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1. Chronic obstructive lung disease “expert system”: validation of a predictive tool for assisting diagnosis

Author

Braido F, Santus P, Corsico AG, Di Marco F, Melioli G, Scichilone N, and Solidoro P

Subjects
Chronic Obstructive Lung Diseases, Expert Systems, Diagnosis, Diseases of the respiratory system, RC705-779
Abstract

Fulvio Braido,1 Pierachille Santus,2 Angelo Guido Corsico,3 Fabiano Di Marco,4 Giovanni Melioli,5 Nicola Scichilone,6 Paolo Solidoro7 1Department of Internal Medicine, IRCCS San Martino di Genova University Hospital, Genoa, Italy; 2Department of Biomedical and Clinical Sciences, University of Milan, Division of Respiratory Diseases, “L. Sacco” University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy; 3Department of Internal Medicine and Therapeutics, Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, University of Pavia, Italy; 4Department of Health Sciences, University of Milan, San Paolo Hospital, Milan, Italy; 5Center for Precision Medicine, Asthma, and Allergy, Humanitas University, Milan, Italy; 6Department of Internal Medicine, University of Palermo, Palermo, Italy; 7Unit of Pulmonology, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Torino, Italy Purpose: The purposes of this study were development and validation of an expert system (ES) aimed at supporting the diagnosis of chronic obstructive lung disease (COLD). Methods: A questionnaire and a WebFlex code were developed and validated in silico. An expert panel pilot validation on 60 cases and a clinical validation on 241 cases were performed. Results: The developed questionnaire and code validated in silico resulted in a suitable tool to support the medical diagnosis. The clinical validation of the ES was performed in an academic setting that included six different reference centers for respiratory diseases. The results of the ES expressed as a score associated with the risk of suffering from COLD were matched and compared with the final clinical diagnoses. A set of 60 patients were evaluated by a pilot expert panel validation with the aim of calculating the sample size for the clinical validation study. The concordance analysis between these preliminary ES scores and diagnoses performed by the experts indicated that the accuracy was 94.7% when both experts and the system confirmed the COLD diagnosis and 86.3% when COLD was excluded. Based on these results, the sample size of the validation set was established in 240 patients. The clinical validation, performed on 241 patients, resulted in ES accuracy of 97.5%, with confirmed COLD diagnosis in 53.6% of the cases and excluded COLD diagnosis in 32% of the cases. In 11.2% of cases, a diagnosis of COLD was made by the experts, although the imaging results showed a potential concomitant disorder. Conclusion: The ES presented here (COLDES) is a safe and robust supporting tool for COLD diagnosis in primary care settings. Keywords: chronic obstructive lung diseases, expert systems, diagnosis

Published
2018

2. Prevention of recurrent respiratory tract infections: a literature review of the activity of the bacterial lysate Lantigen B.

Author

BRAIDO, F., MELIOLI, G., NICOLINI, G., and CANONICA, G. W.

Abstract

OBJECTIVE: Lantigen B, a bacterial lysate, was developed in the 1960s and showed a prophylactic effect in patients with recurrent respiratory tract infections. The objective of this article is to review the literature to update the efficacy and safety profile of Lantigen B in preventing recurrent respiratory tract infections (RRTI). MATERIALS AND METHODS: Articles available from international data banks and producing company archives were used. Only clinical studies providing a control group were considered. The effects of Lantigen B on the number of infectious episodes or comparable parameters were analyzed. RESULTS: 22 randomized clinical trials on 4,571 patients published between 1963 and 2014, with different methodologic accuracy, consistently demonstrated that Lantigen B reduced RRTI vs. placebo (RR -0.47; 95% CI = -0.38 to -0.56). The RR always favored Lantigen B in all the other subsets analyzed in adults with RRTI (RR = -0.48; 95% CI = - 0.33 to -0.62) and children (RR = -0.490; 95% CI = - 0.36 to -0.61). Unfortunately, some studies performed in the past evaluated a small number of patients, and clinical procedures were not always performed according to the more recent good clinical practices. Despite these evident limitations of considered studies, the response frequency has remained almost unchanged since the first articles in the 1960s. CONCLUSIONS: These data confirm the efficacy of Lantigen B alone in the prophylaxis of acute respiratory infections in adults and children but also suggest that Lantigen B, used with novel therapeutic strategies, can further improve clinical outcomes. [ABSTRACT FROM AUTHOR]

Published
2023

4. IgE allergy diagnostics and other relevant tests in allergy, a World Allergy Organization position paper (vol 12, 100080, 2020)

Author

Ansotegui, IJ, Melioli, G, Canonica, GW, Caraballo, L, Villa, E, Ebisawa, M, Passalacqua, G, Savi, E, Ebo, D, Gomez, RM, Sanchez, OL, Oppenheimer, JJ, Jensen-Jarolim, E, Fischer, DA, Haahtela, T, Antila, M, Bousquet, JJ, Cardona, V, Chiang, WC, Demoly, PM, DuBuske, LM, Puga, MF, Wijk, RGV, Diaz, SNG, Gonzalez-Estrada, A, Jares, E, Kalpaklioglu, AF, Tanno, LK, Kowalski, ML, Ledford, DK, Ortega, OPM, Morais-Almeida, M, Pfaar, O, Poulsen, LK, Pawankar, R, Renz, HE, Romano, AG, Rosario Filho, NA, Rosenwasser, L, Borges, MAS, Scala, E, Senna, G-E, Sisul, JC, Tang, MLK, Thong, BY-H, Valenta, R, Wood, RA, Zuberbier, T, Ansotegui, IJ, Melioli, G, Canonica, GW, Caraballo, L, Villa, E, Ebisawa, M, Passalacqua, G, Savi, E, Ebo, D, Gomez, RM, Sanchez, OL, Oppenheimer, JJ, Jensen-Jarolim, E, Fischer, DA, Haahtela, T, Antila, M, Bousquet, JJ, Cardona, V, Chiang, WC, Demoly, PM, DuBuske, LM, Puga, MF, Wijk, RGV, Diaz, SNG, Gonzalez-Estrada, A, Jares, E, Kalpaklioglu, AF, Tanno, LK, Kowalski, ML, Ledford, DK, Ortega, OPM, Morais-Almeida, M, Pfaar, O, Poulsen, LK, Pawankar, R, Renz, HE, Romano, AG, Rosario Filho, NA, Rosenwasser, L, Borges, MAS, Scala, E, Senna, G-E, Sisul, JC, Tang, MLK, Thong, BY-H, Valenta, R, Wood, RA, and Zuberbier, T

Abstract

[This corrects the article DOI: 10.1016/j.waojou.2019.100080.].

