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E A Pastorello

Publications and source records attributed to E A Pastorello.

At least 55 records · Page 3Linked to original sources
PubMed1994

Comparison of rhinomanometry, symptom score, and inflammatory cell counts in assessing the nasal late-phase reaction to allergen challenge.

Inspiratory nasal resistance, symptom score, and influx of inflammatory cells into the nose were evaluated before and after a nasal challenge in 15 patients with grass pollen rhinitis and in six nonallergic control subjects, to study the nasal late-phase reaction and its relationship with nasal cytology. All patients had an immediate positive reaction to specific nasal challenge. In seven allergic subjects we observed a later inspiratory nasal resistance increase, but only two had a significant late symptom score. Inflammatory cells increased by 8 hours in all the patients; the higher the cell influx, the higher the symptom score. Close correlations were found between the inspiratory nasal resistance increase, nasal obstruction at hours 8 and 24, and all cell counts. In control challenges there were no significant increases of symptom score or inspiratory nasal resistance either during the challenge or in the next 24 hours. A weakly significant increase was found only for neutrophil counts at 8 hours. These results indicate that an inflammatory reaction constantly occurs after a specific nasal challenge; its extent is closely related to inspiratory nasal resistance and to the intensity of nasal obstruction. Moreover, our data outline the pivotal role played by eosinophils and basophils in the genesis of an allergic late-phase reaction in the nose.

Adolescent↗
PubMed1994

A double-blind, placebo-controlled study of immunotherapy with an alginate-conjugated extract of Parietaria judaica in patients with Parietaria hay fever.

A double-blind, placebo-controlled study was conducted to evaluate the efficacy and safety of immunotherapy (IT) with a partially purified alginate-conjugated extract of Parietaria judaica (Conjuvac Parietaria, Dome/Hollister-Stier) in patients suffering from rhinoconjunctivitis caused by Parietaria pollen. Eighteen patients (10 women, 8 men, mean age 35 years) received active treatment and 17 (10 women, 7 men, mean age 42.5 years) received placebo. Actively treated patients had significantly lower nasal symptom/medication scores (running nose P = 0.0087 and sneezing P = 0.048) during the Parietaria pollen season. Significant decreases in specific skin (P < 0.01), nasal (P < 0.05), and conjunctival (P < 0.01) reactivity to the Parietaria extract and significant increases of specific IgG (P < 0.001), IgG1 (P < 0.001), and IgG4 (P < 0.001) in actively treated patients, but not in placebo, were found. IT was well tolerated, the active extract inducing five mild systemic reactions (four rhinitis and one urticaria) and placebo two (rhinitis). A significant correlation was found between low skin reactivity and high specific IgG (P = 0.0002) and IgG4 (P = 0.036). These findings indicate that IT with a partially purified P. judaica extract is an effective and safe treatment for Parietaria pollen allergy. The correlation between low immediate skin reactivity and high specific IgG and IgG4 suggests that, at least in the studied cutaneous model, these antibodies may exert a blocking effect.

Adjuvants, Immunologic↗
PubMed1993

IgE-mediated allergy from vegetable allergens.

Allergy to fresh fruits and vegetables is IgE-mediated. Its main clinical features are local, such as oral pruritus and swelling of lips and tongue but systemic symptoms such as urticaria, asthma, or anaphylactic shock may occur. Clinical associations with allergic rhinitis due to cross-reactive antigens of pollens and foods are frequent.

Adolescent↗
PubMed1992

Clinical evaluation of CAP System and RAST in the measurement of specific IgE.

We investigated the diagnostic value of a new in vitro test, Pharmacia CAP System (Pharmacia Diagnostics AB, Uppsala, Sweden), for the quantitative measurement of allergen-specific IgE antibodies by comparison with RAST in 2 groups of patients, 71 atopic and 48 non-atopic. In the last 20 years RAST has supplied a good diagnostic tool, but this test presents some problems, the main one being sensitivity. The new test has a solid phase able to bind even very small amounts of specific IgE and an anti-IgE tracer with very low cross-reactivity with other immunoglobulins, thus presenting more favourable conditions. From the analysis of our results, Pharmacia CAP System gave higher sensitivity (94% compared to 88% of RAST) with no loss of specificity (96% for both tests). The reliability of these results is ensured by the proper selection of patients who were all suffering from pollinosis and were clinically diagnosed as certainly hypersensitive to a single pollen. A positive trend was found between severity of asthma and levels of specific IgE for timothy. Pharmacia CAP System appears to identify a larger number of atopic patients than RAST.

