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  1. Article: The Very Low IgE Producer: Allergology, Genetics, Immunodeficiencies, and Oncology.

    Matricardi, Paolo Maria

    Biomedicines

    2023  Volume 11, Issue 5

    Abstract: Opposite to other immunoglobulin (Ig) classes and subclasses, there is no consensus on the definition of normal levels of serum total IgE. However, longitudinal studies on birth cohorts produced growth charts of total IgE levels in helminth-free and ... ...

    Abstract Opposite to other immunoglobulin (Ig) classes and subclasses, there is no consensus on the definition of normal levels of serum total IgE. However, longitudinal studies on birth cohorts produced growth charts of total IgE levels in helminth-free and never atopic children and defining the normal ranges of total serum IgE concentration at the individual, rather than population, level. Accordingly, very 'low IgE producers' (i.e., children whose tIgE level belong to the lowest percentiles) became atopic while keeping their total IgE levels in a range considered 'normal' if compared to the general age-matched population but 'abnormally high' if projected on the tIgE growth chart against the trajectory of that child's own percentile levels. In 'low IgE producers', the IgE-specific activity, i.e., the ratio between allergen-specific and total IgE, is more important than the absolute specific IgE levels to confirm causality between allergen exposure and allergic symptoms. Patients with allergic rhinitis or peanut anaphylaxis but low or undetectable allergen-specific IgE levels must therefore be reconsidered considering their total IgE levels. Low IgE producers have been also associated with common variable immunodeficiency, lung diseases, and malignancies. A few epidemiological studies have shown a higher risk of malignancies in very low IgE producers, leading to a debated hypothesis proposing a novel, evolutionistic-relevant function for IgE antibodies for antitumor immune surveillance.
    Language English
    Publishing date 2023-05-06
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2720867-9
    ISSN 2227-9059
    ISSN 2227-9059
    DOI 10.3390/biomedicines11051378
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: IgE to cross-reactive carbohydrate determinants: Origins, functions, and confounding role in nPhl p 4-IgE assays.

    Matricardi, Paolo Maria

    The Journal of allergy and clinical immunology

    2020  Volume 145, Issue 6, Page(s) 1554–1555

    MeSH term(s) Allergens ; Carbohydrates ; Humans ; Immunoglobulin E ; Poaceae ; Pollen/immunology ; Rhinitis, Allergic, Seasonal
    Chemical Substances Allergens ; Carbohydrates ; Immunoglobulin E (37341-29-0)
    Language English
    Publishing date 2020-07-07
    Publishing country United States
    Document type Editorial ; Research Support, Non-U.S. Gov't ; Comment
    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.2020.04.012
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: The "allergic nose as a pollen detector" concept: e-Diaries to predict pollen trends.

    Matricardi, Paolo Maria / Hoffmann, Tara / Dramburg, Stephanie

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

    2023  Volume 34, Issue 6, Page(s) e13966

    Abstract: Hirst pollen traps and operator pollen recognition are worldwide used by aerobiologists, providing essential services for the diagnosis and monitoring of allergic patients. More recently, semiautomated or fully automated detector systems have been ... ...

    Abstract Hirst pollen traps and operator pollen recognition are worldwide used by aerobiologists, providing essential services for the diagnosis and monitoring of allergic patients. More recently, semiautomated or fully automated detector systems have been developed, which facilitate prediction of pollen exposure and risk for the individual patient. In parallel, smartphone apps consisting of short questionnaires filled in daily by the patient/user provide daily scores, time trajectories, and descriptive reports of the severity of respiratory allergies in patients with pollen allergy. The usual scientific and clinical approach to this matter is to monitor the environment (pollen concentration) in order to predict the risk of symptoms (allergic rhinitis) in a population. We discuss here the opposite, contraintuitive possibility, that is, the use of e-diaries to collect daily information of mono-sensitized pollen-allergic patients in order to predict the clinically efficient airborne exposure to a given pollen, area, and time period. In line with the "Patient as Sensor" concept, proposed in 2013 by Bernd Resch, the "allergic nose" may be used as a pollen detector in addition to existing calibrated hardware sensors, namely the pollen stations, thus contributing with individual measurements, sensations, and symptoms' perception. The target of this review is to present a novel concept of pollen monitoring based on "pollen-detector" patients to inspire future cooperative studies aimed at investigating and hopefully validating our hypothesis.
    MeSH term(s) Humans ; Pollen ; Rhinitis, Allergic, Seasonal/diagnosis ; Rhinitis, Allergic, Seasonal/epidemiology ; Nose ; Rhinitis, Allergic/diagnosis ; Mobile Applications ; Allergens
    Chemical Substances Allergens
    Language English
    Publishing date 2023-06-27
    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.13966
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Molecular Diagnosis of Allergy: The Pediatric Perspective.

