[Allergy to cow's milk proteins in childhood: the authors' personal experience and new diagnostic and therapeutic proposals]. / L'allergia alle proteine del latte vaccino nell'infanzia: esperienze personali e nuove proposte di diagnosi e di terapia.

Cow's milk protein is quite commune in infancy (2-3% in first year of age). Casein, beta-lactoglobulin and alpha-lactalbumin are the main allergens of cow's milk. The authors describe the immunological reaction involved in IgE synthesis and consequential inflammation after ingestion of cow's milk proteins and present soy and protein extensive hydrolysates as alternative diets for children with cow's milk allergy. Moreover, the authors present their studies on immunogenicity of hydrolysed formulae. At the end they suggest the therapeutic strategy in the cow's milk protein allergy.

[The inhalational therapy of respiratory pathology]. / La terapia inalatoria nella patologia respiratoria.

The inhalation of aerosolized drugs for therapeutic purpose has been used for many years in respiratory diseases as asthma, chronic bronchitis, cystic fibrosis. Therapeutic aerosols have the advantages to deliver active substances directly to the site of disease, without systemic side effects, to produce a more rapid clinical response, to avoid barriers to the absorption of drugs such as the gastrointestinal tract. We review the mechanisms and the site of lung deposition and the range of devices that can provide an effective aerosol such as metered dose-inhaler and spacers. Besides drugs as cromolyn, beta-2-agonists and topical steroids, recently new inhalation therapies were proposed using antiviral drugs (interferon), pentamidine for Pneumocystis carinii in immunocompromised host, inhalation of attenuated virus (measles) for active immunization. However there is a need for further work in this area.

IgG2 deficiency and intractable epilepsy of childhood.

Twelve children with intractable childhood epilepsy (ICE) were treated with high-dose intravenous immunoglobulins every 21 days for 6 months after immunologic and neurologic evaluations had been carried out. 50% (6/12) were found to have a deficiency of serum IgG2 and all but 1 of these responded to treatment with marked reduction in the daily number of seizures assessed both clinically and electroencephalographically. The response to treatment was, in fact, significantly higher in the children with IgG2 deficiency than in the others. IgG4 deficiency, observed in 5 children, did not affect treatment response. It is suggested that IgG2 deficiency may predispose to some form of viral encephalitis which may trigger an immune mechanism leading to the ICE.