Vernal keratoconjunctivitis: atopy and autoimmunity

BACKGROUND: Vernal Keratoconjunctivitis (VKC) is a rare chronic ocular inflammatory disease and it mainly affects boys in the first decade of life. Although it is a self-limiting disease, patients may present many phases characterized by an exacerbation of inflammatory symptoms with a consequent decline of the quality of life. PURPOSE: define the clinical and immunological profile of patients affected by VKC and investigate their familiar history of autoimmune disorders and their autoimmunity pattern. PATIENTS AND METHODS: 28 children were enrolled (20 males, 71%) aged between 4 and 14 years of life affected by VKC. Family history of allergic and immunological diseases was collected for each patient. In particular, it was asked whether some components of their families were affected by Hashimoto's thyroiditis, type I diabetes, psoriasis or rheumatoid arthritis and Systemic Lupus Erythematosus (SLE). All VKC children underwent a serological evaluation of antinuclear antibodies (ANA). RESULTS: A family history of immunological disorders was found in 46% of patients, 28% of Hashimoto's thyroiditis, 14% of type I diabetes, 14% of psoriasis, and 1 of Systemic Lupus Erythematosus. Furthermore, 35% of patients was ANA positive and they corresponded to patients with a higher ocular score and with the most important clinical symptoms. CONCLUSIONS: the detection of ANA positivity and of a familiar history of autoimmune disorders in a high percentage of children with VKC may help us to better understand the association of this ocular inflammatory disease with systemic autoimmune disorders and atopic condition

Livelli sierici di resistina in bambini con Rinite Allergica

La resistina è una proteina sierica prodotta dagli adipociti e dai macrofagi circolanti con dimostrata attività proinfiammatoria. Molti autori hanno descritto un aumento dei livelli di questa adipochina sierica negli atopici con malattie respiratorie come la rinite allergica (RA)

The growth of Streptococcus mutans in different milks for infant feeding. Int J Immunopathol Pharmacol. 2014 In press

After birth various bacterial species, mainly streptococci, colonize the oral cavity and are frequently isolated from carious lesions in children. Previous studies suggest that an earlier colonization of a child s mouth by cariogenic organisms might be related to a higher risk of caries. The aim of this study is to assess the influence of different milks for infant feeding on the growth of Streptococcus mutans (SM) colonies. Three human milk samples from three different mothers and five infant formulas were tested. To prepare the bacterial inoculum, SM was grown in Brain Heart Infusion broth for 18 hours at 37°C in microaerophilic atmosphere. The growth of SM was determined immediately after the inoculation of milks (T0) and after 24 hours (T24) of incubation. After 24 hours of incubation (DT= CFUs/ml at T24 minus CFUs/ml at T0) the bacterial growth changes were different among milks. Among the complementary milks tested, ΔT of formulas supplemented with Lactobacillus reuteri and with Bifidobacterium lactis was lower than those of non-supplemented formula. In conclusion, on the basis of the reduced SM growth in milks supplemented with probiotics, we may speculate that these formulas have a preventive effect on the development of caries in children

L'efficacia clinica della SLIT è associata ad una variazione del diametro dei pomfi allo Skin Prick Test?

La terapia desensibilizzante specifica per via sublinguale è considerata un valido trattamento delle malattie respiratorie di natura allergica

Studio pediatrico sui fenotipi della rinite allergica in Italia

La rinite allergica (RA) è una patologia causata da iperproduzione di IgE specifiche verso allergeni ambientali innocui e ubiquitari con infiammazione della mucosa nasale che può interessare organi contigui e distanti anche attraverso riflessi neuronali e processi infiammatori sistemici

Allergia alimentare: Qualità della Vita nei bambini a dieta di esclusione

Pochi studi sono stati condotti sulla Qualità di Vita (QdV) su bambini italiani con allergia alimentare. La nostra ricerca si propone di valutare la QdV nei bambini con allergie alimentari che effettuano diete di esclusione

