16 research outputs found
Safety profile of oral immunotherapy with cow's milk and hen egg: A 10-year experience in controlled trials
No full textBackground: Oral immunotherapy (OIT) for food allergy is gaining interest due to the favorable clinical results reported with cow's milk, hen egg and peanut. The safety of the procedure remains a critical aspect that can limit the introduction of OIT in clinical practice. Objective: We described herein, in detail, the occurrence and characteristics of adverse events (AE) with OIT in children who participated in controlled trials at our unit. Methods: The clinical records of 68 children who received active treatment (40 for cow's milk and 28 for hen egg) were carefully reviewed. The inclusion and exclusion criteria, and the grading of AEs were the same across the trials. Of the 68 children involved, 6 (9%) had to discontinue the OIT procedure due to severe AEs. Fifty percent of the children underwent the buildup and maintenance phases without AEs. Mild-to-moderate AEs were documented in 28 patients, who could complete the desensitization. The majority of reactions were mild or moderate, occurred during an acute intercurrent illness and required only symptomatic treatment. Conclusion: A careful review of the patients who received food OIT in controlled trials confirmed that AEs were not rare but that ∼90% of children could achieve an effective desensitization. The procedure remains investigational and should be performed only by trained physicians, especially in the pediatric setting
Omalizumab therapy in a 13-year-old boy with severe persistent asthma and concomitant eosinophilic esophagitis
No full textBackground: Eosinophilic esophagitis (EoE) has been defined as "asthma of the esophagus" for the large number of similarities between the two diseases. Omalizumab is an anti-Immunoglobulin E (IgE) antibody currently approved only in allergic IgE-mediated severe persistent uncontrolled asthma and in chronic spontaneous urticaria unresponsive to antihistamines, but it has been tried in other diseases, too. Case presentation: We present herein the case of a 13-year-old boy, affected from preschool age by severe chronic allergic asthma poorly controlled despite a generous long-term therapy, and, since he was 8 years old, by eosinophilic esophagitis, responsive to courses of strict elimination diet and semi-elemental diet, even if very burdensome for his quality of life. At the age of 11.5 years, for inadequate asthma control, he started to receive therapy with omalizumab. After the first month and for the entire duration (18 months) of omalizumab treatment, asthma was well controlled, long-term conventional therapy was gradually withdrawn and lung- function improved. Concerning EoE, after an initial clinical but not histological remission during the first few months of treatment with omalizumab, the patient experienced an exacerbation of gastrointestinal symptoms. Therefore, he started treatment with topical steroids which was effective to improve gastrointestinal symptoms. However, EoE is still steroid-dependent. Currently, he continues both treatments: omalizumab for asthma and topical steroid for EoE. Conclusions: This case report confirms that omalizumab is an effective treatment in patients with severe persistent, uncontrolled asthma. On the other hand, in our patient it did not produce persistent improvement neither on symptoms nor on biopsy findings of EoE. The outcome of this case might indicate different pathogenic mechanism(s) of the two diseases
IgE-Mediated Legume Allergy: A Pediatric Perspective
No full textLegumes are an inexpensive and essential protein source worldwide. The most consumed legumes include peanuts, soybeans, lentils, lupines, peas, common bean and chickpeas. In addition, the food industry is growing interested in expanding the use of legumes to partially replace or substitute cereals. Legumes were described to cause IgE-mediated allergies, and their growing use may also increase the incidence of allergy. The epidemiology of legume allergy varies by region; peanuts and soybeans are the legumes most involved in food allergies in Western countries, whereas lentils, peas, and chickpeas are reported as culprit allergens mainly in the Mediterranean area and India. This review, edited by the Italian Society of Pediatric Allergology and Immunology, summarizes the scientific literature on legume allergy in children and proposes a diagnostic workup and therapeutic approach
Exploring CI combustion of ammonia and hydrogen in an ICE with a single-zone thermodynamic model incorporating reaction kinetics
No full textThis graduation thesis studies the CI combustion of ammonia and hydrogen in an ICE. It contains a review of the literature and a modeling study of the ignition and cylinder performance of the AmmoniaDrive test engine. AmmoniaDrive is a NWO-funded research project that aims to decarbonize shipping by introducing an ammonia-fuelled SOFC-ICE power plant for ships and other heavy-duty applications.Ammonia (NH3) has unfavorable properties for combustion, such as a high heat of vaporization, narrow flammability limits, a high flame quenching distance, low flame speed, and most important: a high resistance to autoignition. Those properties have to be overcome and hydrogen (H2) is known to be capable of playing a role. As the properties of hydrogen are extremely high combustion speed, very wide flammability limits and a very short flame quenching distance. Unfortunately, both ammonia and hydrogen have a high resistance to autoignition, while CI engines need a fuel with low resistance to auto-ignition. For this reason, a carbon-based fuel, like DME or HVO, is considered necessary to achieve ignition.The state-of-the-art experimentally achieved combustion concepts are an homogeneous charge compression ignition (HCCI) combustion concept of Pochet et al. [2020a] and an reactivity controlled