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A Arena

Publications and source records attributed to A Arena.

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Safety and tolerability of ultra-Rush (20 minutes) sublingual immunotherapy in patients with allergic rhinitis and/or asthma.

BACKGROUND: The safety and good tolerability of sublingual immunotherapy (SLIT) has already been proved in allergic patients, but only one study has investigated the occurrence of immediate adverse reactions in allergic patients after a 2-hour ultra-rush regimen of SLIT performed with a chemically modified extract (sublingual monomeric allergoid, Lais, Lofarma S.p.A., Milan). The objective of the present study was to evaluate the occurrence of immediate adverse reactions in allergic patients after a very fast (20 minutes) ultra-rush regimen of sublingual allergoid SLIT. METHODS AND RESULTS: We studied 105 patients: 28 children (20 male, mean age 13.3 +/- 2.1 yr) and 77 adults (29 male, mean age 34.7 +/- 9.9 years) with a history of intermittent/persistent rhinitis or intermittent/mild persistent asthma due to House Dust Mite (n = 56), Parietaria (n = 34) and Timothy-grass (n = 15) The build-up ultra-rush phase involved the administration, every five minutes, of increasing doses of the sublingual allergoid SLIT. All patients tolerated the treatment very well. Only one patient out of 105 (0.9%) had a mild local symptom (gastric pirosis) that occurred 30 minutes after the last initial dose and spontaneously disappeared as the treatment was continued. CONCLUSIONS: These data show the excellent safety and tolerability profile of an ultra-rush SLIT regimen performed with a chemically modified extract, even when high doses were administered through an extremely short induction phase (20 minutes), thus confirming the previously reported results.

Administration, Sublingual↗

Safety and tolerability of ultra-rush (20 minutes) sublingual immunotherapy in patients with allergic rhinitis and/or asthma.

BACKGROUND: The safety and good tolerability of sublingual immunotherapy (SLIT) has already been proved in allergic patients, but only one study has investigated the occurrence of immediate adverse reactions in allergic patients after a 2-hour ultra-rush regimen of SLIT performed with a chemically modified extract (sublingual monomeric allergoid, Lais, Lofarma S.p.A., Milan). The objective of the present study was to evaluate the occurrence of immediate adverse reactions in allergic patients after a very fast (20 minutes) ultra-rush regimen of sublingual allergoid SLIT. METHODS AND RESULTS: We studied 105 patients: 28 children (20 male, mean age 13.3 +/- 2.1 yr) and 77 adults (29 male, mean age 34.7 +/- 9.9 years) with a history of intermittent/persistent rhinitis or intermittent/mild persistent asthma due to House Dust Mite (n = 56), Parietaria (n = 34) and Timothy-grass (n = 15) The build-up ultra-rush phase involved the administration, every five minutes, of increasing doses of the sublingual allergoid SLIT. All patients tolerated the treatment very well. Only one patient out of 105 (0.9%) had a mild local symptoms (gastric pirosis) that occurred 30 minutes after the last initial dose and spontaneously disappeared as the treatment was continued. CONCLUSIONS: These data show the excellent safety and tolerability profile of an ultra-rush SLIT regimen performed with a chemically modified extract, even when high doses were administered through an extremely short induction phase (20 minutes), thus confirming the previously reported results.

Administration, Sublingual↗

Haemostasis unbalance in Pugh-scored liver cirrhosis: characteristic changes of plasma levels of protein C versus protein S.

Liver cirrhosis leads to a protido-synthetic impairment that alters the levels of blood clotting factors and haemostasis. The aim of this study was to assess the alterations of haemostatic parameters in the evolution of liver cirrhosis scored according to Child's classification, with Pugh's modifications. Thirty-seven patients suffering from alcoholic and non-alcoholic liver cirrhosis, representing stages A5, A6, B7, B8 and C10, were tested for the main blood clotting parameters, i.e. prothrombin time, factor VII, partial activated thromboplastin time, fibrinogen, plasminogen, alpha 2-antiplasmin and physiological inhibitors [antithrombin III (ATIII), protein C (PC), protein S (PS)]. No variations were observed between substages A5 and A6 in any of the parameters, except for coagulation inhibitor levels. Most parameters showed a progressive decrease in stages B and C of the disease. The most significant alterations were found in the physiological coagulation inhibitors, with a sharper decrease in PC and AT III level and a lesser decrease in the level of PS through stages A5 and B8: this evidence could assume an important biological and diagnostic significance.

