Search PubMed⌕ Search

Biomedical subjects

G Senna

Publications and source records attributed to G Senna.

50 records · Page 3Linked to original sources
PubMed1993

[Anaphylaxis induced by exertion].

Exercise induced anaphylaxis (EIA) is a relatively new syndrome described in 1980. It is associated with different kinds of exercise, although jogging is the most frequently reported. The clinical manifestations progress from pruritus, erythema and urticaria to some combination of cutaneous angioedema, gastrointestinal and laryngeal symptoms and signs of angioedema and vascular collapse. In the full-blown phase a differential diagnosis must be done with the following syndromes: exercise-induced asthma, idiopathic anaphylaxis, cardiac arrhythmias, carcinoid syndrome. An elevated serum histamine level during experimentally-induced attacks and cutaneous degranulation of mast cells after attacks proved a mast cell participation in the pathogenesis of the syndrome. As predisposing factors, a specific or even aspecific sensitivity to food has been reported and such cases are called "food-dependent EIA". Another precipitating factor includes drug intake; moreover a familial tendency has been reported in some studies. Although the prognosis of this syndrome is not well defined, a reduction of attacks occurs in 45% of patients by means of elimination diets and behavioural changes. Treatment of attacks should include all the manoeuvres efficacious in the management of conventional anaphylactic syndrome, including the epinephrine administration. Prevention of attacks may be achieved by limitation of the exercise program or interruption of the program at the appearance of the first premonitory symptoms. The use of H1 antihistamine-receptor antagonists in maintenance therapy seems to be useful, although no controlled data are available.

Adult↗
PubMed1993

Immunoblotting study of specific antibody patterns against latex and banana.

We evaluated three nurses presenting with hypersensitivity to latex gloves: the first suffered from rhinitis and asthma caused by latex and cutaneous and respiratory symptoms by banana; the second, allergic to grass pollens, had systemic symptoms handling latex gloves but no reactivity against banana; the third, with no history of allergic disease, had contact urticaria caused by latex. Skin prick tests and RAST confirmed the presence of specific IgE to latex in all the patients. By means of immunoblot after SDS-PAGE the pattern of antibody response (IgE/IgG) proved to be characteristic to each subject. Moreover, pre-incubation of patient sera with the banana extract could completely absorb the specific anti-banana IgE of the patient allergic to both latex and banana, but failed to modify the anti-latex IgE pattern of the three patients, even if the anti-latex IgG pattern partially changed. In our opinion immunoblotting techniques could play a role in clarifying a complex individual response to unusual allergens.

Adult↗
PubMedDate not supplied

Anaphylaxis due to carrot as hidden food allergen.

Carrot is frequently involved in food allergies and oral allergy syndromes, usually in association with other foods. Nevertheless, carrot alone is rarely responsible for severe systemic reactions. We report a case of anaphylactic shock due to the inadvertent ingestion of carrot as a hidden allergen contained in an ice-cream. The etiological role of carrot in provoking the symptoms was thoroughly ascertained through appropriate in vivo and in vitro assays and by excluding, through double-blind placebo-controlled challenge, the involvement of other ingredients of the food. We highlight once again the harm and risks due to hidden food allergens contained in commercial preparations and the importance of thorough patient education and information.

Adult↗
PubMedDate not supplied

Anaphylaxis to pine nuts and immunological cross-reactivity with pine pollen proteins.

Despite the wide use of pine nuts, the fruit of Pinus pinea, only a few reports of allergic reactions to them have been published. We present herein a case of food allergy to pine nuts in a patient who showed no clinical symptoms to pine pollen despite the presence in her serum of specific IgE antibodies. In order to verify whether the reaction against pine nuts was IgE mediated, specific IgE against pine nuts and pollen were evaluated by skin-prick test, prick by prick and RAST. Immunoblotting and immunoblotting-inhibition were used to evaluate the allergenic components of both extracts and their cross-reactivity. Prick by prick with fresh pine nuts and RAST with pine nut and pine pollen extracts showed that the patient had high levels of specific IgE against both extracts. Immunoblotting experiments showed the presence in serum of IgE antibodies against several components in pine nuts and pollen. Immunoblotting-inhibition experiments demonstrated the presence of some cross-reacting components. These data confirm the existence of food allergy induced by pine nuts. This sensitization to pine nuts developed with no symptoms of pine pollinosis. Development of pollinosis may require a longer time of exposure to allergens. Based on the cross-reactivity between pine nut and pine pollen extracts, cosensitization to these two allergens could be possible.

