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Biomedical subjects

G Ciprandi

Publications and source records attributed to G Ciprandi.

At least 55 records · Page 3Linked to original sources
PubMed2000

Minimal persistent inflammation is also present in patients with seasonal allergic rhinitis.

BACKGROUND: The allergic reaction is characterized by an inflammatory response, which is correlated to the allergen exposure, and is detectable in mite allergic patients, even when symptoms are absent. OBJECTIVE: The study was aimed at assessing the presence of inflammation in patients with pollen allergy during a long observation period. METHODS: Six patients, sensitized only to Betula alba, were enrolled. Evaluated parameters were (1) nasal symptoms, (2) inflammatory markers (ie, neutrophil and eosinophil number and intercellular adhesion molecule-1 expression on nasal epithelial cells), and (3) pollen count. Patients were examined during the pollen season every 4 days for 40 days and were observed 3 times after the pollen season. RESULTS: A significant inflammatory reaction was evident throughout the pollen season, even during the days with a low pollen count and low or absent symptoms. CONCLUSIONS: The results of this study indicate that the global therapeutic strategy for allergic rhinitis should be revised and targeted to inflammatory phenomena rather than to symptoms alone.

Adolescent↗
PubMed2000

Safety and efficacy comparison of emedastine 0.05% ophthalmic solution compared to levocabastine 0.05% ophthalmic suspension in pediatric subjects with allergic conjunctivitis. Emadine Study Group.

PURPOSE: To determine the efficacy and tolerance of emedastine 0.05% ophthalmic solution compared to levocabastine 0.05% ophthalmic suspension in pediatric subjects. METHODS AND MATERIALS: In a randomized, double-masked, parallel controlled study, emedastine 0.05% ophthalmic solution BID was compared to levocabastine 0.05% ophthalmic suspension BID, for control of the signs and symptoms of allergic conjunctivitis in pediatric subjects ages 3-16. Subjects who met all inclusion and exclusion criteria received masked study medication with instructions to instill drops twice daily, in the morning and evening. A diary was completed by the parents four times daily for the first two and last two weeks of the study. Treatment lasted 42 days. Drug efficacy was assessed at the initial administration in the office at Day 0 and after 3, 7, 14, 30 and 42 days. RESULTS: Overall results showed both drugs have an effect and that emedastine was significantly superior (p < 0.05) to levocabastine for the relief of chemosis on Days 14, 30 and 42; of itching on follow-up Days 30 and 42 (p < 0.05); of redness on Days 30 and 42; for eyelid swelling on Days 14 and 30; and for physician's impression score on Days 7, 14, 30 and 42. CONCLUSION: These results confirm previous preclinical and clinical data on the potent and long acting efficacy of this promising new ophthalmic anti-allergic drug, emedastine in pediatric subjects.

Adolescent↗
PubMed2000

Relationship between degree of nonspecific hyperresponsiveness and number of positive skin tests in asthmatics.

Bronchial hyperresponsiveness (BHR) is a typical feature of asthma, and is, at least in part, related to the chronic inflammation. Allergen exposure is a major trigger and cause of allergic inflammation. The possible relationship between the degree of bronchial reactivity and the number of positive skin test was studied. One hundred and one patients with allergic asthma (and rhinitis) underwent skin-prick tests and methacholine bronchial challenge according to standard protocols. No significant relation was found between the degree of BHR and age or sex. Conversely, it was found that the number of positive skin tests correlated well with the degree of BHR (p = 0.046); in particular, those patients with three or more sensitivities showed greater bronchial reactivity. The present data support the hypothesis that allergic polysensitized patients may exhibit greater bronchial hyperresponsiveness, possibly due to an enhanced inflammatory component related to the exposure to multiple allergens.

Adolescent↗
PubMed1999

Spinal cord vascular injuries following surgery of advanced thoracic neuroblastoma: an unusual catastrophic complication.