Published
2021

7. IgE allergy diagnostics and other relevant tests in allergy, a World Allergy Organization position paper

Author

Ansotegui, I.J. (I.), Melioli, G. (Giovanni), Canonica, G. (Gwalter), Caraballo, L.R. (L.), Villa, E. (Elisa), Ebisawa, M. (Motohiro), Passalacqua, G. (Giovanni), Savi, E. (Eleonora), Ebo, D. (Didier), Gómez, R.M. (R. Maximiliano), Luengo Sánchez, O. (Olga), Oppenheimer, J.J. (John J.), Jensen-Jarolim, E. (Erika), Fischer, D.A. (David A.), Haahtela, T. (Tari), Antila, M. (Martti), Bousquet, J.J. (Jean J.), Cardona, D. (Doris), Chiang, W.C. (Wen Chin), Demoly, P., DuBuske, L.M. (Lawrence M.), Ferrer Puga, M. (Marta), Gerth van Wijk, R. (Roy), González Díaz, S.N. (Sandra Nora), Gonzalez-Estrada, A. (Alexei), Jares, E. (Edgardo), Kalpaklioğlu, A.F. (Ayse Füsun), Kase Tanno, L. (Luciana), Kowalski, M.L., Ledford, D.K. (Dennis K.), Monge Ortega, O.P. (Olga Patricia), Morais-Almeida, M. (Mario), Pfaar, O. (Oliver), Poulsen, L.K., Pawankar, R. (Ruby), Renz, H.E. (Harald E.), Romano, A.G. (Antonino G.), Rosário Filho, N.A. (Nelson A.), Rosenwasser, L. (Lanny), Sánchez Borges, M.A. (Mario A.), Scala, E. (Enrico), Senna, G.E. (Gianenrico), Sisul, J.C. (J.), Tang, M.L.K. (Mimi L.K.), Thong, B.Y.-H. (Bernard Yu-Hor), Valenta, R. (Rudolf), Wood, R.A. (Robert A.), Zuberbier, T. (Torsten), Ansotegui, I.J. (I.), Melioli, G. (Giovanni), Canonica, G. (Gwalter), Caraballo, L.R. (L.), Villa, E. (Elisa), Ebisawa, M. (Motohiro), Passalacqua, G. (Giovanni), Savi, E. (Eleonora), Ebo, D. (Didier), Gómez, R.M. (R. Maximiliano), Luengo Sánchez, O. (Olga), Oppenheimer, J.J. (John J.), Jensen-Jarolim, E. (Erika), Fischer, D.A. (David A.), Haahtela, T. (Tari), Antila, M. (Martti), Bousquet, J.J. (Jean J.), Cardona, D. (Doris), Chiang, W.C. (Wen Chin), Demoly, P., DuBuske, L.M. (Lawrence M.), Ferrer Puga, M. (Marta), Gerth van Wijk, R. (Roy), González Díaz, S.N. (Sandra Nora), Gonzalez-Estrada, A. (Alexei), Jares, E. (Edgardo), Kalpaklioğlu, A.F. (Ayse Füsun), Kase Tanno, L. (Luciana), Kowalski, M.L., Ledford, D.K. (Dennis K.), Monge Ortega, O.P. (Olga Patricia), Morais-Almeida, M. (Mario), Pfaar, O. (Oliver), Poulsen, L.K., Pawankar, R. (Ruby), Renz, H.E. (Harald E.), Romano, A.G. (Antonino G.), Rosário Filho, N.A. (Nelson A.), Rosenwasser, L. (Lanny), Sánchez Borges, M.A. (Mario A.), Scala, E. (Enrico), Senna, G.E. (Gianenrico), Sisul, J.C. (J.), Tang, M.L.K. (Mimi L.K.), Thong, B.Y.-H. (Bernard Yu-Hor), Valenta, R. (Rudolf), Wood, R.A. (Robert A.), and Zuberbier, T. (Torsten)

Abstract

Currently, testing for immunoglobulin E (IgE) sensitization is the cornerstone of diagnostic evaluation in suspected allergic conditions. This review provides a thorough and updated critical appraisal of the most frequently used diagnostic tests, both in vivo and in vitro. It discusses skin tests, challenges, and serological and cellular in vitro tests, and provides an overview of indications, advantages and disadvantages of each in conditions such as respiratory, food, venom, drug, and occupational allergy. Skin prick testing remains the first line approach in most instances; the added value of serum specific IgE to whole allergen extracts or components, as well as the role of basophil activation tests, is evaluated. Unproven, non-validated, diagnostic tests are also discussed. Throughout the review, the reader must bear in mind the relevance of differentiating between sensitization and allergy; the latter entails not only allergic sensitization, but also clinically relevant symptoms triggered by the culprit allergen.

Published
2020
Full Text
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8. A WAO - ARIA - GA2LEN consensus document on molecular-based allergy diagnosis (PAMD@): Update 2020

Author

Ansotegui, IJ, Melioli, G, Canonica, GW, Maximiliano Gomez, R, Jensen-Jarolim, E, Ebisawa, M, Luengo, O, Caraballo, L, Passalacqua, G, Poulsen, LK, Savi, E, Zuberbier, T, Villa, E, Oppenheimer, J, Asero, R, Bernstein, J, Bousquet, J, Cardona, V, Cox, L, Demoly, P, Ferreira, F, Bianchi, PG, Gonzalez Diaz, S, Jakob, T, Tanno, LK, Kleine-Tebbe, J, Levin, M, Martin, B, Matricardi, PM, Monge Ortega, OP, Almeida, MM, Nunes, C, Ortega Martell, JA, Renz, H, Rosario Filho, N, Rouadi, P, Ruiba, A, Sampson, H, Sanchez Borges, M, Scala, E, Schmid-Grendelmeier, P, Senna, G-E, Carlos Sisul, J, Tang, MLK, Valenta, R, van Hage, M, Wong, GWK, Yanez, A, Ansotegui, IJ, Melioli, G, Canonica, GW, Maximiliano Gomez, R, Jensen-Jarolim, E, Ebisawa, M, Luengo, O, Caraballo, L, Passalacqua, G, Poulsen, LK, Savi, E, Zuberbier, T, Villa, E, Oppenheimer, J, Asero, R, Bernstein, J, Bousquet, J, Cardona, V, Cox, L, Demoly, P, Ferreira, F, Bianchi, PG, Gonzalez Diaz, S, Jakob, T, Tanno, LK, Kleine-Tebbe, J, Levin, M, Martin, B, Matricardi, PM, Monge Ortega, OP, Almeida, MM, Nunes, C, Ortega Martell, JA, Renz, H, Rosario Filho, N, Rouadi, P, Ruiba, A, Sampson, H, Sanchez Borges, M, Scala, E, Schmid-Grendelmeier, P, Senna, G-E, Carlos Sisul, J, Tang, MLK, Valenta, R, van Hage, M, Wong, GWK, and Yanez, A