Adult↗
PubMedDate not supplied

Pollen mixtures used as health food may be a harmful source of allergens.

We describe herein one case of systemic anaphylaxis due to the ingestion of an undefined mixture of pollens, sold as a dietary supplement. The patient, who suffered from rhinoconjunctivitis due to grass pollen (with sensitization to several trees), had a severe episode of anaphylaxis immediately after eating this health food. The episode required emergency care. We attempted to study the pollen mixture responsible, but no pollen granules could be identified. We prepared a solid phase with the pollen mixture, and we observed a RAST positivity with the patient's serum and pools of sera containing specific IgE to trees. Furthermore, a RAST-inhibition assay of the patient's serum showed highly positive results with grasses, birch, alder and Compositae. Therefore, we concluded that the pollen mixture contained determinants capable of cross-reacting with the patient's IgE. This case report is evidence of the possible risks due to the use of undefined herbal products by allergic patients.

Allergens↗
PubMedDate not supplied

Cold-induced rhinitis in skiers--clinical aspects and treatment with ipratropium bromide nasal spray: a randomized controlled trial.

Cold-induced rhinitis (CIR) is common among skiers and is perceived as a troublesome disease. We studied the clinical characteristics of CIR in a population of skiers and we evaluated the effectiveness of ipratropium bromide nasal spray (IBNS) in relieving symptoms in a double-blind placebo-controlled fashion. By means of specific questionnaires, we evaluated 144 subjects (69% men; mean age, 42.2 years). The prevalence of CIR was 48.6% and the distinctive symptom was rhinorrhea (96%), often severe. The prevalence of atopy was higher in the CIR patients (chi2; p = 0.004). Twenty-eight CIR subjects participated in a double-blind placebo-controlled cross-over trial for evaluating the effectiveness of IBNS (80 microg twice per day [b.i.d.]). The severity of symptoms was assessed by a visual analog scale, and the number of cleaning tissues used also was evaluated. The actively treated group showed a significant improvement of rhinorrhea (p = 0.0007) and a reduction in the number of cleaning tissues used (p = 0.0023). Only four mild local side effects were reported. We conclude that IBNS could be regarded as an optimal therapeutic option for treating CIR symptoms in skiers.

Adolescent↗
PubMedDate not supplied

[Occupational asthma induced by casein inhalation].

Reported cases of occupational asthma due to inhalation of milk proteins are rare. Our report is about the first evidence of occupational asthma in a health care worker, caused by an hidden exposure to casein, contained in a commercial dermatological powder widely used in geriatric patients treatment. The diagnosis is based on the case-history and on the positive skin prick test to a commercial and extemporary extract of the occupational allergen.

Adult↗
PubMedDate not supplied

[Bronchial asthma in women: peculiar aspects].

Some peculiar aspects of bronchial asthma in women are pointed out and critically examined. The course of asthma is considered during the typical endocrine phases in women (i.e. pregnancy, menstrual cycle and menopause). A worsening is often reported between the 29th and 36th week of pregnancy; the clinical status during pregnancy is attributed to the interaction between the positive effect of cortisol and the antagonism of DOCA, progesterone, aldosterone on the cortisol-glucocorticoid pulmonary receptors. Also the increase of hypotalamic concentration of noradrenaline which inhibits the pituitary-adrenal axis is considered among of the causes of the worsening of symptoms; moreover the increase of progesterone enhances the gastroesophageal reflux which acts as a trigger stimulus and causes bronchospasm. The therapeutic aspects are examined. All the pharmacologic principles are considered regarding the possible harm to the pregnant woman or the fetus. The oldest and well established molecules are considered the most reliable. Bronchial asthma is then examined with regard to menstrual cycle; pre-menstrual asthma is critically reviewed. The Authors conclude that there are neither conclusive data nor a specific therapy. Finally the pathogenesis of perimenopausal asthma is discussed. A possible hyperestrogenism with possible modification of the PGF2/PGE2 rate may be the cause of this syndrome.

