing children treated with AIT with house dust mite (HDM) to subjects who did not receive AIT, with a long-term observation period (at least 3 years including treatment and follow-up) have been included. Results Eight studies totaling 721 children (390 treated with AIT and 331 with pharmacotherapy) met the inclusion criteria. The risk of bias was high. Low evidence supports the conclusion that AIT prevents the onset of new allergen sensitizations, with 3 of 8 studies reporting a reduction in the onset of new sensitizations in patients treated with AIT vs pharmacotherapy. Our meta-analysis found no difference between AIT and pharmacotherapy, with high heterogeneity (RD, −0.10; 95% confidence interval [CI], −0.31 to 0.11; p = 0.32; I2 = 91.4%). Conclusion The data of this systematic review do not support a preventive effect in the onset of new allergen sensitizations, in children treated with AIT in comparison with those treated with pharmacotherapy.

Background. This thesis consist of parts(i)Introduction in wich we present the clinical problem of rhinitis;(ii)the methods to evaluate the diagnostic choises;(iii)the rational errors in Allergy,(iv)the experimental part of thesis with wich we developed the software ARTSTAT,wich is the application of the analysis reported.Objective: We studied the ability of the logistic regression model obtained by the evaluaqtion of a database, to detect patients with positive allergy skin prick test(SPT)and patients with negative SPT. The model developed was valitated using the data set obtained from another medical institution. Methods: The analysis was carried out using a database obtained from a questionnaire administered to the patients with nasal symptoms containing personal data, clinical data result of allergy testing (SPT). All variables found to be significantly different between patients with positive and negative SPT(P

Introduction: The significance of the association between allergic rhinitis and abnormal airway responsiveness is unclear. For this reason, we have studied, in patients with seasonal allergic rhinitis, non specific bronchial hyperreactivity, total serum IgE and blood eosinophils, with reference to the responsible allergen, during and out of the pollen season. Materials and methods: Fourty-nine, non-smoking patients, living in Palermo, with clinical diagnosis of allergic rhinitis, skin prick tests and specific serum IgE mono-sensitive to pollen allergens, were enrolled in the study. Twenty patients suffered from seasonal rhinitis to Parietaria pollen, 15 patients to Graminacee pollen and 14 patients to Olea pollen. In all patients lung function measurements (assessed as response to methacholine), total serum IgE and blood eosinophil counts were measured, during and out of the pollen season. Results: During pollen season, 16 out of 49 rhinitis patients demonstrated values of bronchial responsiveness, measured as response to inhaled methacholine, in the asthmatic range (PC20-FEV1 ≤ 1,500 μg/mL), whereas, out of the pollen season, only 8 patients were in the asthmatic range. By analyzing the results with reference to the responsible allergen, during the pollen season, 15 out of 16 patients were Parietaria-sensitive and, out of the pollen season, 7 out of 8 patients. Finally, in Parietaria-sensitive rhinitis, bronchial responsiveness significantly correlated, during and out of the pollen season, with total serum IgE and blood eosinophil counts. Conclusions: The results of this study underline that the percentage of allergic patients to Parietaria with a PC20-FEV1 to methacholine in the asthmatic range is greater to that of allergic patients to Graminacee and Olea. Besides, our results are consistent with the hypothesis that Parietaria is more important than Graminacee and Olea as a risk factor for developing of non specific bronchial hyperresponsiveness, expecially during the pollen season.

Background Biologics are currently one of the main treatment options for a number of diseases. The IgG4 monoclonal antibody dupilumab targets the Interleukin-4 receptor alpha chain, thus preventing the biological effects of the cytokines IL-4 and IL-13, that are essential for the Th2 response. Several controlled trials showed that dupilumab is effective and safe in patients with atopic dermatitis (AD), severe asthma and chronic rhinosinusitis with nasal polyps (CRSwNP), thus resulting in approval by regulatory agencies. Aim of the study was to evaluate the efficacy and safety of dupilumab in adult patients with CRSwNP stratified by common overlapping comorbid conditions. Methods We performed a multicenter, observational, prospective study enrolling adult patients with severe CRSwNP who had started dupilumab treatment in the context of standard care from January 2021 to October 2021. Data were collected from twentynine Italian secondary care centers for allergy and clinical immunology, all of which were part of the Italian Society of Allergy, Asthma and Clinical Immunology (SIAAIC). A number of efficacy parameters were used. Patient data were compared using the Wilcoxon test for paired data. All statistical analyses were performed with SPSS version 20 (IBM, Armonk, NY, USA). Results In total, 82 patients with nasal polyposis were identified. A significant improvement was detected for all the applied efficacy parameters, i.e. 22-item Sino-Nasal Outcome Test (SNOT-22) and bilateral endoscopic nasal polyp score (NPS) scores for CRSwNP, Rhinitis Control Scoring System (RCSS) and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) scores for allergic perennial rhinitis, Forced Expiratory Volume in the 1st second (FEV1) and Asthma Quality of Life Questionnaire (AQLQ) scores for asthma, Eczema Area and Severity Index (EASI) and Dermatology Life Quality Index (DLQI) scores for AD. A non-significant improvement was also obtained in the Urticaria Activity Score over 7 days (UAS7) for chronic spontaneous urticaria. Treatment with dupilumab was well tolerated. Conclusions These data suggest that dupilumab treatment in patients suffering from CRSwNP and associated comorbidities may be suitable. Such outcome, although confirmation by trials is warranted, suggests the possibility to treat different disorders with a single therapy, with favorable effects especially under the cost-effectiveness aspect.