BACKGROUND: Spinal cord injury is a possible complication associated with removal of thoracic dumbbell neuroblastomas. Our experience with two children whose postsurgical course was complicated by midthoracic spinal cord ischemia is reported there. Permanent paraplegia resulted in both. PROCEDURE AND RESULTS: Preoperative awareness of the origin and distribution of the Adamkiewicz artery (arteria radiculomedullaris magna, ARMM) and of the possible collateral pathways for spinal cord blood supply may be helpful in the planning of operations that involve dissection in the midthoracic posterior mediastinum. Otherwise, a flaccid paraplegia may result. CONCLUSIONS: The syndrome is presumed to be triggered by a spasm, an embolism, or a iatrogenic interruption of the ARMM.

Child, Preschool↗
PubMed1999

Differences in prevalence of allergic sensitization in urban and rural school children.

BACKGROUND: Environmental factors are important causes of sensitization, even though the effect of specific pollutants and the interaction between pollution and aeroallergens are not completely known. PURPOSE: To evaluate whether the exposure to pollutants or to allergens is a more important contributing factor in causing sensitization. METHODS: A group of 312 children living in the city and a group of 225 children living in a rural area, ages 11 to 14, were studied. All subjects underwent a skin prick test. The pollen counts were performed in the two different areas during the peak of the pollen season. At the same time the levels of ozone and suspended particulates were measured. RESULTS: The students living in the rural area showed a significantly higher percentage of sensitization than those in the city (P = .046). Sensitization to pollen was more frequent in the rural area (P < .001) but pet sensitization was more frequent in the city. More rural area students were sensitive to multiple allergens (P = .034). Pollen levels were higher in the rural area (P = .001). Both ozone and suspended particulate levels were higher in the city (P = .001 and P < .001, respectively). CONCLUSIONS: The degree of pollen exposure is a larger contributing pathogenic factor in inducing sensitization than air pollution.

Adolescent↗
PubMed1999

Minimal persistent inflammation may be controlled by cetirizine.

OBJECTIVE: Recent pathophysiologic research demonstrated the crucial role played by adhesion molecules in recruiting and activating inflammatory cells during allergic reaction. DATA SOURCES: Intracellular adhesion molecule (ICAM-1) expression on nasal epithelial cells is involved in two main pathogenetic phenomena. The first is to allow leukocyte infiltration of respiratory mucosa, since they express LFA1 and Mac1, which are ligands of ICAM-1. This point is very important, because it has been demonstrated that patients with mite allergy (ie, continuously exposed to allergen) present a minimal persistent inflammation (MPI) both at nasal and conjunctival levels. This inflammation is characterized by the presence of leukocyte infiltration and ICAM-1 expression on epithelial cells and by a relationship between specific and nonspecific hyperreactivity in the absence of clinical symptoms. The second is that ICAM-1 is also the main receptor of the human rhinoviruses. This fact may partially explain the relationship among allergy, viral infections, and asthma attacks. STUDY SELECTION: Different studies have been performed to demonstrate the possible effects on the different clinical aspects of MPI exerted by an antiallergic drug. RESULTS: It has been demonstrated that cetirizine is able to reduce ICAM-1 expression on nasal epithelial cells and conjunctival nonspecific hyperreactivity in asthmatic asymptomatic children with MPI. CONCLUSIONS: The therapeutical strategy of mite allergy should be targeted to treat minimal persistent inflammation.

Animals↗
PubMed1999

Continuous antihistamine treatment controls allergic inflammation and reduces respiratory morbidity in children with mite allergy.

