Biomedical subjects

Ignazio Cirillo

Publications and source records attributed to Ignazio Cirillo.

25 records · Page 2Linked to original sources

PubMed2003

Bronchial hyperreactivity and spirometric impairment in patients with perennial allergic rhinitis.

BACKGROUND: Allergic disorders are characterized by a systemic involvement of the immune response. There is a clear link between allergic rhinitis and asthma. Bronchial hyperreactivity (BHR) may be present in rhinitics. Smaller airways may also be impaired in mild asthma. This study aimed at evaluating a group of subjects suffering from perennial allergic rhinitis alone to investigate the presence of BHR and spirometric impairment. METHODS: One hundred rhinitics sensitized only to perennial allergens were evaluated. Spirometry and methacholine bronchial challenge were performed. RESULTS: Five rhinitics showed reduced values of forced expiratory volume/1 s (FEV(1)) without symptoms of asthma. Forty-eight rhinitics had reduced forced expiratory flow at 25 and 75% of pulmonary volume (FEF(25-75)) values. Seventy-two patients showed a positive methacholine challenge. In this group, reduced values of FVC (p < 0.05), FEV(1) (p < 0.05), and FEF(25-75) (p < 0.01) were demonstrated in comparison with BHR-negative rhinitics. There was a relationship between the degree of BHR and FEV(1) values (p < 0.05) and FEF(25-75) values (p < 0.01). CONCLUSIONS: This study evidences that an impairment of spirometric parameters may be observed in patients with perennial allergic rhinitis alone. A high percentage of these patients have BHR. Thus, new management strategies should be employed in rhinitics.

Adult↗

PubMed2003

The effect of budesonide on the cytokine pattern in patients with perennial allergic rhinitis.

BACKGROUND: A T(H)2-polarized cytokine pattern has been demonstrated in allergic rhinitis. Budesonide represents an effective topical corticosteroid in the management of allergic rhinitis. OBJECTIVE: To evaluate cytokine pattern and symptoms in patients with perennial allergic rhinitis before and after treatment with intranasal budesonide. METHODS: All patients received budesonide aqueous nasal spray or placebo for 2 weeks. The study was double-blind, parallel group, placebo controlled, and randomized. Nasal lavage was performed in all patients before and after treatment. A panel of cytokines, including interleukin 4 (IL-4), IL-5, and IL-6, was measured by immunoassay on fluids recovered from nasal lavage. Total symptom score (including rhinorrhea, nasal itching, sneezing, and nasal obstruction) was evaluated before and after treatment. RESULTS: Twenty patients with perennial allergic rhinitis were evaluated (13 men and 7 women; mean age, 24.7 years). Budesonide aqueous nasal spray treatment showed a significant decrease of IL-4 (P = .007), IL-5 (P = .04), and IL-6 levels (P = .009). Budesonide aqueous nasal spray treatment also induced significant symptom relief (P = .006). Placebo treatment did not significantly affect the evaluated parameters. CONCLUSIONS: This study shows that budesonide aqueous nasal spray is effective in exerting immunomodulatory activity by reducing cytokine pattern and relieving symptoms. These findings are evidence of the effects of intranasal budesonide in treating perennial allergic rhinitis.

Adolescent↗

PubMed2003

Airway reactivity and diving in healthy and atopic subjects.

BACKGROUND: The short- and long-term effects of self-contained underwater breathing apparatus (SCUBA) dives on airway responsiveness in nonasthmatic atopic subjects have not been systematically investigated. PURPOSE: To compare the effect of SCUBA diving at 50-m depth on lung function and airway responsiveness to methacholine (MCh) in atopic nonasthmatics and healthy subjects. METHODS: We studied 15 atopic nonasthmatic subjects and 15 controls who underwent the visit for the professional SCUBA-diving license at the Navy Medical Center, La Spezia, Italy. All subjects underwent spirometry and skin-prick test for common environmental allergens. MCh challenge was performed 24 h before, and 20 min and 24 h after a standardized SCUBA-dive test and after hyperbaric-chamber test. RESULTS: At 20 min, the provocative dose of MCh causing 20% fall of the forced expiratory volume at the first second (MCh PD20 - FEV1) was significantly reduced in atopic, asymptomatic subjects from 1712 x 2.6 microg (mean x geometric standard deviation) to 1202 x 2.2 microg (P < 0.0005) after the hyperbaric-chamber test and to 1204 x 2.3 microg (P < 0.005) after SCUBA diving. In healthy subjects, the baseline value of MCh PD20 was 2977 x 1.1 microg, and this value did not change significantly after the hyperbaric-chamber test (2575 x 1.4 microg) and after SCUBA dives (2553 x 1.4 microg, P > 0.1 for both comparisons). In atopic subjects, the MCh PD20 returned near to the baseline value 24 h after the hyperbaric-chamber test (1776 x 2.4 microg) and after the SCUBA test (1500 x 2.67 microg). No significant change in FEV1 was observed after the tests in both groups. CONCLUSION: SCUBA diving is associated with development of early airway hyperresponsiveness to MCh in atopic subjects.