Adolescent↗
PubMed1992

Clinical and immunological effects of immunotherapy with alum-absorbed grass allergoid in grass-pollen-induced hay fever.

A double-blind, placebo-controlled study of immunotherapy was conducted in 19 patients with grass-pollen hay fever to evaluate the efficacy and safety of a formalinized depot grass allergoid. The patients were assessed before and during IT by clinical (symptom-medication scores during the grass- pollen season, specific nasal and skin reactivity) and immunological (specific IgE, IgG, IgG1 and IgG4 antibodies) parameters. High doses of grass allergoid, corresponding to a cumulative pre-seasonal dosage of 46,050 PNU, were administered, with only one systemic reaction. The actively treated patients had significantly lower symptom-medication scores than placebo (p less than 0.01) during the month of May and showed a significant decrease in specific skin (p less than 0.01) and nasal (p less than 0.05) reactivity, and a significant early increase in specific IgE (p less than 0.01), IgG (p less than 0.0005), IgG1 (p less than 0.001) and IgG4 (p less than 0.05), with a subsequent decrease of IgE and IgG1. No differences were detected in any of these parameters in the placebo group. A correlation was found between high IgG4/IgG1 ratio and the specific skin reactivity decrease (r = 0.691, p less than 0.05), whereas a high IgG4/IgG1 ratio was associated with higher symptom-medication scores (r = 0.654, p less than 0.05). Possible explanations of these apparent discrepancies are proposed.

Adolescent↗
PubMed1990

A double-blind study of hyposensitization with an alginate-conjugated extract of Dermatophagoides pteronyssinus (Conjuvac) in patients with perennial rhinitis. II. Immunological aspects.

In a 2-year double-blind placebo controlled study an immunological evaluation was carried out on 33 patients (15 males, 18 females, mean age 29.2 years) with mite-induced perennial rhinitis who were submitted to specific immunotherapy (IT) with an alginate-conjugated extract of D. pteronyssinus. The behaviour of IgE, IgG, IgG1 and IgG4 antibodies specific to D. pteronyssinus and its major allergen Der p1 was characterized by assessment of their changes in serum, and changes in IgG in nasal secretions during the treatment. The placebo-treated patients did not show any significant variation in the levels of specific antibodies, while in the actively treated patients we found: a statistically significant decrease (P less than 0.005) of specific IgE, a statistically significant increase of specific IgG (P less than 0.005), IgG1 (P less than 0.005) and IgG4 (P less than 0.005) in serum and a statistically significant increase (P less than 0.001) of specific IgG in nasal secretions. The IgG response showed an early relative predominance of the IgG1 subclass and a late absolute predominance of IgG4 subclass, that confirmed the model of IgG4 restriction in prolonged allergen stimulation. No correlation was found between immunological and clinical data.

Adjuvants, Immunologic↗
PubMed1989

Comparison of results of skin prick tests (with fresh foods and commercial food extracts) and RAST in 100 patients with oral allergy syndrome.

One hundred adult patients with a history of oral allergy syndrome (OAS) after ingestion of fruits and vegetables, 77 patients with hay fever and 13 with skin prick tests and RAST positive to pollens but without seasonal symptoms, and 32 normal nonallergic control subjects, had Phadebas RAST and skin prick tests with commercial extracts (CSPT) and with fresh foods (FFSPT) to assess the reliability of these three tests. Sensitivity was better with FFSPT for carrot, celery, cherry, apple, tomato, orange, and peach; better with CSPT for peanut, pea, and walnut; and better with RAST for hazelnut. Specificity, negative predictive value, and positive predictive value of the three tests were determined for apple, carrot, hazelnut, orange, pea, peanut, and tomato. Specificity in the patient groups ranged between 40% (pea) and 100% (apple) for CSPT, between 61% (peanut) and 87% (carrot) for RAST, and between 42% (carrot) and 93% (peanut) for FFSPT. However, all tests were negative in the control group. Thus, false positive results may result from cross-reactivity with pollen allergens. The diagnostic accuracy of these tests in the population with OAS proved comparable for peanut, carrot, hazelnut, and pea. FFSPT proved more sensitive than CSPT or RAST in confirming a history of OAS to certain alimentary allergens, such as apple, orange, tomato, carrot, cherry, celery, and peach.

Adolescent↗
PubMed1989

Role of the elimination diet in adults with food allergy.

