Itraconazole as 'bridge therapy' to anti-IgE in a patient with severe asthma with fungal sensitisation.

Sensitisation to fungi has been reported to play an important role in a particular phenotype of severe asthma, the so-called severe asthma with fungal sensitisation, characterised by high levels of total IgE, which may be an obstacle to anti-IgE therapy. We describe here the case of a polysensitised woman with refractory asthma, sensitised to Aspergillus fumigatus with high total IgE values (1793 kUA/l), but without the diagnostic criteria for allergic bronchopulmonary aspergillosis. Additional therapy with itraconazole leads to the decrease of total IgE to the limits recommended for proper omalizumab dosing (30–1500 kUA/l). Itraconazole, used as bridge therapy, provided us the opportunity to start anti-IgE treatment in a patient with high levels of total IgE, beyond the upper limits recommended for proper prescription of omalizumab

Exhaled breath condensate nitrates, but not nitrites or FENO, relate to asthma control.

SummaryBackgroundAsthma is a chronic respiratory disease, characterised by airways inflammation, obstruction and hyperresponsiveness. Asthma control is the goal of asthma treatment, but many patients have sub-optimal control. Exhaled NO and exhaled breath condensate (EBC) NO metabolites (nitrites and nitrates) measurements are non-invasive tools to assess airways inflammation. Our aim was to investigate the relationships between asthma control and the above-named biomarkers of airways inflammation.MethodsThirty-nine non-smoking asthmatic patients (19 women) aged 50 (21–80) years performed measurements of exhaled NO (FENO), EBC nitrates, nitrites and pH, and answered Asthma Control Questionnaire (ACQ) and Asthma Control Test (ACT)-questionnaire.ResultsThe ACT and ACQ score were strongly interrelated (ρ=−0.84, p<0.001). No relationships between ACT or ACQ score and FENO were found (p>0.05). EBC nitrates were negatively related to ACT score (ρ=−0.34, p=0.03) and positively related to ACQ score (ρ=0.41, p=0.001) while no relation of EBC nitrites to either ACQ or ACT score was found (p>0.05).ConclusionEBC nitrates were the only biomarker that was significantly related to asthma control. This suggests that nitrates, but not nitrites or FENO, reflect an aspect of airways inflammation that is closer related to asthma symptoms. Therefore there is a potential role for EBC nitrates in objective assessment of asthma control

Non-Melanoma Skin Cancer: news from microbiota research

Recently, research has been deeply focusing on the role of the microbiota in numerous diseases, either affecting the skin or other organs. What it is well established is that its dysregulation promotes several cutaneous disorders (i.e. psoriasis and atopic dermatitis). To date, little is known about its composition, mediators and role in the genesis, progression and response to therapy of Non-Melanoma Skin Cancer (NMSC). Starting from a bibliographic study, we classified the selected articles into four sections: i) normal skin microbiota; ii) in vitro study models; iii) microbiota and NMSC and iv) probiotics, antibiotics and NMSC. What has emerged is how skin microflora changes, mainly represented by increases of Staphylococcus aureus, Streptococcus pyogenes and Pseudomonas aeruginosa strains, modifications in the mutual quantity of \u3b2-Human papillomavirus genotypes, of Epstein Barr Virus and Malassezia or candidiasis, may contribute to the induction of a state of chronic self-maintaining inflammation, leading to cancer. In this context, the role of S. aureus and that of specific antimicrobial peptides look to be prominent. Moreover, although antibiotics may contribute to carcinogenesis, due to their ability to influence the microbiota balance, specific probiotics, such as Lacticaseibacillus rhamnosus GG, Lactobacillus johnsonii NCC 533 and Bifidobacteria spp., may be protective

Oxidation and Cross-Linking in the Curing of Air-Drying Artists' Oil Paints

In this study, the chemistry of air-drying artist's oil paint curing and aging up to 24 months was studied. The objective is to improve our molecular understating of the processes that lead to the conversion of the fluid binder into a dry film and how this evolves with time, which is at the base of a better comprehension of degradation phenomena of oil paintings and relevant to the artists' paint manufacturing industry. To this aim, a methodological approach based on thermogravimetric (TG) analysis, differential scanning calorimetry (DSC), gas chromatography-mass spectrometry (GC-MS), and analytical pyrolysis coupled with gas chromatography and mass spectrometry (Py-GC-MS) was implemented. Model paintings based on linseed oil and safflower oil (a drying and a semidrying oil, respectively) mixed with two historically relevant pigments - lead white (a through drier) and synthetic ultramarine blue (a pigment often encountered in degraded painting layers) - were investigated. The oil curing under accelerated conditions (80 °C under air flow) was followed by isothermal TG analysis. The oxygen uptake profiles were fit by a semiempiric equation that allowed to study the kinetics of the oil oxidation and estimate oxidative degradation. The DSC signal due to hydroperoxide decomposition and radical recombination was used to monitor the radical activity over time and to evaluate the stability of peroxides formed in the paint layers. GC-MS was performed at 7 and 24 months of natural aging to investigate the noncovalently cross-linked fractions and Py-GC-MS to characterize the whole organic fraction of the model paintings, including the cross-linked network. We show that the oil-pigment combination may have a strong influence on the relative degree of oxidation of the films formed with respect to its degree of cross-linking, which may be correlated with the literature on the stability of painting layers. Undocumented pathways of oxidation are also highlighted