BACKGROUND: Allergic reaction is characterized by a complex inflammatory process. Some of the new antihistamines have antiallergic effects and can affect the inflammatory cell recruitment via adhesion molecule downregulation. We aimed to assess in a 12-month study whether continuous treatment with an antihistamine (terfenadine) can reduce respiratory symptoms and local inflammation in children with mite allergy. METHODS: The study was double-blind and placebo-controlled: it involved two parallel groups of children suffering from rhinoconjunctivitis and/or mild intermittent asthma due to mite allergy. They received either terfenadine (1 mg/kg per body weight per day) or placebo for 1 year. Nasal, conjunctival, and bronchial symptoms were recorded by diary cards; at each of the programmed control visits, a nasal scraping for inflammatory cells and ICAM-1 was performed. Some additional clinical parameters were also recorded: days of school absence, extra visits for acute respiratory symptoms, and days of hospital admission. RESULTS: Only children treated with terfenadine achieved significant control of symptoms (P<0.05 in 8 out of 12 months) and allergic inflammation, as shown by inflammatory cell infiltrate and ICAM-1 expression at nasal level (P<0.001), and had significantly fewer extra visits and school absences than the placebo group (P<0.03). No side-effects were reported in either group. CONCLUSIONS: The present study demonstrates that continuous terfenadine treatment (1 mg/kg body weight per day) could decrease respiratory symptoms and allergic inflammation, and it had an additional antiallergic effect in reducing ICAM-1 expression on nasal epithelial cells. Therefore, the present results confirm the efficacy of a long-term therapeutic strategy in controlling allergic inflammation.

Adolescent↗
PubMed1999

Effects of H1 antihistamines on adhesion molecules: a possible rationale for long-term treatment.

Our knowledge of the mechanisms underlying the allergic reaction has increased rapidly and has revealed a complex network of cells, mediators and cytokines. The intercellular adhesion system (and the ICAM-1 molecule in particular) appeared to play a pivotal role in the accumulation of inflammatory cells at the site of allergic reaction. The new antihistamines have been demonstrated to be capable of affecting several phenomena of the allergic inflammation, including mediator release, cellular activation and adhesion molecule expression. Taking into consideration the central role of adhesion molecules, the modulation of their expression may represent an important therapeutic target. The nasal and the conjunctival challenges represent two useful models for the in vivo study of the antiallergic activity of drugs, as they allow investigation of a wide variety of parameters: inflammatory infiltrate, ICAM-1 expression, concentration of soluble mediators.

Animals↗
PubMed1998

A ten-year experience of Brescia-Cimino arteriovenous fistula in children: technical evolution and refinements.

PURPOSE: The arteriovenous fistula (AVF) of Brescia-Cimino fulfills nearly all of the criteria for an optimal access for chronic hemodialysis, such as long-term patency rate, low complication rate, and respect of vascular morphologic features. Alternative dialytic methods (i.e., external shunts and vascular grafts) cannot easily be applied to pediatric patients, and in addition, these methods are responsible for higher complication rates. METHODS: From January 1985 to December 1994, 112 Brescia-Cimino AVFs were performed in 90 children (average age, 5.5 years; range, 5 months to 18 years). The average weight of the children was 28 kg (range, 6.5 to 54 kg); 16% of AVFs were performed in children who were less than 5 years old, and 18% in children who were less than 15 kg in body weight. RESULTS: Chronic renal failure was caused by a nephropathy in 53 cases (14 with a nephrotic syndrome), and 37 cases had a uropathy. In all cases a phlebography was performed before the microsurgical treatment. Since 1994 an inflatable tourniquet has been placed on the selected upper arm because of an optimal exsanguination of the operating field. The primary patency rate was obtained in all but six of the children; 35% of AVFs had either immediate or late complications. Thrombosis was the most frequent complication that we observed. In comparison with 79% of late thrombosis, 60% of early thrombosis was cured. Of the 80 AVFs, 63.5% with a 4-year follow-up are still patent. CONCLUSION: We emphasize the following two conclusions: first, microsurgery is essential to create AVFs with good results in children as well as in adult patients; and second, the results improved after the adoption of an upper-arm exsanguination and ischemia (pressure range, 400 mm Hg to 600 mm Hg) that avoided spasm of the vessels with a final 35% reduction in surgical time.

Adolescent↗
PubMed1998

Terfenadine and fexofenadine reduce in vitro ICAM-1 expression on human continuous cell lines.

