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Biomedical subjects

G Cavagni

Publications and source records attributed to G Cavagni.

At least 37 records · Page 2Linked to original sources

Use of immunoblotting and monoclonal antibodies to evaluate the residual antigenic activity of milk protein hydrolysed formulae.

BACKGROUND: Partial and extensive hydrolysed protein formulae have been developed to lower or eliminate the antigenicity of milk proteins. Although normally well tolerated, extensive hydrolysates have been reported to induce serious allergic reactions in very sensitive children. Moreover, clinical practice has often raised concern about the role of partial hydrolysates in cow's milk allergy prevention. OBJECTIVE: Starting from these considerations, we used anti-casein monoclonal antibodies to evaluate the presence of residual antigenic activity in both partially and extensively protein hydrolysates. METHODS: Electrophoretic analyses associated with immunoblotting technique were performed using nine protein-enriched commercial formulae. RESULTS: The presence of different amounts of residual intact cow's milk proteins and/or polypeptidic material with conserved antigenic activity (according to the extensive or partial hydrolysis) was verified in most milk-based samples considered. CONCLUSION: The use of monoclonal antibodies and immunoblotting could be useful for the quality of commercial 'hypoallergenic' formulae.

Antibodies, Monoclonal↗

Relationship between oral challenges with previously uningested egg and egg-specific IgE antibodies and skin prick tests in infants with food allergy.

BACKGROUND: Positive skin prick test (SPT) and RAST reactions to egg that had never previously been ingested have been observed in infants with food allergy. The likelihood of having clinical hypersensitivity reactions when egg is first ingested and the predictive value of SPT and RAST remain to be elucidated. OBJECTIVE: We investigated the relationship between egg-specific IgE antibodies and positive SPT reaction to egg, and the development of clinical hypersensitivity on the first exposure, in infants with food allergy. METHODS: The patient group consisted of 21 infants with food allergy and positive SPT and/or RAST reaction to egg, which they had never previously ingested; the control group of 12 infants had food allergy and negative test results. All subjects underwent double-blind placebo-controlled food challenges with egg. RESULTS: Thirteen of 21 patients (61%) and one of 12 control subjects (8%) had positive reactions to challenges (p < 0.01). Thirteen positive reactions to challenges (93%) elicited immediate symptoms. Late-onset eczema occurred in two children. SPT results showed a high sensitivity (0.92) and negative predictive accuracy (0.92), whereas specificity (0.57) and positive predictive accuracy (0.61) were poor. RAST did not have any diagnostic advantage over SPT. CONCLUSIONS: In infants with food allergy SPT with egg may be helpful in predicting which patients will react to the first exposure.

Child, Preschool↗

X-linked thrombocytopenia and Wiskott-Aldrich syndrome are allelic diseases with mutations in the WASP gene.

X-linked thrombocytopenia (XLT) is a rare recessive hereditary disorder characterized by isolated thrombocytopenia with small-sized platelets. The XLT locus has been located to chromosome Xp11 by linkage analysis, which is also where the recently cloned Wiskott-Aldrich syndrome (WAS) gene, maps. The relationship between XLT and WAS has long been debated; they might be due to different mutations of the same gene or to mutations in different genes. We now show that mutations in the WAS gene, different from those found in WAS patients, are present in three unrelated male patients with isolated thrombocytopenia and small-sized platelets. Our results demonstrate that XLT and WAS are allelic forms of the same disease, but the causes of the differences need to be further investigated.

Alleles↗

Elimination diet and intestinal permeability in atopic eczema: a preliminary study.

We measured small intestinal permeability to lactulose and rhamnose in 18 healthy children and in 15 children with atopic eczema, before and after a 14-day elimination diet. The children with atopic eczema had higher initial urinary lactulose/rhamnose ratios than the controls. After dietary restriction, there was no overall change in permeability. Dietary therapy did however result in a large reduction in permeability in three of the nine children whose skin disease was improved, but a statistically significant decrease in permeability was not observed in the diet-responsive group as a whole. Larger studies would be required to confirm that dietary restrictions can reduce intestinal permeability in some children with atopic eczema.

Adolescent↗

Double blind, placebo controlled study of nedocromil sodium in asthma.