compression ignition (RCCI) combustion concept of Chiera et al. [2022]. The HCCI combustion concept is fueled by NH3 and H2, without a carbon-based fuel. However, it requires a compression ratio (CR) of 22, a high intake temperature, and is limited by the maximum pressure rise rate (MPRR). The RCCI combustion concept is fueled by NH3 and diesel. This concept can achieve up to 81%e NH3, but still requires 19%e diesel.A modeling study is done to investigate how to improve the CI combustion strategies, taking into consideration the context of AmmoniaDrive. The modeling study consists of two closed volume single-zone thermodynamic reactor models: the ignition model and the engine cylinder model. The ignition model is a constant volume model, resembling top dead center (TDC) conditions. The engine cylinder model simulates a closed volume from bottom dead center (BDC) to 90 CAD after TDC and incorporates volume change and the heat loss. Bothmodels make use of the chemical kinetic mechanism of Shrestha et al. [2018] to incorporate the combustion reaction. Due to the limitation imposed by the available species in chemical kinetic mechanisms, the carbon-based fuel in the modeling study is DME. For the future, hydrotreated vegetable oil (HVO) seems a more favorable carbon-based fuel, based on experimental results in a constant volume combustion chamber (CVCC) of Hernandez et al. [2023].The results of the two models indicate that an HCCI combustion concept of ammonia and hydrogen, without a carbon-based fuel, will not ignite within the engine limits of the AmmoniaDrive test engine. An HCCI combustion concept of ammonia, hydrogen, with DME will ignite, but has a limited power output due to the MPRR. An RCCI combustion concept with stratification of DME throughout the cylinder looks promising based on the engine cylinder model results. Stratifying DME concentration, and with that the fuel reactivity, is likely to reduce the MPRR. This would allow for a higher power output due to the possibility to injectmore fuel energy without exceeding the engine limits.Combining the literature and modeling results, it is likely that an RCCI combustion concept with ammonia, hydrogen, and HVO will lead to a higher power output and a decreased required amount of carbon-based fuel, whilst staying within engine limits.Marine Technology | Marine Engineerin
Nutritional and Psychosocial Impact of Food Allergy in Pediatric Age
No full textTreatment of IgE-mediated food allergy involves avoiding the food causing the allergic reaction. In association, an action plan for allergic reactions is indicated, sometimes including self-injectable adrenaline. In addition to these dietary and medical implications, there are two equally important ones: nutritional and psychosocial. From a nutritional point of view, it is known that children suffering from food allergy have a growth delay in height and weight compared to their non-allergic peers. Specifically, this condition is directly related to the specific food excluded from the diet, the number of foods excluded and the duration of the elimination diet. From a psychosocial point of view, the child often cannot eat the foods other guests eat. Children with food allergy may perceive an aura of parental anxiety around their mealtime and may be afraid that what they eat could have harmful consequences for their health. Furthermore, children’s and their parents’ quality of life appears to be affected. The need to manage the allergy and the nutritional and psychosocial problems positions the pediatric nutritionist and the child neuropsychiatrist as support figures for the pediatric allergist in managing the child with food allergy
The Role of Gut and Lung Microbiota in Susceptibility to Tuberculosis
Get PDFInternational audienceTuberculosis is one of the most common infectious diseases and infectious causes of death worldwide. Over the last decades, significant research effort has been directed towards defining the understanding of the pathogenesis of tuberculosis to improve diagnosis and therapeutic options. Emerging scientific evidence indicates a possible role of the human microbiota in the pathophysiology of tuberculosis, response to therapy, clinical outcomes, and post-treatment outcomes. Although human studies on the role of the microbiota in tuberculosis are limited, published data in recent years, both from experimental and clinical studies, suggest that a better understanding of the gut–lung microbiome axis and microbiome–immune crosstalk could shed light on the specific pathogenetic mechanisms of Mycobacterium tuberculosis infection and identify new therapeutic targets. In this review, we address the current knowledge of the host immune responses against Mycobacterium tuberculosis infection, the emerging evidence on how gut and lung microbiota can modulate susceptibility to tuberculosis, the available studies on the possible use of probiotic–antibiotic combination therapy for the treatment of tuberculosis, and the knowledge gaps and future research priorities in this field
Phenotypes and Endotypes of Peach Allergy: What Is New?
No full textInternational audiencePeach allergy is emerging as a common type of fresh-fruit allergy in Europe, especially in the Mediterranean area. The clinical manifestations of peach allergy tend to have a peculiar geographical distribution and can range from mild oral symptoms to anaphylaxis, depending on the allergic sensitization profile. The peach allergen Pru p 7, also known as peamaclein, has recently been identified as a marker of peach allergy severity and as being responsible for peculiar clinical features in areas with high exposure to cypress pollen. This review addresses the latest findings on molecular allergens for the diagnosis of peach allergy, the clinical phenotypes and endotypes of peach allergy in adults and children, and management strategies, including immunotherapy, for peach allergy