Immunological features in children with vernal keratoconjunctivitis

Background: Vernal Keratoconjunctivitis (VKC) is a rare (<1:10 000 in Europe) chronic, bilateral, seasonally exacerbed inflammation of the ocular surface involving tarsal and/or bulbar conjunctiva. VKC especially affects male children and young boys and it tends to regress in puberty. The diagnosis is based on the common conjuncitval symptoms (itching, photophobia and tearing) and on the characteristic signs (giant papillae, conjunctival hyperaemia and Horner-Trantas dots on the limbal conjunctiva). Moreover, photophobia is a constant feature of the VKC. Aim: To define a clinical, anamnestic and immunological profile of patients with VKC evaluating also the presence of biomarker autoantibodies. Methods: The study was performed at the Immunology and Allergology service of the Pediatric Department, Policlinico Umberto I Hospital, Rome. We enrolled 28 children (18:M) aged 4–14 years with diagnosis of VKC made by an ophthalmologist. To each patient, we asked the family history of allergic and immunological diseases. Among the immunological disorders, we evaluated mainly the presence of Hashimoto′ s thyroiditis, type I diabetes, psoriasis, rheumatoid arthritis and Systemic Lupus Erythematosus (SLE). All patients with a diagnosis of VKC underwent to a serological evaluation with the dosage of ANA autoantibodies. Results: 17 patients (60.7%) patients reported a family history of allergic diseases. About the immunological disorders, one patient presented type 1 diabetes and 14 patients (53%) reported a positive family history for autoimmune diseases: 6 (21%) for Hashimoto′s thyroiditis, 4 (14%) for type I diabetes, 3 (10%) for psoriasis and one for Systemic Lupus Erythematosus. 10 (35.7%) patients were ANA positive and they tended to present an higher severity of VKC. The association between ANA positivity and the family history of immune disorders was not demonstrated. Conclusions: These findings encourage us to consider the VKC as a multifactorial disease that can not be explained only by an allergic mechanism. Moreover, among the patients with VKC, it is important to recognise those subgroups with certain anamnestic, clinical and serum characteristics in order to find out an appropriate therapeutic management and a careful follow-up

Cephalometric pattern and nasal patency in children with primary snoring: the evidence of a direct correlation.

INTRODUCTION: Sleep disordered breathing (SDB) might affect craniofacial growth and children with obstructive sleep apnea syndrome present an increase in total and lower anterior heights of the face and a more anterior and inferior position of the hyoid bone when compared to nasal breathers. OBJECTIVE: To investigate the correlation between rhinomanometric and cephalometric parameters in children with primary snoring (PS), without apnea or gas exchange abnormalities. MATERIALS AND METHODS: Thirty children with habitual snoring (16 females and 14 males) aged 4-8 years (mean age 6.85±1.51 years) were selected by a SDB validate questionnaire. All subjects underwent lateral cephalometric, panoramic radiographies. RESULTS: In our sample 10 children (33%) had snoring 3 nights/week, 11 (37%) 4-6 nights/week and 9 (30%) every night/week. Overall 7 patients (23.3%) were affected by adenoid hypertrophy (AH), 4 (13.3%) by tonsillar hypertrophy (TH) and 13 (43.3%) by AH and TH. We found a more vertical position of the hyoid bone to the mandibular plane (H⊥VT) in patients with a higher frequency (7.3±2.7 vs 7.6±3.7 vs 10.9±2.5 in children snoring 3 nights/week, 4-6 nights/week and every night/week respectively; p = 0.032). Concerning nasal patency significant correlations were found with ANB (maxillary and jaw position with respect to the cranial base), NS∧Ar (growth predictor), sumangle, FMA (total divergence), SnaSnp∧GoMe (inferior divergence), BaN∧PtGn (facial growth pattern), Phw1_PsP (posterosuperior airway space), AHC3H (the horizontal distance between the most anterosuperior point of the hyoid bone and the third cervical vertebra). CONCLUSION: The present study supports the relationship between nasal obstruction and specific craniofacial characteristics in children with primary snoring and lead us to hypothesize that nasal obstruction might explain the indirect link between snoring and cephalometric alterations

Un caso di sbagliata diagnosi di allergia alla penicillina

Vi presentiamo il caso clinico di una bambini di 8 anni con diagnosi di malattia reumatica. Nell'anamnesi familiare si segnalano madre e sorella con deficit del citocromo p450 con conseguente allergia ritardata a diverse classi di farmaci