    Dramburg, Stephanie / Matricardi, Paolo Maria

    Frontiers in pediatrics

    2019  Volume 7, Page(s) 369

    Abstract: In times of "Precision Medicine" it is fundamental to identify the individual disease phenotype in order to provide an individualized therapy for every patient. This concept is also becoming increasingly important for the treatment of allergic diseases. ... ...

    Abstract In times of "Precision Medicine" it is fundamental to identify the individual disease phenotype in order to provide an individualized therapy for every patient. This concept is also becoming increasingly important for the treatment of allergic diseases. Thanks to the biological engineering of recombinant and native allergens for the assessment of allergen-specific IgE antibodies, it is now possible to easily obtain the individual sensitization profile of a patient. This allows the allergist to precisely identify the primary elicitor of an IgE response and, based on this knowledge, to choose the best treatment option. Several studies have observed the longitudinal evolution of sensitization profiles and identified a phenomenon termed "molecular spreading," which describes a broadening of the recognized allergen spectrum from a source over time. Additionally, the identification of marker proteins, which can trigger an IgE response or correlate with an increased risk for certain clinical symptoms, helps to establish an individual risk profile. This information may not only affect the decision-making concerning immunotherapy, but also opens up avenues for future investigations with regard to prevention strategies. We provide here an overview on the role of individual sensitization patterns and their predictive value.
    Language English
    Publishing date 2019-09-24
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2711999-3
    ISSN 2296-2360
    ISSN 2296-2360
    DOI 10.3389/fped.2019.00369
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  5. Article ; Online: Digital health for allergen immunotherapy.

    Dramburg, Stephanie / Matricardi, Paolo Maria / Pfaar, Oliver / Klimek, Ludger

    Allergologie select

    2022  Volume 6, Page(s) 293–298

    Abstract: In the recent past, digital healthcare technologies are experiencing a significant leap in development, with an additional unforeseen acceleration in implementation due to the SARS-CoV-2 pandemic. The increased use of mobile applications as well as ... ...

    Abstract In the recent past, digital healthcare technologies are experiencing a significant leap in development, with an additional unforeseen acceleration in implementation due to the SARS-CoV-2 pandemic. The increased use of mobile applications as well as communication technologies to search for services and support hold particular advantages for the management of chronic diseases requiring medium- to long-term treatments and regular follow-up visits. Allergen immunotherapy (AIT), requiring regular application of treatment, represents an optimal scenario for feasible digital support. From patient stratification and care pathways, over personalized decision support for complex clinical scenarios, towards a close and flexible patient-doctor communication in blended care settings: the current article summarizes the latest knowledge on the use and potential of digital health technologies in the area of AIT .
    Language English
    Publishing date 2022-12-05
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 2893503-2
    ISSN 2512-8957 ; 2512-8957
    ISSN (online) 2512-8957
    ISSN 2512-8957
    DOI 10.5414/ALX02301E
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: The first, holistic immunological model of COVID-19: Implications for prevention, diagnosis, and public health measures.

    Matricardi, Paolo Maria / Dal Negro, Roberto Walter / Nisini, Roberto

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

    2020  Volume 31, Issue 5, Page(s) 454–470

    Abstract: The natural history of COVID-19 caused by SARS-CoV-2 is extremely variable, ranging from asymptomatic or mild infection, mainly in children, to multi-organ failure, eventually fatal, mainly in the eldest. We propose here the first model explaining how ... ...

