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2. Profiling the risk of hepatocellular carcinoma after long-term HCV eradication in patients with liver cirrhosis in the PITER cohort

Author

Kondili, L, Quaranta, M, Cavalletto, L, Calvaruso, V, Ferrigno, L, D'Ambrosio, R, Simonelli, I, Brancaccio, G, Raimondo, G, Brunetto, M, Zignego, A, Coppola, C, Iannone, A, Biliotti, E, Verucchi, G, Massari, M, Licata, A, Barbaro, F, Persico, M, Russo, F, Morisco, F, Pompili, M, Vigano, M, Puoti, M, Santantonio, T, Villa, E, Craxi, A, Chemello, L, Panetta, V, Gaeta, G, Filomia, R, Coco, B, Monti, M, Amoruso, D, Madonia, S, Ieluzzi, D, Taliani, G, Badia, L, Migliorino, G, Giorgini, A, Masarone, M, Blanc, P, Cossiga, V, De Siena, M, Tata, X, Rumi, M, Chessa, L, Lampertico, P, Ferrari, C, Gentile, I, Parruti, G, Baiocchi, L, Ciancio, A, Invernizzi, P, Federico, A, Torti, C, Morsica, G, Andreone, P, Aghemo, A, Popoli, P, Vella, S, Kondili L. A., Quaranta M. G., Cavalletto L., Calvaruso V., Ferrigno L., D'Ambrosio R., Simonelli I., Brancaccio G., Raimondo G., Brunetto M. R., Zignego A. L., Coppola C., Iannone A., Biliotti E., Verucchi G., Massari M., Licata A., Barbaro F., Persico M., Russo F. P., Morisco F., Pompili M., Vigano M., Puoti M., Santantonio T., Villa E., Craxi A., Chemello L., Panetta V., Gaeta G. B., Filomia R., Coco B., Monti M., Amoruso D. C., Madonia S., Ieluzzi D., Taliani G., Badia L., Migliorino G. M., Giorgini A., Masarone M., Blanc P., Cossiga V., De Siena M., Tata X., Rumi M. G., Chessa L., Lampertico P., Ferrari C., Gentile I., Parruti G., Baiocchi L., Ciancio A., Invernizzi P., Federico A., Torti C., Morsica G., Andreone P., Aghemo A., Popoli P., Vella S., Kondili, L, Quaranta, M, Cavalletto, L, Calvaruso, V, Ferrigno, L, D'Ambrosio, R, Simonelli, I, Brancaccio, G, Raimondo, G, Brunetto, M, Zignego, A, Coppola, C, Iannone, A, Biliotti, E, Verucchi, G, Massari, M, Licata, A, Barbaro, F, Persico, M, Russo, F, Morisco, F, Pompili, M, Vigano, M, Puoti, M, Santantonio, T, Villa, E, Craxi, A, Chemello, L, Panetta, V, Gaeta, G, Filomia, R, Coco, B, Monti, M, Amoruso, D, Madonia, S, Ieluzzi, D, Taliani, G, Badia, L, Migliorino, G, Giorgini, A, Masarone, M, Blanc, P, Cossiga, V, De Siena, M, Tata, X, Rumi, M, Chessa, L, Lampertico, P, Ferrari, C, Gentile, I, Parruti, G, Baiocchi, L, Ciancio, A, Invernizzi, P, Federico, A, Torti, C, Morsica, G, Andreone, P, Aghemo, A, Popoli, P, Vella, S, Kondili L. A., Quaranta M. G., Cavalletto L., Calvaruso V., Ferrigno L., D'Ambrosio R., Simonelli I., Brancaccio G., Raimondo G., Brunetto M. R., Zignego A. L., Coppola C., Iannone A., Biliotti E., Verucchi G., Massari M., Licata A., Barbaro F., Persico M., Russo F. P., Morisco F., Pompili M., Vigano M., Puoti M., Santantonio T., Villa E., Craxi A., Chemello L., Panetta V., Gaeta G. B., Filomia R., Coco B., Monti M., Amoruso D. C., Madonia S., Ieluzzi D., Taliani G., Badia L., Migliorino G. M., Giorgini A., Masarone M., Blanc P., Cossiga V., De Siena M., Tata X., Rumi M. G., Chessa L., Lampertico P., Ferrari C., Gentile I., Parruti G., Baiocchi L., Ciancio A., Invernizzi P., Federico A., Torti C., Morsica G., Andreone P., Aghemo A., Popoli P., and Vella S.

Abstract

Background and aims: Severe liver disease markers assessed before HCV eradication are acknowledged to usually improve after the SVR. We prospectively evaluated, in the PITER cohort, the long-term HCC risk profile based on predictors monitored after HCV eradication by direct-acting antivirals in patients with cirrhosis. Methods: HCC occurrence was evaluated by Kaplan-Meier analysis. Cox regression analysis identified the post-treatment variables associated with de-novo HCC; their predictive power was presented in a nomogram. Results: After the end of therapy (median follow-up:28.47 months), among 2064 SVR patients, 119 (5.8%) developed de-novo HCC. The HCC incidence was 1.90%, 4.21%, 6.47% at 12-, 24- and 36-months from end-of-therapy, respectively (incidence rate 2.45/100 person-years). Age, genotype 3, diabetes, platelets (PLT)≤120,000/µl and albumin ≤3.5g/dl levels were identified as pre-treatment HCC independent predictors. Adjusting for age, the post-treatment PLT≤120,000/µl (AdjHR 1.92; 95%CI:1.06-3.45) and albumin≤3.5g/dl (AdjHR 4.38; 95%CI 2.48-7.75) values were independently associated with HCC occurrence. Two different risk profiles were identified by combining long-term post-therapy evaluation of PLT ≤ vs. >120,000/µl and albumin ≤ vs. >3.5g/dl showing a significant different HCC incidence rate of 1.35 vs. 3.77/100 p-y, respectively. Conclusions: The nomogram score based on age, PLT and albumin levels after SVR showed an accurate prediction capability and may support the customizing management for early HCC detection.

Published
2023

3. Antibody Response to COVID-19 Booster Vaccination in Healthcare Workers

Author

Pani, A, Romandini, A, Schianchi, A, Senatore, M, Gagliardi, O, Gazzaniga, G, Agliardi, S, Conti, T, Schenardi, P, Maggi, M, D'Onghia, S, Panetta, V, Renica, S, Molteni, S, Vismara, C, Campisi, D, Bertuzzi, M, Giroldi, S, Zoppini, L, Moreno, M, Merli, M, Bosio, M, Puoti, M, Scaglione, F, Pani A., Romandini A., Schianchi A., Senatore M., Gagliardi O. M., Gazzaniga G., Agliardi S., Conti T., Schenardi P. A., Maggi M., D'Onghia S., Panetta V., Renica S., Molteni S. N., Vismara C., Campisi D., Bertuzzi M., Giroldi S., Zoppini L., Moreno M., Merli M., Bosio M., Puoti M., Scaglione F., Pani, A, Romandini, A, Schianchi, A, Senatore, M, Gagliardi, O, Gazzaniga, G, Agliardi, S, Conti, T, Schenardi, P, Maggi, M, D'Onghia, S, Panetta, V, Renica, S, Molteni, S, Vismara, C, Campisi, D, Bertuzzi, M, Giroldi, S, Zoppini, L, Moreno, M, Merli, M, Bosio, M, Puoti, M, Scaglione, F, Pani A., Romandini A., Schianchi A., Senatore M., Gagliardi O. M., Gazzaniga G., Agliardi S., Conti T., Schenardi P. A., Maggi M., D'Onghia S., Panetta V., Renica S., Molteni S. N., Vismara C., Campisi D., Bertuzzi M., Giroldi S., Zoppini L., Moreno M., Merli M., Bosio M., Puoti M., and Scaglione F.

