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G Cadario

Publications and source records attributed to G Cadario.

At least 19 recordsLinked to original sources
PubMed2006

Practice parameters for sublingual immunotherapy.

The efficacy and safety of sublingual immunotherapy (SLIT) are currently supported by clinical trials, meta-analysis and post-marketing surveys. Practice parameters for clinical use of SLIT are proposed here by a panel of Italian specialists, with reference to evidence based criteria. Indications to SLIT include allergic rhinoconjunctivitis, asthma, and isolated conjunctivitis (strength of recommendation: grade A). As to severity of the disease, SLIT is indicated in moderate/severe intermittent rhinitis, persistent rhinitis and mild to moderate asthma (grade D). SLIT may be safely prescribed also in children aged three to five years (grade B), and its use in subjects aged more than 60 years is not prevented when the indications and contraindication are ascertained (grade D). The choice of the allergen to be employed for SLIT should be made in accordance with the combination of clinical history and results of skin prick tests (grade D). Polysensitisation, i.e. the occurrence of multiple positive response does not exclude SLIT, which may be done with the clinically most important allergens (grade D). As to practical administration, co-seasonal, pre co-seasonal, and continuous schedules are available, being the latter recommended for perennial allergens or for pollens with particularly prolonged pollination, such as Parietaria (grade D). For pollens with relatively short pollination, such as grasses and trees (cypress, birch, alder, hazelnut, olive) the pre co-seasonal and perennial schedules are preferred (grade C). The build-up phases suggested by manufacturers can be safely used (grade A), but they can be modified according to the patient's tolerance (grade C). A duration of SLIT of 3-5 years is recommended to ensure a long-lasting clinical effect after the treatment has been terminated (grade C).

Administration, Sublingual↗
PubMed2005

Increased CD34+ cell peripheral traffic appears to be an unique feature of the allergic inflammation.

Evidence has been cumulated during the last years concerning the immaturity of the cells involved in the local and systemic aspects of allergic inflammation. Hematopoietic precursors (HPC) are mobilized from the bone matrix as multipotent cells or, more often, as progenitors that, after the initial white-lineage commitment reach through the peripheral blood (PB) their final destinations constituted by the target organs of allergy. Although several studies have investigated the CD34+ cells traffic and location at the level of the inflamed peripheral mucosae in allergic populations, limited information is available on their behaviour on the time-course of infectious diseases. The current study thus was designed to asses the peripheral traffic of CD34+ HPC during the infectious inflammation. To this end CD34+ HPCs have been enumerated, by flow-cytometric techniques, in PB of 24 adult healthy beings (Group A), 24 adult subjects with symptomatic extrinsic allergy (Group B) and in PB of 24 adult patients hospitalised for febrile infectious pathology (Group C). CD34+ cell values ranged 0.01-0.08% with a median of 0.03 in Group A. In Group B values ranged 0.17-0.75% with a median of 0.28 and in Group C values ranged 0.00-0.12% with a median of 0.07. Variance analysis test among the three groups was statistically significant (p<0.001) supporting the conclusion that CD34+ HPC mobilizing and increased peripheral traffic is an unique feature of the allergic inflammation.

Adult↗
PubMed2005

Methodology and potential pitfalls in allergic diseases study designs: measurements for the assessment of the overall severity of atopic dermatitis--the four step severity score (FSSS), SCORAD-related, electronic system, for the simple and rapid evaluation of the skin and mucosal allergic inflammation.

