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  1. Article ; Online: Non-IgE-mediated anaphylaxis.

    Cianferoni, Antonella

    The Journal of allergy and clinical immunology

    2021  Volume 147, Issue 4, Page(s) 1123–1131

    Abstract: Anaphylaxis is a rapidly evolving, acute, life-threatening reaction that occurs rapidly on contact with a trigger. Anaphylaxis is classically defined as an allergen-driven process that induces specific IgE and the activation of mast cells and basophils ... ...

    Abstract Anaphylaxis is a rapidly evolving, acute, life-threatening reaction that occurs rapidly on contact with a trigger. Anaphylaxis is classically defined as an allergen-driven process that induces specific IgE and the activation of mast cells and basophils through the cross-linking of IgE receptors. However, it is clear that non-IgE-mediated pathways can induce symptoms indistinguishable from those of classic anaphylaxis, and their activation could explain the severity of IgE-mediated anaphylaxis. Indeed, mast cells and basophils can be activated by antibodies against IgE or their receptors, by molecules such as anaphylatoxins, or through G-coupled receptors. Some other allergens can induce antibodies of class IgG that can activate neutrophils to produce a molecule similar to histamine to induce anaphylaxis. Finally, some inflammatory mediators such as bradykinin or prostaglandin can also modulate mast cell and basophil activation as well as directly cause vasodilation and bronchoconstriction, resulting in anaphylaxis-like reactions.
    MeSH term(s) Allergens/immunology ; Anaphylatoxins/metabolism ; Anaphylaxis/immunology ; Animals ; Basophils/immunology ; Bronchoconstriction ; Cell Degranulation ; Histamine/metabolism ; Humans ; Hypersensitivity/immunology ; Immunoglobulin E/immunology ; Immunoglobulin E/metabolism ; Mast Cells/immunology ; Neutrophils/immunology ; Receptors, IgE/immunology ; Receptors, IgE/metabolism ; Vasodilation
    Chemical Substances Allergens ; Anaphylatoxins ; Receptors, IgE ; Immunoglobulin E (37341-29-0) ; Histamine (820484N8I3)
    Language English
    Publishing date 2021-04-05
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 121011-7
    ISSN 1097-6825 ; 1085-8725 ; 0091-6749
    ISSN (online) 1097-6825 ; 1085-8725
    ISSN 0091-6749
    DOI 10.1016/j.jaci.2021.02.012
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  2. Article ; Online: Food protein-induced enterocolitis syndrome epidemiology.

    Cianferoni, Antonella

    Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology

    2021  Volume 126, Issue 5, Page(s) 469–477

    Abstract: Objective: Food protein-induced enterocolitis syndrome (FPIES) is a condition with heterogeneous features (ie, age at presentation, severity, food triggers, comorbidities) and is not as rare as initially believed. In the last few years, the first ... ...

    Abstract Objective: Food protein-induced enterocolitis syndrome (FPIES) is a condition with heterogeneous features (ie, age at presentation, severity, food triggers, comorbidities) and is not as rare as initially believed. In the last few years, the first population-based epidemiologic study, few prospective birth cohort evaluating FPIES prevalence, and several larger (>100 patients) studies have been published, making epidemiologic estimation more reliable. In this review, we report on the available data on the epidemiology of FPIES.
    Data sources: PubMed review using the following words: FPIES, epidemiology, and prevalence.
    Study selections: The review focused on the population-based epidemiologic study, few prospective birth cohort evaluating FPIES prevalence, and several larger (>100 patients) studies.
    Results: We identified 8 population or cohort studies.
    Conclusion: FPIES is not rare in both children and adults and may affect as many as 900,000 people in the United States alone. Most children and adult with FPIES seem to react to 1 to 2 foods; however, they may need further diet restriction owing to high level of comorbidity with immunoglobulin E-mediated food allergies and eosinophilic esophagitis. Globally, cow's milk, rice/oat, and seafood seem to be the most common triggers.
    MeSH term(s) Adult ; Allergens/immunology ; Child ; Comorbidity ; Dietary Proteins/immunology ; Enterocolitis/epidemiology ; Enterocolitis/immunology ; Enterocolitis/pathology ; Female ; Food Hypersensitivity/epidemiology ; Food Hypersensitivity/immunology ; Food Hypersensitivity/pathology ; Humans ; Male ; Risk Factors
    Chemical Substances Allergens ; Dietary Proteins
    Language English
    Publishing date 2021-02-16
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1228189-x
    ISSN 1534-4436 ; 0003-4738 ; 1081-1206
    ISSN (online) 1534-4436
    ISSN 0003-4738 ; 1081-1206
    DOI 10.1016/j.anai.2021.02.006
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  3. Article ; Online: Eosinophilic esophagitis and other eosinophilic disorders of the gastrointestinal tract.