Abstract

Objective: To evaluate the mean increase of anti-S IgG antibody titer between the basal, pre-booster level to the titer assessed 14 days after the booster dose of BNT162b2. Patients and Methods: The RENAISSANCE study is an observational, longitudinal, prospective, population-based study, conducted on healthcare workers of Niguarda Hospital in Milan, Italy who received a BNT162b2 booster dose at least 180 days after their second dose or after positivity for SARS-CoV-2 and accepted to take part in the study. The RENAISSANCE study was conducted from January 1, 2021 through December 28, 2021. Findings: 1,738 subjects were enrolled among healthcare workers registered for the booster administration at our hospital. Overall, 0.4% of subjects were seronegative at the pre-booster evaluation, and 1 subject had a titer equal to 50 AU/ml: none of the evaluated subjects was seronegative after the booster dose. Thus, the efficacy of the booster in our population was universal. Mean increase of pre- to post-booster titer was more significant in subjects who never had SARS-CoV-2 (44 times CI 95% 42-46) compared to those who had it, before (33 times, CI 95% 13-70) or after the first vaccination cycle (12 times, CI 95% 11-14). Differently from sex, age and pre-booster titers affected the post-booster antibody response. Nevertheless, the post-booster titer was very similar in all subgroups, and independent of a prior exposure to SARS-CoV-2, pre-booster titer, sex or age. Conclusion: Our study shows a potent universal antibody response of the booster dose of BNT162b2, regardless of pre-booster vaccine seronegativity.

Published
2022

4. A prospective study of direct-acting antiviral effectiveness and relapse risk in HCV cryoglobulinemic vasculitis by the Italian PITER cohort

Author

Kondili, L, Monti, M, Quaranta, M, Gragnani, L, Panetta, V, Brancaccio, G, Mazzaro, C, Persico, M, Masarone, M, Gentile, I, Andreone, P, Madonia, S, Biliotti, E, Filomia, R, Puoti, M, Fracanzani, A, Laccabue, D, Ieluzzi, D, Coppola, C, Rumi, M, Benedetti, A, Verucchi, G, Coco, B, Chemello, L, Iannone, A, Ciancio, A, Russo, F, Barbaro, F, Morisco, F, Chessa, L, Massari, M, Blanc, P, Zignego, A, Kondili L. A., Monti M., Quaranta M. G., Gragnani L., Panetta V., Brancaccio G., Mazzaro C., Persico M., Masarone M., Gentile I., Andreone P., Madonia S., Biliotti E., Filomia R., Puoti M., Fracanzani A. L., Laccabue D., Ieluzzi D., Coppola C., Rumi M. G., Benedetti A., Verucchi G., Coco B., Chemello L., Iannone A., Ciancio A., Russo F. P., Barbaro F., Morisco F., Chessa L., Massari M., Blanc P., Zignego A. L., Kondili, L, Monti, M, Quaranta, M, Gragnani, L, Panetta, V, Brancaccio, G, Mazzaro, C, Persico, M, Masarone, M, Gentile, I, Andreone, P, Madonia, S, Biliotti, E, Filomia, R, Puoti, M, Fracanzani, A, Laccabue, D, Ieluzzi, D, Coppola, C, Rumi, M, Benedetti, A, Verucchi, G, Coco, B, Chemello, L, Iannone, A, Ciancio, A, Russo, F, Barbaro, F, Morisco, F, Chessa, L, Massari, M, Blanc, P, Zignego, A, Kondili L. A., Monti M., Quaranta M. G., Gragnani L., Panetta V., Brancaccio G., Mazzaro C., Persico M., Masarone M., Gentile I., Andreone P., Madonia S., Biliotti E., Filomia R., Puoti M., Fracanzani A. L., Laccabue D., Ieluzzi D., Coppola C., Rumi M. G., Benedetti A., Verucchi G., Coco B., Chemello L., Iannone A., Ciancio A., Russo F. P., Barbaro F., Morisco F., Chessa L., Massari M., Blanc P., and Zignego A. L.

Abstract

Background and Aims: Mixed cryoglobulinemia is the most common HCV extrahepatic manifestation. We aimed to prospectively evaluate the cryoglobulinemic vasculitis (CV) clinical profile after a sustained virologic response (SVR) over a medium-term to long-term period. Approach and Results: Direct-acting antiviral–treated cryoglobulinemic patients, consecutively enrolled in the multicentric Italian Platform for the Study of Viral Hepatitis Therapy cohort, were prospectively evaluated. Cumulative incidence Kaplan-Meier curves were reported for response, clinical deterioration, relapse and relapse-free survival rates. Cox regression analysis evaluated factors associated with different outcomes. A clinical response was reported in at least one follow-up point for 373 of 423 (88%) patients with CV who achieved SVR. Clinical response increased over time with a 76% improvement rate at month 12 after the end of treatment. A full complete response (FCR) was reached by 164 (38.8%) patients in at least one follow-up point. CV clinical response fluctuated, with some deterioration of the initial response in 49.6% of patients (median time of deterioration, 19 months). In patients who achieved FCR and had an available follow-up (137 patients) a relapse was observed in 13% and it was transient in 66.7% of patients. The rate of patients without any deterioration was 58% and 41% at 12 and 24 months, respectively. After achieving SVR, a clinical nonresponse was associated with older age and renal involvement; a clinical deterioration/relapse was associated with high pretreatment rheumatoid factor values, and FCR was inversely associated with age, neuropathy, and high cryocrit levels. Conclusion: In patients with CV, HCV eradication may not correspond to a persistent clinical improvement, and clinical response may fluctuate. This implies an attentive approach to post-SVR evaluation through prognostic factors and tailored treatment.

