Publications by authors named "Alessandra Arcolaci"

The management of patients with immediate hypersensitivity reactions (IHSR) to COVID-19 vaccines and their components, polyethylene glycol (PEG) 2000 and polisorbate 80 (PS80), has evolved since the beginning of the vaccination campaign. Despite the end of the pandemics, ensuring safe access to COVID-19 vaccination remains critical, especially for individuals with underlying health conditions. In this retrospective study, we evaluated 333 patients who underwent a standardized allergy work-up, including skin testing (ST) with vaccine components, to assess their eligibility for COVID-19 vaccination.

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Celiac disease (CD) is an autoimmune disorder caused by gluten intake in genetically predisposed individuals. This article provides an overview of the available data on the risks of infectious diseases and the mechanisms involved in CD, including a detailed analysis of vaccine efficacy, immunogenicity, and safety. The published articles were retrieved from the PubMed database using the terms "celiac disease", "efficacy", "hyposplenism", "immune response", "infections", "immunization", "immunogenicity", "safety", "vaccination", and "vaccine".

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Article Synopsis
  • Delayed anaphylaxis due to alpha-gal syndrome, triggered by the ingestion of red meat, has become more common, linked to an immune reaction from tick bites.
  • A case study revealed severe allergic reactions, including anaphylaxis and hypovolemic shock, due to a gelatin-containing drug given during emergency surgery.
  • The report emphasizes the need for better communication regarding risks associated with medical products for patients with alpha-gal syndrome and urges manufacturers to clearly label the origins of their ingredients.
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  • Guidelines for treating asthma exacerbations typically recommend bronchodilators and corticosteroids, but antibiotic use is often overlooked despite frequent prescriptions in practice.
  • A survey involving 252 healthcare professionals revealed a 19% antibiotic prescription rate for asthma exacerbations, with significant variation among different specialties like pediatrics, pulmonology, general practice, and allergy.
  • The study highlights the need for evidence-based guidelines to ensure more rational use of antibiotics in treating asthma exacerbations, especially considering factors like purulent sputum, fever, and comorbidities that influence prescription decisions.
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In drug hypersensitivity, drug provocation testing (DPT), also called drug challenge, is the gold standard for investigation. In recent years, risk stratification has become an important tool for adjusting the diagnostic strategy to the perceived risk, whilst still maintaining a high level of safety for the patient. Skin tests are recommended before DPT but may be omitted in low-risk patients.

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Proton pump inhibitors (PPIs) are invaluable therapeutic options in a variety of dyspeptic diseases. In addition to their well-known risk profile, PPI consumption is related to food and environmental allergies, dysbiosis, osteoporosis, as well as immediate and delayed hypersensitivity reactions (HSRs). The latter, although a rare event, around 1%-3%, due to the extraordinarily high rate of prescription and consumption of PPIs are related to a substantial risk.

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Currently available vaccines are safe, but, potentially, any vaccine can cause an allergic reaction and, albeit very rare, anaphylaxis can occur. Although its rarity, the precise diagnostic management of a suspected anaphylaxis postvaccination is of paramount importance due to the risk of a potentially serious reaction after re-exposure, while a misdiagnosis might lead to an increase in the number of children that interrupt vaccinations resulting in an unjustifiably individual and collective risk of loss of protection against immune preventable diseases. In the light that most cases of suspected allergy to a vaccine are not effectively confirmed in up to 85% of the cases referred for an allergy evaluation, patients can continue the vaccination schedule with the same formulation and tolerance of the booster doses.

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Article Synopsis
  • Conventional vaccines are generally safe with mild allergic reactions, but mRNA-based COVID-19 vaccines showed higher risks of severe allergies compared to standard vaccines.
  • A literature review was conducted to examine the frequency, risk factors, and mechanisms of allergic reactions related to COVID-19 vaccines, using MEDLINE, Google Scholar, and other databases for data analysis.
  • The study also compiled recommendations from scientific societies and regulatory agencies for preventing and managing allergic reactions to COVID-19 vaccines, particularly for individuals with previous allergies.
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Background: Anaphylaxis, which is rare, has been reported after COVID-19 vaccination, but its management is not standardized.

Method: Members of the European Network for Drug Allergy and the European Academy of Allergy and Clinical Immunology interested in drug allergy participated in an online questionnaire on pre-vaccination screening and management of allergic reactions to COVID-19 vaccines, and literature was analysed.

Results: No death due to anaphylaxis to COVID-19 vaccines has been confirmed in scientific literature.

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Microbiota composition and associated metabolic activities are essential for the education and development of a healthy immune system. Microbial dysbiosis, caused by risk factors such as diet, birth mode, or early infant antimicrobial therapy, is associated with the inception of allergic diseases. In turn, allergic diseases increase the risk for irrational use of antimicrobial therapy.

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Purpose Of Review: This review aims to provide an updated report in regards to the correlation between vaccines and anaphylaxis and the related risk in the population.

Recent Findings: Initial reports showed higher incidence of anaphylaxis following messenger RNA COVID-19 vaccines compared with 'routine' vaccinations, likely influenced by the great attention paid to these 'new' vaccines. However, anaphylaxis has still to be considered quite rare and its incidence will be systematically reconsidered in the light of additional data collected.

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Article Synopsis
  • * The pandemic has prompted urgent inquiries about COVID-19's unique clinical features, including severe complications, and has driven rapid vaccine and drug development efforts.
  • * A paper addresses 150 critical questions posed by young clinicians and scientists about COVID-19, covering topics such as virology, diagnosis, treatment, and the interplay between the virus and allergic diseases.
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We assessed the safety of allergoid adjuvanted by monophosphoryl lipid A (uSCIT-MPL-4) in a real-life setting. Patients treated with uSCIT-MPL-4 were followed-up for 1 year. Systemic reactions (SRs) were registered and the association with potential risk factors was evaluated.

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Background: Drug provocation test (DPT) represents the gold standard for the diagnosis of drug allergy. A DPT can be performed in a single-blind placebo-controlled manner. In anxiety and depressive disorders, patients need to be evaluated to understand the nature of placebo reactions.

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