After a two week baseline, 209 asthmatic children (mean age 10 years, range 6-17) were randomly allocated to receive 4 mg nedocromil sodium (n = 110) or placebo (n = 99) four times daily for 12 weeks in addition to their current treatment. The children completed daily diary cards and visited the clinic at four week intervals. Statistically significant differences in favour of nedocromil sodium were seen for clinician assessment of asthma severity and diary card symptom scores, pulmonary function and inhaled beta 2 bronchodilator use. Total symptom score decreased by 50% from baseline in the nedocromil sodium group and by 9% in the placebo group during the final four weeks. Nedocromil sodium was considered very or moderately effective by 78% of children/parents (placebo 59%) and 73% of clinicians (placebo 50%). Nausea, headache and sleepiness, and dyspnoea led to withdrawal of one child from nedocromil sodium and placebo treatments, respectively. Reports of sore throat and headache were marginally greater with the nedocromil sodium treatment. It is concluded that nedocromil sodium was both effective and safe in the treatment of asthma in children.

Adolescent↗

[The use of thymopentin in the prevention of recurrent infections of the respiratory system. Multicenter study].

Eighty children, between 1-12 years, suffering from recurrent respiratory infections were admitted to a multicentre study and treated with thymopentin, an immunomodulating compound that represents the active site of the natural thymic hormone thymopoietin. Thymopentin efficacy, measured as reduction in the number of infective episodes, and tolerability were assessed and, at the end of the study a global evaluation was made by each investigator. Moreover, the following factors were recorded: clinical course, duration of symptoms/signs, frequency of administration of antipyretic, antibiotic, anti-inflammatory and mucolytic therapy, school attendance and hospitalization. Thymopentin treatment resulted in a statistically significant decrease of infective recurrences. The use of symptomatic and antibiotic drugs was also reduced. Side effects were few and mild. The investigators' overall evaluation of thymopentin's efficacy and tolerability was favourable. In conclusion, thymopentin, administered subcutaneous for 5 weeks in winter, may be useful in the treatment of children with recurrent infections of the respiratory tract.

Child↗

Pharmacokinetics of two oral liquid formulations of oxatomide in children.

A study on the pharmacokinetics of two suspensions of oxatomide at the concentrations of 25 and 2.5 mg/ml was carried out on 12 children (7M, 5F) with a mean age of 9 years and weight of 29 kg. The plasmatic concentration peak, the time to reach the peak and the area under the curve displayed no significant differences between the two formulations. The maximum concentrations and the peak time of oxatomide in children are similar to those observed in adults.

Administration, Oral↗

Screening for delayed-hypersensitivity in Italian children: multicentric study by multitest skin testing.

The Multitest skin test allows the simultaneous intradermal application of seven standardized recall antigens in a reproducible manner. Response reading is based on a scoring system that distinguishes between normal and diminished delayed hypersensitivity (DH). To determine incidence and size of DH responses for each antigen in relation to age and sex in healthy Italian children, a multicentric study was performed on a representative paediatric population of 491 subjects (285 males and 296 females) aged from 4 months to 16 years. In both sexes DH reactivity as measured by score and number of positive responses increased significantly with age. The incidence of anergy was 8.8% for the whole population and decreased significantly with age in both sexes. Incidence of positive responses was highest for tetanus and diphteria toxoids, intermediate for Candida, Proteus and Streptococcus, and lowest for tuberculin and Trichophyton antigens. There was no significant difference between sexes in the incidence of positive response to each antigen.

Adolescent↗

"Food allergy in children: an attempt to improve the effects of the elimination diet with an immunomodulating agent (thymomodulin). A double-blind clinical trial".

During 90 days of elimination diet nineteen children with food allergy manifesting atopic dermatitis were treated with either 120 mg/day of thymomodulin (10 subjects) or placebo (9 subjects) in a double blind design. After this period an improvement in skin lesions was observed in both groups. Subsequently a food challenge was performed for two weeks: in the group treated with thymomodulin skin lesions did not modify while they worsened in the placebo group and the comparison was statistically significant (p less than 0.01). Before the beginning of the trial laboratory assessments evidenced an increase in total and specific IgE serum levels, which decreased by the end of the study only in the group receiving the thymic derivative (p less than 0.05).

