Publications by authors named "Spadaro G"

Background: Many patients with X-linked agammaglobulinemia (XLA) nowadays have reached adulthood, as well as their sisters, possibly carriers of a deleterious Bruton tyrosine kinase variant. Studies on motherhood outcomes in families with XLA are lacking.

Objective: We sought to investigate adherence to carrier status screening, interest in preconception and prenatal genetic counseling, and reproductive decisions in relatives with XLA.

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Acute suppurative thyroiditis (AST), a rare yet potentially life-threatening infection, comprises less than 1 % of neck pathologies and requires prompt treatment. Symptoms range from neck pain and fever to dysphagia and possible abscess formation. Broad-spectrum antibiotics are the primary treatment; however, surgical drainage may be necessary for abscesses to prevent systemic infection.

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Introduction: In patients with Hereditary Angioedema (HAE) related to primary C1 inhibitor deficiency (C1INH), the defective clearance of immune complexes and apoptotic materials along with impairment of normal humoral response potentially leads to autoimmunity. Few studies report evidence on autoimmune diseases in C1INH-HAE, but no large population studies focus on rare connective tissue diseases (RCTDs). We aim at evaluating for the first time prevalence and distribution of RCTDs - Systemic Lupus Erytematosus (SLE), primary Sjogren Syndrome (SjS), primary antiphospholipid syndrome (APS), Systemic Sclerosis (SSc), and mixed connective tissue diseases (MCTD) in a large Italian cohort of C1INH-HAE patients.

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Cooperation underlies the ability of groups to realize collective benefits (e.g., creation of public goods).

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Article Synopsis
  • - This study found two types of patients with severe eosinophilic asthma who respond differently to the medication mepolizumab.
  • - Patients with a family history of asthma, positive skin tests, and higher lung function showed better responses to treatment.
  • - The findings emphasize the importance of tailoring treatment plans to individual patient characteristics for improved outcomes.
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Introduction: The Janus kinase (JAK) family includes four cytoplasmic tyrosine kinases (JAK1, JAK2, JAK3, and TYK2) constitutively bound to several cytokine receptors. JAKs phosphorylate downstream signal transducers and activators of transcription (STAT). JAK-STAT5 pathways play a critical role in basophil and mast cell activation.

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Article Synopsis
  • Hereditary angioedema (HAE) is a rare genetic disorder causing episodes of swelling, particularly due to an increase in a substance called bradykinin, especially in patients with mutations in the F12 gene that affect C1 inhibitor activity.
  • A study comparing 40 patients with FXII-HAE to 40 healthy individuals found increased plasma levels of specific lipid mediators and enzymes, indicating an altered biochemical response in those with the condition.
  • The findings suggest that the overproduction of bradykinin impacts certain pathways in FXII-HAE, opening up potential avenues for further research on the role of these lipid mediators in the disease.
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Background And Objective: Several randomized controlled trials (RCTs) have shown that benralizumab is characterized by a good profile of efficacy and safety, thereby being potentially able to elicit clinical remission on-treatment of severe eosinophilic asthma (SEA). The main goal of this multicentre observational study was to verify the effectiveness of benralizumab in inducing a sustained remission on-treatment of SEA in patients with or without comorbid chronic rhinosinusitis with nasal polyps (CRSwNP).

Methods: Throughout 2 years of treatment with benralizumab, a four-component evaluation of sustained remission of SEA was performed, including the assessment of SEA exacerbations, use of oral corticosteroids (OCSs), symptom control and lung function.

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Article Synopsis
  • Idiopathic non-histaminergic acquired angioedema (InH-AAE) is a rare disease that causes swelling and doesn't respond well to common medications like antihistamines.
  • The study looked at 26 patients with InH-AAE to understand their symptoms and possible markers of the disease, collecting a lot of health-related information.
  • Findings included changes in specific proteins in the blood and differences in blood vessel shape, helping to improve the understanding of InH-AAE and possibly leading to better treatments in the future.
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Thymic stromal lymphopoietin (TSLP), mainly expressed by epithelial cells, plays a central role in asthma. In humans, TSLP exists in two variants: the long form TSLP (lfTSLP) and a shorter TSLP isoform (sfTSLP). Macrophages (HLMs) and mast cells (HLMCs) are in close proximity in the human lung and play key roles in asthma.

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  • The study examines long COVID (LC) in patients with common variable immunodeficiency (CVID), finding a 65.7% prevalence of LC symptoms lasting over 12 weeks after SARS-CoV-2 infection.
  • Key symptoms reported include fatigue, joint and muscle pain, and difficulty breathing, with 60% of patients experiencing these symptoms for at least six months post-infection.
  • Factors such as complicated CVID phenotype, obesity, and female sex were found to significantly increase the risk of developing long COVID in this patient group, highlighting the need for tailored management strategies.
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  • The Italian Society of Echography and Cardiovascular Imaging (SIECVI) conducted a national survey to investigate stress echocardiography (SE) practices across Italy, collecting data from 228 laboratories in November 2022.
  • The survey revealed that out of 179 centers performing SE, most were located in northern Italy, and the study categorized them into low, moderate, and high volume of activity based on the number of SE examinations.
  • Key findings indicated differences in the use of stressors, with a tendency for high-volume centers to employ multiple stress techniques and incorporate advanced evaluations like coronary flow velocity reserve (CFVR) more frequently than low and moderate volume centers.
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Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare, systemic necrotizing vasculitis affecting small-to-medium-sized vessels. EGPA's clinical manifestations are heterogeneous, affecting different organs and systems, and the upper respiratory tract can be affected by ear, nose and throat (ENT) involvement. The aim of our study was to assess type manifestations at the time of diagnosis in a cohort of EGPA patients and correlate findings with baseline variables (sex, age, antineutrophil cytoplasmic antibodies-ANCA-status) and literature reports.