Adult↗

PubMed2003

Asthma in Italian conscripts: a four year study.

BACKGROUND: Italian conscripts showed underdiagnosis and undertreatment of asthma in a previous 9-year study (1990-1998). METHODS: We extended those findings in a new 4-year study (1999-2002) by screening 28,327 18-year old males referred to La Spezia Military Navy Hospital for call-up visit. RESULTS: Asthma was diagnosed in 1,847 conscripts (6.52%). Along the observational period there was a significant decrease of mild persistent asthmatic subjects (from 39.6 to 30.1%, p < 0.01). The use of inhaled corticosteroids and antileukotrienes significantly increased. However, about one third of the asthmatic subjects did not receive any treatment at all and about 40% of asthmatic subjects showed impaired spirometry. CONCLUSIONS: In this age, data show a partial success of educational efforts, since underdiagnosis and undertreatment are still present.

Administration, Inhalation↗

PubMed2003

Prevalence and treatment of allergic rhinitis in Italian conscripts.

BACKGROUND: Previous surveys on Italian conscripts showed a low prevalence of allergic rhinitis. This study investigated the prevalence and the treatment of allergic rhinitis in the "conscript model" during a four-year period (1999-2002). METHODS: 28,327 18-year old males were screened and referred to La Spezia Military Navy Hospital for call-up visit. Detailed history, clinical examination, skin prick test, spirometry, and metacholine challenge were performed in subjects with suspected diagnosis of respiratory allergy. RESULTS: Allergic rhinitis was diagnosed in 2,876 conscripts (10.15%). Most of them showed an association with asthma (67.2%). Prevalence of allergic rhinitis increased five-fold in comparison with a previous survey. Sneezing was the most common nasal symptom. The use of antihistamines and intranasal corticosteroids increased significantly. However, about one third of the rhinitis subjects did not receive any treatment at all. CONCLUSIONS: Prevalence of allergic rhinitis in Italian conscripts has increased. Treatment of allergic rhinitis was correctly based on antihistamines and corticosteroids, but many rhinitis subjects remained still untreated.

Adolescent↗

PubMedDate not supplied

Role of FEF25-75 as an early marker of bronchial impairment in patients with seasonal allergic rhinitis.

BACKGROUND: Allergic rhinitis may be associated with asthma. Forced expiratory flow between 25 and 75% of vital capacity (FEF2575) is a measure of small airways narrowing. The aim of this study was to evaluate whether patients with seasonal allergic rhinitis (SAR) without symptoms of asthma might, nevertheless, have airways obstruction both in and out of the pollen season. METHODS: Fifty patients (mean age, 23.7+/-4.9 years) with SAR were evaluated both during and outside the pollen season. All of them had moderate-severe grade of nasal obstruction. Total symptom score, rhinomanometry, nasal lavage, nasal scraping, spirometry, and methacholine (MCH) bronchial challenge were assessed in all subjects. RESULTS: Although data on forced vital capacity and response to MCH were similar in and out of the pollen season, all other parameters were markedly different. The major finding of the study was that FEF25-75 was significantly associated with nearly all of the parameters considered, including bronchial hyperreactivity, with Pearson R ranging from 31 to 75% and differences in mean FEF25-75 ranging between 14.5 and 16.5% of predicted. The more significant association was with nasal airflow in the pollen season (R = 82.8%; p < 0.001). A significant association persisted for all parameters while controlling for season. CONCLUSION: This study highlights the link between upper and lower airways and the role of FEF25-75 as an early marker of bronchial impairment in those patients with SAR alone.

Adult↗

PubMedDate not supplied

Decongestion test in patients with allergic rhinitis: functional evaluation of nasal airflow.

BACKGROUND: Rhinomanometry measures nasal airflow that is frequently impaired in allergic rhinitis. Decongestion tests consist of spraying an intranasal vasoconstrictor drug to evaluate the reversibility of nasal airflow limitation. The aim of this study was to evaluate the decongestion test in patients with seasonal allergic rhinitis (SAR) caused by pollen sensitization, perennial allergic rhinitis (PAR) caused by sensitization to perennial allergens only, or mixed allergic rhinitis (MAR) caused by sensitization to both allergens. METHODS: One hundred twenty-three subjects (112 men and 11 women, mean age, 22.9 +/- 5.7 years) were studied; 40 subjects had PAR, 43 subjects had MAR, and 40 subjects had SAR. Total symptom score (including: nasal itching, sneezing, rhinorrhea, and nasal obstruction) was assessed. Rhinomanometry and decongestion tests were performed in all subjects. RESULTS: Nasal symptom severity was superimposable in the three groups (p was not significant). After decongestion tests, an increase of nasal airflow and a decrease of nasal resistance was shown in PAR (p < 0.01), MAR (p < 0.001), and SAR subjects (p < 0.001). The intergroup analysis showed that SAR patients had less reversibility than PAR (p < 0.01). CONCLUSION: This study provides the first evidence of the different response to decongestion tests, taking into consideration the causal allergens.

Administration, Intranasal↗