Medical statistics may contribute to ameliorate research by improving the design of studies and identifying the optimal method for the analysis of results. Sometimes, nevertheless, it could be misemployed flawing the benefit potential. Allergic diseases pathogenesis is recognized to be systemic but global initiatives such as GINA and ARIA documents define allergic asthma and rhinitis as organ diseases; such an asymmetrical view raises a set of known and unknown confounding that could influence the quality of the process of evidence-based decision-making (topic symptomatic therapeutic interventions versus systemic pathogenetic interventions). This article shows the first scoring system for the assessment of atopic dermatitis lesions developed in the allergy-area. A four-step severity score (FSSS) was chosen in agreement with those developed for asthma and rhinitis in global initiatives, to avoid any further differences in evaluating the severity of allergic diseases. FSSS relates each step with the objective signs of the SCORAD and rates the disease course as intermittent or persistent. A devoted electronic program has been also framed to allow a quick and simple contemporary evaluation of the SCORAD Index (Section I) and of the FSSS (Section II); the program furthermore foresees a third section named ESAS (Extra Skin Allergic Signs) (Section III) in which it is possible to check whether organs other than the skin are involved by the allergic inflammation. The limitations potential generated by a misemployment of medical statistics for clinical trials designed to establish benefits rising from specific immunotherapy for allergic diseases have been also discussed extensively.

Asthma↗
PubMed2004

Higher frequency of early local side effects with aqueous versus depot immunotherapy for hymenoptera venom allergy.

Venom immunotherapy has proven a very effective method for the treatment of allergy to Hymenoptera venom. Aqueous instead of depot extracts are prevalently used for this immunotherapy. The advantage of using aqueous extracts has not been fully investigated. We made an open, non-controlled study on 45 subjects sensitized to either Apis mellifera or Vespula spp. Patients were assigned to either a depot (N=27) or an aqueous (N=18) immunotherapy regimen, and side effects were monitored during the induction and the 3-year maintenance phase. The effect of naturally occurring stings during the treatment and after its interruption was recorded as well. Side effects were less frequent with the depot extract both on a "per patient" (22.2% versus 50.0%) and on a "per dose" (2.9% versus 10,2%) basis (p=0.026 and p<0.000, respectively). Better tolerance was mainly due to the lower frequency of local side effects occurring at early times after vaccination. The efficacy of vaccination was comparable in the 2 cohorts, as expected. We conclude that depot immunotherapy to Hymenoptera venom should be preferred to aqueous immunotherapy for the lower occurrence of local side effects. This might influence a better compliance with this potentially life-saving treatment.

Adolescent↗
PubMed2003

Lower intestinal bleeding due to aorto-enteric fistula.

The case is described of a man who complained of intermittent fever and fatigue. After three digestive endoscopies and computed tomography, a 99m technetium-HM-PAO-labelled white cell scan was usefully employed to establish diagnosis. Anaerobic aortic Graft infection and anaemia due to lower intermittent occult intestinal bleeding were found. The intestinal bleeding was caused by secondary aorto-jejunal fistula. This condition is rare, but should be suspected whenever a patient with aortic prosthesis presents with occult digestive bleeding and unexplained fever.

Aged↗
PubMed1992

[The use of thymopentin in preventing acute infectious relapses in elderly subjects with COPD].

In this study the authors considered the effectiveness of thymus hormone in the prevention of acute infections within a group of elderly subjects affected by COPD. Ten subjects were considered, nine males and one female in the age included between 65 and 89 years (medium age = 70.2 +/- 6.96 years), with clinical evaluation and altered functional respiratory tests (FEV1 < 70%). The patients were treated with timopentina 50 mg s c three times a week for a month. The following parameters were considered: leucocytes/mm3; lymphocytes/mm3 in standard conditions, in the first and in the second month after the therapy start, contagious episodes two months before and two months after the beginning of therapy. The Authors noticed a real reduction in the relapses of the infectious episodes (11 relapses in the months before therapy and 2 relapses after therapy had begun). Leucocytes/mm3 rates were reduced (8.070 +/- 3.414 in standard conditions, 6.420 +/- 1.041 after 60 days; 0.2 < P < 0.1). Lymphocytes/mm3 rates were increased, 1.579 +/- 752 in standard conditions, 2103 +/- 491 after 60 days 0.2 < P < 0.1). These preliminary data seem to show in the small number of cases considered, the effectiveness of the thymus hormone (thymopentina) in elderly subjects affected by COPD.

Acute Disease↗
PubMed1989

[Use of house dust extracts in allergological diagnosis and therapy].

