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Biomedical subjects

C E Baena-Cagnani

Publications and source records attributed to C E Baena-Cagnani.

At least 19 recordsLinked to original sources
PubMed2006

Pharmacologic and anti-IgE treatment of allergic rhinitis ARIA update (in collaboration with GA2LEN).

The pharmacologic treatment of allergic rhinitis proposed by ARIA is an evidence-based and step-wise approach based on the classification of the symptoms. The ARIA workshop, held in December 1999, published a report in 2001 and new information has subsequently been published. The initial ARIA document lacked some important information on several issues. This document updates the ARIA sections on the pharmacologic and anti-IgE treatments of allergic rhinitis. Literature published between January 2000 and December 2004 has been included. Only a few studies assessing nasal and non-nasal symptoms are presented as these will be discussed in a separate document.

Animals↗
PubMed2004

Is secondary lymphoid-organ chemokine (SLC/CCL21) much more than a constitutive chemokine?

Chemokines are a superfamily of small cytokines with activities ranging from leukocyte traffick to hematopoiesis, angiogenesis, and tissue organogenesis. Secondary lymphoid-organ chemokine (SLC/CCL21) was originally reported as a chemokine constitutively expressed by stromal cells and high endothelial venules in secondary lymphoid tissues and endothelium of afferent lymphatics, directing CCR7+ cells. More recently, others and we have demonstrated that SLC/CCL21 is up-regulated in different skin inflammatory conditions. Thereafter, this molecule is much more than a constitutive chemokine, which could play a role in effector and regulatory immune functions.

Chemokine CCL21↗
PubMed2003

Expression of CS-1 fibronectin precedes monocyte chemoattractant protein-1 production during elicitation of allergic contact dermatitis.

BACKGROUND: Leucocyte migration within inflammatory skin compartments in allergic contact dermatitis (ACD) is the result of a sophisticated multi-step event where multiple molecules are involved. OBJECTIVE: Since non-antigen-specific mechanisms have been described as an early participant in elicitation of ACD, we investigated the kinetics of the expression of monocyte chemoattractant protein-1 (MCP-1/CCL2) and the type of infiltrating cells. We compared the time course production of MCP-1/CCL2 with connecting segment-1 (CS-1) fibronectin and thymus and activation-regulated chemokine (TARC/ CCL17) expression. METHODS: Biopsies from 10 individuals challenged in their back with the antigen responsible for their contact dermatitis and an irrelevant antigen were taken at different times and histology, immunohistochemistry for CS-1 fibronectin, TARC/CCL17, CD3, CD68, CXCR3, CCR4 and in situ hybridization for MCP-1/CCL2 were performed. RESULTS: At positive antigen stimulated sites expression of MCP-1/CCL2 by basal keratinocytes and isolated cells in dermis started at 10 h. CS-1 fibronectin and TARC/CCL17 expression by blood endothelial cells was found at 2 and 10 h, respectively. This was followed by dermal accumulation of mononuclear cells with a significant increase of CD3+ and CD68+cells. At 48 h, approximately 58% of infiltrating cells were CXCR3+, and 35% CCR4+. CONCLUSIONS: We showed evidence of the fact that CS-1 fibronectin expression precedes the production of MCP-1/CCL2 and TARC/CCL17 in the skin of patients with ACD, suggesting that these molecules participate in the early complex process of migrating mononuclear cells during elicitation of ACD.

Adult↗
PubMed2001

Allergic rhinitis and asthma in children: disease management and outcomes.

Antihistamines and inhaled glucocorticoids, which can be targeted toward multiple points in the "allergic cascade" underlying allergic rhinitis and asthma, extend the promise of enhanced outcomes in children with allergic rhinitis, asthma, or both. Antihistamine therapy confers significant relief of subjective ratings of seasonal and perennial allergic symptoms (e.g., rhinorrhea, congestion, sneezing, pruritus), whereas topical steroids alleviate such discomfort while also improving objective anatomic and functional indices of nasal patency (e.g., nasal peak inspiratory flow). Youngsters with asthma also experience substantial clinical benefits from inhaled steroids, which improve objective measures of pulmonary function and reduce rescue beta 2-agonists for symptom management and quality-of-life enhancement. This paper reviews recent clinical findings on the role of antihistamines and topical corticosteroids in pediatric allergy and asthma management, as well as the favorable effects of these medications on both objective and subjective health outcomes.

Administration, Inhalation↗
PubMed2001

Role of food allergy in asthma in childhood.

