[Immunotherapy of extrinsic respiratory allergy. II. Longitudinal study of the blocking antibody level].
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Antibodies↗
Biomedical subjects
F Filiaci
Publications and source records attributed to F Filiaci.
Rhino-rheo-manometric (R.R.M.) nasal provocation test.
The nasal provocation test--which has been considered till now too much time-consuming and troublesome for the patient--becomes rapid and simple by the use of the rhino-rheo-manometry. It is possible, by this method, to evaluate the conductance of a single nasal fossa and its reduction after allergen challenge. The results of test performed in patients suffering from extrinsic perennial nasal atopy by Dermatophagoides pt. have proved that the test becomes rapid and not troublesome by using the rhino-rheo-manometry. This method, giving a provocation threshold, may be used both in diagnosis and control of specific immunotherapy.
Antigen-Antibody Reactions↗
Nasal obstruction improvement induced by topical furosemide in subjects affected by perennial nonallergic rhinitis.
Inhaled furosemide decreases bronchial response to several physical and chemical irritants. To evaluate the effect of topical furosemide on nasal resistance in patients affected by perennial nonallergic rhinitis, we studied 12 patients. This diagnosis of perennial nonallergic rhinitis was based on the history of rhinorrhea, sneezing, and nasal obstruction, on anterior rhinoscopy and endoscopy, on negative allergic tests, and on the absence of eosinophilia in nasal secretion. The study was performed on two nonconsecutive days. On the first day, one puff (100 microliters) of 0.9% saline was sprayed into both nostrils and nasal resistance was measured by anterior rhinomanometry before the puff and 15 and 30 minutes later. On the second day, one puff (100 microliters) of a solution of furosemide (10 mg/mL) was sprayed into both nostrils and nasal resistance was measured before the puff and 15, 30, 45, 60, 90, 120, and 180 minutes later. Initial nasal resistance was abnormally high in all patients on both days. A slight but significant increase was observed after spraying isotonic saline (base: 1.38 +/- .69; 15 minutes: 1.47 +/- 0.72; 30 minutes: 1.44 +/- 0.73); by contrast a marked decrease was observed after spraying the furosemide solution. Nasal resistance was lowest between 30 and 90 minutes after giving furosemide. Then it progressively increased, but values at 180 minutes were still lower than the initial ones (base: 1.43 +/- 0.67; 15 minutes: 0.70 +/- 0.47; 30 minutes: 0.48 +/- 0.24; 45 minutes: 0.49 +/- 0.21; 60 minutes: 0.50 +/- 0.20; 90 minutes: 0.56 +/- 0.23; 120 minutes: 0.62 +/- 0.32; 180 minutes: 0.67 +/- 0.30). After topical furosemide, all patients had subjective relief of nasal obstruction that lasted more that 12 hours in 9 subjects.
Administration, Inhalation↗
Non-specific hyperreactivity before and after nasal specific immunotherapy.
BACKGROUND: Specific local immunotherapy (SLIT) improves symptom scores for allergic rhinitis during treatment and after its conclusion, as confirmed by non-specific tests. However, the duration of clinical and instrumental improvement after discontinuing SLIT is unknown. OBJECTIVE: To evaluate the changes in the non-specific reaction time of patients with allergy to Dermatophagoides pteronissinus before and during 3 years of SLIT, and 6, 12, 18, and 24 months after discontinuing SLIT. MATERIAL AND METHODS: Sixteen patients were diagnosed by clinical history, positive skin test for D. pteronissinus, RAST, nasal provocation test (NPT) specific for D. pteronissinus, NPT with cold water solution. SLIT was administered by nasal spray. Patients were evaluated before, at 6, 12, 24, and 36 months of SLIT, and 6, 12, and 18 months after discontinuing SLIT. At the beginning of SLIT, the allergen concentration used was similar to that used in NPT. Maintenance doses were administered 3 times a week for 1 year and 2 times a week for 2 years. All patients kept a symptom diary. RESULTS: After the first year of SLIT, total nasal resistance (TNR) decreased sharply. TNR then remained constant at the end of the second year and decreased at the end of the third year of treatment. Discontinuation of SLIT did not produce evident variations in average TNR at 6 or 12 months, but 3/16 patients at 6 months and 9/16 patients at 12 months complained of symptomatic deterioration. The most evident deterioration was noted at the 18-month post-SLIT visit, in which TNR values were similar to those recorded at the onset of treatment. Positive response to stimulation and increased TNR were found after SLIT in 8/16 patients at 6 months, 13/16 at 12 months, 12/13 at 18 months, and 7/7 at 24 months. The symptom score indicated the return of symptoms. Twelve months after discontinuing SLIT, the patients complained about increased secretion and itching. The initial non-specific hyperreactivity, which had been present in all patients, was not evident in 68.7% after 3 years of SLIT, but persisted in a milder form in 31.3%. CONCLUSION: SLIT successfully reduced symptoms of D. pteronissinus sensitivity. Non-specific hyperreactivity was absent at the end of SLIT, but returned by 6 months after discontinuing SLIT. Therefore, SLIT did not maintain the clinical results achieved at the beginning of treatment for more than 12 months.