Abstract

Precision allergy molecular diagnostic applications (PAMD@) is increasingly entering routine care. Currently, more than 130 allergenic molecules from more than 50 allergy sources are commercially available for in vitro specific immunoglobulin E (sIgE) testing. Since the last publication of this consensus document, a great deal of new information has become available regarding this topic, with over 100 publications in the last year alone. It thus seems quite reasonable to publish an update. It is imperative that clinicians and immunologists specifically trained in allergology keep abreast of the new and rapidly evolving evidence available for PAMD@. PAMD@ may initially appear complex to interpret; however, with increasing experience, the information gained provides relevant information for the allergist. This is especially true for food allergy, Hymenoptera allergy, and for the selection of allergen immunotherapy. Nevertheless, all sIgE tests, including PAMD@, should be evaluated within the framework of a patient's clinical history, because allergen sensitization does not necessarily imply clinical relevant allergies.

Published
2020

9. IgE allergy diagnostics and other relevant tests in allergy, a World Allergy Organization position paper

Author

Ansotegui, IJ, Melioli, G, Canonica, GW, Caraballo, L, Villa, E, Ebisawa, M, Passalacqua, G, Savi, E, Ebo, D, Maximiliano Gomez, R, Luengo Sanchez, O, Oppenheimer, JJ, Jensen-Jarolim, E, Fischer, DA, Haahtela, T, Antila, M, Bousquet, JJ, Cardona, V, Chiang, WC, Demoly, PM, DuBuske, LM, Ferrer Puga, M, van Wijk, RG, Gonzalez Diaz, SN, Gonzalez-Estrada, A, Jares, E, Kalpaklioglu, AF, Tanno, LK, Kowalski, ML, Ledford, DK, Monge Ortega, OP, Almeida, MM, Pfaar, O, Poulsen, LK, Pawankar, R, Renz, HE, Romano, AG, Rosario Filho, NA, Rosenwasser, L, Sanchez Borges, MA, Scala, E, Senna, G-E, Carlos Sisul, J, Tang, MLK, Thong, BY-H, Valenta, R, Wood, RA, Zuberbier, T, Ansotegui, IJ, Melioli, G, Canonica, GW, Caraballo, L, Villa, E, Ebisawa, M, Passalacqua, G, Savi, E, Ebo, D, Maximiliano Gomez, R, Luengo Sanchez, O, Oppenheimer, JJ, Jensen-Jarolim, E, Fischer, DA, Haahtela, T, Antila, M, Bousquet, JJ, Cardona, V, Chiang, WC, Demoly, PM, DuBuske, LM, Ferrer Puga, M, van Wijk, RG, Gonzalez Diaz, SN, Gonzalez-Estrada, A, Jares, E, Kalpaklioglu, AF, Tanno, LK, Kowalski, ML, Ledford, DK, Monge Ortega, OP, Almeida, MM, Pfaar, O, Poulsen, LK, Pawankar, R, Renz, HE, Romano, AG, Rosario Filho, NA, Rosenwasser, L, Sanchez Borges, MA, Scala, E, Senna, G-E, Carlos Sisul, J, Tang, MLK, Thong, BY-H, Valenta, R, Wood, RA, and Zuberbier, T

Abstract

Currently, testing for immunoglobulin E (IgE) sensitization is the cornerstone of diagnostic evaluation in suspected allergic conditions. This review provides a thorough and updated critical appraisal of the most frequently used diagnostic tests, both in vivo and in vitro. It discusses skin tests, challenges, and serological and cellular in vitro tests, and provides an overview of indications, advantages and disadvantages of each in conditions such as respiratory, food, venom, drug, and occupational allergy. Skin prick testing remains the first line approach in most instances; the added value of serum specific IgE to whole allergen extracts or components, as well as the role of basophil activation tests, is evaluated. Unproven, non-validated, diagnostic tests are also discussed. Throughout the review, the reader must bear in mind the relevance of differentiating between sensitization and allergy; the latter entails not only allergic sensitization, but also clinically relevant symptoms triggered by the culprit allergen.