BACKGROUND: Epithelial cells and fibroblasts play an important role in allergic inflammation. Modulation of surface expression of adhesion molecules on epithelial cells by antiallergic drugs has been shown by both in vivo and in vitro studies. OBJECTIVE: The aim of the study was to evaluate the effect exerted by terfenadine and fexofenadine on adhesion molecules expression (CD54/ICAM-1 and CD29) of a human continuously cultured conjunctival epithelial cell line (WK) and a fibroblast cell line (HEL). METHODS: By means of flow cytometry analysis, we evaluated ICAM-1 and CD29 expression by WK and HEL epithelial cells in basal condition (at baseline) or after IFN gamma or TNF alpha stimulation in the presence or in the absence of terfenadine and fexofenadine. We also performed immunoenzymatic assays in order to evaluate soluble ICAM-1 released by WK cells and procollagen type I and III and IL6 released by HEL cells. RESULTS: Terfenadine and fexofenadine significantly reduced ICAM-1 basal expression on WK cells at the concentration of 1 microg/mL and 50 microg/mL, respectively. In addition, both terfenadine and fexofenadine were able to decrease soluble ICAM-1 levels in IFN gamma-stimulated WK cells. On HEL fibroblasts, fexofenadine only was able to inhibit ICAM-1 upregulation induced by IFN gamma. Concerning the release of fibroblast products, we observed a dose-dependent decrease of spontaneous IL6 release only in the presence of fexofenadine. CONCLUSION: This study shows that terfenadine and fexofenadine exert a biologic effect directly on epithelial cells and fibroblasts reducing ICAM-1 expression and partially reducing soluble ICAM-1 release.

Cell Line↗
PubMed1998

Intranasal fluticasone propionate reduces ICAM-1 on nasal epithelial cells both during early and late phase after allergen challenge.

BACKGROUND: Allergen specific nasal challenge (ASNC) is an optimal method to study the pathophysiological mechanisms sustaining the allergic inflammation and in particular the adhesion molecule system, which is involved in cellular infiltration of nasal mucosa. Topical steroids have been accepted as a highly effective anti-inflammatory therapy for allergic rhinitis. OBJECTIVE: The aim of this double-blind placebo- controlled study was the evaluation of clinical and cytological parameters, including ICAM-1 expression on nasal epithelial cells, after a 4 week treatment with nasal fluticasone propionate (200 microg/daily) or placebo, using the model of ASNC. METHODS: Twenty allergic rhinitics underwent nasal challenge before and after treatment. The following parameters were evaluated: (i) nasal symptoms (rhinorrhoea, itching, sneezing, obstruction), (ii) inflammatory cells (eosinophils and neutrophils), (iii) ICAM-1 expression on nasal epithelial cells at baseline, 30 min (early phase) and 6 h (late phase) after ASNC. RESULTS: Fluticasone propionate was capable of reducing: (i) clinical symptoms during both early (P<0.001) and late phase (P<0.04), (ii) eosinophil (P<0.002) and neutrophil (P<0.001) infiltrate during late phase, and (iii) ICAM-1 expression on nasal epithelial cells during both early (P < 0.01) and late phase (P < 0.03). CONCLUSIONS: The present results demonstrate that fluticasone propionate exerts a significant action on early and late phase clinical events following specific nasal challenge, reducing also the cellular influx during the late phase. This event is likely due to the modulation of ICAM-1 expression on epithelial cells.

Adolescent↗
PubMed1998

Allergen-specific nasal challenge: response kinetics of clinical and inflammatory events to rechallenge.

Allergen-specific nasal challenge is a valid and reliable tool for studying the pathophysiological mechanisms involved in allergic inflammation. Nasal challenge induces an immediate clinical response in allergic subjects and a concomitant appearance of an inflammatory infiltrate. The mucosal inflammation may persist up to 48-72 h after allergen exposure. If the subjects are rechallenged within this period the response is more pronounced: the so-defined priming effect. The aim of the study was to evaluate the effects of the nasal rechallenge, performed at different time intervals: 3 days, 1, 2 and 4 weeks after the first challenge. Forty allergic subjects underwent two nasal challenges: at baseline and after the periods mentioned above (10/group). Symptoms and inflammatory cells (eosinophils and neutrophils recovered by nasal brushing) were assessed. The 3-day-interval group showed a hyperreactive response (priming effect), the 1- and 4-week-interval groups showed a response similar to baseline, and the 2-week-interval group showed a hyporeactive response ('tolerogenic effect'). The last phenomenon may be due to a possible immunologic response similar to that achievable during local specific immunotherapy. The present results further elucidate the kinetics of allergen-driven inflammatory events and highlight the importance of the time period chosen for rechallenge. The latter fact may be of primary importance in clinical trials involving specific challenge.

