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Dive into the research topics where Nicola Ullmann is active.

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Featured researches published by Nicola Ullmann.


The Journal of Allergy and Clinical Immunology | 2013

IL-33 promotes airway remodeling in pediatric patients with severe steroid-resistant asthma.

Sejal Saglani; Stephen Lui; Nicola Ullmann; Gaynor A. Campbell; Rebekah Sherburn; Sara A. Mathie; Laura Denney; Cara Bossley; Timothy Oates; Simone A. Walker; Andrew Bush

BACKGROUND TH2 cytokines are not responsible for the ongoing symptoms and pathology in children with severe therapy-resistant asthma (STRA). IL-33 induces airway hyperresponsiveness, but its role in airway remodeling and steroid resistance is unknown. OBJECTIVE We sought to investigate the relationship between IL-33 and airway remodeling in pediatric patients with STRA. METHODS IL-33 levels were quantified in neonatal mice given inhaled house dust mite (HDM), and the effect of blocking IL-13 on remodeling and IL-33 levels was assessed. HDM-induced allergic airways disease (AAD) in neonatal ST2(-/-) mice lacking the IL-33 receptor was assessed, together with collagen production after IL-33 administration. The effect of steroid therapy on IL-33 levels in patients with neonatal AAD was explored. IL-33 expression was quantified in endobronchial biopsy (EB) specimens from children with STRA and related to remodeling, and collagen production by airway fibroblasts from pediatric patients stimulated with IL-33 and budesonide was quantified. RESULTS Blocking IL-13 after AAD was established in neonatal mice and did not reduce remodeling or IL-33 levels; airway hyperresponsiveness was only partially reduced. IL-33 promoted collagen synthesis both from asthmatic fibroblasts from pediatric patients and after intranasal administration in mice. Increased cellular expression of IL-33, but not IL-13, was associated with increased reticular basement membrane thickness in EB specimens from children with STRA, whereas remodeling was absent in HDM-exposed ST2(-/-) mice. IL-33 levels were maintained, whereas IL-13 levels were abrogated by steroid treatment in neonatal HDM-exposed mice and in EB specimens from children with STRA. CONCLUSION IL-33 is a relatively steroid-resistant mediator that promotes airway remodeling in patients with STRA and is an important therapeutic target.


The Journal of Allergy and Clinical Immunology | 2013

Increased airway smooth muscle in preschool wheezers who have asthma at school age

Ruth O'Reilly; Nicola Ullmann; Samantha Irving; Cara Bossley; Samatha Sonnappa; Jie Zhu; Timothy Oates; Winston Banya; Peter K. Jeffery; Andrew Bush; Sejal Saglani

BACKGROUND Increased airway smooth muscle (ASM) is a feature of established asthma in schoolchildren, but nothing is known about ASM in preschool wheezers. OBJECTIVE We sought to determine endobronchial biopsy specimen ASM area fraction in preschool wheezers and its association with asthma at school age. METHODS ASM area, reticular basement membrane thickness, and mucosal eosinophil and ASM mast cell values were quantified in endobronchial biopsy specimens previously obtained from preschool children undergoing clinically indicated bronchoscopy: severe recurrent wheezers (n=47; median age, 26 months) and nonwheezing control subjects (n=21; median age, 15 months). Children were followed up, and asthma status was established at age 6 to 11 years. Preschool airway pathology was examined in relation to asthma at school age. RESULTS Forty-two (62%) of 68 children had 1 or more evaluable biopsy specimens for ASM. At school age, 51 of 68 children were followed up, and 15 (40%) of 37 preschool wheezers had asthma. Children who had asthma and an evaluable biopsy specimen had increased preschool ASM area fraction (n=8; median age, 8.2 years [range, 6-10.4 years]; median ASM, 0.12 [range, 0.08-0.16]) compared with that seen in children without asthma (n=24; median age, 7.3 years [range, 5.9-11 years]; median ASM, 0.07 [range, 0.02-0.23]; P=.007). However, preschool reticular basement membrane thickness and mucosal eosinophil or ASM mast cell values were not different between those who did or did not have asthma at school age. CONCLUSION Increased preschool ASM is associated with those children who have asthma at school age. Thus a focus on early changes in ASM might be important in understanding the subsequent development of childhood asthma.


Pediatric Pulmonology | 2012

Necrotizing sarcoid granulomatosis of the lung in a 12-year-old boy with an atypical clinical course†

Serena Panigada; Nicola Ullmann; Oliviero Sacco; Claudio Gambini; Andrew Bush; Giovanni A. Rossi

Necrotizing sarcoid granulomatosis (NSG) is a disorder of unknown etiology, rarely described in childhood, belonging to the heterogeneous group of the pulmonary angiitis and granulomatosis. One of the characteristics of NSG is to have typically a benign clinical course with minimal treatment with systemic steroids or even with no therapy at all. Here, we report the case of a boy with a lung consolidation, with morphological and histological features consistent with a diagnosis of NSG. Good clinical and roentgenographic response to high dose prednisone treatment was followed three times by relapses, when steroid treatment was tapered. New lesions were detected in different areas of the lung and not in initially affected area, never previously described in NSG and only rarely in other pulmonary angiitides. Pediatr Pulmonol. 2012. 47:831–835.