    Abstract The natural history of COVID-19 caused by SARS-CoV-2 is extremely variable, ranging from asymptomatic or mild infection, mainly in children, to multi-organ failure, eventually fatal, mainly in the eldest. We propose here the first model explaining how the outcome of first, crucial 10-15 days after infection, depends on the balance between the cumulative dose of viral exposure and the efficacy of the local innate immune response (natural IgA and IgM antibodies, mannose-binding lectin). If SARS-CoV-2 runs the blockade of this innate immunity and spreads from the upper airways to the alveoli in the early phases of the infections, it can replicate with no local resistance, causing pneumonia and releasing high amounts of antigens. The delayed and strong adaptive immune response (high-affinity IgM and IgG antibodies) that follows, causes severe inflammation and triggers mediator cascades (complement, coagulation, and cytokine storm), leading to complications often requiring intensive therapy and being, in some patients, fatal. Low-moderate physical activity can still be recommended. However, extreme physical activity and oral breathing with hyperventilation during the incubation days and early stages of COVID-19 facilitates re-inhalation and early direct penetration of high numbers of own virus particles in the lower airways and the alveoli, without impacting on the airway's mucosae covered by neutralizing antibodies ("viral auto-inhalation" phenomenon). This allows the virus to bypass the efficient immune barrier of the upper airway mucosa in already infected, young, and otherwise healthy athletes. In conclusion, whether the virus or the adaptive immune response reaches the lungs first is a crucial factor deciding the fate of the patient. This "quantitative and time-/sequence-dependent" model has several implications for prevention, diagnosis, and therapy of COVID-19 at all ages.
    MeSH term(s) Betacoronavirus/immunology ; COVID-19 ; COVID-19 Testing ; Clinical Laboratory Techniques/methods ; Coronavirus Infections/diagnosis ; Coronavirus Infections/immunology ; Coronavirus Infections/prevention & control ; Humans ; Immunity, Innate/immunology ; Models, Immunological ; Pandemics/prevention & control ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/immunology ; Pneumonia, Viral/prevention & control ; Public Health/methods ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-06-05
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; 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.13271
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Use of telemedicine by practising allergists before and during the SARS-CoV-2 pandemic: A survey among members of the Association of German Allergists (AeDA).

    Dramburg, Stephanie / Matricardi, Paolo Maria / Casper, Ingrid / Klimek, Ludger

    Allergo journal international

    2021  Volume 30, Issue 6, Page(s) 193–197

    Abstract: Background: The severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pandemic presented unprecedented challenges to both inpatient and outpatient care. In order to maintain good care under necessary contact restrictions, especially in the ... ...

    Abstract Background: The severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pandemic presented unprecedented challenges to both inpatient and outpatient care. In order to maintain good care under necessary contact restrictions, especially in the outpatient sector, the use of telemedical applications was demanded and promoted. The exploratory survey among members of the Association of German Allergists (AeDA) was intended to show how these were received among allergists in private practice.
    Methods: The survey was restricted to actively practising members of the AeDA who had previously given their consent to receive such surveys (
    Results: In all, 76 specialists with additional qualification in allergology took part in the survey. Of these, 71 completed the full questionnaire. Before the start of the pandemic-related contact restrictions, 46.5% (33/71) stated that they had used telemedicine in their clinical practice. This number increased to 73.2% (52/71) after 31 January 2020. The largest increase (4.3% vs. 15.6%) was seen in the area of video consultations. Furthermore, 43/76 participants can imagine integrating telemedicine services into their daily clinical routine in the future.
    Conclusion: The use of telemedical services, especially video consultations, increased significantly during the SARS-CoV‑2 pandemic in Germany. The majority of respondents perceive the implementation as positive and can imagine continuing to use telemedical methods after the end of the pandemic.
    Language English
    Publishing date 2021-06-11
    Publishing country Germany
    Document type Journal Article
    ISSN 2197-0378
    ISSN 2197-0378
    DOI 10.1007/s40629-021-00175-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: The impact of a digital wheeze detector on parental disease management of pre-school children suffering from wheezing-a pilot study.

    Dramburg, Stephanie / Dellbrügger, Ellen / van Aalderen, Wim / Matricardi, Paolo Maria

    Pilot and feasibility studies

    2021  Volume 7, Issue 1, Page(s) 185

    Abstract: Background: Viral airway infections are a major reason for doctor's visits at pre-school age, especially when associated with wheezing. While proper treatment requires adequate recognition of airway obstruction, caretakers are often struggling with this ...

    Abstract Background: Viral airway infections are a major reason for doctor's visits at pre-school age, especially when associated with wheezing. While proper treatment requires adequate recognition of airway obstruction, caretakers are often struggling with this judgment, consequently leading to insufficient or late treatment and an unnecessary discomfort of the patient. Digital technologies may serve to support parental decision taking. The aim of the present pilot study is to acquire data on the feasibility of recruitment and observation procedures for a randomized controlled trial on the impact of a digital wheeze detector in a home management setting of pre-school wheezing.
    Methods: This single-armed pilot study enrolled patients with a doctor's diagnosis of wheezing aged 9 to 72 months. Participants were asked to use a digital wheeze detector (WheezeScan, Omron Healthcare, Japan) 2×/day for 30 days and record the child's respiratory symptoms, detection of wheezing, and medication intake via an electronic diary (eDiary) app. Demographic and clinical data were collected at the recruitment visit. The asthma control test and the Parent Asthma Management Self-Efficacy Scale (PAMSES) were assessed both, at recruitment and follow-up.
    Results: Twenty families were recruited and completed the monitoring. All but one completed the follow-up after 30 days. The recruitment procedures were feasible, and adherence to daily monitoring reached an average of 81%. The use of the wheeze detector was rated as uncomplicated. Parents detected wheezing without digital support in only 22/708 (3.1%) of the recorded events. By contrast, the wheeze detector indicated an airway obstruction in 140/708 (19.8%) of the recordings.
    Conclusion: In parallel to feasible recruitment procedures, we observed good usability of the wheeze detection device and high adherence to eDiary recording. The positive outcomes show that the WheezeScan may empower parents by increasing their capacity for wheeze detection. This deserves to be investigated in a larger randomized controlled trial.
    Language English
    Publishing date 2021-10-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 2809935-7
    ISSN 2055-5784
    ISSN 2055-5784
    DOI 10.1186/s40814-021-00917-w
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  9. Article ; Online: The Potential of Clinical Decision Support Systems for Prevention, Diagnosis, and Monitoring of Allergic Diseases.