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Article Synopsis
  • Nitric oxide (NO) is a short-lived gas important for signaling in blood vessels and various biological processes like immunity, inflammation, and aging.
  • Fractional exhaled nitric oxide (FeNO) is a non-invasive method to measure airway inflammation, particularly in asthma, and is responsive to anti-inflammatory treatments.
  • The review focuses on the use of FeNO as a biomarker for type 2 inflammation and its role in various allergic disorders, highlighting both past and current research findings.
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Background: The current definition of severe eosinophilic asthma (SEA) super-responders to biologic treatment does not include patients with other eosinophil-based comorbidities. Although eosinophilic granulomatosis with polyangiitis (EGPA) is frequently associated with SEA, we lack data on a possible super-response to biologic treatments in patients suffering from these two diseases. We aim to assess super-responder features in real-life patients with SEA and EGPA treated with mepolizumab and benralizumab.

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Article Synopsis
  • In patients with Common Variable Immunodeficiency (CVID), malignancy is the primary cause of death, especially due to high risks of B-cell lymphomas and gastric cancer.
  • A five-year study of 512 CVID patients showed a decline in the frequency of upper gastrointestinal endoscopies during the COVID-19 pandemic, with approximately one-third of patients exhibiting precancerous lesions.
  • Despite no recent gastric cancer deaths reported, the need for focused surveillance programs remains crucial due to the significant presence of precancerous lesions and uncertainties regarding cancer detection trends during the pandemic.
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Introduction: Common variable immunodeficiency (CVID) is the most prevalent symptomatic primary immunodeficiency. CVID is a heterogeneous disorder with a presumed multifactorial etiology. Intravenous or subcutaneous immunoglobulin replacement therapy (IgRT) can prevent severe infections but not underlying immune dysregulation.

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Hereditary angioedema (HAE) is a rare autosomal dominant disease, with patients often suffering with associated symptoms for many years before receiving a correct diagnosis. The symptoms greatly impact a patient's quality of life (QoL) and include excruciating abdominal pain and angioedema of the skin and submucosa. Angioedema of the larynx represents a significant mortality risk in undiagnosed patients, and a large proportion of patients with HAE receive incorrect diagnoses and undergo unnecessary surgery.

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SARS-CoV-2 vaccination is the standard of care for the prevention of COVID-19 disease. Although vaccination triggers both humoral and cellular immune response, COVID-19 vaccination efficacy is currently evaluated by measuring antibodies only, whereas adaptative cellular immunity is unexplored. Our aim is to test humoral and cell-mediated response after three doses of BNT162b vaccine in two cohorts of fragile patients: Common Variable Immunodeficiency (CVID) patients and Kidney Transplant Recipients (KTR) patients compared to healthy donors.

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Neurologic manifestations have been occasionally described in patients with bradykinin-mediated angioedema. The existing literature is currently limited to case series and case reports mainly described in the hereditary forms (HAE) concerning central nervous system (CNS) involvement. On the contrary, very little is known about peripheral and autonomic nervous system manifestations.

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Background: Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare vasculitis characterized by asthma, systemic manifestations, and blood and tissue eosinophilia.

Objective: To assess the effectiveness and safety of mepolizumab (anti-IL-5) and benralizumab (anti-IL-5Rα) in EGPA for 24 months.

Methods: We conducted a multicenter observational study, including patients with EGPA treated with anti-IL-5/Rα biologics in 9 Italian specialized facilities.

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Background: The Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI) conducted a national survey to understand better how different echocardiographic modalities are used and accessed in Italy.

Methods: We analyzed echocardiography laboratory activities over a month (November 2022). Data were retrieved via an electronic survey based on a structured questionnaire, uploaded on the SIECVI website.

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Patients with atopic/allergic disorders, including atopic dermatitis (AD), allergic rhino-conjunctivitis (AR), chronic rhinosinusitis with/without nasal polyps (CRSwNP/CRSsNP), bronchial asthma, food allergy, and eosinophilic esophagitis (EoE), often share a common genetic background, a type Th2 polarized immune response, and several environmental factors [...

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Article Synopsis
  • The first case of pulsed-field ablation (PFA) for treating focal atrial tachycardia (FAT) in a pediatric patient, specifically an 11-year-old girl with obesity, is presented.
  • The procedure involves targeting the earliest atrial activation in the left superior pulmonary vein and is noted to have a lower success and higher complication rate compared to standard radiofrequency ablation (RFA) in adults.
  • PFA is shown to effectively restore stable sinus rhythm after treatment, highlighting its potential as a safer alternative for young patients with FAT, minimizing the risk of complications associated with traditional methods.
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