Antihistamines in children and adolescents: A practical update

Histamine is a chemical mediator, released predominantly by tissue mast cells, circulating basophils, and neurons, which are activated in response to various immunological and non-immunological stimuli. Histamine has to bind to specific receptors to exert its physiological and pathophysiological functions. Endogenous histamine is the main mediator of the immediate allergic response, which moreover, performs other multiple functions, including regulation of gastric secretion, neurotransmission in the central nervous system, and immunomodulatory activity. The involvement of histamine in various disorders and the importance of receptors in the clinical features have relevant implications in clinical practice. Anti-H1 antihistamines contrast the histamine-dependent effects, mainly concerning nasal symptoms and cutaneous itching and wheal. Antihistamines are among the most prescribed drugs in pediatric care. This review updates the practical use of antihistamines in children and adolescents

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Hymenoptera venom allergy among children in Italy: time for pediatricians to take action

Hymenoptera venom allergy (HVA) is one of the most frequent causes of anaphylaxis following a bee, vespid or ant sting. Real-life data regarding the management of HVA in children are lacking. To address this unmet need, we carried out a survey defining the current management of HVA in children among pediatric allergists in Italy. Educational investments on the improvement of the management of pediatric patients with HVA are urgently needed, and our analysis represents a relevant instrument in targeting a roadmap with this aim. The time for pediatric allergists to take action has come, and a task force from the Rare Allergic Diseases Commission of the Italian Society of Pediatric Allergy and Immunology is working on the topic to improve pediatricians' knowledge and optimize the care of these patients

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The relevance of symptom perception in the management of severe asthma in adolescents

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Association between pollen exposure and nasal cytokines in grass pollen-allergic children

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Profiles of birch Sensitization (Bet v 1, Bet v 2, and Bet v 4) and oral allergy syndrome acrsss Italy

Background: Birch allergy (BA) is a common pollinosis caused by the allergens Bet v 1, Bet v 2, and Bet v 4. Oral allergy syndrome (OAS) is frequently associated with BA. A gradient of sensitization to birch allergen across Europe has been reported. Therefore, this study aimed to investigate the birch sensitization profile, including OAS, across Italy. Methods: We performed a retrospective study of 854 patients (391 males, mean age 35.9 years, range 18-93 years): 196 patients were recruited in Genoa, 188 in northern Italy, 359 in central Italy, and 111 in southern Italy. Serum IgE to Bet v 1, Bet v 2, and Bet v 4 was assessed, and OAS was analyzed. Results: With respect to the geographical path Genoa-North-Center-South, the frequency of sensitization to Bet v 1 decreased significantly (P<.0001) from Genoa (95.41%) to southern Italy (58.56%). The frequency of sensitization to Bet v 2 increased significantly (P<.0001) from Genoa (6.12%) to southern Italy (52.25%). The frequency of Bet v 4 also increased significantly (P=.0002) from Genoa (6.12%) to southern Italy (14.41%). The distribution of patients with OAS differed significantly across the areas (P<.0001), the most marked difference ranging between 33.5% in Genoa and 76.9% in northern Italy. The frequency of birch allergens correlated with OAS in central Italy only. Conclusions: The present study demonstrated a significant difference between sensitization to birch and its clinical expression across Italy (AU)

Introducción: El síndrome de alergia oral (SAO) se encuentra frecuentemente asociado a la alergia al polen de abedul. Se han descrito diferentes gradientes de sensibilización a polen de abedul en Europa. Este estudio pretende determinar el perfil de sensibilización a polen de abedul, incluyendo la presencia de SAO, en Italia. Métodos: Estudio retrospectivo con 854 pacientes (391 hombres, edad media 35,9 años, rango 18-93 años): 196 pacientes procedían de Génova, 188 del Norte de Italia, 359 de Italia Central y 111 del Sur de Italia. Se determinó la IgE específica a Bet v 1, Bet v 2 y Bet v 4, así como la presencia de SAO. Resultados: De acuerdo a la procedencia geográfica Génova-Norte-Centro-Sur de Italia, la sensibilización a Bet v 1 disminuye significativamente (P<0,0001) desde Génova (95,41%) hasta el Sur de Italia (58,56%). La sensibilización a Bet v 2 aumenta significativamente (P<0,0001) desde Génova (6,12%) hasta el Sur de Italia (52,25%). También la sensibilización a Bet v 4 aumenta significativamente (P<0,0002) desde Génova (6,12%) hasta el Sur de Italia (14,41%). Existe una distribución del SAO significativamente diferente entre las diferentes áreas geográficas consideradas, siendo la máxima diferencia la presentada entre Génova (33,5%) y el Norte de Italia (76,9%). Las frecuencias de sensibilización a las diferentes moléculas del polen de abedul se correlacionan con el SAO solo en la región Central de Italia. Conclusiones: El presente estudio demuestra la existencia de diferencias significativas entre la sensibilización a las diferentes moléculas del polen de abedul y su expresión clínica en diferentes regiones italianas (AU)

Cow’s milk allergy: how to deal with it

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