Published
2022

5. Sex differences in electrolyte imbalances caused by SARS-CoV-2: A cross-sectional study

Author

Pani, A, Inglese, E, Puoti, M, Cento, V, Alteri, C, Romandini, A, Di Ruscio, F, Senatore, M, Moreno, M, Tarsia, P, Colombo, F, Epis, O, Panetta, V, Vismara, C, Bellone, A, Scaglione, F, Pani A., Inglese E., Puoti M., Cento V., Alteri C., Romandini A., Di Ruscio F., Senatore M., Moreno M., Tarsia P., Colombo F., Epis O. M., Panetta V., Vismara C., Bellone A., Scaglione F., Pani, A, Inglese, E, Puoti, M, Cento, V, Alteri, C, Romandini, A, Di Ruscio, F, Senatore, M, Moreno, M, Tarsia, P, Colombo, F, Epis, O, Panetta, V, Vismara, C, Bellone, A, Scaglione, F, Pani A., Inglese E., Puoti M., Cento V., Alteri C., Romandini A., Di Ruscio F., Senatore M., Moreno M., Tarsia P., Colombo F., Epis O. M., Panetta V., Vismara C., Bellone A., and Scaglione F.

Abstract

Background: Since SARS-CoV-2 spread, evidence regarding sex differences in progression and prognosis of COVID-19 have emerged. Besides this, studies on patients' clinical characteristics have described electrolyte imbalances as one of the recurrent features of COVID-19. Methods: We performed a cross-sectional study on all patients admitted to the emergency department (ED) from 1 March to 31 May 2020 who had undergone a blood gas analysis and a nasopharyngeal swab test for SARS-CoV-2 by rtPCR. We defined positive patients as cases (n = 710) and negatives as controls (n = 619), for a total number of patients of 1.329. The study was approved by the local ethics committee Area 3 Milan. Data were automatically extracted from the hospital laboratory SQL-based repository in anonymised form. We considered as outcomes potassium (K+), sodium (Na+), chlorine (Cl−) and calcium (Ca++) as continuous and as categorical variables, in their relation with age, sex and SARS-CoV-2 infection status. Results: We observed a higher prevalence of hypokalaemia among patients positive for SARS-CoV-2 (13.7% vs 6% of negative subjects). Positive patients had a higher probability to be admitted to the ED with hypokalaemia (OR 2.75, 95% CI 1.8-4.1, P <.0001) and women were twice as likely to be affected than men (OR 2.43, 95% CI 1.67-3.54, P <.001). Odds ratios for positive patients to manifest with an alteration in serum Na+ was (OR 1.6, 95% CI 1.17-2.35, P <.001) and serum chlorine (OR 1.6, 95% CI 1.03-2.69, P <.001). Notably, OR for positive patients to be hypocalcaemic was 7.2 (95% CI 4.8-10.6, P <.0001) with a low probability for women to be hypocalcaemic (OR 0.63, 95% CI 0.4-0.8, P =.005). Conclusions: SARS-CoV-2 infection is associated with a higher prevalence of hypokalaemia, hypocalcaemia, hypochloraemia and sodium alterations. Hypokalaemia is more frequent among women and hypocalcaemia among men.

Published
2021

6. Diagnostic relevance of IgE sensitization profiles to eight recombinant Phleum pratense molecules

Author

Cipriani, F., Mastrorilli, C., Tripodi, S., Ricci, G., Perna, S., Panetta, V., Asero, R., Dondi, A., Bianchi, A., Maiello, N., Miraglia del Giudice, M., Frediani, T., Macrì, F., Lucarelli, S., Dello Iacono, I., Patria, M. F., Varin, E., Peroni, D., Chini, L., Moschese, V., Bernardini, R., Pingitore, G., Pelosi, U., Tosca, M., Paravati, F., Sfika, I., Businco, A. Di Rienzo, Povesi Dascola, C., Comberiati, P., Frediani, S., Lambiase, C., Verga, M. C., Faggian, D., Plebani, M., Calvani, M., Caffarelli, C., and Matricardi, P. M.

Published
2018
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10. The application of Kubler-Ross model in Newly Diagnosed Patients with Relapsing-Remitting Multiple Sclerosis

Author

Maniscalco G. T., Ziello A. R., Panetta V., Guarcello G., Improta, G., Maniscalco, G. T., Ziello, A. R., Panetta, V., Guarcello, G., amp, and Improta, G.

Abstract

Background: Anxiety and depressive disorders affect Multiple Sclerosis (MS) patients since the early stages of the disease. Although the presence of these symptoms is widely recognized, the beginning and the psychological mechanisms at the basis of these disorders have rarely been examined in detail. This observational study aims to assess the presence of emotional distress in the early stages of the disease in patients with relapsing-remitting MS (MS-RR) and to check similarities and dissimilarities with a shared conceptual framework: the “curve of change” of the Kübler-Ross model. Thirtysix RR-MS patients were examined at 1 and 24 months after the diagnosis, and they were asked to answer to the questionnaire “State-Trait Anxiety Inventory (STAI X-1 and X-2) for the evaluation of anxiety, Beck Depression Inventory 2nd Edition (BDI-II)”, for the assessment of depressive symptoms. Results: STAI X-1 scores were significantly higher than the BDI II during the first 6 months, while the mean BDI II resulted higher from the 18th to the 22th month, especially on the cognitive domain. Conclusions: The study showed that psychological symptoms follow a clearly time course in newly diagnosed patients. During the first six months we found high levels of anxiety with a decrease until the first year of MS disclosure. From the first year on depressive symptoms begin to increase with a significant involvement of the cognitive domain. During the 20th month the depressive symptomatology reaches its highest level. The time course of the anxiety and depression symptoms in RR-MS patients is in accordance with the Kübler-Ross model.

Published
2019

12. The safety profile of probiotic VSL#3®. A meta-analysis of safety data from double-blind, randomized, placebo-controlled clinical trials

Author

Panetta, V., Bacchieri, A., Papetti, S., Stefani, E. D. E., Navarra, Pierluigi, Navarra P. (ORCID:0000-0002-4424-650X), Panetta, V., Bacchieri, A., Papetti, S., Stefani, E. D. E., Navarra, Pierluigi, and Navarra P. (ORCID:0000-0002-4424-650X)

Abstract

OBJECTIVE: A high-concentration of a multi-strain probiotic mixture, VSL#3® is widely used ‘whenever it is useful to promote the balance of intestinal flora’. As a food supplement, VSL#3® has been so far scarcely investigated on the aspect of safety. To fill this gap, in this paper, we analyzed the adverse events (AEs) recorded during the conduct of three (3) double-blind, randomized, placebo-controlled trials carried out to explore the efficacy of VSL#3® in various clinical settings. Data from a large open-label observational trial were also considered. MATERIALS AND METHODS: All trials included in the analysis were carried out according to good clinical practice (GCP) rules. AEs were classified by System Organ Class (SOC), Preferred Term (PT) and frequency. Differences vs. placebo control were considered as statistically significant if the p-value was < 0.05. RESULTS: A total of 120 patients were analyzed, 70 patients being included in the randomized controlled trials. In this population, 45 patients had at least one AE, 20 (64.5%) in the placebo group and 25 (64.1%) in the VSL#3® group. 29 patients had at least one related AE, 14 (45.2%) and 15 (38.5%) in the two treatment groups, respectively. Only one AE was assessed as serious, i.e., Foetal malformation, which occurred in the placebo group and was considered unrelated. No significant difference was found between VSL#3® and placebo for any of the SOC considered, with the exception of Injury, poisoning and procedural complications, which was in favor of VSL#3®. CONCLUSIONS: Based on GCP-quality data from clinical trials, we conclude that VSL#3® is a safe and well-tolerated agent.