Adult↗

In vitro interleukin-8 production by monocytes treated with lithium chloride from breast cancer patients.

AIMS AND BACKGROUND: Since interleukin-8 (IL-8) has a suppressive effect on hematopoiesis, lithium induces leukocytosis and granulocytosis and mononuclear cells are defective in patients affected by neoplastic disease, we analyzed IL-8 production by monocytes obtained from patients with nonmetastatic breast cancer (BCaM0) and metastatic breast cancer (BCaM1) and the effect of lithium chloride (LiCl) on these cells. Lithium salt compounds are used to limit the degree and duration of neutropenia in patients receiving chemotherapy for cancer and acute leukemia. Lithium influences the hematopoietic system, which is known to be regulated by numerous cytokines including IL-8. METHODS: We selected three groups of subjects (15 per group): patients affected by BCaM0, BCaM1 and healthy donors (HD) matched for sex and age. IL-8 release was assessed in supernatants of lipopolysaccharide (LPS) and/or LiCl-treated monocyte cultures. RESULTS: Monocytes from BCaM1 released higher IL-8 levels than monocytes from BCaM0 (P <0.0001); the IL-8 levels of both groups were significantly higher (P <0.0001) than those of HD. In vitro LiCl treatment reduced IL-8 production by monocytes obtained from all subjects compared to the same cells when untreated or LPS treated. The suppressive effect of LiCl on IL-8 production by monocytes from breast cancer patients was particularly marked in monocytes from BCaM0 with respect to those from BCaM1. LPS treatment increased the IL-8 production more in BCaM1 monocytes than in BCaM0 monocytes. Moreover, combined LPS/LiCl treatment of monocytes significantly (p <0.0001) downregulated the release of IL-8 compared to treatment with LPS alone. CONCLUSIONS: Our data demonstrate that monocytes from BCaM0 release larger amounts of IL-8 than monocytes from BCaM0 and from HD. Lithium was able to downregulate IL-8 production by monocytes from different subgroups. Further studies are needed to clarify if the improvement of the hematopoietic system in vivo observed following lithium therapy could reside, at least in part, in the ability of lithium to downregulate this chemokine.

Adjuvants, Immunologic↗

Specific immunotherapy [correction of immunotheraphy] of allergic diseases: a three years perspective observational study.

In order evaluate the long-term benefit of Specific ImmunoTherapy (SIT), administered either subcutaneously or sublingually, in comparison with drug therapy, in terms of efficacy, tolerability and patients' adherence to the treatment, a three year perspective, observational study was carried out over tree years in a rather large number of allergic subjects. One hundred and ten patients of both sex (50F, 60M; age: 22.4 - 35.5 years) were admitted. Sixty of them were rhinitics, some with concomitant mild intermittent asthma or conjunctivitis; 43 had a persistent asthma, often with concomitant rhinitis. Seven had urticaria. Sixty patients were treated with the allergoid sublingual SIT (in tablets) plus drugs on demand, 19 with the subcutaneous SIT (depot, aluminium hydroxide subcutaneous SIT) and 31 with the pharmacological therapy alone, mainly nasal steroids and antihistamines. The treatment efficacy, evaluated after 36 months, by symptoms and drug consumption reduction, was statistically better in the group assigned to the allergoid sublingual SIT than in the other two groups. This was the case also for the tolerability, the patient's compliance and the physicians' and patients' opinion. The present findings, obtained by a non-randomized study, show that the allergoid sublingual SIT was very appreciated by both patients and physicians for the good effectiveness and the high degree of safety guaranteed, in addition to its simplicity of use.

Adult↗

Effect of fluticasone propionate on interleukin-12 and interferon-gamma production in patients affected by allergic bronchial asthma.