Published
2020

20. Strategies for preventing group B streptococcal infections in newborns: A nation-wide survey of Italian policies

Author

Tzialla, C, berardi, A, farina, C, clerici, P, borghesi, A, viora, E, scollo, P, stronati, M, Task Force for group B streptococcal infections for the Italian Society of Neonatology including Stival, G, barbaglia, Ma, guala, A, giunta, E, parola, L, grossignani, Mr, perri, P, tubaldi, L, alletto, G, daidone, S, flacco, V, dani, C, sterpa, A, rapisardi, G, elicio, Mr, faldella, G, capretti, Mg, messner, H, bandiera, M, achille, C, azzali, A, montrasio, G, mariani, S, galvagno, G, giacosa, E, de Angelis, F, spandrio, M, serra, A, garofalo, F, perona, A, porcelli, F, ferrero, F, De Franco, S, paollilo, P, picone, S, besana, R, varisco, T, farina, M, memo, L, nicolini, G, lietti, D, Di Chiara, G, rottoli, A, Bonabitacola, T, Cortis, E, Neri, E, Martinelli, S, Ilardi, L, Rondanini, Gf, Calzi, P, Gatta, A, Quntadamo, Pa, Ivaldi, M, Terenzani, L, Di Lascio, N, Travaglio, Md, Vetrano, G, Furcolo, G, Vitacco, V, Intini, C, Frigerio, M, Stroppiana, P, Policicchio, G, Mesirca, P, Gianino, P, Audenio, E, Paludetto, R, Raimondi, F, Pugliese, A, Valentino, L, Nosari, N, Marchesano, G, Chirico, G, Bellù, R, Menchini, M, Poletti, A, E T, Vacchiano, Pinto, L, E D, Perri, Coppola, R, Perini, R, Vetrella, A, De Luca, G, Lista, G, Cavigioli, F, Bettinelli, A, Massironi, E, Franco, C, Bernardo, L, Poli, S, Palladini, M, Tota, V, Spadavecchia, F, Zuccotti, Gv, Pogliani, L, Bracaglia, G, Mancini, Al, Zocco, F, Iozzia, G, Auriemma, A, Teani, M, Mangilli, G, Tempra, Am, Di Terlizi, L, Bottino, R, Salvi, C, Fortunato, V, Musaico, R, Gargantini, G, Carrera, G, Magaldi, R, Taurino, L, D'Onofrio, Am, Buffone, E, Tempera, A, Agosti, M, Garzia, P, Mosca, F, Pugni, L, Tagliabue, P, Colombo, C, Demi, M, Picco, G, Carlucci, A, Zorzi, G, Padula, D, Cardone, Ml, Buonocore, G, Muraca, Mc, Boldrini, A, Ciantelli, M, Lanari, M, Serra, L, Felici, L, Banderalli, G, Brambilla, C, Dall'Agnola, A, Viviani, E, Zonca, Mc, Licardi, G, Chiara, A, Ancora, G, Papa, I, Gancia, P, Pomero, G, Deloglu, A, Villani, P, Mussini, P, Canidio, E, Migliavacca, D, Di Fabio, S, Cipollone, I, Biasucci, G, Rubbi, P, Piepoli, M, Guastaferro, N, Infriccioli, F, Bertino, E, Perathoner, C, Parmigiani, S, Suriano, G, Ianniello, C, Biasini, A, Azzalli, M, Timpani, G, Barresi, S, Caoci, G, Ciccotti, R, De Curtis, M, Natale, F, Finocchi, M, Haass, C, Milillo, F, Lucieri, S, Guercio, E, Canepa, Sa, Scozia, G, Antonucci, R, Limongelli, O, Macciò, S, Mongelli, F, Colonna, F, Dragovic, D, Calipa, Mt, Cohen, A, Moresco, L, Italian Society of Obstetricians and Gynecologists including La Spina, R, Ruggeri, R, Luehwink, A, Brattoli, M, Fedi, A, Lacchi, L, Ettore, G, Pappalardo, E, Conoscenti, G, Zeni, B, Spellecchia, D, Favretti, L, Spagna, L, Zaglio, S, Bresciani, D, Bandini, A, Mancini, R, Mustoni, P, Dodero, D, Grimaldi, M, Di Mario, M, Migliorini, P, Kemeny, A, Anastasio, Ps, Riccardi, T, Maggino, T, Cerri, G, Puggina, P, Marconi, Am, Morgia, S, Bellia, G, D'Anna, Mr, Catania, M, Bacchi Modena, A, Franchi, L, Calonaci, N, Schettini, S, Paradiso, R, Saccucci, P, Ioppi, M, Zorzi, M, Stellin, G, Patacchiola, F, Carrata, L, Bassini, D, San Marco, L, Todros, T, Tibadi, C, Liborio, M, Italian Association of Clinical Microbiologists including Laricchia, R, Tauro, L, Ferrara, F, Nuara, C, Ghiraldi, E, Molinari, F, Comessatti, A, Rocchetti, A, Di Matteo, L, Miconi, V, Calvi, P, Pernigotti, A, Fabozzi, F, Micca, G, Monticone, G, Sarti, M, Da Rin, G, Zoppelletto, M, Modolo, E, Landini, Mp, Furlini, G, Galluppi, E, Pagani, E, Aschbacher, R, Innocenti, P, Bresolin, N, Raggi, Me, Bonfanti, C, De Francesco, M, Santer, P, Griessmaier, A, De Francesco, D, Pirali, A, Prasciolu, C, Usai, F, Cuzzone, G, Scutellà, M, Tramacere, P, Fossati, D, Piaserico, G, Bordignon, G, Sciacca, A, Di Vincenzo, F, Imbriani, A, Melotti, D, Catanoso, G, Rivetti, I, Neri, G, Bruno, R, Bacelle, L, Sartore, P, Giana, G, Sala, E, Giraldi, C, Cavalcanti, P, Perugini, M, Perugini, A, Ginardi, C, Maritano, D, Ferrini, A, Bonettini, A, Avanzini, A, Gasperoni, S, Pieretti, B, Montanari, E, Carillo, C, Rossi, Mr, Laureti, A, Baldoni, Ml, Serra, D, Melioli, G, Bandettini, R, Oneto, F, Colla, R, Storchi Incerti, S, Lanzini, F, Pauri, P, Tili, E, Leone, Ra, Verdastro, G, Megha, M, Luzzaro, F, Conti, A, Busulini, L, Mirri, P, Diodati, R, Vettori, C, Pittalis, S, Anesi, A, Fiore, A, Goglia, L, Vitullo, E, Sinno, A, Platzgummer, S, Spitaler, C, Trabucchi, Mc, Besozzi, M, Cesana, E, Inghilleri, G, Grosso, S, D'Angelo, R, Fogato, E, Lavarda, F, Ortisi, G, Clementi, M, Cichero, P, Rumpianesi, F, Venturelli, C, Mortillaro, F, Daffara, S, Catania, Mr, Iula, D, Andreoni, S, Politi, A, Agostinelli, C, Paparella, C, Capozzi, D, Notaris, P, Bistoni, F, Mencacci, A, Valentini, M, Filippetti, A, Confalonieri, M, Novarese, O, Bonini, F, Salamone, D, Camporese, A, De Rosa, R, Casprini, P, Degl'Innocenti, R, Giordano, R, Allù, Mt, Zanella, D, Malandrino, M, Tronci, M, Valmarin, M, Leonetti, G, Falco, S, Meledandri, M, Ballardini, M, Spanò, A, Cava, Mc, Mascellino, Mt, Schinella, M, Gualdi, P, Casari, E, Scattolo, N, Motta, C, Perfetti, C, Bassano, M, Cera, G, Iafisco, P, Mura, I, Palmieri, A, Migliardi, M, Ferlini, M, Grandi, G, Giardini, F, Albano, F, Latino, M, Ferrero, Mp, Bellizia, L, Russolo, M, Russolo, S, Pesenti, A, Fasano, Ma, Previato, S, Radillo, O, Busetti, M, Ferrari, P, Siderini, V, Puzzolante, L, Scarparo, C, Arzese, A, Cappuccia, N, Lodolo, L, Delledonne, L, Gramoni, A, Maiolo, V, Gheller, A, Spadaro, S, Balzaretti, M, Tzialla, C., Berardi, A., Farina, C., Clerici, P., Borghesi, A., Viora, E., Scollo, P., Stronati, M., Stival, G., Barbaglia, M. A., Guala, A., Giunta, E., Parola, L., Grossignani, M. R., Perri, P., Tubaldi, L., Alletto, G., Daidone, S., Flacco, V., Dani, C., Sterpa, A., Rapisardi, G., Elicio, M. R., Faldella, G., Capretti, M. G., Messner, H., Bandiera, M., Achille, C., Azzali, A., Montrasio, G., Mariani, S., Galvagno, G., Giacosa, E., de