In this study (1980-1987) the Authors considered the incidence of sensitization to house dust in patients with respiratory allergic disease. The Authors identified 399 subjects with sensitization to house dust out of 1825 subjects sensitized to at least one of the tested allergens (21.9%). The number of patients exclusively sensitized to house dust resulted very small (13 patients, 0.7%). Most frequently the Authors identified sensitization to house dust and mites (324 patients, 81.2%). Bronchial asthma resulted in 156 patients (39.1%). These results are similar to those recognized in subjects with mites sensitization. The conclusion is drawn that, at the moment, mites are the only house dust allergens with clinical importance.

Adolescent↗
PubMed1987

[Housedust mites: their importance in the pathogenesis of respiratory allergic diseases in Piedmont].

In this study we have considered the importance of house dust mites (Dermatophagoides farinae and pteronyssinus) in the pathogenesis of respiratory allergic diseases in Piedmont. We have identified, from 1980 to 1986, 1530 subjects with sensitization to at least one of the tested allergens; 479 of these (31.3%) were allergic to both or to one of the tested mites. Particularly 97 subjects (6.3%) were sensitized to Dermatophagoides farinae, 73 (4.8%) to Dermatophagoides pteronyssinus and 309 (20.2%) to both of them. This group included 258 males (53.9%) and 221 females (46.1%). Most of the examined subjects had shown the clinical symptoms before the 35th year of age (366 subjects, 76.4%). The mean age of beginning of clinical picture has come out to be of 27.377 +/- 11.527 SD year old. This result shows no significant differences with the mean age come out in allergic subjects to other allergens (26.939 +/- 10.755 SD); 196 subjects (40.9%) presented rhinitis-conjunctivitis, while 102 subjects presented bronchial asthma-rhinitis-conjunctivitis. We have found that bronchial asthma (alone or with other symptoms) was present in 186 subjects (38.8%), while in the allergic subjects sensitized to other allergens was present only in 299 out of 1051 (28.4%); 277 subjects had continuous symptoms (57.8%) while 202 subjects (42.2%) had symptoms only in some periods of the year.

Adolescent↗
PubMed1987

Plasma exchange in the treatment of nonadvanced stages of progressive systemic sclerosis.

Ten patients suffering from progressive systemic sclerosis, who responded poorly to conventional therapy, underwent plasma exchange (PE) therapy in conjunction with drug therapy. The frequency of PE was twice weekly for 4-6 weeks, two or three times per year, with a summer interruption, when in our own experience a spontaneous relief of symptoms occurs. To judge the efficacy of our therapeutic device, we assessed several laboratory and clinical parameters before and after therapy. The changes in circulating immune complexes, in IgG and IgA, and in some functional indices were significant (P less than 0.001). Eight of 10 patients improved satisfactorily. The remaining two did not improve sufficiently to continue the apheretic treatment. In conclusion, our study suggests that the PE, together with conventional therapy, can be an effective therapeutic device in the treatment of progressive systemic sclerosis.

Antigen-Antibody Complex↗
PubMed1986

[Statistical study of 428 Piedmont residents suffering from bronchial asthma of allergic etiology].

This 6-year (1979-1984) study was conducted on subjects with allergic bronchial asthma diagnosed by scarification skin tests. The skin tests identified 428 subjects with bronchial asthmatic symptoms including 228 females and 220 males (females/males = 1.04). In the 6-15 age range there was a clear predominance of males over females (42 against 24 or males/females = 1.75). At the time of testing, 309 subjects (72.2%) were in the 6-35 age range. In terms of symptoms, 61 subjects (14.2%) presented bronchial asthma alone. The most common combination of symptoms encountered was asthma-rhinitis-conjunctivitis found in 317 subjects (74.1%). Symptoms were seasonal in 305 patients (71.3%) while 123 (28.7%) presented asthmatic symptoms throughout the year. 382 patients (89.25%) presented pollen allergy with grass pollen accounting for the highest percentage (328 subjects or 76.6%). 46 subjects (10.7%) were allergic to tree pollen and 103 (24.1%) to flower pollen. 197 patients (46%) were allergic to permanent inhalants (domestic inhalants, epithelia, mycophytes) with Dermatophagoides Farineae accounting for the largest number (33.4%). 55 subjects (12.9%) were sensitive to at least one of the epithelia tested while mycophyte sensitivity was negligible (10 subjects or 2.3%).