Atopy is the major predisposing factor for asthma identified up to now, and allergen exposure, particularly indoor allergens, is considered as a causal factor for asthma. Food allergy is frequently underestimated in association with asthma, however food allergy has been shown to trigger or exacerbate broncho-obstruction in 2 to 8.5% of children with asthma. There is also evidence that double-blind placebo-controlled oral challenge is able to increase unspecific bronchial hyperresponsiveness. Sensitization to food can occur early in life involving T cell response, mainly of the Th2 phenotype, but also IgE-mediated hypersensitivity. Moreover, it has been shown that sensitization to food allergens early in life is a risk factor for sensitization to inhalent allergens and respiratory symptoms later on. Epidemiological studies suggest that changes in the dietary composition, such as trans-fatty acids, could be involved in the increase of asthma prevalence. The introduction of formula during the first trimester of life increases the risk of having asthma. The diagnosis of food allergy associated with asthma is not easy, nevertheless is important for allergists, pulmonologists and paediatricians to consider food allergy in children with respiratory symptoms, especially when asthma symptoms start early in life and when they are associated with other manifestations of food allergy. Children sensitized to cow's milk proteins and also having atopic eczema are at higher risk for asthma. Since avoidance of the offending food is the first step in the management of children with asthma associated with food allergy, a careful identification should be done in order to avoid unnecessary elimination of foods.

Asthma↗
PubMed2001

Desloratadine activity in concurrent seasonal allergic rhinitis and asthma.

Seasonal allergic rhinitis (SAR) and asthma, which are frequently comorbid, share some common allergic pathogenic bases. Clinical manifestations of these disorders might therefore be viewed as local manifestations of a systemic inflammatory state. Not only do the onsets of allergic-rhinitis (AR) and asthma symptoms often coincide (within 1 year), but also nasal challenges with SAR allergens can induce airways hyperreactivity (AHR). Eosinophils, which are key effector cells in both SAR and asthma, cause AHR, tissue damage, and neuronal effects through secretion of toxic granule proteins, enzymes, and other mediators. The novel, nonsedating, histamine H1-receptor antagonist, desloratadine, which exerts various favorable effects on the allergic cascade, significantly decreased SAR symptoms (e.g., nasal congestion) and diminished daily beta2-agonist use and improved asthma symptoms, while maintaining pulmonary function, in patients with SAR-asthma who were treated with once-daily desloratadine regimens.

Asthma↗
PubMedDate not supplied

[Dissemination program of GINA in Mexico].

Asthma is a global public health problem. Even though the prevalence is variable in different parts of the world, including Latin America, asthma morbility is high, particularly in countries with emerging economies. Asthma mortality is unacceptable, especially since it has been estimated that a high percentage of asthma deaths could be prevented. Fortunately, most patients suffer mild persistent asthma, however, there is evidence that asthma is many times underdiagnosed and undertreated. Primary care physicians, family doctors and paediatricians have to deal with the majority of asthma patients together with different medical conditions; such as heart problems, diabetes, and infectious, etcetera. In order to help these physicians in the process of decision making, guidelines have been developed. There are many asthma guidelines; they range from opinion based guidelines (in the past) to a current more evidence based approach. Among GINA, Global Initiative for Asthma, is the most comprehensive and widespread all around the world. More than a guideline, GINA is actually a programme directed at asthma specialists, other health care providers and patients and their families.

Asthma↗
PubMedDate not supplied

Pollinosis: some immunologic and regional considerations and the description of Melia azedarach respiratory allergy.

Pollens constitute one of the most allergenic groups for man. Their prevalence make them an important factor when studying antigens that induce allergical diseases such as rhinitis, asthma, conjunctivitis, etc., wherein immunological mechanisms play a fundamental role. It is believed that genetic factors are involved in pollinosis and this could probably explain the enhanced susceptibility of certain individuals to acquire this type of allergy. Here we mention the HLA system, among others involved. Ecological aspects of each region must be carefully evaluated because of the importance of detecting the specific pollen area and the pollen's behaviour which, in turn, will permit an accurate etiological diagnosis. We have investigated a pollen widely spread in our province, called Melia azedarach and have demonstrated its property of inducing allergic respiratory disease. Finally, therapeutics in pollinosis is discussed and attention is paid to drugs such as antihistamines, ketotifen, among others but we think that specific immunotherapy plays a most important role.

Argentina↗
PubMedDate not supplied

HLA and pollinosis.