    Cianferoni, Antonella

    Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology

    2020  Volume 31 Suppl 24, Page(s) 25–27

    Abstract: Eosinophilic disorders of the gastrointestinal tract (EGID) are a group of diseases characterized by an eosinophilic inflammation limited to the GI tract. EoE is by far the most common EGID and is an atopic chronic/relapsing eosinophilic inflammation of ... ...

    Abstract Eosinophilic disorders of the gastrointestinal tract (EGID) are a group of diseases characterized by an eosinophilic inflammation limited to the GI tract. EoE is by far the most common EGID and is an atopic chronic/relapsing eosinophilic inflammation of the esophagus. It is now recognized as an increasingly common cause of esophageal dysfunction, fibrosis, stricture, and food impaction in children and adults. There are globally accepted guidelines for its treatment that are based on the use of proton pump inhibitors (PPI), corticosteroids, and diet. Many clinical trials have been published on the use of biologics in this disease. Non-EoE-EGID is a rare, more severe disease. No globally accepted guidelines exist for their treatment and diagnosis. Corticosteroids are at the moment the most effective treatment of those diseases.
    MeSH term(s) Adrenal Cortex Hormones/therapeutic use ; Adult ; Child ; Diet Therapy ; Eosinophilic Esophagitis/immunology ; Eosinophilic Esophagitis/therapy ; Esophagus/pathology ; Gastrointestinal Tract/pathology ; Humans ; Inflammation/immunology ; Inflammation/therapy ; Practice Guidelines as Topic ; Proton Pump Inhibitors/therapeutic use
    Chemical Substances Adrenal Cortex Hormones ; Proton Pump Inhibitors
    Language English
    Publishing date 2020-02-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 1057059-7
    ISSN 1399-3038 ; 0905-6157 ; 0906-5784
    ISSN (online) 1399-3038
    ISSN 0905-6157 ; 0906-5784
    DOI 10.1111/pai.13153
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  4. Article ; Online: Eosinophilic Esophagitis as a Side Effect of Food Oral Immunotherapy.

    Cianferoni, Antonella

    Medicina (Kaunas, Lithuania)

    2020  Volume 56, Issue 11

    Abstract: Food allergies (FAs) include a spectrum of immune-mediated serious and potentially life-threatening medical conditions with an overall estimated prevalence ranging from 4% to 8% in the U.S. and Europe. Significant progress in food allergen-specific ... ...