Adolescent↗
PubMed1986

[Statistical study done in Piedmont on 1100 cases of rhinitis caused by hypersensitivity to inhaled allergens].

In this study conducted from 1979 to 1984 we have examined 2315 subjects with rhinitis. All the subjects lived in Piedmont. The skin tests identified 1100 subjects (47.5%) allergic to at least one of the tested allergens. This group included 575 (52.3%) males and 525 (47.7%) females (males/females = 1.1). In the 6-15 age range we have found a clear predominance of males over females (112 against 57 or males/females = 2). At the time of testing, 854 patients (77.7%) were in the 6-35 age range. Only 75 subjects (6.8%) had rhinitis alone; the most common combination of symptoms encountered was rhinitis-conjunctivitis, found in 580 patients (52.7%). Symptoms were seasonal in 909 subjects (82.6%), while 191 (17.4%) were symptomatic throughout the year. Among the subjects with pollen allergy, the grass pollen accounted for the highest percentage (883 subjects or 80.3%). Among the subjects allergic to permanent inhalants Dermatophagoides Farinae (252 subjects or 22.9%) and Dermatophagoides Pteronyssinus (240 subjects or 21.8%) accounted for the largest number. Mycophyte sensitivity was negligible (36 subjects or 3.3%). In the end we have seen that grass pollen and Dermatophagoides sensitivity prefer males, while Parietaria sensitivity prefers females.

Adolescent↗
PubMed1984

[Behçet's disease. II. Etiopathogenetic and therapeutic aspects. Personal observations].

The aetiopathogenesis of Behcet's disease is still not known. In the light of current knowledge, the most likely hypothesis seems to be that of an autoimmune reaction set off by viral, bacterial or other antigens. The reaction may manifest itself in the vascular system, and cause vasculitic conditions in genetically susceptible subjects. The existence of a constitutional susceptibility factor would seem to be confirmed by the high and significant incidence of determinant histocompatibility antigens: HLA-B5 in Japan and in Mediterranean countries, HLA-A2 and HLA-A28 in Great Britain and the United States. Corticosteroids are most commonly used to treat the disease; immunosuppressants are also recommended--possibly in association with corticosteroids. Three personally observed cases of Behcet's disease are reported. The first was an example of the disease in its complete form (oral and genital aphthae, ocular lesions); the second case incomplete (no genital aphthae); and the third characterised by severe neurological involvement (neuro-Behcet).

Adult↗
PubMed1984

[Behçet's disease. I. Clinical and histopathological aspects].

Behçet disease is characterised by a triple symptom picture (genital and oral aphthae, ocular lesions) named after the Turkish dermatologist, Hulusi Behçet. It is found all over the world, but is particularly frequent in Japan and the Mediterranean basin. Adult males are primarily affected. The classic symptomatological triad may be accompanied by other manifestations involving the skin (hypersensitivity to microtrauma is a peculiar feature), joints, nervous system, gastroenteric system, cardiovascular system (phlebitis, phlebothrombosis), lungs and kidneys. There is a chronic course marked by periods of exacerbation and remission, which may last for years. Diagnosis is clinical only, since neither the laboratory data nor the histopathological signs of vasculitis are truly pathognomonic. The prognosis quoad valetudinem is uncertain with regard to the eye lesions, which may result in blindness. The prognosis quoad vitam is usually good, though it is poor if the nervous system is involved, or in the event of lung and large vessel lesions, since death may occur from haemoptysis or the rupture of aneurysms.

Behcet Syndrome↗
PubMedDate not supplied

Cryodependent and cryoproducing involvement of organs in type II essential mixed cryoglobulinemia.