Adjuvants, Immunologic↗

Passage of food antigens into circulation of breast-fed infants with atopic dermatitis.

We have selected 13 babies presenting with atopic dermatitis during exclusive breast feeding. After evaluation of reaginic reaction, we detected beta-lactoglobulin (BLG) in breast milk and babies sera before and after maternal elimination diet and after maternal challenge. beta-Lactoglobulin was present only in the sera of infants ingesting breast milk containing BLG. We have seen reaginic reactions to cow's milk in seven babies. The maternal elimination diet improved eczema in 11/13 infants, maternal challenge worsened atopic dermatitis in 9/9 children. We demonstrated the transport of food antigen via breast milk into infants' circulation.

Breast Feeding↗

IgG subclasses to food antigens.

Involvement of sub-classes of IgG that are specific for food allergens in anaphylactoid reactions and some manifestations of atopy no longer needs to be shown. Accordingly, sub-classes of IgG specific for ovalbumin (OVA) and beta-lactoglobulin (BLG) were compared in healthy subjects and those who presented with an intolerance or food allergy to OVA and BLG to decide whether a restrictive diet was necessary. The four sub-classes of IgG1, IgG2, IgG3 and IgG4 were isolated in all the groups. IgG4 was highest in the allergic subjects and the IgG sub-class values were modified by the diet differently in each group. Unfortunately, the small number of subjects does not allow the formation of a definite conclusion to this study.

Antigens↗

[Evaluation of markers in pediatric allergies].

Atopic diseases are more and more frequent (10-20%) in childhood with high social costs. The Author decided to analyze the markers useful to forecast the risk and development of atopic diseases in newborns by perusing the existing literature and personal experience, in order to evaluate the possibilities of adopting, first, a mass screening and, subsequently, precautionary measures suitable to avoid the onset of atopic diseases. A family history of atopic disease and the total serum IgE from the umbilical cord are the markers which are easiest to investigate. They allow detecting 80% of the subjects at allergological risk. But they are not sufficient to program a screening and a primary prevention in children at allergological risk.

Adolescent↗

[Total IgE synthesis in diabetic children].

Antibodies (ICA and other organ-specific and non-organ-specific antibodies), HLA histocompatibility antigens and serum IgE levels were analysed in 27 diabetic children aged 2 to 14 years. The results obtained are as follows : 59% of examined subjects had ICA; the HLA-B8 incidence in our diabetic patients was significantly higher (p less than 0.0005) than in normal population; serum IgE levels were higher than +1 SD in 67% of patients; this percentage reaches 76% in diabetics with ICA and 86% in diabetics with ICA and HLA-B8. Enhancement of IgE production could be the consequence of a reduction in the number and/or function of suppressor T lymphocytes.

Adolescent↗

[Premature thelarche and precocious puberty. Clinical findings and endocrinological data useful for differential diagnosis].

Clinical features, urocytogram and gonadotropin response to LHRH (100 microgram/1,73 m2 i.v.) were evaluated in 10 girls with premature thelarche and 4 girls with precocious puberty to purpose to describe the differences between the two diseases. The subjects with Premature Thelarche showed peculiar clinical and endocrinological characteristics which allowed their discrimination from patients with Precocious Puberty: 1) breast development of mild degree without any modification of nipples and areolae and not accompanied by pubic hair or morphologic changes of genitalia; 2) spontaneous regression of thelarche more or less complete (6/10 cases); 3) not anticipation of puberal maturation; 4) growth rate not accelerate (only a mild advancement of statural age was observed); 5) LH/FSH ratio at prepuberal levels; 6) mean LH peak values overlapping to those obtained in normal infants under 1 year of age. Our findings confirm that: 1) the girls with Premature Thelarche showed different growth pattern and clinical features than those observed in the girls with Precocious Puberty; 2) LHRH test and urocytogram are further valuable parameters for the differential diagnosis between Premature Thelarche and Precocious Puberty; 3) the isolated breast enlargement in girls under 8 years of age is likely to originate from a protracted gonadotropin hyperstimulation as in early life; 4) it is a variant of the normal, not difficult to asses, which merits, however further follow-up.

Adolescent↗