Adolescent↗
PubMed1998

[Peripheral neuroectodermal tumors of the chest wall. Description of a case].

The authors discuss a case of malignant small round cell tumor of the thoracopulmonary region (Askin tumor) in which the initial pathological diagnosis was "sarcoma". Only a review of the histological specimens and the clinical features and evolution revealed the correct diagnosis of "Askin tumor". A 15 year old girl with fever, dyspnoea, cough underwent thoracentesis, which revealed hemothorax. At surgery, a large mass not involving the lung, with pleural thickening, was found in the left hemithorax and excised, without rib resection. No metastasis was observed at that time. Histological findings revealed features of malignant small round cell tumors, with occasional pseudo-rosettes. Chemotherapy was performed. 16 months after clinical presentation the girl died with abdomino-thoracic metastatic disease.

Adolescent↗
PubMed1997

Seasonal rhinitis and azelastine: long- or short-term treatment?

BACKGROUND: Azelastine is a topical antihistamine, clinically demonstrated to be effective in allergic rhinitis. OBJECTIVE: We evaluated the clinical efficacy and the antiallergic activity of azelastine nasal spray, administered 0.56 mg per day, 0.28 mg per day, or on demand over a 3-month period during natural allergen exposure, in a double-blind, placebo-controlled fashion. METHODS: Thirty patients, sensitized to grass or Parietaria pollen, were allocated to three treatment groups: those receiving the standard dosage (0.14 mg/nostril two times a day), half the dosage (0.07 mg/nostril two times a day), or placebo daily for 3 months. All patients were allowed to take additional doses of azelastine when needed. Evaluation parameters were as follows: clinical symptoms recorded on a diary card, number of additional, on-demand azelastine puffs, nasal inflammatory cell count, intercellular adhesion molecule-1 expression on nasal epithelial cells, and pollen count. RESULTS: This study showed the following: (1) the half dose (0.28 mg/day) and the standard dose (0.56 mg/day) were equally effective in reducing clinical symptoms (p = NS), although the standard dosage required fewer additional puffs during times of peak pollen counts (p < 0.05); (2) both dosages were able to reduce the allergic inflammation (p < 0.05 vs placebo); and (3) on-demand use achieved acceptable clinical control but did not significantly reduce allergic inflammation. CONCLUSION: Continuous treatment was more effective than on-demand use as assessed by both clinical evaluation and antiinflammatory action.

Administration, Intranasal↗
PubMed1997

Continuous versus on demand treatment with cetirizine for allergic rhinitis.

BACKGROUND: Cetirizine is an antihistamine used in the treatment of allergic rhinoconjunctivitis, that has antiallergic activity. OBJECTIVE: The aim of this double-blind, placebo-controlled, parallel group study was to evaluate the clinical efficacy and the antiallergic activity of cetirizine, administered either continuously or on demand over a 4-week period of natural allergen exposure. METHODS: Twenty patients, with allergic rhinoconjunctivitis due to grass and/or Parietaria pollen, were enrolled. They were randomized into 2 parallel groups: one group received the standard dose of 10 mg cetirizine daily and the other received placebo, all patients were allowed to take an additional daily dose of cetirizine when needed. Variables evaluated were clinical symptoms (recorded on diary cards), number of additional on demand cetirizine doses, nasal inflammatory cells, and pollen counts. RESULTS: The results of the present study show that patients treated with continuous administration of cetirizine achieved significant symptomatic relief and inflammatory control (decreases in numbers of infiltrating neutrophils and eosinophils) in comparison to patients treated on demand. CONCLUSION: Continuous treatment with cetirizine is more effective than on demand treatment. Continuous treatment reduces clinical and inflammatory variables more than symptomatic treatment and the on demand therapy can determine acceptable clinical control, but does not reduce allergic inflammation.

Adult↗