A review of the less frequent organ damage seen in the so-called essential mixed cryoglobulinemia, and distinguishing between cryodependent and cryofavouring organ involvement, is presented in this paper. In the first group, along with the well-known renal, cutaneous and articular lesions, the peripheral neuropathy and respiratory involvement, to date too little considered, are worthy of more accurate study. Gastroenteric and cardiac participations are rare. Among the cryofavouring manifestations of the disease, we have pointed out those affecting the liver. In our experience, however, as the immunohistochemical findings suggest, the histological patterns usually considered to be chronic persistent hepatitis are frequently an expression of a lymphoproliferative lymphoma-like process. A noteworthy percentage of lymphoid cells in the bone marrow has been found in 22 type II cryoglobulinemias after either needle puncture or osteomedullary biopsy. The histological pictures often resemble a lymphoproliferative disease. Clinical and laboratory (computerized tomographic scan) researches frequently show a moderate splenomegaly, but in none of the patients was superficial or deep lymph node enlargement found. The authors conclude by considering type II essential cryoimmunoglobulin to be a sign and a marker of a low-grade proliferative disease with rare evolution into overt lymphoma. At the same time, however, cryoimmunoglobulins themselves cause important injuries that affect the prognosis of the syndrome.

Bone Marrow↗
PubMedDate not supplied

Mite antigens enhance ICAM-1 and induce VCAM-1 expression on human umbilical vein endothelium.

Although sublingual allergen-specific immunotherapy has been proved to be effective in the treatment of allergic diseases, controversy surrounds the means by which such a local therapy can induce systemic immunological changes. Adhesion molecules are critical in the regulation of leukocyte traffic. It has been hypothesized that allergenic extract, administered locally, may induce an up-regulation of the mucosal vessel vascular adhesion molecules (CAMs) resulting in local recruitment of circulating inflammatory cells. In the present study we investigated whether the mite antigens, Der p1 and Der p2, can modulate CAM expression of human endothelial cells (HEC). To do this, slices of whole human umbilical cord vein underwent short-term (8 hours) cultures in the presence or absence of mite antigen (baseline, unstimulated controls). Cryostatic sections of the specimens were then evaluated immunohistochemically for expression of intercellular adhesion molecule (ICAM-1) and vascular cell adhesion molecule (VCAM-1) molecules. The results revealed that while Der p1 is capable of significantly up-regulating ICAM-1 and VCAM-1 on HEC, Der p2 antigen moderately up-regulates ICAM-1 expression but is ineffective in modulating VCAM-1. Although preliminary, these results clearly support the hypothesis that at least some of the effects of sublingual immunotherapy may derive from inflammatory cell recruitment at the site of allergen release.

Administration, Sublingual↗
PubMedDate not supplied

Expression of T-lineage early developmental markers by cells establishing atopic dermatitis skin infiltrates.

The association between the atopic dermatitis, eczema and T-cell immunodeficiency disorders are well known, thus suggesting that bone marrow T-precursors could use the micro-environment of the skin as an extrathymic site for compensatory ontogenesis. In keeping with this hypothesis, we analyzed the atopic dermatitis skin lymphocytic infiltrate phenotypes to establish their ontogenetic stage of development. Cryostatic sections (4 microns) obtained from acute lesional skin biopsies of six patients with extrinsic atopic dermatitis were processed with indirect immunoperoxidase, using a panel of first-step monoclonal antibodies (mAb) specific to CD104 (integrin beta 4 chain), CD90w (Thy 1 antigen), CD44 (phagocytic glycoprotein-1; Pgp-1), CD1a and the DNA polymerase terminal deoxynucleotidyl transferase (TdT). Within the lymphocytic dermal infiltrate different levels of immunoreactivity were observed with respect to CD104, CD90w and CD1a. A strong, spread staining was also detected for mAb specific to Pgp-1 and TdT. Together, the reported features indicate that the atopic dermatitis skin-homing lymphocytes express immunophenotypes which are distinctive of the early T-ontogeny.

Adult↗