Publications by authors named "Stefania Arasi"

From a taxonomic point of view, Hymenoptera are subclassified into families: Apidae, including honeybees (Apis mellifera) and bumblebees (Bombus), and Vespidae, which, in turn, are divided into the subfamilies of Vespinae (wasps, including hornets, vespules, dolichovespules) and Polistinae (paper wasp). Hypersensitivity to Hymenoptera venom can be linked to immunological (IgE-mediated or non-IgE-mediated) and non-immunological mechanisms. Reactions are classified into local reactions, large local reactions, systemic reactions, toxic reactions, and unusual reactions.

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  • IgE-mediated food allergies are the most common type, causing quick and serious reactions that affect patients' and caregivers' lives.
  • Omalizumab is a humanized monoclonal antibody that binds to IgE, reducing allergic reactions, and has been approved by the FDA for treating these food allergies.
  • The GALEN ANACARE Consensus Statement supports omalizumab's use based on a systematic review and expert agreement, noting it is currently the only drug that can significantly reduce IgE-mediated food allergic reactions, although more evidence is needed for stronger guideline recommendations.
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  • Precautionary Allergen Labelling (PAL) is used to warn people about possible allergens in food that could affect those with allergies.
  • The World Allergy Organization found that PAL is not consistently regulated, which makes it confusing for people with food allergies.
  • There are discussions among global organizations to create better rules for PAL so that it is clear and helpful for everyone, but there are still some challenges to making these rules work everywhere.
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  • Food protein-induced enterocolitis syndrome (FPIES) is a food allergy mostly affecting infants, characterized by severe vomiting and shock, and its diagnosis can be delayed due to unclear genetic markers.
  • This study analyzed the genomes of 41 FPIES patients, identifying significant genetic variants linked to the syndrome, including genes that may influence immune response and gut health.
  • The results enhance understanding of FPIES' genetic basis and could pave the way for better diagnosis, treatment, and prevention strategies in the future.
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  • * The food industry is exploring ways to use legumes as substitutes for cereals, but this could lead to a rise in legume allergies.
  • * The prevalence of legume allergies differs by region, with peanuts and soybeans being common in Western countries, while lentils and chickpeas are more problematic in areas like the Mediterranean and India; the review also outlines diagnostic and therapeutic strategies for children with these allergies.
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Food protein-induced enteropathy (FPE) belongs to non-IgE gastrointestinal mediated food allergies. FPE is a syndrome characterized by diarrhea, weight loss and failure to thrive in young infants. Cow milk is the culprit food that most frequently causes FPE.

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Background: Cow's milk allergy (CMA) is the most complex and common food allergy in infants. Elimination of cow's milk from the diet and replacement with a specialized formula for infants with cow's milk allergy who cannot be breastfed is an established approach to minimize the risk of severe allergic reactions while avoiding nutritional deficiencies. Given the availability of multiple options, such as extensively hydrolyzed cow's milk-based formula (eHF-CM), aminoacid formula (AAF), hydrolyzed rice formula (HRF), and soy formula (SF), there is some uncertainty regarding which formula might represent the most suitable choice with respect to health outcomes.

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Background: In Europe, Omalizumab (anti-IgE) is indicated for the treatment of moderate to severe asthma, but not for IgE-mediated food allergy (FA).

Objective: We assessed the impact of Omalizumab on efficacy, safety, and quality of life (FA-QoL) in patients with moderate to severe asthma and who have a history of anaphylaxis to peanut, tree nuts, fish, egg, milk, and/or wheat.

Methods: Food-allergic children (6-18 years) with moderate to severe asthma underwent oral food challenges (OFCs) to establish the threshold of reaction to the culprit food(s) at baseline (T0) and at 4-month intervals (T1, T2, and T3) during their first year of treatment with Omalizumab.