Administration, Intranasal↗
[The treatment of nasal polyposis with the neodymium-YAG laser].
Recurrent nasal polyposis is one of the most common problem in clinical rhinology. The authors describe the anatomic and functional results obtained by Nd:Yag laser procedures performed on 47 patients, with recurrent polyposis. The use of Nd:Yag laser under local anaesthesia, by means of a rigid fiberscope, permitted to obtain a well limited excision of the pathological tissue with respect of nasal physiology. At the end no nasal packing was used because unnecessary. The authors explain the details of the method and the results obtained, pointing out this well tolerated treatment, even when repeated, taking care, in the same time, the different pathogenesis of disease.
Adolescent↗
[Immunological study of laryngeal neoplasm cases].
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Aged↗
Non-specific rhinoreactivity: non-specific nasal provocation tests with methacholine and cold water solution.
The Department of Allergo-Immunology of the II ENT Division of Rome University has studied the behaviour, relative to non-specific nasal provocation with methacholine and with cold water solution, in normal subjects, in subjects with seasonal allergic rhinitis in and out of crisis, and in subjects with perennial rhinitis of allergic and non-allergic origin. All subjects underwent an ENT visit, rhinoreomanometry (RRM), mucociliary Clearance (MCT) and quantitative evaluation of nasal secretion, both before and after the single non-specific provocations. We saw that even though provocation with methacholine didn't cause a significant reduction of nasal conductance, it was the cause of noticeable modifications of the amount of nasal secretion, according to the groups taken into consideration. Furthermore, provocation with the cold water solution, which didn't provoke noticeable changes in the mucociliary clearance and in the quantity of nasal secretion, did, however cause noticeable modification of the nasal conductance in all groups examined.
Adolescent↗
[Control of the rhino-tubal function in subjects with maxillofacial dysmorphism after Le Fort I osteotomy of the upper jaw].
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Adolescent↗
[Short-stay in otorhinolaryngology].
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Adult↗
Otorhinolaryngological aspects of HIV infections: personal experience.
The involvement of the ENT sphere in HIV infections is fairly common, but the relative manifestations, though not to be considered atypical, are not pathognomonic. The present study has been set up for the otoiatric assessment of a group of HIV patients and the correlation of ENT symptoms with the various stages of the disease. To this end, 60 patients were examined (35 belonged to groups 2-3 and 25 to group 4) of whom 50% were drug addicts, 36% homosexuals and 14% heterosexuals. All patients underwent a complete ENT examination as well as the assessment of hearing and vestibular function, of olfactory and taste functions, of respiratory and nasal mucociliary functions along with an anti-HIV antibody check of nasal secretion. Results showed a prevalence of otologic and rhinosinusal symptoms as well as cervical-facial swelling. Testing revealed a hearing loss of mainly conductive origin caused by otitis and tubal stenosis; vestibular hyporeflexia; mixed hyposmia and hypogeusia owing to the involvement of multiple cranial nerves; respiratory and mucociliary changes due to rhinitis and hypertrophy of the nasal mucosa. In all cases anti-HIV antibodies were found in nasal secretion. From a diagnostic point of view there was a prevalence of specific pathologies: oropharyngeal candidosis, stage 4; cervical lymphoadenopathy, stages 2-3; chronic rhinosinusitis, nasal vestibulitis and nosebleed; mainly chronic otitis media. All such manifestations suggest a marked involvement of ENT organs, which can be attributed to the anatomical characteristics of the area, with the relative diagnostic and prognostic implications of HIV infection.
AIDS-Related Opportunistic Infections↗
Local treatment of aspecific nasal hyperreactivity with capsaicin.
Ten patients with vasomotor rhinitis underwent local treatment with capsaicin (30 micromol.), once per week for five weeks; controls were carried out at weekly intervals and 1, 3 and 6 months after therapy. Assessment was made using symptom score and nasal resistance scores both basal and subsequent to aspecific nasal provocation. Results showed abatement of symptoms, and reduction of nasal resistance and aspecific hyperreactivity already during the second week. This trend continued for six months, with endoscopic improvement also. Hence, this treatment proved to be efficient in reducing nasal reactivity.