Asthma↗
PubMedDate not supplied

Safety of specific immunotherapy: a retrospective study.

A large experience in specific immunotherapy is reviewed in order to assess the safety of this treatment. From 1968 through September 30, 1993, 300,086 injections were administered to 6,319 patients suffering from allergic asthma and/or rhinitis. Systemic reactions reported during the whole period were 184 (0.061%) in 134 subjects (2.1%) and consisted of: urticaria (59.3%), mild asthmatic attacks (23.9%), asthma and urticaria (9.7%), and spasmodic rhinitis (7.1%). The absence of cases of anaphylaxis confirms the safety of specific immunotherapy. This kind of treatment should be considered as first-line therapy, if carried out in a specialized setting.

Asthma↗
PubMedDate not supplied

[Epidemiology of allergic respiratory diseases: many questions, few answers].

Over the last twenty years an increase of allergic respiratory diseases has been observed, even if a broad variability of incidence has been reported. Asthma and allergic rhinitis are more common among young subjects, but there are data of an increase of allergic respiratory diseases in older patients. Moreover it has to be underlined the increase of the severity of these diseases, as shown by the higher use of anti-allergic drugs and by the increase of fatal asthma. The reasons of this trend are not understood. One reason can be the more appropriate diagnosis of asthma by the general practitioners. Other factors must be considered: the most important one can be air pollution; many air components (i.e. SO2, NO2, O3), particularly in industrialized countries, may play a role in allergic sensitization through an irritative-inflammatory mechanism. Socio-economic factors can also influence the incidence of allergic diseases. Other factors as cigarette smoke, foods, allergenic load have to be mentioned. Finally a viral etiology has been reported. Very recently, the allergic inflammation has been considered as the crucial event in the pathogenesis of allergic respiratory diseases. As allergic diseases can lead to chronic inflammation, an early and long-lasting treatment is mandatory.

Adolescent↗
PubMedDate not supplied

[New drugs in the treatment of respiratory allergic diseases].

The drugs recently available for the treatment of allergic respiratory diseases include: 1) topical steroids as fluticasone and budesonide; 2) nasal and ocular sodium nedocromil; 3) nasal N-acetyl-aspartyl-glutamic acid; 4) topical antihistamines as levocabastine and azelastine; 5) antileukotrienes and anti PAF (experimental). Topical steroids are the most effective drugs; the new molecules have a low gastric absorption and a rapid liver-metabolism which decreases the risks of systemic side effects. In the treatment of allergic conjunctivitis ocular sodium nedocromil seems to be more effective than cromoglycate, however further studies are needed to evaluate the effectiveness of the nedocromil nasal formulation. In allergic rhinitis good clinical results are obtained using NAAGA. In the treatment of allergic rhino-conjunctivitis topical antihistamines seem as effective as the antihistamines administered by oral route; moreover they cause less side effects. The anti-leukotrienes drugs can be used in the treatment of moderate asthma. In the treatment of bronchial asthma no clinical and functional improvement has been reported using PAF or thromboxane A2 receptor antagonists.

Administration, Topical↗
PubMedDate not supplied

The relationship between clinical efficacy of specific immunotherapy and serum intercellular adhesion molecule-1 levels.

The intracellular adhesion molecule-1 (ICAM-1) is a reliable marker of allergic inflammation; its soluble isoform in serum is hypothesized to reflect the severity of the disease, therefore it may be used to monitor the efficacy of specific immunotherapy. We evaluated the levels of soluble ICAM-1 in the serum of 14 patients with grass-induced respiratory allergy before and after 12 months of specific immunotherapy, and correlated this parameter with the clinical outcome, measured using a visual analog scale. We found that in the majority of the patients, soluble ICAM-1 levels paralleled the clinical trend of the disease, with a significant decrease of soluble ICAM-1 in patients with successful specific immunotherapy (Spearman's correlation test: r = 0.57; p < 0.001). Therefore, we hypothesize that soluble ICAM-1 could be regarded as a reliable indirect marker of specific immunotherapy efficacy and that it could be used for monitoring clinical outcome.

Adolescent↗