Sixty-two patients were selected who suffered from seasonal pollen-induced bronchial asthma and rhinitis. Histocompatibility antigen typing was carried out with a panel of 70 antisera (Behringwerke) of 33 HLA specificities. The results obtained at locus A of the most representative by percent phenotypic frequency of the HLA studies shows a decreased frecuency of HLA-A11. The phenotyic frequencies of the most representative HLA of B locus in the group of patients shows an increase in the frequency of HLA-B8. This represents 22.6% compared with 9.1% of the controls, which is definitely significant. The results obtained in a study of the haplotype frequency of three combinations of HLA antigens, in a group of allergic patients compared with the controls shows that the frequency of the haplotype A1 B8 is greater in the allergic patients than in the control group, a statistically significant finding. As regards the other two haplotypes A2 B12 and A3 B7, the respective results of the comparison were not significant in the first and marginally significant in the second. Even these few studied cases demonstrate the predominance of HLA-B8 in atopic or hyperreactive states. As regards the A1 B8 haplotype, we also find a slightly increased occurrence, in agreement with the literature. This suggests that the hyperergic response might be associated with the presence of the A1 B8 haplotype.

Female↗
PubMedDate not supplied

Etiological factors in child bronchial asthma.

Available statistics regarding the different activating mechanisms of asthma vary greatly and they are a product of an era wherein only the extrinsic factors were considered to be fundamental in the etiology of bronchospasm. For the present study were selected 700 clinical case histories of children suffering from bronchial asthma. Emphasis was placed on the sex, age of onset, family history, presence of associated allergic disorders, intracutaneous tests and their relation to the anamnesis and evolution of the disease in the treatment period for no less than three years. A purely bacterial cause, without other types of sensitization involved, was present in 54% of the cases, on the contrary, purely extrinsic factors were present in 10% of the cases, summing up to 46%, if their role in the mixed group is taken into consideration. The high percentage of bacterial asthma (94.7%) was found fundamentally in children below one year of age. The results obtained in this demonstrate the great importance of the bacterial factor in child bronchial asthma.

Allergens↗
PubMedDate not supplied

Bacterial immunotherapy of childhood bronchial asthma.

In everyday practice, we usually encounter two types of childhood asthma, as regards etiology. On the one hand, primary allergic bacterial asthma and on the other, primary allergic extrinsic asthma; it is rare to encounter other types of asthma in infancy. Our point of vieew, as previously expressed elsewhere, is that the bacterial or infective factor is the most important etiologically. For this reason, we consider of major importance not only antibiotic treatment of the causative agent, but also immunotherapy with bacterial vaccines. Eighty patients were studied, 48 boys and 32 girls, aged between 2 and 10 years at the time immunotherapy was started. All had been diagnosed as having bronchial asthma of exclusively bacterial etiology, with or without associated paranasal sinusitis. In order to provide an objective estimate and evaluation of the efficacy of immunotherapy, the parents of the patients were interviewed and asked to complete the questionnaire shown in figure 1. There were 46 patients whose progress was classified as very good, amounting to 57.5%, 23 patients, or 28.7% had good results. The sume of these two groups was 69 cases, amounting to 86.2%. The remainder (fair, poor, did not complete treatment) amounted to 13.8% or 11 cases. In this last group, the highest proportion made fair progress, with 8 cases (10%). As far as tolerance to bacterial immunotherapy is concerned, in 47 cases, or 58%, no reactions occurred, while in 33 cases, or 41% of the total, side effects were observed. We should like to repeat once again that, on the basis of our results up to now, we consider the administration of appropriate bacterial immunotherapy essential as an etiological treatment in this type of asthma.

Asthma↗
PubMedDate not supplied

Cutaneous sensitivity to six mite species in asthmatic patients from five Latin American countries.

The prevalence of positive skin prick tests to the mite species Dermatophagoides pteronyssinus, D. farinae, Blomia tropicalis, Chortoglyphus arcuatus, Lepidoglyphus destructor and Aleuroglyphus ovatus was determined in 297 asthmatic adults and children living in seven cities of five Latin American countries. A standardized protocol and a common battery of extracts were used at each site. The mean wheal diameters were measured after 15 min, and those > or = 3 mm were considered positive. Sensitization to D. pteronyssinus varied from 60.7% in Cartagena to 91.2% in São Paulo; to D. farinae from 53.3% in Córdoba to 97.2% in Caracas; to A. ovatus from 26.6% in Bogotá to 71.2% in São Paulo; to B. tropicalis from 46.5% in Mexico City to 93.7% in São Paulo; to C. arcuatus from 33.3% in Mexico City to 75% in São Paulo; and to L. destructor from 30% in Mexico City to 76.2% in São Paulo. This study reported the results of skin test sensitivities in both children and adults. The studies from São Paulo and Córdoba were confined to children and thus could be compared; there was a significantly higher prevalence of cutaneous sensitivity to mite allergens in the children of São Paulo than in those of Córdoba (p < 0.001 for all mite species). Cutaneous sensitivity to mite allergens is very common in young and adult asthmatics in Latin America, in areas both at sea level and at high altitudes. Environmental control measures should be reinforced in the treatment of asthmatics in Latin America.

Adolescent↗