Adolescent↗
Local treatment of nasal polyposis with capsaicin: preliminary findings.
The inflammatory process triggered by the nasal hyperreactivity, whether specific or aspecific, presents three components: immunomediation-neurogenic-interconnection between the nervous and the immunitary systems. Neuropeptides (eg SP and CGRP) are among the agents responsible for neurogenic phlogosis and, in our opinion, they contribute towards the onset of polyps. Capsaicin, which acts on the C fibres, has been applied locally (30 microns) by the AA in 15 patients affected by aspecific nasal hyperreactivity with polyps, in the course of a double blind study with an equal number of patients. Treatment was given once a week for 5 consecutive weeks in order to evaluate the effect on both the hyperreactivity and the polyps. Before and after each session and at the 1- and 3-month controls the following tests were carried out: assessment of symptoms, nasal endoscopy, sizing of the polyps, aspecific nasal provocation test and nasal cytology. Apart from an improvement in symptoms and in nasal hyperreactivity, results showed a reduction in the size of the polyps even though accompanied by a gradual increase of eosinophiles which was not correlated to a degranulation process.
Adult↗
Rhinoreactivity in a patient affected by the Darier-White disease.
The Darier-White disease is a rare hyperkeratosic skin-disease which can also affect other organs. From an otoiatric point or view, there are alterations of the oral cavity, salivary glands and congenital deafness, but there is nothing against the nasal mucosa. The clinical case we studied, shows the presence of aspecific nasal hyperreactivity correlated to sun exposure as it happens for cutaneous lesions, independently of the presence of eosinophiles in the nasal secretion. This could mean that the Darler-White disease can also alter the function of the nasal mucosa.
Airway Obstruction↗
The behaviour of non-specific nasal provocation tests in subjects with allergic rhinitis and not, in and out of crisis. A longitudinal study.
The non specific nasal hypersensitivity (N.S.N.H.) is characterized by an exaggerated reaction towards various non-specific stimuli in rhinopathic subjects. This N.S.N.H. involves the afferent structure of nasal mucosa, the effector organ and the central modulation system. The physiopathogenetic and clinical implications induced the authors to study the N.S.N.H. behaviour in 218 subjects divided into 5 groups, as follows: control group, subjects with perennial rhinitis of non allergic origin, subjects with seasonal rhinitis due to allergy towards Graminaceae during seasonal crisis and not, subjects with perennial rhinitis due to allergy towards Dermatophagoides pteronissinus. All subjects moreover have been subdivided according to the years of illness. The N.S.N.H. behaviour has been studied with non-specific nasal provocation tests with methacholine, cold water solution and histamine, so the amount of sneezes were assessed. The results show a reduction of the reaction, previously high, to methacholine and cold water solution tests after 6-12 years of illness in subjects with perennial rhinitis, while the test with histamine always gives higher results. This could mean a reduction of N.S.N.H. during the years of illness, probably connected to the answer of the effector organ, without involvement of that afferent portion of nasal mucosa.
Adolescent↗
The non-specific hypersensitivity of the upper and lower airways in Reinke's edema: preliminary results.
Reinke's edema is characterized by swelling of the vocal cords, which generally is bilateral but often is more pronounced in one cord. The disease is named after the anatomist Reinke, who undertook a morphological study of the subepithelial connective tissue of the vocal cords in order to investigate edematous spread. In general, swelling of the vocal cords develops gradually and may increase considerably over months or even years. To evaluate an eventual relation ship between airways (nasal and bronchial) and Reinke's edema of the vocal cords, the authors studied 9 subjects suffering from Reinke's edema. These patients underwent to an accurate clinical history, skin-test for inhalant pollens and mycetes to evaluate the eventual presence of specific allergies, non-specific nasal provocation test with Histamine, baseline RRM to evaluate the non-specific nasal hypersensitivity and besides the RRM values has been considered the number of sneezes after Histamine stimulation, finally a bronchial provocation test with ultrasonic fog to evaluate the presence of non-specific hypersensitivity of the lower airways.
Airway Obstruction↗
Nasal hypersensitivity in purulent middle ear effusion.