Published
2020

13. Laparoscopic and open liver resection for hepatocellular carcinoma with Child–Pugh B cirrhosis: multicentre propensity score-matched study

Author

Troisi, R I, primary, Berardi, G, additional, Morise, Z, additional, Cipriani, F, additional, Ariizumi, S, additional, Sposito, C, additional, Panetta, V, additional, Simonelli, I, additional, Kim, S, additional, Goh, B K P, additional, Kubo, S, additional, Tanaka, S, additional, Takeda, Y, additional, Ettorre, G M, additional, Russolillo, N, additional, Wilson, G C, additional, Cimino, M, additional, Montalti, R, additional, Giglio, M C, additional, Igarashi, K, additional, Chan, C -Y, additional, Torzilli, G, additional, Cheung, T T, additional, Mazzaferro, V, additional, Kaneko, H, additional, Ferrero, A, additional, Geller, D A, additional, Han, H -S, additional, Kanazawa, A, additional, Wakabayashi, G, additional, Aldrighetti, L, additional, and Yamamoto, M, additional

Published
2021
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16. The weight of pre-existing cofactors for liver disease progression in patients who successfully eradicated HCV virus infection: An interim analysis in the PITER cohort

Author

Kondili, L.A., primary, Quaranta, M.G., additional, Monti, M., additional, Amoruso, D.A., additional, Filomia, R., additional, Biliotti, E., additional, Iannone, A., additional, Ieluzzi, D., additional, Coco, B., additional, Russo, F.P., additional, Beretta, I., additional, Parruti, G., additional, Blanc, P., additional, Vinci, M., additional, Cossiga, V., additional, Degasperi, E., additional, Chemello, L., additional, Massari, M., additional, Badia, L., additional, Puoti, M., additional, Bruno, S.R., additional, De Siena, M., additional, Panetta, V., additional, and Aghemo, A., additional

Published
2020
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20. Rate of serious infections in spondyloarthropathy patients treated with anti-tumour necrosis factor drugs: a survey from the Italian registry GISEA

Author

Atzeni, F., Sarzi-Puttini, P., Sebastiani, M., Panetta, V., Salaffi, F., Florenzo Iannone, Carletto, A., Foti, R., Gremese, E., Govoni, M., Marchesoni, A., Favalli, E., Gorla, R., Ramonda, R., Ferraccioli, G., and Lapadula, G.

Subjects
Adult, Male, predictive factors, Settore MED/16 - REUMATOLOGIA, spondyloarthropathy, infections, anti-TNF drugs, Adalimumab, Antirheumatic Agents, Etanercept, Female, Humans, Infections, Infliximab, Italy, Middle Aged, Registries, Spondylarthropathies, Surveys and Questionnaires, Tumor Necrosis Factor-alpha, serious infections, serious infections, spondyloarthropathy,anti-tumour necrosis factor drugs, Italian registry GISEA, anti-tumour necrosis factor drugs, Ambientale, Infection, Italian registry GISEA
Abstract

To determine the incidence of serious infections (SIs) among the spondyloarthropathy (SpA) patients from the "Gruppo Italiano per lo Studio delle Early Arthritis" (GISEA) registry and treated with tumour necrosis factor (TNF) inhibitors (TNFIs), and to identify the factors associated with the development of the infections.This observational study on 3321 GISEA-registered SpA patients collected real-world demographic and clinical data relating to their biological drug treatments. The overall incidence of infections was analysed by type of SpA.A total of 3321 SpA patients (1731 males, 52.2%; mean age 47±13 years; median disease duration 3 years, interquartile range [IQR] 0-8) were eligible for inclusion in the analysis. Two hundred and fifty-nine patients experienced at least one of 391 microbiologically diagnosed SIs, 32% of which were recorded during the first 12 months of treatment. The overall incidence of SIs was 43.9/1000 patient-years of follow-up (95% confidence interval [CI] 39.6-48.4): 29.9/1000 (95% CI 23.1-38.1) among those treated with adalimumab (ADA); 36.1/1000 (95% CI 30.0-43.1) among those treated with etanercept (ETN); and 61.4/1000 (95% CI 53.3-70.5) among those treated with infliximab (INF). The highest incidence was observed among the patients with psoriatic arthritis (PsA), but the difference was statistically significant only in comparison with the patients with undifferentiated SpA (p=0.002), whose incidence of SIs was also lower than in the patients with ankylosing spondylitis (AS) (p=0.034). Multivariate models showed that the number of comorbidities (hazard ratio [HR] 1.29, 95%CI 1.2-1.4; p0.001), age at the start of TNFi treatment (HR 0.99, 95%CI 0.97-0.99; p=0.030), steroid use (HR 1.40, 95%CI 1.1-1.8; p=0.012) and male sex (HR 0.72, 95%CI 0.5-0.9; p=0.012) were all statistically significant predictors of infection. The factors independently associated with a lower risk of SIs were the use of ETN (HR 0.52, 95%CI 0.4-0.7; p0.001) or ADA (HR 0.59, 95%CI 0.4-0.8; p=0.002) rather than INF.The incidence of SIs was higher among patients with PsA or AS than among those with undifferentiated SpA, and among patients treated with INF than among those treated with ADA or ETN. Male sex, steroid use and the number of comorbidities were all factors predictive of SIs.

Published
2019

26. Prevalence and Clinical Relevance of IgE Sensitization to Profilin in Childhood: A Multicenter Study

Author

Dondi, A, Tripodi, S, Panetta, V, Asero, R, Businco, Ad, Bianchi, A, Carlucci, A, Ricci, G, Bellini, F, Maiello, N, del Giudice, Mm, Frediani, T, Sodano, S, Dello Iacono, I, Macrì, F, Massaccesi, V, Caffarelli, C, Rinaldi, L, Patria, Mf, Varin, E, Peroni, Diego, Chinellato, I, Chini, L, Moschese, V, Lucarelli, S, Bernardini, R, Pingitore, G, Pelosi, U, Tosca, M, Paravati, F, La Grutta, S, Meglio, P, Calvani, M, Plebani, M, Matricardi, Pm, Asero, Riccardo, Tripodi, Salvatore, Dondi, Arianna, Di Rienzo Businco, Andrea, Sfika, Ifigenia, Bianchi, Annamaria, Candelotti, Paolo, Caffarelli, Carlo, Povesi Dascola, Carlotta, Ricci, Giampaolo, Calamelli, Elisabetta, Maiello, Nunzia, MIRAGLIA DEL GIUDICE, Michele, Frediani, Tullio, Frediani, Simone, Macri, Francesco, Moretti, Matteo, Iacono, Iride Dello, Patria, Maria Francesca, Varin, Elena, Peroni, Diego, Comberiati, Pasquale, Chini, Loredana, Moschese, Viviana, Lucarelli, Sandra, Bernardini, Roberto, Pingitore, Giuseppe, Pelosi, Umberto, Tosca, Mariangela, Cirisano, Anastasia, Faggian, Diego, Plebani, Mario, Verga, Carmen, Matricardi, Paolo Maria, and Del Giudice, Michele Miraglia