The aim of the study was to check whether, after a period of complete exclusion of the offending foods in adult subjects suffering from food allergy, these foods could subsequently be safely reintroduced into the diet. Patients with chronic urticaria and/or perennial rhinitis negative for secondary pathology or other allergies were subjected to a strict diagnostic protocol for food allergy. Briefly, out of a case list of 207 patients, we found 23 patients whose symptoms were clearly related, on open reintroduction, to at least one food. The really offending foods in these patients were subsequently identified by double-blind, placebo-controlled food challenges. Only 10 of the 23 patients had positive challenges for 13 foods. Double-blind challenges were repeated after 1 year or more of avoidance of the offending foods to evaluate the persistence or disappearance of sensitivity. We found that five (38%) of the 13 previously offending foods were well tolerated. Thus, in adults, as previously proved in children, dietary avoidance of the offending foods appears to be an effective measure for dealing with food allergy. The kind of foods involved and the completeness of their avoidance appeared to be important factors favoring the reestablishment of tolerance in adults.

Adolescent↗
PubMed1989

[Allergy to Hymenoptera venom in children. Diagnosis and therapy].

We studied 52 children, 3 to 15 years of age, suffering from allergic reactions following Hymenoptera stings. The diagnosis of allergy was based on history, results of skin tests and RAST performed by purified venoms of Apis mellifera, Vespula species and Polistes species. The history of children with multiple stings of the same insect showed an essential favourable prognosis, thus suggesting to submit to specific immunotherapy only children with severe reactions. For these patients it is necessary to perform therapy only in specialized Centres, because of the high frequency of adverse reactions which we observed in 33% of our treated patients.

Adolescent↗
PubMed1988

Food allergies.

Explore the source record for details and available documents.

Food Hypersensitivity↗
PubMed1988

Clinical reliability of diagnostic tests in allergic rhinoconjunctivitis.

To determine the diagnostic value and precision of the quantitative skin test (QST), RAST, specific nasal (NPT) and conjunctival (CPT) provocation tests, we studied 91 patients, suffering from allergic rhinoconjunctivitis with positive skin prick tests (SPT) to common allergens, among whom sixty-nine of them had symptoms related to the positive SPT, and 22 had no clinical correspondence. In these two groups, by comparing the threshold of positivity, we investigated whether there was any parallelism between responses to the tests considered. We also compared the level of specific IgE (RAST) to the wheal-areas evoked by preliminary SPT for the corresponding allergen in order to detect any quantitative relationship between these investigations. Increasing concentrations of standardized allergen extracts (from 10 to 100,000 BU/ml) were used in all in vivo tests. NPT was evaluated on the basis of multiple recordings of nasal resistances by anterior passive rhinomanometry. QST proved to correlate well with RAST and its easier method ensures it a major role in assessing the levels of allergic sensitization. SPT wheal-areas and RAST vales correlated well only for grass and birch, presumably because of better standardization of these allergen extracts. When provocation tests, especially NPT, were positive, patients were almost always symptomatic for the allergen tested (high positive predictive value). Likewise, 21 out of the 22 asymptomatic subjects had negative NPT (high specificity). These results suggested the utility of standardized provocation tests in order to restrict diagnosis to the truly causative allergens in patients with multiple positive SPT results.

Adolescent↗
PubMed1988

[Epidemiological and clinical study on bee venom allergy among beekeepers].

A randomized population of 222 beekeepers from Lombardy (203 males, 19 females, of mean age 42.5 years) was studied to determine the frequency of allergic reactions to bee sting. The type of reactions, the clinical evolution at the subsequent stings and the risk factors concerning the development of allergy (presence of venom specific IgE, number of stings in a year, atopy, age) were evaluated. It was found that 170 beekeepers never presented reactions to stings while 52 (23.4%) showed allergic reactions consisting in 31 large local reactions and 21 systemic reactions; of these, 3 (5.7%) were life-threatening. In the group of beekeepers with allergic reactions at the subsequent stings, 26 (50%) showed a spontaneous loss of reactivity, 16 (30.8%) presented persistent, but unchanged in severity, reactions and 10 (19.2%) had a worsening of symptoms. Specific honey bee venom IgE levels (measured by means of RAST) were significantly lower in immune beekeepers when compared with the group with allergic reactions (p less than 0.01) and in beekeepers with previous allergy when compared to the ones with persistent reactions (p less than 0.05). We also found significant differences about the number of stings received in a year by beekeepers with persistent allergic reactions (17.5 stings), beekeepers with previous allergy (89.8 stings) and immune subjects (126.9 stings). On the contrary, no significant differences were detected about the age and the presence of atopy. These results suggest that practice of bee-keeping induces a relatively high incidence of allergic reactions but with a trend to the spontaneous improvement of symptoms and a low incidence of severe reactions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1987

IgE-mediated food allergy.