Fluticasone propionate is a very effective topical treatment for asthma. Interleukin-12, which is produced by monocyte-macrophage and B lymphocytic cell lines, plays an important role in the induction of Th1 cells; whereas interferon-gamma (IFN-gamma), mainly produced by Th1 cells, exhibits a crucial effect on macrophage and natural killer cell activation. Since previous studies have demonstrated a reduced production of IL-12 and IFN-gamma in patients with allergic asthma, we examined whether fluticasone propionate therapy could influence the release of these cytokines in asthma. We selected two groups of subjects (15 per group): nonatopic healthy donors (group A) and asthmatic patients (group B). Cytokine release was assessed in sera as well as in supernatants of whole blood cultures after IFN-gamma priming and lipopolysaccharide stimulation. Venous blood and spirometric tests from patients in group B were obtained before and after treatment. Fluticasone propionate therapy significantly increased interleukin-12 levels in both supernatants of blood cultures (1,152.12 +/- 225.57 vs. 540.87 +/- 130.07 pg/ml; p < 0.05) or in sera (72.24 +/- 15.76 vs. 10.83 +/- 2.70 pg/ml; p < 0.05). Patients treated with fluticasone propionate also displayed increased levels of IFN-gamma in either blood culture supernatants (59.12 +/- 16.88 vs. 18.87 +/- 7.53 IU/ml; p < 0.05) or in sera (5.60 +/- 2.87 vs. < 1 IU/ml; p < 0.05). In addition, we observed a significant increase in FEV1 values in asthmatic patients after fluticasone propionate therapy (51.86 +/- 5.31 vs. 71.46 +/- 10.37% predicted). We propose that fluticasone propionate may exert at least in part of its antiinflammatory activity through the modulation of the cytokine output.

Adolescent↗

Anaphylactic reaction to the ingestion of raw onion. A case report.

A case of severe systemic reactions (intense itching, urticaria, confusion, blurred vision, transient loss of consciousness, sweating, tachycardia) after ingestion of raw or lightly-cooked onion is described. The patient, a 44-year-old woman, had no troubles with well-cooked onions. Differently from the cases of sensitivity to onion described in literature, this patient was monosensitized, being skin tests negative to pollens, inhalants and other foods. The patient had 3.7 kU/L of onion-specific segum IgE, as determined by REAST. The density of onion-specific IgE (calculated as percent ratio to total IgE) was 30.8%. The reactivity of patient's serum IgE towards thermolabile and thermostable components has been tested with unheated and heated (30' at 100 degrees C) onion extracts bound to polystyrene beads and tested in the RAST system. Unheated extract resulted positive in class 2, heated extract negative, demonstrating that this patients, differently from similar clinical cases described in literature, had IgE antibodies recognizing just thermolabile onion fraction. This is the first case described in literature of a monosensitization to the thermolabile component of onion, negative also to related foods (Liliacee) and characterized by severe systemic reactions. The importance of specific-IgE density (%) rather their absolute amount (kU/L) as parameter predictive for the clinical severity of allergic reactions is discussed.

Adult↗

Interferon release by LPS-treated macrophages from patients affected by neoplasia.

Concerning the modulatory role of LPS on immunocompetent cells, the production of interferon by macrophages primed with human gamma interferon (HUIFN gamma), was studied. In particular the production of IFN from primed macrophages of patients affected by breast cancer, differentiated in presence of autologous serum or in serum from healthy donors, was compared with the IFN production from macrophages of healthy donors. The levels of endotoxin-induced IFN were enhanced by priming macrophages with HUIFN gamma. The "in vitro" treatment with Escherichia coli LPS restores the interferon production of primed macrophages, obtained from patients affected by breast cancer, differentiated in presence of serum from healthy donors. Moreover, LPS treatment of primed macrophages from patients, differentiated in autologous serum, did not influence the interferon production of these cells. Nevertheless, primed macrophages from healthy donors appeared to be more sensitive to LPS treatment in comparison with primed macrophages from patients affected by breast cancer.

Breast Neoplasms↗

Impairment of macrophage antiviral activity by soluble tumor products. Effects of bacterial immunomodulators.