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  • Idiopathic anaphylaxis (IA) poses significant challenges for both patients and healthcare providers, particularly among pediatric populations.
  • This paper suggests diagnostic algorithms tailored to specific age groups—infants, children, and adolescents—due to the variability in identifying causes of anaphylactic episodes.
  • A thorough clinical history and quick recognition of symptoms are crucial for selecting appropriate diagnostic tests and ensuring accurate differential diagnosis in young patients.
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Breastfeeding is the most important nutrition source for infants. However, managing breastfed infants with signs and symptoms related to food allergy can be difficult. Many studies have shown the presence of different food allergens in breast milk, but the clinical role of these antigens in human milk is still much debated.

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Treatment of IgE-mediated food allergy involves avoiding the food causing the allergic reaction. In association, an action plan for allergic reactions is indicated, sometimes including self-injectable adrenaline. In addition to these dietary and medical implications, there are two equally important ones: nutritional and psychosocial.

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Breastmilk is the optimal source of nutrition for infants and should ideally be provided exclusively for the first 6 months of life, and alongside complementary food until 2 years of life. However, there are circumstances where a breastmilk substitute (BMS) may be required. This includes maternal and/or child conditions or personal preference.

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Background: Cow's milk allergy (CMA) is the most common food allergy in infants. The replacement with specialized formulas is an established clinical approach to ensure adequate growth and minimize the risk of severe allergic reactions when breastfeeding is not possible. Still, given the availability of multiple options, such as extensively hydrolyzed cow's milk protein formula (eHF-CM), amino acid formula (AAF), hydrolyzed rice formula (HRF) and soy formulas (SF), there is some uncertainty as to the most suitable choice with respect to health outcomes.

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Purpose Of Review: To explore the groundbreaking international consensus on the DEFASE (DEfinition of Food Allergy Severity) project as a revolutionary grading system for IgE-mediated food allergy severity. Against the backdrop of the growing public health challenge posed by food allergy, this article delves into the importance of validating and implementing DEFASE in real-world clinical settings.

Recent Findings: With new therapeutic options available for food allergy, including biologics alongside immunotherapy, it is urgent to properly support clinical decision-making in the management of the disease.

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Background: Despite the promise of oral immunotherapy (OIT) to treat food allergies, this procedure is associated with potential risk. There is no current agreement about what elements should be included in the preparatory or consent process.

Objective: We developed consensus recommendations about the OIT process considerations and patient-specific factors that should be addressed before initiating OIT and developed a consensus OIT consent process and information form.

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  • Exercise-induced bronchoconstriction (EIB) is when airways narrow during or after exercise, causing symptoms like wheezing and shortness of breath, and it's important to differentiate it from exercise-induced asthma (EIA).
  • EIB is commonly seen in young athletes, especially those with allergies, suggesting a connection between allergic reactions and respiratory issues during exercise due to various influencing factors.
  • Effective management of EIB in children requires accurate diagnosis and a mix of medication and lifestyle changes, with recent research shedding light on the condition's relationship with allergies and sports participation.
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Background: The supply chains of food raw materials have recently been heavily influenced by geopolitical events. Products that came from, or transited through, areas currently in conflict are now preferentially supplied from alternative areas. These changes may entail risks for food safety.

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Anaphylaxis is a life-threatening reaction characterized by the acute onset of symptoms involving different organ systems and requiring immediate medical intervention. The incidence of fatal food anaphylaxis is 0.03 to 0.

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Imported allergens are involved in many allergic reactions, with unexpected and unusual implications. They can be involved in developing asthma, allergic rhinoconjunctivitis, Hymenoptera venom allergies and food allergies. Imported allergens can be implied in respiratory allergies attributable to commercial practices and accidental diffusion through air currents that have introduced non-native species in new geographical contexts.

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Food allergy is a global public health problem that until recent years lacked any aetiological treatment supported by academy, industry and regulators. Food immunotherapy (AIT) is an evolving treatment option, supported by clinical practice and industry trial data. Recent AIT meta-analyses have highlighted the difficulty in pooling safety and efficacy data from AIT trials, due to secondary heterogeneity in the study.

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