The existence of a physiopathologic connection between nose and middle ear is widely accepted so that chronic purulent middle ear effusion (CPMEE) could be expected to be usually associated with nasal chronic disease or impaired function. Nevertheless such association is less frequently observed in clinical practice than one could expect, possibly because of inadequate nasal function evaluation. Thirty-five patients affected by CPMEE were included in this study in order to assess the incidence of nasal disorders. E.N.T. clinical history was obtained and E.N.T. physical examination, nasal endoscopy by fiber optics, anterior rhino-rheo-manometry, non-specific nasal provocation test with histamine, mucociliary transport test, and allergic skin tests were performed. In the clinical history assessment 26 patients were affected by chronic rhinopathies, 16 by chronic pharyngitis, and 20 by frequent headache. At rhinoscopy we registered nasal septum deviation in 24 cases and mean and inferior turbinates hypertrophy in 31 cases. CPMEE and nasal septum deviation or turbinates hypertrophy were more frequently ipsilateral (p < .001 and p < .05, respectively). Total nasal resistance was 0.99 +/- 0.49; it was abnormally high in 11 subjects bilaterally and in 4 subjects monolaterally and increased significantly in 32 patients following nasal provocation test. Mucociliary transport time was longer in CPMEE subjects than in 10 healthy subjects (18 +/- 5 vs 13 +/- 4 min; p < .05). Finally 10 patients presented positive skin tests. On the whole, 96% of non allergic patients included in this study showed signs of non-specific nasal hypersensitivity which could theoretically cause purulent middle ear effusion to chronicize. Indeed recurrent histamine release in response to specific and/or aspecific stimuli could cause the obstruction of the Eustachian tube and consequently inadequate middle ear ventilation.
Adolescent↗
Nasal hypersensitivity and recurrent adenoids disease.
Authors studied nasal hypersensitivity (NH) behaviour on 41 subjects suffering from recurrent adenoids disease during their paediatric age. All subjects underwent clinical history, ENT examination, skin-test, RAST and non-specific nasal provocation test with histamine and assessment of the amount of sneezes. The results showed a familial transmission of the NH in 53.6% of cases, a hypogammaglobulinemia in 14.6% of cases. NH was present in 57% of subjects, much more with higher number of phlogosis, with higher possibility of familial transmission and with premature socialisation. These data showed a strict correlation between NH and recurrent adenoids disease. This NH didn't reduce in subjects undergone adenoidectomy and with time it conditioned the answer of the whole airways which could be noticed also in adulthood subjects. The presence of this NH had remarkable significance for diagnosis and therapeutic behaviour.
Adenoidectomy↗
Research of non-specific hyperreactivity of upper airways in subjects with gastro-esophageal reflux (G.E.R.): preliminary reports.
An association between asthma and gastro-esophageal reflux (GER) is well recognized but the underlying mechanism is still unclear. The authors suggest that could exist an association between GER and upper airways hyperreactivity and this association could represents the mechanism underlying the lower esophageal sphincter releasing, that determine the reflux. In fact they suppose that, the noxious injury of acid reflux follows a course that could be: pharynx-->larynx-->bronchi-->1/3 inferior of the esophagus-->reflux. From these presuppositions the authors carried out a study on the possible relationship between GER and non-specific hyperreactivity of upper airways on 14 subjects, divided in 2 groups: 10 subjects with functional GER, 4 subjects suffering from GER caused by hiatus hernia as control group. All patients had a thorough medical history, ENT examination with rigid and flexible endoscope, anterior Rhinomanometry (RRM), skin-test for inhalant and alimentary allergens, RAST, audiometric exam, non-specific nasal provocation test (NSNPT) with histamine, using as control the number of sneezes. From a through analysis of objective examination and from the results of the NSNPT with histamine resulted that all subjects with functional GER were rhinopathics. In all tests both in vivo (Skin-test) and in vitro(RAST) for the most common allergens (pollens-inhalant-mycophites-alimentary) the results were negative. The authors also found an involvement of paranasal sinuses that raised: 91% in the patients with recurrents phlogosis due to non specific nasal hyperreactivity; 40.9% in the allergic subjects (20% in the Graminacee +; 32% in the Parietaria O. +; 76% in the Dermatophagoides Pt. +; others 4%); 100% in the ASA-intolerance subjects. The NSNSPT with histamine showed in the group with functional GER a hyperreactivity with sneezes in 6/10 subjects, and 1/4 subjects of the group with GER with hiatus hernia. The RRM variations showed an unilateral nasal hyperreactivity in 6/10, bilateral in 3/10 subjects of the group with functional GER. In the group with GER with hiatus hernia only 1/4 subject showed reliable unilateral RRM variation. From the analysis of data resulted that subjects with functional GER showed a completely involvement of the upper airways and not only of the pharynx and larynx, caused by non specific hyperreactivity at the NSNPT with histamine, associated with a chronic pathology.
Adult↗