Could it be hereditary angioedema?—Perspectives from different medical specialties

Magerl, Markus; Sala‐Cunill, Anna; Weber‐Chrysochoou, Christina; Trainotti, Susanne; Mormile, Ilaria; Spadaro, Giuseppe

doi:10.1002/clt2.12297

Cited by 5 publications

(1 citation statement)

References 105 publications

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“…Food allergies can manifest with various clinical symptoms, from mild to severe, up to anaphylaxis [ 137 ]. Skin and mucous membrane-related symptoms are common in food allergies and can include urticaria, eczema, itchy or tingling sensation in the mouth or the throat, and angioedema [ 138 , 139 , 140 , 141 ]. Food allergies can also affect the gastrointestinal tract, and the respiratory and cardiovascular systems leading, in severe cases, to a systemic reaction and finally to anaphylaxis [ 82 , 142 ].…”

Section: Spectrum Of Clinical Severity In Food Allergymentioning

confidence: 99%

Worldwide Heterogeneity of Food Allergy: Focus on Peach Allergy in Southern Italy

D’Aiuto,

Mormile,

Granata

et al. 2024

JCM

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Food allergy (FA) has shown an increasing prevalence in the last decades, becoming a major public health problem. However, data on the prevalence of FA across the world are heterogeneous because they are influenced by several factors. Among IgE-mediated FA, an important role is played by FA related to plant-derived food which can result from the sensitization to a single protein (specific FA) or to homologous proteins present in different foods (cross-reactive FA) including non-specific lipid transfer proteins (nsLTPs), profilins, and pathogenesis-related class 10 (PR-10). In addition, the clinical presentation of FA is widely heterogeneous ranging from mild symptoms to severe reactions up to anaphylaxis, most frequently associated with nsLTP-related FA (LTP syndrome). Considering the potential life-threatening nature of nsLTP-related FA, the patient’s geographical setting should always be taken into account; thereby, it is highly recommended to build a personalized approach for managing FA across the world in the precision medicine era. For this reason, in this review, we aim to provide an overview of the prevalence of nsLTP-mediated allergies in the Mediterranean area and to point out the potential reasons for the different geographical significance of LTP-driven allergies with a particular focus on the allergenic properties of food allergens and their cross reactivity.

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Section: Spectrum Of Clinical Severity In Food Allergymentioning

confidence: 99%

Worldwide Heterogeneity of Food Allergy: Focus on Peach Allergy in Southern Italy

D’Aiuto,

Mormile,

Granata

et al. 2024

JCM

Self Cite

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Clinical features and potential markers of disease in idiopathic non-histaminergic angioedema, a real-life study

Mormile,

Gigliotti,

Ferrara

et al. 2024

Immunol Res

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Idiopathic non-histaminergic acquired angioedema (InH-AAE) is a rare disease, with unknown etiology and pathogenesis, characterized by recurrent clinical manifestations and resistance to antihistamines and corticosteroids. We aim to evaluate clinical features and potential markers of disease in an Italian cohort of patients with InH-AAE. We enrolled 26 patients diagnosed with InH-AAE. Information about clinical features, treatments, routine laboratory investigations, immunological and genetic tests were collected. We assessed plasma levels of complement components, angiogenic and lymphangiogenic mediators, proinflammatory cytokines and chemokines, and activity of phospholipases A2. Finally, patients underwent nailfold videocapillaroscopy (NVC); both quantitative and qualitative capillaroscopic parameters were analyzed. Plasma levels of VEGFs were similar in healthy controls and in InH-AAE patients. ANGPT1 was decreased in InH-AAE patients compared to controls while ANGPT2 was similar to controls. Interestingly, the ANGPT2/ANGPT1 ratio (an index of vascular permeability) was increased in InH-AAE patients compared to controls. sPLA2 activity, elevated in patients with C1-INH-HAE, showed differences also when measured in InH-AAE patients. TNF-α concentration was higher in InH-AAE patients than in healthy controls, conversely, the levels of CXCL8, and IL-6 were similar in both groups. At the NVC, the capillary loops mainly appeared short and tortuous in InH-AAE patients. InH-AAE represents a diagnostic challenge. Due to the potential life-threatening character of this condition, a prompt identification of the potentially bradykinin-mediated forms is crucial. A better comprehension of the mechanism involved in InH-AAE would also lead to the development of new therapeutic approaches to improve life quality of patients affected by this disabling disease.

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Assessing the control of the disease on current treatments available in Romania for hereditary angioedema patients

Bara,

Nadasan,

Nadasan

et al. 2024

Acta Marisiensis - Seria Medica

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Background: Acute treatment must be permanently accessible for every patient diagnosed with hereditary angioedema (HAE). In many cases this type of therapy does not provide/offer sufficient control of the disease, so long-term prophylaxis (LTP) is recommended. In the case of regular and prolonged/extended administration of drugs, the route of administration is essential. The aim of the investigation was to assess the control of HAE among patients in Romania receiving the available medications, while also examining potential correlations within the outcomes. Material and methods: A phone call was made to all adult patients registered in the Romanian HAE Registry. Patients with confirmed diagnosis of HAE who had at least one angioedema attack in the last three months were asked to complete, online, the angioedema control test (AECT) for one- and three months respectively. AECT scores were calculated according to the authors’ instructions. Results: A total of 121 patients were contacted. Of these, 83 complies with the eligibility criteria and 56 completed the questionnaires (response rate 67.4%), 18 (32.1%) men and 38 (67.9%) women. Acute, home administered treatment with Icatibant or pdC1-INH was available for every patient during the study time. Nine (14.5%) participants used LTP too, with pdC1-INH. These treatments ensured an adequate control of the disease in only 13 patients (21%) in case of the three-month AECT, of whom 2 used LTP. The one-month questionnaire showed a well-controlled disease in 14 patients (23%), from which only 1 was on prophylactic therapy. Conclusion: In most Romanian HAE patients, the available drugs do not offer a proper control of the disease. Even though a first-line drug for LTP is available, its administration route by intravenous injections makes it inconvenient for many patients, highlighting the necessity for new, easy-to administer drugs for HAE patients from our country.

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Could it be hereditary angioedema?—Perspectives from different medical specialties

Cited by 5 publications

References 105 publications

Worldwide Heterogeneity of Food Allergy: Focus on Peach Allergy in Southern Italy

Worldwide Heterogeneity of Food Allergy: Focus on Peach Allergy in Southern Italy

Clinical features and potential markers of disease in idiopathic non-histaminergic angioedema, a real-life study

Assessing the control of the disease on current treatments available in Romania for hereditary angioedema patients

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