The antiviral activities of normal rat peritoneal macrophages versus Herpes Simplex Virus type 1 were inhibited by sera from tumor-bearing rats and 3M KCl extracts of tumor mass. The inhibitory activity was demonstrated on the extrinsic as well as on the intrinsic macrophage functions. Sera from Corynebacterium parvum and Listeria monocytogenes treated tumor bearing rats did not inhibit these macrophages functions. Furthermore the 3 M KCl extracts from the tumor mass of the above treated TBR show a decrease in the capability to impair these macrophage functions. On the other hand, the treatment with the oral polyvalent adjuvant "Buccalin" was not able to restore the compromised antiviral activity in tumor bearing rats.

Adjuvants, Immunologic↗

[Evaluation of risk factors and blood coagulation parameters in cerebral ischemia].

Different parameters of coagulation and vascular risk factors have been studied in 24 subjects with previous strokes and in 21 control subjects matched by age. The two groups appeared statistically different for arterial pressure (max and min), glycemia, platelet aggregation ADP-induced and C1s-inactivator. Authors suggest to consider the changes of hemostasis as a vascular risk factor.

Aged↗

"In vitro" study on human mononuclear phagocytic cells behaviour versus DNA and RNA viruses.

It is generally accepted that mononuclear phagocytic cells are of crucial importance in defence against viral infections. Using a method of "in vitro" differentiation from human blood monocytes to macrophages, the interactions between human monocyte-macrophage with herpes simplex virus type 1 and 2, adenovirus type 17, coxsackie virus B type 4, poliovirus type 1 and ECHO virus type 2, are reported. In all viruses tested on monocytes, the infection of the cells was very poor according to the data of specific immunofluorescence and of the residual infectivity. In the macrophage stage all viruses tested were able to infect the cells.

DNA Viruses↗

Human mononuclear phagocytic cell interaction with some Paramyxoviridae.

In consideration of the peculiar relationship between Paramyxoviridae and immunocompetent system, we studied interactions of measles virus, Newcastle-disease virus and respiratory syncytial virus with human monocytes and macrophages differentiated "in vitro". Mononuclear cells were challenged with three different Paramyxovirus at different multiplicities of infection. Infected cells were then checked for expression of specific viral antigens by immunofluorescent test (FA). Moreover, we have evaluated the intrinsic antiviral activity and single cycle growth curves.

Cell Differentiation↗

Comparative study between fluticasone propionate and cetirizine in the treatment of allergic rhinitis.

Among the most frequently used drugs in the treatment of allergic rhinitis we have to mention topical nasal corticosteroids and H1 antihistamines used both systemically and topically. The present study focused the effectiveness and tolerability of cetirizine and fluticasone propionate in seasonal allergic rhinitis. 54 patients, divided into three homogeneous groups, underwent the following different treatments: Group 1: Placebo of fluticasone (2 puff per nostril once daily by aerosol) + cetirizine (10 mg/die per os) for 60 days. Group 2: Fluticasone (100 mg per nostril once daily by aerosol) + placebo of cetirizine (per os) for 60 days. Group 3: Cetirizine (10 mg/die per os) for 60 days + fluticasone (100 mg per nostril once daily by aerosol) for 20 days. The patients reported nasal symptoms (sneezing, obstruction, itching, rhinorrea) on a clinical diary. ECP levels in nasal secretions were investigated in all patients to determine the anti-inflammatory activity of both treatments. Cetirizine resulted very effective in the treatment of sneezing, itching and acqueous rhinorrea whereas not much effective on nasal obstruction. On the contrary, fluticasone, which acted effectively on nasal obstruction, resulted inefficacious on the other symptoms. The third group of patients achieved the best results on all four symptoms, including obstruction, which continued even after interrupting the treatment with fluticasone. The ECP levels were significantly reduced by both treatments. The side effects in all 3 groups were rare and not serious. From these results we can assert that the synergic action of the two drugs, achieves the best effectiveness, that the fluticasone treatment can be limited to 20 days cycles and finally that both molecules are well tolerated.

Adult↗