    Abstract Food allergies (FAs) include a spectrum of immune-mediated serious and potentially life-threatening medical conditions with an overall estimated prevalence ranging from 4% to 8% in the U.S. and Europe. Significant progress in food allergen-specific immunotherapy has been accomplished over the past 10 years. The most studied strategy has been oral immunotherapy (OIT), also known as food desensitization, a treatment in which a child is slowly and deliberately given a small amount of the food to ingest (that previously was a food allergy trigger) with the ultimate goal of the child eating that food without a reaction. OIT is now recommended in the European guidelines for the treatment of milk, egg, and peanut allergies and was the first American Food Drug Administration (FDA) approved product for the prevention of severe reaction to peanuts in 4-17 year olds to be released on the market. The side effects associated with OIT treatment trials are mild to moderate, predominantly oropharyngeal, and easily treated. More severe reactions, such as generalized urticaria/angioedema, wheezing/respiratory distress, laryngeal edema, and repetitive emesis, have been reported. However systemic reactions are very rare. Low-dose immunotherapy is associated with significantly fewer side effects. Currently, its most limiting allergic side effect is that approximately 10-15% of subjects treated with OIT experience gastrointestinal symptoms, preventing the continuation of therapy. Eosinophilic esophagitis (EoE) has also been reported as a cause of persistent abdominal symptoms in OIT.
    MeSH term(s) Allergens ; Animals ; Child ; Desensitization, Immunologic ; Eosinophilic Esophagitis/therapy ; Europe ; Food Hypersensitivity/therapy ; Humans ; Peanut Hypersensitivity
    Chemical Substances Allergens
    Language English
    Publishing date 2020-11-16
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2188113-3
    ISSN 1648-9144 ; 1010-660X
    ISSN (online) 1648-9144
    ISSN 1010-660X
    DOI 10.3390/medicina56110618
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  5. Article ; Online: Eosinophilic Esophagitis as a Side Effect of Food Oral Immunotherapy

    Antonella Cianferoni

    Medicina, Vol 56, Iss 618, p

    2020  Volume 618

    Abstract: Food allergies (FAs) include a spectrum of immune-mediated serious and potentially life-threatening medical conditions with an overall estimated prevalence ranging from 4% to 8% in the U.S. and Europe. Significant progress in food allergen-specific ... ...

    Abstract Food allergies (FAs) include a spectrum of immune-mediated serious and potentially life-threatening medical conditions with an overall estimated prevalence ranging from 4% to 8% in the U.S. and Europe. Significant progress in food allergen-specific immunotherapy has been accomplished over the past 10 years. The most studied strategy has been oral immunotherapy (OIT), also known as food desensitization, a treatment in which a child is slowly and deliberately given a small amount of the food to ingest (that previously was a food allergy trigger) with the ultimate goal of the child eating that food without a reaction. OIT is now recommended in the European guidelines for the treatment of milk, egg, and peanut allergies and was the first American Food Drug Administration (FDA) approved product for the prevention of severe reaction to peanuts in 4–17 year olds to be released on the market. The side effects associated with OIT treatment trials are mild to moderate, predominantly oropharyngeal, and easily treated. More severe reactions, such as generalized urticaria/angioedema, wheezing/respiratory distress, laryngeal edema, and repetitive emesis, have been reported. However systemic reactions are very rare. Low-dose immunotherapy is associated with significantly fewer side effects. Currently, its most limiting allergic side effect is that approximately 10–15% of subjects treated with OIT experience gastrointestinal symptoms, preventing the continuation of therapy. Eosinophilic esophagitis (EoE) has also been reported as a cause of persistent abdominal symptoms in OIT.
    Keywords eosinophilic esophagitis ; oral immunotherapy ; food allergy ; Medicine (General) ; R5-920
    Subject code 590
    Language English
    Publishing date 2020-11-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
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  6. Article ; Online: Non-IgE Mediated Food Allergy.

    Cianferoni, Antonella

    Current pediatric reviews

    2019  Volume 16, Issue 2, Page(s) 95–105

    Abstract: Food allergies, defined as an immune response to food proteins, affect as many as 8% of young children and 2% of adults in western countries, and their prevalence appears to be rising like all allergic diseases. In addition to well-recognized urticaria ... ...