Angelis, F., Spandrio, M., Serra, A., Garofalo, F., Perona, A., Porcelli, F., Ferrero, F., De Franco, S., Paollilo, P., Picone, S., Besana, R., Varisco, T., Farina, M., Memo, L., Nicolini, G., Lietti, D., Di Chiara, G., Rottoli, A., Bonabitacola, T., Cortis, E., Neri, E., Martinelli, S., Ilardi, L., Rondanini, G. F., Calzi, P., Gatta, A., Quntadamo, P. A., Ivaldi, M., Terenzani, L., Di Lascio, N., Travaglio, M. D., Vetrano, G., Furcolo, G., Vitacco, V., Intini, C., Frigerio, M., Stroppiana, P., Policicchio, G., Mesirca, P., Gianino, P., Audenio, E., Paludetto, R., Raimondi, F., Pugliese, A., Valentino, L., Nosari, N., Marchesano, G., Chirico, G., Bell(`u), R., Menchini, M., Poletti, A., Vacchiano, T., Pinto, L., Perri, D., Coppola, R., Perini, R., Vetrella, A., De Luca, G., Lista, G., Cavigioli, F., Bettinelli, A., Massironi, E., Franco, C., Bernardo, L., Poli, S., Palladini, M., Tota, V., Spadavecchia, F., Zuccotti, G. V., Pogliani, L., Bracaglia, G., Mancini, A. L., Zocco, F., Iozzia, G., Auriemma, A., Teani, M., Mangilli, G., Tempra, A. M., Di Terlizi, L., Bottino, R., Salvi, C., Fortunato, V., Musaico, R., Gargantini, G., Carrera, G., Magaldi, R., Taurino, L., D?onofrio, A. M., Buffone, E., Tempera, A., Agosti, M., Garzia, P., Mosca, F., Pugni, L., Tagliabue, P., Colombo, C., Demi, M., Picco, G., Carlucci, A., Zorzi, G., Padula, D., Cardone, M. L., Buonocore, G., Muraca, M. C., Boldrini, A., Ciantelli, M., Lanari, M., Serra, L., Felici, L., Banderalli, G., Brambilla, C., Dall?agnola, A., Viviani, E., Zonca, M. C., Licardi, G., Chiara, A., Ancora, G., Papa, I., Gancia, P., Pomero, G., Deloglu, A., Villani, P., Mussini, P., Canidio, E., Migliavacca, D., Di Fabio, S., Cipollone, I., Biasucci, G., Rubbi, P., Piepoli, M., Guastaferro, N., Infriccioli, F., Bertino, E., Perathoner, C., Parmigiani, S., Suriano, G., Ianniello, C., Biasini, A., Azzalli, M., Timpani, G., Barresi, S., Caoci, G., Ciccotti, R., De Curtis, M., Natale, F., Finocchi, M., Haass, C., Milillo, F., Lucieri, S., Guercio, E., Canepa, S. A., Scozia, G., Antonucci, R., Limongelli, O., Macci(`o), S., Mongelli, F., Colonna, F., Dragovic, D., Calipa, M. T., Cohen, A., Moresco, L., La Spina, R., Ruggeri, R., Luehwink, A., Brattoli, M., Fedi, A., Lacchi, L., Ettore, G., Pappalardo, E., Conoscenti, G., Zeni, B., Spellecchia, D., Favretti, L., Spagna, L., Zaglio, S., Bresciani, D., Bandini, A., Mancini, R., Mustoni, P., Dodero, D., Grimaldi, M., Di Mario, M., Migliorini, P., Kemeny, A., Anastasio, P. S., Riccardi, T., Maggino, T., Cerri, G., Puggina, P., Marconi, A. M., Morgia, S., Bellia, G., D?anna, M. R., Catania, M., Bacchi Modena, A., Franchi, L., Calonaci, N., Schettini, S., Paradiso, R., Saccucci, P., Ioppi, M., Zorzi, M., Stellin, G., Patacchiola, F., Carrata, L., Bassini, D., San Marco, L., Todros, T., Tibadi, C., Liborio, M., Laricchia, R., Tauro, L., Ferrara, F., Nuara, C., Ghiraldi, E., Molinari, F., Comessatti, A., Rocchetti, A., Di Matteo, L., Miconi, V., Calvi, P., Pernigotti, A., Fabozzi, F., Micca, G., Monticone, G., Sarti, M., Da Rin, G., Zoppelletto, M., Modolo, E., Landini, M. P., Furlini, G., Galluppi, E., Pagani, E., Aschbacher, R., Innocenti, P., Bresolin, N., Raggi, M. E., Bonfanti, C., De Francesco, M., Santer, P., Griessmaier, A., De Francesco, D., Pirali, A., Prasciolu, C., Usai, F., Cuzzone, G., Scutell(`a), M., Tramacere, P., Fossati, D., Piaserico, G., Bordignon, G., Sciacca, A., Di Vincenzo, F., Imbriani, A., Melotti, D., Catanoso, G., Rivetti, I., Neri, G., Bruno, R., Bacelle, L., Sartore, P., Giana, G., Sala, E., Giraldi, C., Cavalcanti, P., Perugini, M., Perugini, A., Ginardi, C., Maritano, D., Ferrini, A., Bonettini, A., Avanzini, A., Gasperoni, S., Pieretti, B., Montanari, E., Carillo, C., Rossi, M. R., Laureti, A., Baldoni, M. L., Serra, D., Melioli, G., Bandettini, R., Oneto, F., Colla, R., Storchi Incerti, S., Lanzini, F., Pauri, P., Tili, E., Leone, R. A., Verdastro, G., Megha, M., Luzzaro, F., Conti, A., Busulini, L., Mirri, P., Diodati, R., Vettori, C., Pittalis, S., Anesi, A., Fiore, A., Goglia, L., Vitullo, E., Sinno, A., Platzgummer, S., Spitaler, C., Trabucchi, M. C., Besozzi, M., Cesana, E., Inghilleri, G., Grosso, S., D?angelo, R., Fogato, E., Lavarda, F., Ortisi, G., Clementi, M., Cichero, P., Rumpianesi, F., Venturelli, C., Mortillaro, F., Daffara, S., Catania, M. R., Iula, D., Andreoni, S., Politi, A., Agostinelli, C., Paparella, C., Capozzi, D., Notaris, P., Bistoni, F., Mencacci, A., Valentini, M., Filippetti, A., Confalonieri, M., Novarese, O., Bonini, F., Salamone, D., Camporese, A., De Rosa, R., Casprini, P., Degl?innocenti, R., Giordano, R., All(`u), M. T., Zanella, D., Malandrino, M., Tronci, M., Valmarin, M., Leonetti, G., Falco, S., Meledandri, M., Ballardini, M., Span(`o), A., Cava, M. C., Mascellino, M. T., Schinella, M., Gualdi, P., Casari, E., Scattolo, N., Motta, C., Perfetti, C., Bassano, M., Cera, G., Iafisco, P., Mura, I., Palmieri, A., Migliardi, M., Ferlini, M., Grandi, G., Giardini, F., Albano, F., Latino, M., Ferrero, M. P., Bellizia, L., Russolo, M., Russolo, S., Pesenti, A., Fasano, M. A., Previato, S., Radillo, O., Busetti, M., Ferrari, P., Siderini, V., Puzzolante, L., Scarparo, C., Arzese, A., Cappuccia, N., Lodolo, L., Delledonne, L., Gramoni, A., Maiolo, V., Gheller, A., Spadaro, S., Balzaretti, M., Tzialla, Chryssoula, Berardi, Alberto, Farina, Claudio, Clerici, Pierangelo, Borghesi, Alessandro, Viora, Elsa, Scollo, Paolo, Stronati, Mauro, [.., Lanari, Marcello, Faldella, Giacomo, and ]

