IgE-mediated fish allergy in children

Abstract: Fish allergy constitutes a severe problem worldwide. Its prevalence has been calculated as high as 7% in paediatric populations, and in many cases, it persists into adulthood with life-threatening signs and symptoms. The following review focuses on the epidemiology of Immunoglobulin E (IgE)-mediated fish allergy, its pathogenesis, clinical manifestations, and a thorough approach to diagnosis and management in the paediatric population. The traditional approach for managing fish allergy is avoidance and rescue medication for accidental exposures. Food avoidance poses many obstacles and is not easily maintained. In the specific case of fish, food is also not the only source of allergens; aerosolisation of fish proteins when cooking is a common source of highly allergenic parvalbumin, and elimination diets cannot prevent these contacts. Novel management approaches based on immunomodulation are a promising strategy for the future of these patients

Oral Immunotherapy for Food-Allergic Children: A Pro-Con Debate.

The prevalence of food allergy has increased in recent years, especially in children. Allergen avoidance, and drugs in case of an allergic reaction, remains the standard of care in food allergy. Nevertheless, increasing attention has been given to the possibility to treat food allergy, through immunotherapy, particularly oral immunotherapy (OIT). Several OIT protocols and clinical trials have been published. Most of them focus on children allergic to milk, egg, or peanut, although recent studies developed protocols for other foods, such as wheat and different nuts. OIT efficacy in randomized controlled trials is usually evaluated as the possibility for patients to achieve desensitization through the consumption of an increasing amount of a food allergen, while the issue of a possible long-term sustained unresponsiveness has not been completely addressed. Here, we evaluated current pediatric OIT knowledge, focusing on the results of clinical trials and current guidelines. Specifically, we wanted to highlight what is known in terms of OIT efficacy and effectiveness, safety, and impact on quality of life. For each aspect, we reported the pros and the cons, inferable from published literature. In conclusion, even though many protocols, reviews and meta-analysis have been published on this topic, pediatric OIT remains a controversial therapy and no definitive generalized conclusion may be drawn so far. It should be an option provided by specialized teams, when both patients and their families are prone to adhere to the proposed protocol. Efficacy, long-term effectiveness, possible role of adjuvant therapies, risk of severe reactions including anaphylaxis or eosinophilic esophagitis, and impact on the quality of life of both children and caregivers are all aspects that should be discussed before starting OIT. Future studies are needed to provide firm clinical and scientific evidence, which should also consider patient reported outcomes.post-print6382 K

Frequency of positive oral food challenges and their outcomes in the allergy unit of a tertiary-care pediatric hospital.

Introduction and objective: The oral food challenge (OFC) is the gold standard to diagnose food allergy (FA); however, it is not a procedure free from the risk of having significant allergic reactions, even life-threatening.The aims of our study were to evaluate the frequency of positive OFCs performed in chil-dren with a suspected diagnosis of IgE- and non-IgE–mediated (food protein–induced enterocolitis syndrome (FPIES)) FA and how the failed challenges were managed.Materials and methods: A retrospective chart review was done on all children who have had OFCs in a tertiary-care pediatric allergy unit from 2017 to 2019.Results: 682 patients were enrolled and 2206 challenges were performed: 2058 (93%) for IgE-mediated FA and 148 (7%) for FPIES. There were 262 (11.8%) challenge failures. The transfer to the emergency department was required 3 times (1.1%). None of the failed challenges resulted in death or hospitalization and 13.3% challenges did not require any treatment.Conclusions: Our findings confirm that food challenges can be performed safely in a specialized setting by well-trained personnel; all food challenge reactions, even the most serious, were reversible, thanks to a prompt recognition and treatment that generally did not worsen over time

Ancora sulle riproduzioni di pitture etrusche a Firenze. Le carte personali di Augusto Guido Gatti (1863-1947)

L’archivio personale del disegnatore della Galleria di facsimile di Firenze, che comprende disegni, fotografie, volumi ed estratti provvisti di dediche, permette di aggiungere alcuni elementi alla conoscenza di questa particolare operazione museografica fiorentina dedicata alla pittura etrusca. In particolare si è voluto tessere il racconto dell’inaugurazione della Galleria avvenuta in occasione di un evento internazionale dedicato agli Etruschi, nonché rendere noti ulteriori disegni relativi alle riproduzioni di pitture etrusche. Questi ultimi, con l’importante acquisizione degli appunti di rilievo presi da Gatti, permettono di completare l’illustrazione del metodo di lavoro del disegnatore fiorentino.More on reproductions of Etruscan paintings in Florence. The private papers of Augusto Guido Gatti. The Gatti family’s archives include drawings, photographs, volumes and extracts from reviews and journals often with dedications to Augusto Guido Gatti. Such material allows us to add to our knowledge of a particular museological practice as the Gallery of Facsimiles in Florence. Illustrated here is the account of its inauguration at the First International Etruscan Congress in Florence in 1928. In addition, the numerous sketches and notes made by Gatti, most of which are published here for the first time, offer a clearer picture of the artist’s method of work in making copies of Etruscan paintings

Facsimile 1. Les collections de dessins modernes reproduisant la peinture étrusque. Organisation des fonds, contextes de production et d’utilisation. Actes des journées d’études organisées à l’École française de Rome, 11-12 décembre 2017

International audienc

Introduzione

Vengono presentati gli atti del convegno Fac-simile 1: le collezioni di documentazione grafica sulla pittura etrusca. Consistenza dei fondi, contesti di produzione e impiego, ospitato dall’École française di Roma a dicembre 2017. Si è trattato del primo incontro tra quelli previsti dal progetto di ricerca quinquennale (2017-2021) Fac-simile. Documentation graphique et musées de peinture étrusque, dell’École française di Roma, la Soprintendenza Archeologia, Belle Arti e Paesaggio di Firenze e ..