The behaviour of some immunologic parameters was studied in order to explain the presence or the lack of symptomatology in subjects with IgE specific to foods. In particular, we compared the levels of serum and salivary IgA and IgE antibody specific to apple in 33 patients allergic to birch and with anti-apple IgE, of whom 24 had oral allergy syndrome after eating apple and nine were apple tolerants. We found no differences in the IgE-related parameters such as levels of anti-apple IgE antibody in serum and secretions, mean size of apple skin prick test, and number of patients with a positive histamine release from peripheral basophils stimulated by apple. Similarly, we detected no statistically significant differences in serum and salivary total IgG and total anti-apple IgA antibody of the two groups. We could, however, observe a significantly higher anti-apple salivary IgA/anti-apple serum IgE and anti-apple salivary IgA/anti-apple serum IgA ratios and a significant correlation between the same parameters in tolerant patients when compared with the intolerants. These results seem to suggest that the presence of appropriate levels of secretory anti-apple IgA associated to anti-apple IgE might be one of the factors playing a key role in the prevention of clinical symptoms in atopic subjects.

Food Hypersensitivity↗
PubMed1987

Antihistaminic treatment of allergic rhinitis: a double-blind study with terfenadine versus dexchlorpheniramine.

A double-blind study was carried out in 65 patients with seasonal rhinitis to compare the effectiveness and tolerance of terfenadine and dexchlorpheniramine. Patients were allocated at random to receive treatment for 1 week with either 60 mg terfenadine twice daily or 2 mg dexchlorpheniramine maleate 3-times daily. Before and after treatment, patients underwent RAST and skin prick tests for reactivity to pollen and those who were positive also had rhinomanometric measurements made of nasal resistance. Diary cards were used by patients to record the severity of nasal obstruction, rhinorrhoea, sneezing, watery, irritated and red eyes, itching of the nose, throat and eyes, and cough. Details were also kept of the frequency and severity of any side-effects. Pollen counts were taken daily during the treatment period. The results showed that both terfenadine and dexchlorpheniramine produced good or excellent relief of the main symptoms in 78% and 73% of the patients, respectively. There was no significant correlation between the pollen count and reduced symptom severity. Both drugs produced a reduction in total nasal resistance but this was not significantly different from initial values, neither was there a significant difference between treatment. Terfenadine was well tolerated and side-effects incidence was significantly lower (p less than 0.01) than in patients treated with dexchlorpheniramine, particularly so with reference to drowsiness.

Adolescent↗
PubMed1987

The role of suggestion in asthma. I. Effects of inactive solution on bronchial reactivity under bronchoconstrictor or bronchodilator suggestion.

Twenty-eight subjects affected by perennial asthma were selected in order to investigate the possibility of inducing or relieving an asthmatic attack by means of suggestion. Twenty-five were positive to methacholine challenge test and, among them, eleven reacted to an ultrasonic nebulized distilled water test. The effect of suggestion on airway response was assessed by eight inhalations of normal saline at 32 degrees C alternately presented as a bronchoconstrictor or as a bronchodilator drug. Eight inhalations of the same diluent without any psychic stimulus were used as control test. Seven patients reacted with bronchoconstriction to both positive and negative suggestion and to control test. Further, this group of patients showed a lower methacholine PD20 when compared with the other subjects. In this study, the effects of suggestion on bronchial reactivity were not observed and bronchoconstriction belonged to an individual hyperreactivity of the airways.

Administration, Inhalation↗
PubMed1987

The role of suggestion in asthma. II. Effects of a bronchoconstrictor drug on bronchial reactivity under bronchoconstrictor or bronchodilator suggestion.

Previous studies have shown that suggestion may modify bronchial reactivity to both inactive diluents and pharmacologically bronchoconstrictor or dilator substances. In our study, 14 patients were subjected to two methacholine challenge tests presented, respectively, as a bronchoconstrictor or as a bronchodilator drug. Forced expiratory volumes in one second were recorded and a PD20 was determined. No significant differences were reported in PD20 values of each patient after the two kinds of suggestion.

Adolescent↗