Subjects
Male, Allergy, Profilin, Prevalence, Immunoglobulin E, Allergic rhinitis, Children, Component-resolved diagnosis, IgE, Oral allergy syndrome, Panallergens, Pollen, Allergens, Antigens, Plant, Carrier Proteins, Child, Cross Reactions, Cucumis sativus, Female, Fruit, Humans, Hypersensitivity, Italy, Poaceae, Profilins, Rhinitis, Allergic, Seasonal, Risk Factors, Skin Tests, Immunology and Allergy, Immunology, Medicine (all), Epidemiology, Outpatient clinic, Sensitization, Rhinitis, Skin Test, biology, Allergen, food and beverages, General Medicine, medicine.anatomical_structure, Cross Reaction, Human, medicine.medical_specialty, Allergic rhinitis, Children, Component-resolved diagnosis, IgE , Oral allergy syndrome, Panallergens, Pollen, Profilin, Socio-culturale, macromolecular substances, Component-resolved diagnosi, Allergic, Allergic rhiniti, medicine, Antigens, Settore MED/38 - Pediatria Generale e Specialistica, Seasonal, business.industry, Risk Factor, Plant, medicine.disease, Cucumis sativu, biology.protein, Panallergen, Carrier Protein, business
Abstract

Background: Little is known about the prevalence and clinical relevance of hypersensitivity to the plant panallergen profilin in children. Objectives: The present study aimed to investigate prevalence, risk factors and clinical relevance of profilin sensitization in a large cohort of Italian children of different ages living in different geographic areas. Methods: Children with pollen allergy enrolled by 16 pediatric outpatient clinics sited in three main geographic areas of Italy were studied. SPT were carried out with commercial pollen extracts and a commercial purified date palm pollen profilin. IgE specific for allergenic pollen molecules, Phl p 12 (grass profilin) and Pru p 3 (peach lipid transfer protein) were tested by ImmunoCAP FEIA. Results: IgE to Phl p 12 (≥0.35 kU/l) was observed in 296 of the 1,271 participants (23%), including 17 of the 108 (16%) preschool children. Profilin SPT was positive (≥3 mm) in 320/1,271 (25%) participants. The two diagnostic methods were concordant in 1,151 (91%, p < 0.0001) cases. Phl p 12 IgE prevalence declined from northern to southern Italy and was directly associated with IgE to Phl p 1 and/or Phl p 5 and Ole e 1. Among children with IgE to Phl p 12, OAS was provoked by kiwi, melon, watermelon, banana, apricot and cucumber. Conclusions: Profilin sensitization is very frequent among pollen-allergic children, occurs at a very young age and contributes to the development of childhood OAS with a typical pattern of offending foods. Pediatricians should always consider IgE sensitization to profilin while examining pollen-allergic children, even if they are at preschool age.

Published
2015

27. Pollen-induced allergic rhinitis in 1360 Italian children: comorbidities and determinants of severity

Author

DONDI, ARIANNA, RICCI, GIAMPAOLO, BELLINI, FEDERICA, Tripodi S, Panetta V, Asero R, Businco AD, Bianchi A, Carlucci A, Maiello N, del Giudice MM, Frediani T, Sodano S, Dello Iacono I, Macrì F, Massaccesi V, Caffarelli C, Rinaldi L, Patria MF, Varin E, Peroni D, Chinellato I, Chini L, Moschese V, Lucarelli S, Bernardini R, Pingitore G, Pelosi U, Tosca M, Paravati F, La Grutta S, Meglio P, Calvani M, Plebani M, Matricardi PM, Italian Pediatric Allergy Network, Dondi, A, Tripodi, S, Panetta, V, Asero, R, Businco, Ad, Bianchi, A, Carlucci, A, Ricci, G, Bellini, F, Maiello, N, MIRAGLIA DEL GIUDICE, Michele, Frediani, T, Sodano, S, Dello Iacono, I, Macrì, F, Massaccesi, V, Caffarelli, C, Rinaldi, L, Patria, Mf, Varin, E, Peroni, D, Chinellato, I, Chini, L, Moschese, V, Lucarelli, S, Bernardini, R, Pingitore, G, Pelosi, U, Tosca, M, Paravati, F, La Grutta, S, Meglio, P, Calvani, M, Plebani, M, Matricardi, Pm, Dondi A, Tripodi S, Panetta V, Asero R, Businco AD, Bianchi A, Carlucci A, Ricci G, Bellini F, Maiello N, del Giudice MM, Frediani T, Sodano S, Dello Iacono I, Macrì F, Massaccesi V, Caffarelli C, Rinaldi L, Patria MF, Varin E, Peroni D, Chinellato I, Chini L, Moschese V, Lucarelli S, Bernardini R, Pingitore G, Pelosi U, Tosca M, Paravati F, La Grutta S, Meglio P, Calvani M, Plebani M, Matricardi PM, Italian Pediatric Allergy Network (I-PAN)., Businco, A, Miraglia del Giudice, M, Patria, M, and Matricardi, P

Subjects
Male, Questionnaires, Allergy, Pediatrics, multiple pollen sydrome, multiple pollen syndrome, Breastfeeding, Comorbidity, Airborne allergen, Surveys and Questionnaires, Epidemiology, Prevalence, Immunology and Allergy, Outpatient clinic, Age of Onset, Child, Conjunctivitis, Allergic, Rhinitis, pan-allergens, profilin, asthma, children, allergic rhinitis, epidemiology, italy, allergic conjunctivitis, Environmental exposure, Humans, Disease Progression, Italy, Allergens, Antigens, Plant, Skin Tests, Pollen, Child, Preschool, Rhinitis, Allergic, Seasonal, Early Diagnosis, Female, Allergic conjunctivitis, panallergen, allergic rhiniti, medicine.medical_specialty, Immunology, Allergic, medicine, allergic conjunctiviti, Antigens, Preschool, Asthma, Settore MED/38 - Pediatria Generale e Specialistica, Seasonal, business.industry, Plant, medicine.disease, Conjunctivitis, pan-allergen, Pediatrics, Perinatology and Child Health, business
Abstract