    Abstract Food allergies, defined as an immune response to food proteins, affect as many as 8% of young children and 2% of adults in western countries, and their prevalence appears to be rising like all allergic diseases. In addition to well-recognized urticaria and anaphylaxis triggered by IgE antibody- mediated immune responses, there is an increasing recognition of cell-mediated disorders, such as eosinophilic esophagitis and food protein-induced enterocolitis. Non-IgE-Mediated gastrointestinal food allergies are a heterogeneous group of food allergies in which there is an immune reaction against food but the primary pathogenesis is not a production of IgE and activation of mast cells and basophils. Those diseases tend to affect mainly the gastrointestinal tract and can present as acute (FPIES) or chronic reaction, such as Eosinophilic Esophagitis (EoE), Food Protein-Induced Allergic Proctocolitis (FPIAP). The role of food allergy in Non-EoE gastrointestinal Eosinophilic disorders (Non- EoE EGID) is poorly understood. In some diseases like EoE, T cell seems to play a major role in initiating the immunological reaction against food, however, in FPIES and FPIAP, the mechanism of sensitization is not clear. Diagnosis requires food challenges and/or endoscopies in most of the patients, as there are no validated biomarkers that can be used for monitoring or diagnosis of Non-IgE mediated food allergies. The treatment of Non-IgE food allergy is dependent on diet (FPIES, and EoE) and/or use of drugs (i.e. steroids, PPI) in EoE and Non-EoE EGID. Non-IgE mediated food allergies are being being investigated.
    MeSH term(s) Allergens/immunology ; Eosinophilic Esophagitis/immunology ; Food Hypersensitivity/diagnosis ; Food Hypersensitivity/etiology ; Food Hypersensitivity/immunology ; Humans ; Immunity, Cellular ; Immunoglobulin E/immunology
    Chemical Substances Allergens ; Immunoglobulin E (37341-29-0)
    Language English
    Publishing date 2019-10-24
    Publishing country United Arab Emirates
    Document type Journal Article ; Review
    ISSN 1875-6336
    ISSN (online) 1875-6336
    DOI 10.2174/1573396315666191031103714
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  7. Article ; Online: Editorial: What epidemiology can teach us about asthma and allergies pathogenesis?

    Cianferoni, Antonella / Annesi-Maesano, Isabella

    Current opinion in allergy and clinical immunology

    2021  Volume 21, Issue 2, Page(s) 166–167

    MeSH term(s) Asthma ; Epidemiology ; Humans ; Hypersensitivity
    Language English
    Publishing date 2021-02-23
    Publishing country United States
    Document type Editorial
    ZDB-ID 2088710-3
    ISSN 1473-6322 ; 1528-4050
    ISSN (online) 1473-6322
    ISSN 1528-4050
    DOI 10.1097/ACI.0000000000000729
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  8. Article ; Online: It takes a village to manage eosinophilic esophagitis.

    Muir, Amanda B / Brown-Whitehorn, Terri / Cianferoni, Antonella

    Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology

    2022  Volume 130, Issue 1, Page(s) 13–14

    MeSH term(s) Humans ; Eosinophilic Esophagitis/diagnosis ; Eosinophilic Esophagitis/therapy ; Gastritis ; Enteritis
    Language English
    Publishing date 2022-10-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1228189-x
    ISSN 1534-4436 ; 0003-4738 ; 1081-1206
    ISSN (online) 1534-4436
    ISSN 0003-4738 ; 1081-1206
    DOI 10.1016/j.anai.2022.10.012
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  9. Article: Wheat allergy: diagnosis and management.

    Cianferoni, Antonella

    Journal of asthma and allergy

    2016  Volume 9, Page(s) 13–25

    Abstract: Triticum aestivum (bread wheat) is the most widely grown crop worldwide. In genetically predisposed individuals, wheat can cause specific immune responses. A food allergy to wheat is characterized by T helper type 2 activation which can result in ... ...