    Dramburg, Stephanie / Marchante Fernández, María / Potapova, Ekaterina / Matricardi, Paolo Maria

    Frontiers in immunology

    2020  Volume 11, Page(s) 2116

    Abstract: Clinical decision support systems (CDSS) aid health care professionals (HCP) in evaluating large sets of information and taking informed decisions during their clinical routine. CDSS are becoming particularly important in the perspective of precision ... ...

    Abstract Clinical decision support systems (CDSS) aid health care professionals (HCP) in evaluating large sets of information and taking informed decisions during their clinical routine. CDSS are becoming particularly important in the perspective of precision medicine, when HCP need to consider growing amounts of data to create precise patient profiles for personalized diagnosis, treatment and outcome monitoring. In allergy care, several CDSS are being developed and investigated, mainly for respiratory allergic diseases. Although the proposed solutions address different stakeholders, the majority aims at facilitating evidence-based and shared decision-making, incorporating guidelines, and real-time clinical data. We offer here an overview on existing tools, new developments and novel concepts and discuss the potential of digital CDSS in improving prevention, diagnosis and monitoring of allergic diseases.
    MeSH term(s) Decision Support Systems, Clinical/standards ; Diagnostic Tests, Routine ; Evidence-Based Medicine ; Humans ; Hypersensitivity/diagnosis ; Monitoring, Physiologic ; Practice Guidelines as Topic ; Precision Medicine/methods
    Language English
    Publishing date 2020-09-10
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2606827-8
    ISSN 1664-3224 ; 1664-3224
    ISSN (online) 1664-3224
    ISSN 1664-3224
    DOI 10.3389/fimmu.2020.02116
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Allergy and Asthma Care in the Mobile Phone Era.

    Huang, Xinyuan / Matricardi, Paolo Maria

    Clinical reviews in allergy & immunology

    2016  Volume 56, Issue 2, Page(s) 161–173

    Abstract: Strategies to improve patients' adherence to treatment are essential to reduce the great health and economic burden of allergic rhinitis and asthma. Mobile phone applications (apps) for a better management of allergic diseases are growing in number, but ... ...

    Abstract Strategies to improve patients' adherence to treatment are essential to reduce the great health and economic burden of allergic rhinitis and asthma. Mobile phone applications (apps) for a better management of allergic diseases are growing in number, but their usefulness for doctors and patients is still debated. Controlled trials have investigated the feasibility, cost-effectiveness, security, and perspectives of the use of tele-medicine in the self-management of asthma. These studies focused on different tools or devices, such as SMS, telephone calls, automatic voice response system, mobile applications, speech recognition system, or cloud-computing systems. While some trials concluded that m-Health can improve asthma control and the patient's quality of life, others did not show any advantage in relation to usual care. The only controlled study on allergic rhinitis showed an improvement of adherence to treatment among tele-monitored patients compared to those managed with usual care. Most studies have also highlighted a few shortcomings and limitations of tele-medicine, mainly concerning security and cost-efficiency. The use of smartphones and apps for a personalized asthma and allergy care needs to be further evaluated and optimized before conclusions on its usefulness can be drawn.
    MeSH term(s) Asthma/diagnosis ; Asthma/therapy ; Cell Phone ; Disease Management ; Electronic Data Processing ; Humans ; Hypersensitivity/diagnosis ; Hypersensitivity/therapy ; Medication Adherence ; Mobile Applications ; Rhinitis, Allergic/diagnosis ; Rhinitis, Allergic/therapy ; Self-Management ; Telemedicine/methods
    Language English
    Publishing date 2016-04-20
    Publishing country United States
    Document type Journal Article ; Meta-Analysis ; Review
    ZDB-ID 1239045-8
    ISSN 1559-0267 ; 1080-0549
    ISSN (online) 1559-0267
    ISSN 1080-0549
    DOI 10.1007/s12016-016-8542-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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