BACKGROUND: Pollen-induced allergic rhinoconjunctivitis (AR) is highly prevalent and rapidly evolving during childhood. General practitioners may not be fully aware of the nature and severity of symptoms experienced by patients and might underestimate the prevalence of moderate or severe disease. Thus, the relevance of early diagnosis and intervention may be overlooked. OBJECTIVES: To investigate the severity of pollen-induced AR and its determinants in Italian children referred to allergy specialists and who had never received specific immunotherapy (SIT). METHODS: Children (age 4-18 yr) affected by pollen-induced AR who had never undergone SIT were recruited between May 2009 and June 2011 in 16 pediatric outpatient clinics in 14 Italian cities. Recruited children's parents answered standardized questionnaires on atopic diseases (International Study of Allergy and Asthma in Childhood, Allergic Rhinitis and its Impact on Asthma, Global Initiative for Asthma). The children underwent skin-prick test (SPT) with several airborne allergens and six food allergens. Information on socio-demographic factors, parental history of allergic diseases, education, perinatal events, breastfeeding, nutrition and environmental exposure in early life was collected through an informatics platform shared by the whole network of clinical centers (AllergyCARD™). RESULTS: Among the 1360 recruited patients (68% males, age 10.5 ± 3.4 yr), 695 (51%) had moderate-to-severe AR, 533 (39%) asthma, and 325 (23.9%) oral allergy syndrome (OAS). Reported onset of pollen-induced AR was on average at 5.3 ± 2.8 yr, and its mean duration from onset was 5.2 ± 3.3 yr. Only 6.2% of the patients were pollen-monosensitized, and 84.9% were sensitized to ≥3 pollens. A longer AR duration was significantly associated with moderate-to-severe AR symptoms (p 0.004), asthma (p 0.030), and OAS comorbidities (p < 0.001). CONCLUSIONS: This nationwide study may raise awareness of the severity of pollen-induced AR among Italian children who have never received pollen SIT. The strong association between pollen-induced AR duration and several markers of disease severity needs replication in longitudinal studies, while suggesting that countrywide initiatives for earlier diagnosis and intervention should be planned.

Published
2013

34. Benefits and drawbacks of open partial horizontal laryngectomies, Part A: Early- to intermediate-stage glottic carcinoma

Author

Succo, Giovanni, Crosetti, Erika, Bertolin, A, Lucioni, M, Caracciolo, Alessandra, Panetta, V, Sprio, ANDREA ELIO, Berta, Giovanni Nicolao, and Rizzotto, G.

Subjects
Adult, Aged, 80 and over, Male, Glottis, Open partial laryngectomy, TNM staging, supracricoid partial laryngectomy, supratracheal partial laryngectomy, glottis cancer, laryngeal cancer, Laryngectomy, Middle Aged, Young Adult, Treatment Outcome, Carcinoma, Squamous Cell, Humans, Female, Laser Therapy, Neoplasm Recurrence, Local, Laryngeal Neoplasms, Organ Sparing Treatments, Aged, Neoplasm Staging, Retrospective Studies
Abstract

Laryngeal squamous cell carcinoma (SCC) accounts for 1.9% of cancers worldwide. Most of these are diagnosed in the early stages (T1-T2, and N0). For these, a larynx preserving/conserving option is preferable. Beyond transoral laser microsurgery (TLM), open partial horizontal laryngectomy is a function-sparing surgical technique used to treat laryngeal SCC.We retrospectively analyzed the clinical outcomes of 216 patients who underwent open partial horizontal laryngectomy for glottic cT2 laryngeal cancer.Five-year overall survival (OS), disease-specific survival (DFS), locoregional control, local control, laryngeal function preservation, and laryngectomy-free survival rates were 93.1%, 98.0%, 97.1%, 97.5%, 97.8%, and 98.5%, respectively. Disease controls were significantly affected by previous treatment and type of surgery used.Although TLM for cT2 laryngeal cancer with unimpaired vocal cord mobility still represents a sound option, open partial horizontal laryngectomy offers higher local control and laryngeal preservation rates for selected patients with impaired mobility of vocal cords combined with involvement of the paraglottic space. © 2015 Wiley Periodicals, Inc. Head Neck 38: E333-E340, 2016.

Published
2015

36. Burnout in Non-Hospital Psychiatric Residential Facilities

Author

Pedrini, Laura, Magni, Lr, Giovannini, C, Panetta, V, Zacchi, V, Rossi, G, Placentino, A., Pedrini, Laura, Magni, Lr, Giovannini, C, Panetta, V, Zacchi, V, Rossi, G, and Placentino, A.

Subjects
Burnout, psychitric services
Abstract

Objective: This study evaluated levels and risk factors of urnout in a sample of mental health professionals employed in hospital psychiatric residential facilities of northern Italy. Methods: Nurses, nurse assistants, and educators completed a questionnaire evaluating demographic variables, burnout (Maslach Burnout Inventory), job characteristics (Job Diagnostic Survey), workload, relationships with colleagues, and support from supervising coordinators. A total of 202 (83% response rate) questionnaires were analyzed. Logistic linear regressions were used to estimate predictors of burnout dimensions. Results: Burnout risk was widespread. Low feedback about job performance, poor support from coordinators, and young age predicted emotional exhaustion. Low feedback about job performance predicted feelings of depersonalization. Low task identity and young age predicted reduced feelings of personal accomplishment. Conclusions: Interventions to prevent burnout among employees should be developed. These include providing feedback about performance, clearly identifying the tasks of the job, and providing support.

Published
2009

40. Diagnostic relevance of IgE sensitization profiles to eight recombinant <italic>Phleum pratense</italic> molecules.

Author

Cipriani, F., Mastrorilli, C., Tripodi, S., Ricci, G., Perna, S., Panetta, V., Asero, R., Dondi, A., Bianchi, A., Maiello, N., Miraglia del Giudice, M., Frediani, T., Macrì, F., Lucarelli, S., Dello Iacono, I., Patria, M. F., Varin, E., Peroni, D., Chini, L., and Moschese, V.

Subjects
CONJUNCTIVITIS, ATOPY, CONJUNCTIVA diseases, EYE inflammation, ALLERGIES, IMMUNOLOGIC diseases
Abstract

Abstract: Background: Grass pollen‐related seasonal allergic rhinoconjunctivitis (SARg) is clinically heterogeneous in severity, comorbidities, and response to treatment. The component‐resolved diagnostics disclosed also a high heterogeneity at molecular level. Our study aimed at analyzing the characteristics of the IgE sensitization to Phleum pratense molecules and investigating the diagnostic relevance of such molecules in childhood. Methods: We examined 1120 children (age 4‐18 years) with SARg. Standardized questionnaires on atopy were acquired through informatics platform (AllergyCARD™). Skin prick tests were performed with pollen extracts. Serum IgE to airborne allergens and eight P. pratense molecules (rPhl p 1, rPhl p 2, rPhl p 4, rPhl p 5b, rPhl p 6, rPhl p 7, rPhl p 11, rPhl p 12) were tested by ImmunoCAP FEIA. Results: The analysis of IgE responses against eight P. pratense molecules showed 87 profiles. According to the number of molecules recognized by IgE, the more complex profiles were characterized by higher serum total IgE, higher grass‐specific serum IgE, and higher number and degree of sensitization to pollens. The most frequent IgE sensitization profile was the monomolecular Phl p 1. Sensitization to Phl p 7 was a reliable biomarker of asthma, whereas Phl p 12 of oral allergy syndrome. Sensitization to Phl p 7 was associated with a higher severity of SARg, and complex profiles were associated with longer disease duration. Conclusions: In a large pediatric population, the complexity of IgE sensitization profiles against P. pratense molecules is related to high atopic features although useless for predicting the clinical severity. The detection of serum IgE to Phl p 1, Phl p 7, and Phl p 12 can be used as clinical biomarkers of SARg and comorbidities. Further studies in different areas are required to test the impact of different IgE molecular profiles on AIT response. [ABSTRACT FROM AUTHOR]

