AIT (allergen immunotherapy): A model for the "precision medicine"

The interpretation of medical approaches, especially therapy, evolved rapidly in the last century. Starting from the simple description of symptoms, we moved to the pathophysiological descriptions, to the evidence-based medicine, until the so-called "precision medicine". This latter can be defined as a structural model aimed at customizing healthcare, with medical decisions/products tailored on an individual patient at a highly detailed level. In this sense, allergen immunotherapy represents an optimal model of "precision medicine", since we know and describe symptoms, function, aetiological agents at molecular level, and we have the possibility to intervene on the natural history of the disease. If considered under the point of view of pharmaco-economy, that is prescribing the optimal treatment to the right patient, allergen immunotherapy represents an almost-ideal model of precision medicine

AIT (allergen immunotherapy): A model for the "precision medicine"

The interpretation of medical approaches, especially therapy, evolved rapidly in the last century. Starting from the simple description of symptoms, we moved to the pathophysiological descriptions, to the evidence-based medicine, until the so-called "precision medicine". This latter can be defined as a structural model aimed at customizing healthcare, with medical decisions/products tailored on an individual patient at a highly detailed level. In this sense, allergen immunotherapy represents an optimal model of "precision medicine", since we know and describe symptoms, function, aetiological agents at molecular level, and we have the possibility to intervene on the natural history of the disease. If considered under the point of view of pharmaco-economy, that is prescribing the optimal treatment to the right patient, allergen immunotherapy represents an almost-ideal model of precision medicine

Comparison of ammoniated and nonammoniated extracts in children with latex allergy

The use of ammoniated or nonammoniated latex extracts for the diagnosis of latex allergy is still a matter of debate. The aim of our study was to compare the characteristics of the two types of extracts by immunoblotting and RAST techniques in children with ascertained latex allergy

Allergen immunotherapy in asthma; what is new?

The use and role of allergen immunotherapy (AIT) in asthma is still a matter of debate, and no definite recommendation about this is made in guidelines, both for the subcutaneous and sublingual routes. This is essentially due to the fact that most controlled randomised trials were not specifically designed for asthma, and that objective measures of pulmonary function were only occasionally considered. Nonetheless, in many trials, favourable results in asthma (symptoms, medication usage, bronchial reactivity) were consistently reported. There are also several meta analyses in favour of AIT, although their validity is limited by a relevant methodological heterogeneity. In addition to the crude clinical effect, a disease modifying action of AIT (prevention of asthma onset and long-lasting effects) have been reported. The safety is an important aspect to consider in asthma. Fatalities were rare: In Europe no fatality was reported in the last three decades, as in the United States in the last 4 years. Based on previous surveys, and common sense, uncontrolled asthma is still recognized as the most important risk factor for severe adverse events. On the contrary, there is no evidence that AIT can worsen or induce asthma. According to the available evidence, AIT can be safely used as add-on treatment when asthma is associated with rhinitis (a frequent condition), provided that asthma is adequately controlled by pharmacotherapy. AIT cannot be recommended or suggested as single therapy. When asthma is the unique manifestation of respiratory allergy, its use should be evaluated case by case

Computational analysis of transport in three-dimensional heterogeneous materials: An OpenFOAM®-based simulation framework

Porous and heterogeneous materials are found in many applications from composites, membranes, chemical reactors, and other engineered materials to biological matter and natural subsurface structures. In this work we propose an integrated approach to generate, study and upscale transport equations in random and periodic porous structures. The geometry generation is based on random algorithms or ballistic deposition. In particular, a new algorithm is proposed to generate random packings of ellipsoids with random orientation and tunable porosity and connectivity. The porous structure is then meshed using locally refined Cartesian-based or unstructured strategies. Transport equations are thus solved in a finite-volume formulation with quasi-periodic boundary conditions to simplify the upscaling problem by solving simple closure problems consistent with the classical theory of homogenisation for linear advection–diffusion–reaction operators. Existing simulation codes are extended with novel developments and integrated to produce a fully open-source simulation pipeline. A showcase of a few interesting three-dimensional applications of these computational approaches is then presented. Firstly, convergence properties and the transport and dispersion properties of a periodic arrangement of spheres are studied. Then, heat transfer problems are considered in a pipe with layers of deposited particles of different heights, and in heterogeneous anisotropic materials

Choosing the optimal dose in sublingual immunotherapy: Rationale for the 300 index of reactivity dose