Subjects
Male, Pediatrics, Group B, 0302 clinical medicine, Neonate, Pregnancy, Surveys and Questionnaires, Prevalence, Mass Screening, Blood culture, 030212 general & internal medicine, Antibiotic prophylaxis, Survey, GBS, Group B streptococcus, Infection, Newborn infant, Adult, Antibiotic Prophylaxis, Female, Health Surveys, Humans, Infant, Newborn, Italy, Neonatal Screening, Pregnancy Complications, Infectious, Prenatal Care, Primary Prevention, Risk Assessment, Streptococcal Infections, Streptococcus agalactiae, reproductive and urinary physiology, Group B streptococcu, medicine.diagnostic_test, lcsh:RJ1-570, Infectious, Perinatology and Child Health, Pediatrics, Perinatology and Child Health, medicine.medical_specialty, Antibiotic sensitivity, Group B Streptococcal Infection, Prenatal care, 03 medical and health sciences, 030225 pediatrics, medicine, Intensive care medicine, Mass screening, business.industry, Public health, Infant, lcsh:Pediatrics, Newborn, Pregnancy Complications, business
Abstract

Background There are no Italian data regarding the strategies for preventing neonatal group B streptococcal (GBS) infection. We conducted a national survey in order to explore obstetrical, neonatal and microbiological practices for the GBS prevention. Methods Three distinct questionnaires were sent to obstetricians, neonatologists and microbiologists. Questionnaires included data on prenatal GBS screening, maternal risk factors, intrapartum antibiotic prophylaxis, microbiological information concerning specimen processing and GBS antimicrobial susceptibility. Results All respondent obstetrical units used the culture-based screening approach to identify women who should receive intrapartum antibiotic prophylaxis, and more than half of the microbiological laboratories (58%) reported using specimen processing consistent with CDC guidelines. Most neonatal units (89 out of 107, 82%) reported using protocols for preventing GBS early-onset sepsis consistent with CDC guidelines. Conclusions The screening-based strategy is largely prevalent in Italy, and most protocols for preventing GBS early-onset sepsis are consistent with CDC guidelines. However, we found discrepancies in practices among centers that may reflect the lack of Italian guidelines issued by public health organizations.

Published
2017

24. Microbiologia clinica

Author

Abbate, I., Amendola, A., Andreoni, S., Cagliotti, C., Capobianchi, M. R., Carozzi, F., Castello, E., Crovatto, M., De Maria, A. F., Debbia, E. A., Delogu, G., Di caro, A., Farina, C. F., Fazii, P., Gauldiero, M., Gava, G., Giraldi, C., Giusto, G. R., Goletti, D., Greco, F., Iester, M., Luzzaro, F., Marchese, A., Mauro, M. V., Melioli, G., Morelli, P., Pagani, L., Perotti, M., Rassu, M., Smeraglia, R., Stevan, M., and Vagge, A.

Published
2018

26. Risk and safety requirements for diagnostic and therapeutic procedures in allergology: World Allergy Organization Statement

Author

Kowalski, ML, Ansotegui, I, Aberer, W, Al-Ahmad, M, Akdis, M, Ballmer-Weber, BK, Beyer, K, Blanca, M, Brown, S, Bunnag, C, Hulett, AC, Castells, M, Chng, HH, De Blay, F, Ebisawa, M, Fineman, S, Golden, DBK, Haahtela, T, Kaliner, M, Katelaris, C, Lee, BW, Makowska, J, Muller, U, Mullol, J, Oppenheimer, J, Park, HS, Parkerson, J, Passalacqua, G, Pawankar, R, Renz, H, Rueff, F, Sanchez-Borges, M, Sastre, J, Scadding, G, Sicherer, S, Tantilipikorn, P, Tracy, J, Van Kempen, V, Bohle, B, Canonica, GW, Caraballo, L, Gomez, M, Ito, K, Jensen-Jarolim, E, Larche, M, Melioli, G, Poulsen, LK, Valenta, R, Zuberbier, T, Kowalski, ML, Ansotegui, I, Aberer, W, Al-Ahmad, M, Akdis, M, Ballmer-Weber, BK, Beyer, K, Blanca, M, Brown, S, Bunnag, C, Hulett, AC, Castells, M, Chng, HH, De Blay, F, Ebisawa, M, Fineman, S, Golden, DBK, Haahtela, T, Kaliner, M, Katelaris, C, Lee, BW, Makowska, J, Muller, U, Mullol, J, Oppenheimer, J, Park, HS, Parkerson, J, Passalacqua, G, Pawankar, R, Renz, H, Rueff, F, Sanchez-Borges, M, Sastre, J, Scadding, G, Sicherer, S, Tantilipikorn, P, Tracy, J, Van Kempen, V, Bohle, B, Canonica, GW, Caraballo, L, Gomez, M, Ito, K, Jensen-Jarolim, E, Larche, M, Melioli, G, Poulsen, LK, Valenta, R, and Zuberbier, T