Published
2018
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42. Functional and molecular evidence of myelin- and neuro-protection by thyroid hormone administration in experimental allergic encephalomyelitis

Author

Dell'Acqua, Maria Daniela, Lorenzini, L, D'Intino, G, Sivilia, S, Pasqualetti, P, Panetta, V, Paradisi, M, Filippi, Mauro, Baiguera, C, Pizzi, M, Giardino, L, Rossini, Paolo Maria, Calzà, L., ML Dell’Acqua, L Lorenzini, G D’Intino, S Sivilia, P Pasqualetti, V Panetta, M. Paradisi, MM Filippi, C. Baiguera, M Pizzi, L Giardino, PM Rossini, and L Calzà

Subjects
Thyroid Hormones, Histology, Encephalomyelitis, Autoimmune, Experimental, Experimental, Physiology (medical), Animals, Experimental allergic encephalomyelitis, Neuroprotection, Remyelination, Somatosensory evoked potentials, Thyroid hormone, Axons, Disease Models, Animal, Female, Myelin Sheath, Neuroprotective Agents, Rats, Spinal Cord, Triiodothyronine, 2734, Neurology, Neurology (clinical), Encephalomyelitis, NEUROPROTECTION, Animal, experimental allergic encephalomyeliti, thyroid hormone, Settore MED/26 - NEUROLOGIA, remyelination, Disease Models, somatosensory evoked potential, Autoimmune
Abstract

AIMS: Recent data in mouse and rat demyelination models indicate that administration of thyroid hormone (TH) has a positive effect on the demyelination/remyelination balance. As axonal pathology has been recognized as an early neuropathological event in multiple sclerosis, and remyelination is considered a pre-eminent neuroprotective strategy, in this study we investigated whether TH administration improves nerve impulse propagation and protects axons. METHODS: We followed up the somatosensory evoked potentials (SEPs) in triiodothyronine (T3)-treated and untreated experimental allergic encephalomyelitis (EAE) Dark-Agouti female rats during the electrical stimulation of the tail nerve. T3 treatment started on the 10th day post immunization (DPI) and a pulse administration was continued until the end of the study (33 DPI). SEPs were recorded at baseline (8 DPI) and the day after each hormone/ vehicle administration. RESULTS: T3 treatment was associated with better outcome of clinical and neurophysiological parameters. SEPs latencies of the two groups behaved differently, being briefer and closer to control values (=faster impulse propagation) in T3-treated animals. The effect was evident on 24 DPI. In the same groups of animals, we also investigated axonal proteins, showing that T3 administration normalizes neurofilament immunoreactivity in the fasciculus gracilis and tau hyperphosphorylation in the lumbar spinal cord of EAE animals. No sign of plasma hyperthyroidism was found; moreover, the dysregulation of TH nuclear receptor expression observed in the spinal cord of EAE animals was corrected by T3 treatment. CONCLUSIONS: T3 supplementation results in myelin sheath protection, nerve conduction preservation and axon protection in this animal model of multiple sclerosis.

Published
2011

44. Lack of Efficacy of Topical Furfuryl Palmitate in Pediatric Atopic Dermatitis: A Randomized Double-Blind Study

Author

Tripodi, S., Di Rienzo Businco, A., Panetta, V., Pingitore, G., Volterrani, A., Frediani, T., Pelosi, S., and Stefano Miceli Sopo

Subjects
Male, Emollients, atopic dermatitis, Palmitates, furfuryl palmitate, Infant, topical administration, Administration, Cutaneous, Dermatitis, Atopic, Treatment Outcome, Double-Blind Method, Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA, children, pediatric atopic dermatitis, Child, Preschool, Humans, Female, Child, Furans
Abstract

Atopic dermatitis is a common disease in children. It is usually treated with topical steroids and/or calcineurin inhibitors in association with emollients but topical antioxidants have been recently introduced as a therapeutic option for children. The aim of this study was to evaluate the efficacy and tolerability of furfuryl palmitate, a new antioxidant molecule, in a multicenter, randomized, double-blind, vehicle-controlled study.Children with atopic dermatitis were randomized into 2 groups treated for 2 weeks. One group of children (n = 60) was treated with a basic emollient cream and the other (n = 57) was treated with the same cream enriched with furfuryl palmitate.In both groups, there was a significant reduction (P.001) in atopic dermatitis-measured using the SCORAD index-after 14 days. The reduction in the per-protocol analysis was higher for the basic cream. Treatment success was defined as a reduction of 20% or more in the SCORAD index from baseline to day 14. Patients who used treatment not permitted by the protocol were also considered treatment failures. The intention-to-treat analysis showed 70% positive results for the basic treatment and 29% for the treatment containing furfuryl palmitate (P.0001) with a number needed to treat of 2.4 (95% confidence interval, 1.6-4.6). The emollient cream without furfuryl palmitate was observed to be more efficacious by pediatricians and parents, and no differences were reported between the 2 products in terms of tolerability.Both products proved to be efficacious in treating atopic dermatitis in children, but the emollient cream not containing furfuryl palmitate showed better clinical efficacy.

Published
2009

47. Consumption of fish, butter and margarine during pregnancy and development of allergic sensitizations in the offspring: role of maternal atopy

Author

Calvani, M, Alessandri, C, MICELI SOPO, S, Panetta, V, Pingitore, G, Tripodi, S, Zapalà, D, Lucarelli, Sandra, and Zicari, Anna Maria

Subjects
Adult, Hypersensitivity, Immediate, Male, Allergy, Meat, prenatal, margarine, Offspring, Immunology, Physiology, pregnancy and development of allergic sensitizations, Atopy, Cohort Studies, Pregnancy, allergic mothers, allergic sensitizations, butter, fish, Hypersensitivity, Immunology and Allergy, Medicine, Animals, Humans, Prospective cohort study, Retrospective Studies, Skin Tests, business.industry, Fishes, medicine.disease, Diet, Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA, Child, Preschool, Prenatal Exposure Delayed Effects, Pediatrics, Perinatology and Child Health, Gestation, Population study, Female, business, Cohort study
Abstract