    Abstract Triticum aestivum (bread wheat) is the most widely grown crop worldwide. In genetically predisposed individuals, wheat can cause specific immune responses. A food allergy to wheat is characterized by T helper type 2 activation which can result in immunoglobulin E (IgE) and non-IgE mediated reactions. IgE mediated reactions are immediate, are characterized by the presence of wheat-specific IgE antibodies, and can be life-threatening. Non-IgE mediated reactions are characterized by chronic eosinophilic and lymphocytic infiltration of the gastrointestinal tract. IgE mediated responses to wheat can be related to wheat ingestion (food allergy) or wheat inhalation (respiratory allergy). A food allergy to wheat is more common in children and can be associated with a severe reaction such as anaphylaxis and wheat-dependent, exercise-induced anaphylaxis. An inhalation induced IgE mediated wheat allergy can cause baker's asthma or rhinitis, which are common occupational diseases in workers who have significant repetitive exposure to wheat flour, such as bakers. Non-IgE mediated food allergy reactions to wheat are mainly eosinophilic esophagitis (EoE) or eosinophilic gastritis (EG), which are both characterized by chronic eosinophilic inflammation. EG is a systemic disease, and is associated with severe inflammation that requires oral steroids to resolve. EoE is a less severe disease, which can lead to complications in feeding intolerance and fibrosis. In both EoE and EG, wheat allergy diagnosis is based on both an elimination diet preceded by a tissue biopsy obtained by esophagogastroduodenoscopy in order to show the effectiveness of the diet. Diagnosis of IgE mediated wheat allergy is based on the medical history, the detection of specific IgE to wheat, and oral food challenges. Currently, the main treatment of a wheat allergy is based on avoidance of wheat altogether. However, in the near future immunotherapy may represent a valid way to treat IgE mediated reactions to wheat.
    Language English
    Publishing date 2016-01-29
    Publishing country New Zealand
    Document type Journal Article ; Review
    ZDB-ID 2494877-9
    ISSN 1178-6965
    ISSN 1178-6965
    DOI 10.2147/JAA.S81550
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  10. Article ; Online: COVID-19 and allergy: How to take care of allergic patients during a pandemic?

    Cianferoni, Antonella / Votto, Martina

    Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology

    2020  Volume 31 Suppl 26, Page(s) 96–101

    Abstract: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, is a new strain of coronavirus that has not been previously identified in humans. SARS-CoV-2 is recognized as a highly contagious respiratory virus with severe ... ...

    Abstract Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, is a new strain of coronavirus that has not been previously identified in humans. SARS-CoV-2 is recognized as a highly contagious respiratory virus with severe morbidity and mortality, especially in vulnerable populations. Being a novel disease, everyone is susceptible, there are no vaccine and no treatment. To contain the spread of the disease, health authorities throughout the world have restricted the social interactions of individuals in various degrees. Allergists, like other physicians, are faced with the challenge of providing care for their patients, while protecting themselves and patients from getting infected, with strategies that are in continuous evolution as states work through the different stages of social distance. Allergist provides care for patients with the most common non-communicable disease in the world: asthma, allergic rhinitis, food allergy, venom allergy, drug allergy atopic dermatitis, and urticarial syndromes. Some of these diseases are not only considered risk factors for severe reactions but also have symptoms such as cough and sneezing that are in differential diagnosis with COVID-19. As we move forward, allergy symptoms may prevent patients from working, go to school, or access medical services that increasingly are allowing only asymptomatic individuals. In this review, we will outline how to take care safety of different allergic patients during the pandemic.
    MeSH term(s) COVID-19/epidemiology ; COVID-19/prevention & control ; Humans ; Hypersensitivity/therapy ; Immunotherapy ; SARS-CoV-2 ; Skin Tests ; Spirometry
    Language English
    Publishing date 2020-11-24
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1057059-7
    ISSN 1399-3038 ; 0905-6157 ; 0906-5784
    ISSN (online) 1399-3038
    ISSN 0905-6157 ; 0906-5784
    DOI 10.1111/pai.13367
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