Abstract

© 2016 The Author(s). One of the major concerns in the practice of allergy is related to the safety of procedures for the diagnosis and treatment of allergic disease. Management (diagnosis and treatment) of hypersensitivity disorders involves often intentional exposure to potentially allergenic substances (during skin testing), deliberate induction in the office of allergic symptoms to offending compounds (provocation tests) or intentional application of potentially dangerous substances (allergy vaccine) to sensitized patients. These situations may be associated with a significant risk of unwanted, excessive or even dangerous reactions, which in many instances cannot be completely avoided. However, adverse reactions can be minimized or even avoided if a physician is fully aware of potential risk and is prepared to appropriately handle the situation. Information on the risk of diagnostic and therapeutic procedures in allergic diseases has been accumulated in the medical literature for decades; however, except for allergen specific immunotherapy, it has never been presented in a systematic fashion. Up to now no single document addressed the risk of the most commonly used medical procedures in the allergy office nor attempted to present general requirements necessary to assure the safety of these procedures. Following review of available literature a group of allergy experts within the World Allergy Organization (WAO), representing various continents and areas of allergy expertise, presents this report on risk associated with diagnostic and therapeutic procedures in allergology and proposes a consensus on safety requirements for performing procedures in allergy offices. Optimal safety measures including appropriate location, type and required time of supervision, availability of safety equipment, access to specialized emergency services, etc. for various procedures have been recommended. This document should be useful for allergists with already established practices a

Published
2016

27. The involvement of IgH enhancer HS1.2 in the pathogenesis of Crohn's disease: how the immune system can influence a multifactorial disease

Author

Cianci, Rossella, Lolli, S, Pagliari, Danilo, Gambassi, Giovanni, Frosali, Simona, Marmo, R, Melioli, G, Orlando, Vito Canio Antonio, Newton, E. E, Serone, E, Landolfi, Raffaele, Pandolfi, Franco, Frezza, D., Cianci, Rossella (ORCID:0000-0001-5378-8442), Gambassi, Giovanni (ORCID:0000-0002-7030-9359), Landolfi, Raffaele (ORCID:0000-0002-7913-8576), Pandolfi, Franco (ORCID:0000-0001-8799-8173), Cianci, Rossella, Lolli, S, Pagliari, Danilo, Gambassi, Giovanni, Frosali, Simona, Marmo, R, Melioli, G, Orlando, Vito Canio Antonio, Newton, E. E, Serone, E, Landolfi, Raffaele, Pandolfi, Franco, Frezza, D., Cianci, Rossella (ORCID:0000-0001-5378-8442), Gambassi, Giovanni (ORCID:0000-0002-7030-9359), Landolfi, Raffaele (ORCID:0000-0002-7913-8576), and Pandolfi, Franco (ORCID:0000-0001-8799-8173)

Abstract

To study the 3' immunoglobulin heavy-chain regulatory region (3'RR) enhancer complex, active in class switching recombination and in B-cells, in Crohn's disease. PATIENTS AND METHODS: A total of 167 patients [79 females (47.3%) and 88 males (52.7%)] affected by Crohn's disease were enrolled in the study. As a control, we included 64 healthy subjects, age and sex matched, from the same geographical area. Blood tests were performed on all subjects to determine their antibody levels and to detect the presence of any possible infections. We conducted a selective PCR, which amplified the hs1.2-A region. The nested second PCR to amplify the polymorphic core of the enhancer was performed. RESULTS: No differences between cases and controls were observed with respect to sex distribution (43.8% females among controls and 49.5% among cases), age, tTG IgA, RF, serum or secretory IgA, IgG1, IgG2 and IgG3. No correlation was found between both seric and secretory immunoglobulins levels, with except of statistically significant differences between cases and controls with respect to IgA and IgG ASCA positivity (p<0.001), serum IgG4 (p<0.001) and IgD (p=0.001). CONCLUSIONS: We have demonstrated that in Crohn's disease, the HS1,2 immunoglobulins enhancer is not implicated in the disease pathogenesis. Moreover, we have found that IgG4 levels are lower in Crohn's disease patients than in controls; these data may be related to an impairment of number and function of Tregs, further linked to the presence of tissue inflammation. Crohn's disease is a complex multifactorial disease. The pathogenesis of Crohn's disease is incompletely understood although it is clear that the disease involves multiple interacting agents.

Published
2016

31. Interchangeability between 24-hour collection and single spot urines for vanillylmandelic and homovanillic acid levels in the diagnosis of neuroblastoma

Author

Cangemi, G, Barco, S, Reggiardo, G, Viscardi, E, DI CATALDO, Andrea, Garaventa, A, Melioli, G, and Conte, M.

Subjects
Male, Time Factors, Infant, Homovanillic Acid, vanillylmandelic acid, Urinalysis, 24-hour collection, Neuroblastoma, Vanilmandelic Acid, Child, Preschool, Biomarkers, Tumor, homovanillic acid, neuroblastoma, single spot urine, Humans, Female, Child
Abstract

The determination of the two urinary catecholamine metabolites homovanillic acid (HVA) and vanillylmandelic acid (VMA) is of crucial importance for the diagnosis and follow-up of neuroblastoma (NB). The standard practice for their measurement requires the use of 24-hour collections that are time consuming and difficult to obtain. In this article, we directly demonstrate that 24-hour collections and single spot urines are interchangeable for the determination of HVA and VMA expressed as ratio on creatinine concentration. This study can be useful for a faster management of NB at onset.

Published
2013

32. Administration of a polyvalent mechanical bacterial lysate to elderly patients with COPD: Effects on circulating T, B and NK cells

Author

Lanzilli G, Traggiai E, Braido F, Garelli V, Folli C, Chiappori A, Riccio AM, Bazurro G, Agazzi A, Magnani A, Canonica GW, and Melioli G.

Abstract

The modifications of the subsets of circulating lymphocytes were evaluated in a group of patients with COPD undergoing treatment with a polyvalent mechanical bacterial lysate (PMBL), a drug that is able to significantly modify the natural history of these patients. Using multicolor immune-florescence and flow cytometry, T, B subsets and NK cells were extensively studied both in the group of treated patients and in a disease and age matched controls. Despite the age, in treated patients, T and NK cells were significantly increased in numbers of circulating cells, but not in percentages, while B cells remained unmodified. CD3+4+T cells were increased in treated patients, while CD3+CD8T cells were unmodified by the treatment. Activated T cells were increased but Treg, resulted reduced both in percentage than in absolute numbers. Transitional B cells resulted increased (in percentage and in absolute numbers) in their late maturation step (T3), while only early Naïve B cells were increased by the treatment, while other naïve subpopulations were unmodified. Memory B cells were reduced in percentage (but remained unmodified as absolute numbers), while the most immature form of memory B cells was significantly increased. Finally, both switch memory B cells and plasma cells resulted unmodified by the PMBL treatment. These results clearly indicated that the administration of the PMBL, even in elderly patients with COPD, was able to induce a significant immune-stimulation and these results, at cellular level, clearly support the evidence that the mechanism of action of PMBL is strictly related to a direct effect on immune-competent cells.