It has been suggested that changes in dietary habits, particularly increased consumption of omega-6 polyunsaturated fatty acids (PUFA) and decreased consumption of omega-3 PUFAs may explain the increase in atopic disease seen in recent years. Furthermore, it seems possible that it is mainly prenatal or very early life environmental factors that influence the development of allergic diseases. It has also been suggested that intrauterine risk factors may act differently if mother themselves suffer from allergic disease. The aim of this study was to investigate whether the consumption of fish, butter and margarine during pregnancy might influence the development of allergic sensitizations in the offspring. The study population was divided into the offspring of allergic and non-allergic mothers. This was a retrospective cohort study enrolling 295 offspring of allergic mothers and 693 of non-allergic mothers. Information regarding maternal intake of fish, butter and margarine during pregnancy as well as other prenatal and perinatal confounding factors were retrospectively assessed by parental report via a standardized questionnaire. Atopy was determined by skin-prick tests (SPT) to eight prevalent inhalant allergens and two foods. In the allergic mothers' group there is no clear correlation between maternal intakes of fish, butter and margarine and sensitizations to food or inhalants. In the non-allergic mothers' group there was no correlation between butter and margarine intake and food or inhalant sensitizations. On the contrary, a protective effect of fish intake on SPT positivity was observed. In particular, frequent maternal intake ('2-3 times/wk or more') of fish reduced the risk of food sensitizations by over a third (aOR 0.23; 95% CI: 0.08-0.69). A similar trend, even if not significant, was found for inhalants. Finally, even in the whole study population, i.e. allergic group plus non-allergic group, there was a similar trend between increased consumption of fish and decreased prevalence of SPT positivity for foods. This study shows that frequent intake of fish during pregnancy may contrast the development of SPT sensitizations for foods in the offspring of mothers without atopic disease. Therefore, larger prospective studies are needed, enrolling mothers with and without allergic disease, to confirm these results.

Published
2006

48. Specific oral tolerance induction with raw hen's egg in children with very severe egg allergy: A randomized controlled trial

Author

Dello Iacovo, I, Tripodi, S, Calvani, M, Panetta, V, Verga, M. C, Miceli Sopo, Stefano, Miceli Sopo, Stefano (ORCID:0000-0002-8175-6146), Dello Iacovo, I, Tripodi, S, Calvani, M, Panetta, V, Verga, M. C, Miceli Sopo, Stefano, and Miceli Sopo, Stefano (ORCID:0000-0002-8175-6146)

Abstract

To cite this article: Dello Iacono I, Tripodi S, Calvani M, Panetta V, Verga MC, Miceli Sopo S. Specific oral tolerance induction with raw hen's egg in children with very severe egg allergy: A randomized controlled trial. Pediatr Allergy Immunol 2012: 00. ABSTRACT: 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: 5-11 yr) were randomized equally into a SOTI treatment group and a control group. The treatment group started SOTI and underwent a second challenge 6 months later. Control children were kept on an egg-free diet for 6 months and then underwent a second challenge. Results: After 6 months, 9/10 children of the SOTI group (90%) achieved partial tolerance (at least 10 ml, but <40 ml of raw HE emulsion, in a single dose) and 1 (10%) was able to tolerate only 5 ml (no tolerance). After 6 months, nine control children tested positive to the second challenge at a dose ≤0.9 ml of raw HE emulsion, and one reacted to 1.8 ml (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.

Published
2013

49. Effects of hemochromatosis and transferrin gene mutations on iron dyshomeostasis, liver dysfunction and on the risk of Alzheimer's disease

Author

Giambattistelli, F, Bucossi, S, Salustri, C, Panetta, V, Mariani, Stefano, Siotto, M, Ventriglia, M, Vernieri, F, Dell'Acqua, Maria Daniela, Cassetta, E, Rossini, Paolo Maria, Squitti, R., Rossini, Paolo Maria (ORCID:0000-0003-2665-534X), Giambattistelli, F, Bucossi, S, Salustri, C, Panetta, V, Mariani, Stefano, Siotto, M, Ventriglia, M, Vernieri, F, Dell'Acqua, Maria Daniela, Cassetta, E, Rossini, Paolo Maria, Squitti, R., and Rossini, Paolo Maria (ORCID:0000-0003-2665-534X)

Abstract

It is now accepted that transition metals, such as iron and copper, are involved in the pathogenesis of the Alzheimer's disease (AD) through their participation in toxic oxidative phenomena. In this context, hemochromatosis (Hfe) and transferrin (Tf) genes are of particular importance, since they play a key role in iron homeostasis. Also, signs of liver distress which accompany metal dysmetabolisms have been shown to be linked to AD. In order to investigate whether and how all these factors are interconnected, in this study we have explored the relationship of the gene variants of Hfe H63D and C282Y and of Tf C2 with serum markers of iron status (iron, ferritin, TF, TF-saturation, ceruloplasmin -CP-, CP and TF serum concentrations (CP/TF) ratio), and of liver function (albumin, transaminases, prothrombin time-prothrombin time (PT)) in a sample of 160 AD patients and 79 healthy elderly controls. Albumin resulted in lower, PT longer and AST/ALT higher ratios in AD patients than in controls, indicating a distress of the liver. Also TF was lower and ferritin higher in AD. Multiple logistic regression backward analyses, performed to evaluate the effects of our biochemical variables upon the probability of developing AD, revealed that a one-unit TF serum-decrease increases the probability of AD by 80%, a one-unit albumin serum-decrease reduces this probability by 20%, and a one-unit increase of AST/ALT ratio generates a 4-fold probability increase. Patients who were carriers of the H63D mutation showed higher levels of iron, lower levels of TF and CP and higher CP/TF ratios, a panel resembling hemochromatosis. This picture was found neither in H63D non-carrier patients, nor in healthy controls. Our results suggest the existence of a link between Hfe mutations and iron abnormalities that increases the probability of developing AD when accompanied by a distress of the liver.

Published
2012

50. Functional and molecular evidence of myelin- and neuroprotection by thyroid hormone administration in experimental allergic encephalomyelitis

Author

Dell'Acqua, Maria Daniela, Lorenzini, L, D'Intino, G, Sivilia, S, Pasqualetti, P, Panetta, V, Paradisi, M, Filippi, Mauro, Baiguera, C, Pizzi, M, Giardino, L, Rossini, Paolo Maria, Calzà, L., Rossini, Paolo Maria (ORCID:0000-0003-2665-534X), Dell'Acqua, Maria Daniela, Lorenzini, L, D'Intino, G, Sivilia, S, Pasqualetti, P, Panetta, V, Paradisi, M, Filippi, Mauro, Baiguera, C, Pizzi, M, Giardino, L, Rossini, Paolo Maria, Calzà, L., and Rossini, Paolo Maria (ORCID:0000-0003-2665-534X)

Abstract

Recent data in mouse and rat demyelination models indicate that administration of thyroid hormone (TH) has a positive effect on the demyelination/remyelination balance. As axonal pathology has been recognized as an early neuropathological event in multiple sclerosis, and remyelination is considered a pre-eminent neuroprotective strategy, in this study we investigated whether TH administration improves nerve impulse propagation and protects axons.

Published
2012

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