Sublingual immunotherapy (SLIT) is an effective and well-tolerated method of treating allergic respiratory diseases associated with seasonal and perennial allergens. In contrast to the subcutaneous route, SLIT requires a much greater amount of antigen to achieve a clinical effect. Many studies have shown that SLIT involves a dose-response relationship, and therefore it is important to use a proven clinically effective dose from the onset of treatment, because low doses are ineffective and very high doses may increase the risk of side effects. A well-defined standardization of allergen content is also crucial to ensure consistent quality, potency and appropriate immunomodulatory action of the SLIT product. Several methods of measuring antigenicity are used by manufacturers of SLIT products, including the index of reactivity (IR), standardized quality tablet unit, and bioequivalent allergy unit. A large body of evidence has established the 300 IR dose of SLIT as offering optimal efficacy and tolerability for allergic rhinitis due to grass and birch pollen and HDM, and HDM-induced moderate, persistent allergic asthma. The 300 IR dose also offers consistency of dosing across a variety of different allergens, and is associated with higher rates of adherence and patient satisfaction. Studies in patients with grass pollen allergies showed that the 300 IR dose has a rapid onset of action, is effective in both adults and children in the short term and, when administered pre-coseasonally in the long term, and maintains the clinical benefit, even after cessation of treatment. In patients with HDM-associated AR and/or asthma, the 300 IR dose also demonstrated significant improvements in symptoms and quality of life, and significantly decreased use of symptomatic medication. The 300 IR dose is well tolerated, with adverse events generally being of mild or moderate severity, declining in frequency and severity over time and in the subsequent courses. We discuss herein the most important factors that affect the selection of the optimal dose of SLIT with natural allergens, and review the rationale and evidence supporting the use of the 300 IR dose

Monitoring biomass in two heterogeneous mountain pasture communities by image based 3D point cloud derived predictors

Abstract Primary productivity is a robust indicator of ecosystem functioning because of its close relationships with the stability of the ecological systems. In ecological research, the above ground biomass (AGB) is the most commonly used proxy of primary productivity. However, despite their ecological relevance, the estimates of primary productivity are not addressed by current protocols for monitoring the conservation status of the habitats of Community interest. In this paper, we analyse the accuracy of AGB measurements obtained by image-derived 3D reconstructions of two contrasting mountain grasslands listed as habitats of Community interest in the Annex I of the Habitats Directive. More specifically, we compared the accuracy of the AGB estimates provided by four models, based on four different predictors (height, volume, volume adjusted, and cover volume), in order to evaluate their robustness against within- and between-community heterogeneity. Our study revealed that AGB measures computed from 3D vegetation reconstructions can be an effective way to evaluate primary productivity in herbaceous communities with complex structure and composition patterns. In particular, the vegetation height showed to have the highest correlation with direct AGB measurements. However, the vegetation volume, once adjusted by the coefficient of density, resulted to be the most effective proxy due to the lowest error level. Therefore, such a parameter could be routinely used as a non-destructive indicator for monitoring habitats of particular conservation concern. As a major limitation for this approach, we detected some loss of predictivity power at very low productivity rates

Contribution to the knowledge of the veterinary science and of the ethnobotany in Calabria region (Southern Italy)

BACKGROUND: A series of preliminary research projects on plants used in Calabria (Southern Italy) in veterinary science and in other ethno-botanical fields (minor nourishment, domestic and handicraft sector) was carried out in the last twenty years. From the ethno-botanical point of view, Calabria is one of the most interesting region, since in the ancient times it was subject to the dominant cultures of several people (Greeks, Romans, Byzantines, Arabs, Normans etc.). Until some decades ago the road network was poorly developed and villages were isolated, so that the culture of the "subsistence" and some archaic customs were kept. METHODS: Data were collected by means of "open" interviews to farmers, shepherds and housewives in the last twenty years. More than 100 informants were interviewed, mostly over 50 years old. Plants were identified by local informants through gathering in the area or through examination of the fresh plants collected by the researchers. The collected data were compared with pharmacobotanical papers mainly of southern Italy and with other studies, in order to highlight novelties or concordances of uses. RESULTS: The use of 62 taxa distributed into 34 families are described. Among these, 8 are or were employed in veterinary science, 8 as anti-parasitic agents, 19 in minor nourishment, 5 as seasoning, 38 for other uses. Some toxic species for cattle are also mentioned. CONCLUSION: Among the major findings: the use of Helleborus bocconei for bronchitis of bovines and of Scrophularia canina for lameness in veterinary science; Nerium oleander and Urginea maritima as anti-parasitic agents; Epilobium angustifolium, Centaurea napifolia L. and C. sphaerocephala L. in minor nourishment

Bronchial hyperresponsiveness in children with atopic rhinitis: a 7-year follow-up

A high prevalence of bronchial hyperresponsiveness (BHR) was found in atopic subjects with rhinitis. Those subjects may be at higher risk for developing bronchial asthma. We evaluated, in a 7-year follow-up, BHR and atopy in a homogeneous population of nonasthmatic children with allergic rhinitis (AR), and their role in asthma development