Published
2013
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33. A WAO-ARIA-GA2LEN consensus document on molecular-based allergy diagnostics

Author

Canonica, G. W., Ansotegui, I. J., Pawankar, R., Schmid-Grendelmeier, P., Van Hage, M., Baena-Cagnani, C. E., Melioli, G., Nunes, C., Passalacqua, G., Rosenwasser, L., Sampson, H., Sastre, J., Bousquet, J., Zuberbier, T., Allen, K., Asero, R., Bohle, B., Cox, L., De Blay, F., Ebisawa, M., Maximiliano-Gomez, R., Gonzalez-Diaz, S., Haahtela, T., Holgate, S., Jakob, T., Larche, M., Matricardi, P. M., Oppenheimer, J., Poulsen, L. K., Renz, H. E., Rosario, N., Rothenberg, M., Sanchez-Borges, M., Scala, E., and Valenta, R.

Published
2013

34. Laboratory diagnosis of Streptococcus pneumoniae infections: past and future

Author

Bandettini, R and Melioli, G

Abstract

Streptococcus pneumoniae is one of the most important causative agent of pneumonia, meningitis, bacteremia, sinusitis and otitis media. The gold standard diagnostic method is still culture evenif bacteriological diagnosis is making progress in molecular biol- ogy and in proteomics areas. The full article is free available on www.jpmh.org, Journal of Preventive Medicine and Hygiene, Vol 53, No 2 (2012)

Published
2012
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36. Document de consensus WAO–ARIA–GA2LEN sur le diagnostic allergologique moléculaire

Author

Canonica, G.W., primary, Ansotegui, I.J., additional, Pawankar, R., additional, Schmid-Grendelmeier, P., additional, van Hage, M., additional, Baena-Cagnani, C.E., additional, Melioli, G., additional, Nunes, C., additional, Passalacqua, G., additional, Rosenwasser, L., additional, Sampson, H., additional, Sastre, J., additional, Bousquet, J., additional, Zuberbier, T., additional, Allen, K., additional, Asero, R., additional, Bohle, B., additional, Cox, L., additional, de Blay, F., additional, Ebisawa, M., additional, Maximiliano-Gomez, R., additional, Gonzalez-Diaz, S., additional, Haahtela, T., additional, Holgate, S., additional, Jakob, T., additional, Larche, M., additional, Matricardi, P.M., additional, Oppenheimer, J., additional, Poulsen, L.K., additional, Renz, H.E., additional, Rosario, N., additional, Rothenberg, M., additional, Sanchez-Borges, M., additional, Scala, E., additional, and Valenta, R., additional

Published
2015
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42. Bacterial lysate in the prevention of acute exacerbation of COPD and in respiratory recurrent infections

Author

Braido, F., Tarantini, F., Ghiglione, V., Melioli, G., and GIORGIO WALTER CANONICA

Subjects
Cell Extracts, Evidence-Based Medicine, Bacteria, respiratory recurrent infections, Pulmonary Disease, Chronic Obstructive, Treatment Outcome, Adjuvants, Immunologic, Italy, Humans, COPD, Respiratory Tract Infections, bacterial lysate, Randomized Controlled Trials as Topic, Original Research
Abstract

Respiratory tract infections (RTIs) represent a serious problem because they are one of the most common cause of human death by infection. The search for the treatment of those diseases has therefore a great importance. In this study we provide an overview of the currently available treatments for RTIs with particular attention to chronic obstructive pulmonary diseases exacerbations and recurrent respiratory infections therapy and a description of bacterial lysate action, in particular making reference to the medical literature dealing with its clinical efficacy. Those studies are based on a very large number of clinical trials aimed to evaluate the effects of this drug in maintaining the immune system in a state of alert, and in increasing the defences against microbial infections. From this analysis it comes out that bacterial lysates have a protective effect, which induce a significant reduction of the symptoms related to respiratory infections. Those results could be very interesting also from an economic point of view, because they envisage a reduction in the number of acute exacerbations and a shorter duration of hospitalization. The use of bacterial lysate could therefore represent an important means to achieve an extension of life duration in patients affected by respiratory diseases.

Published
2008

45. Molecular diagnosis and the Italian Board for ISAC

Author

De Nettis, E., primary, Bonifazi, F., additional, Bonini, S., additional, Di Leo, E., additional, Maggi, E., additional, Melioli, G., additional, Passalacqua, G., additional, Senna, G., additional, Triggiani, M., additional, Vacca, A., additional, and Canonica, G.W., additional

Published
2014
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48. A WAO - ARIA - GA2LEN consensus document on molecular-based allergy diagnostics

Author

Canonica, GW, Ansotegui, IJ, Pawankar, R, Schmid-Grendelmeier, P, van Hage, M, Baena-Cagnani, CE, Melioli, G, Nunes, C, Passalacqua, G, Rosenwasser, L, Sampson, H, Sastre, J, Bousquet, J, Zuberbier, T, Canonica, GW, Ansotegui, IJ, Pawankar, R, Schmid-Grendelmeier, P, van Hage, M, Baena-Cagnani, CE, Melioli, G, Nunes, C, Passalacqua, G, Rosenwasser, L, Sampson, H, Sastre, J, Bousquet, J, and Zuberbier, T

Abstract

Molecular-based allergy (MA) diagnostics is an approach used to map the allergen sensitization of a patient at a molecular level, using purified natural or recombinant allergenic molecules (allergen components) instead of allergen extracts. Since its introduction, MA diagnostics has increasingly entered routine care, with currently more than 130 allergenic molecules commercially available for in vitro specific IgE (sIgE) testing.MA diagnostics allows for an increased accuracy in allergy diagnosis and prognosis and plays an important role in three key aspects of allergy diagnosis: (1) resolving genuine versus cross-reactive sensitization in poly-sensitized patients, thereby improving the understanding of triggering allergens; (2) assessing, in selected cases, the risk of severe, systemic versus mild, local reactions in food allergy, thereby reducing unnecessary anxiety for the patient and the need for food challenge testing; and (3) identifying patients and triggering allergens for specific immunotherapy (SIT).Singleplex and multiplex measurement platforms are available for MA diagnostics. The Immuno-Solid phase Allergen Chip (ISAC) is the most comprehensive platform currently available, which involves a biochip technology to measure sIgE antibodies against more than one hundred allergenic molecules in a single assay. As the field of MA diagnostics advances, future work needs to focus on large-scale, population-based studies involving practical applications, elucidation and expansion of additional allergenic molecules, and support for appropriate test interpretation. With the rapidly expanding evidence-base for MA diagnosis, there is a need for allergists to keep abreast of the latest information. The aim of this consensus document is to provide a practical guide for the indications, determination, and interpretation of MA diagnostics for clinicians trained in allergology.

Published
2013

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