Pediatric Pulmonology | 2014

Late diagnosis of double aortic arch: consequences on long-term follow-up.

Nicola Ullmann; Laura Menchini; Teresa Salerno; Paolo Tomà; Renato Cutrera

Double aortic arch is the most common congenital anomaly of the aortic arch system, in which the trachea and esophagus are completely encircled by vascular segments of the aortic arch and its branches, often resulting in variable airway compression. One case of late diagnosis of this congenital malformation and long‐term consequences of late surgical treatment with persistent tracheo‐broncomalacia and dynamic airway obstruction is reported. This report emphasizes the importance of an early diagnosis to minimise the progressive airways damage and subsequent respiratory symptoms, that need an accurate medical follow‐up. Pediatr Pulmonol. 2014; 49:E75–E77.


Italian Journal of Pediatrics | 2017

Management of acute respiratory diseases in the pediatric population: the role of oral corticosteroids

Renato Cutrera; Eugenio Baraldi; Luciana Indinnimeo; Michele Miraglia del Giudice; Giorgio Piacentini; Francesco Scaglione; Nicola Ullmann; Laura Moschino; Francesca Galdo; Marzia Duse

Respiratory diseases account for about 25% of all pediatric consultations, and 10% of these are for asthma. The other main pediatric respiratory diseases, in terms of incidence, are bronchiolitis, acute bronchitis and respiratory infections. Oral corticosteroids, in particular prednisolone, are often used to treat acute respiratory diseases given their anti-inflammatory effects. However, the efficacy of treatment with oral corticosteroids differs among the various types of pediatric respiratory diseases. Notably, also the adverse effects of corticosteroid treatment can differ depending on dosage, duration of treatment and type of corticosteroid administered — a case in point being growth retardation in long-course treatment. A large body of data has accumulated on this topic. In this article, we have reviewed the data and guidelines related to the role of oral corticosteroids in the treatment and management of pediatric bronchiolitis, wheezing, asthma and croup in the attempt to provide guidance for physicians. Also included is a section on the management of acute respiratory failure in children.


Archives of Disease in Childhood | 2017

Unusual cause of dyspnoea

Nicola Ullmann; Giulia Ceglie; Maria Giovanna Paglietti; Sergio Bottero; Renato Cutrera

A 4-year-old boy was admitted to our department with fever, cough and dyspnoea, unresponsive to salbutamol and antibiotic therapy. He had previously contracted bronchiolitis at 20 days of life, followed by intermittent episodes of wheeze that never required hospitalisation and responded to short inhaled corticosteroid cycles. He had an atopic family history. On examination, he had dyspnoea, persistent cough with bronchospasm but normal oxygen saturations. Bloods showed elevated eosinophils (2004 µL), a slightly elevated C-reactive protein (1.5 mg/dL) and total IgE (326 kU/L), and specific IgE was raised for various inhalant allergens (box). A chest X-ray was performed (figure 1). Box Positive inhalant allergens Anthoxanthum odoratum Cynodon dactylon Dactylis glomerata Dermatophagoides farinae Dermatophagoides pteronissimus Holcus lanatus Poa pratensis Phleum pratense Figure 1 Chest X-ray of the patient. Questions 1. What does the chest X-ray in figure 1 show? interstitial pneumonia pneumothorax lung atelectasis with mild mediastinal shift diffuse air trapping enlargement of right hilar lymph nodes 2. Given the clinical picture and the chest X-ray, what would your differential diagnosis include from the following? plastic bronchitis (PB) mycoplasma infection tuberculosis foreign body aspiration lung perforation 3. Are any of these conditions not associated with a specific type of cast/PB? Fontan procedure haemophilia lymphatic abnormalities asthma and other allergic disorders sickle cell disease.


Frontiers in Pediatrics | 2018

Asthma: Differential Diagnosis and Comorbidities

Nicola Ullmann; Virginia Mirra; Antonio Di Marco; Martino Pavone; Federica Porcaro; Valentina Negro; Alessandro Onofri; Renato Cutrera


Italian Journal of Pediatrics | 2017

Age and seasons influence on at-home pulse oximetry results in children evaluated for suspected obstructive sleep apnea

Martino Pavone; Elisabetta Verrillo; Nicola Ullmann; Serena Caggiano; Valentina Negro; Renato Cutrera


European Journal of Human Genetics | 2016

Erratum: Clinical and ultrastructural spectrum of diffuse lung disease associated with surfactant protein C mutations (European Journal of Human Genetics (2015) 23 (10331041)) DOI:10.1038/ejhg.2015.45

Donatella Peca; Renata Boldrini; Jan Johannson; Joseph T.C. Shieh; Arianna Citti; Stefania Petrini; Teresa Salerno; Salvatore Cazzato; Raffaele Testa; Francesco Messina; Alfredo Onofri; Giovanna Cenacchi; Per Westermark; Nicola Ullmann; Paola Cogo; Renato Cutrera; Olivier Danhaive


/data/revues/00916749/unassign/S0091674915001062/ | 2015

Pediatric severe asthma with fungal sensitization is mediated by steroid-resistant IL-33

Susana Castanhinha; Rebekah Sherburn; Simone A. Walker; Atul Gupta; Cara Bossley; James Buckley; Nicola Ullmann; Ruth Grychtol; Gaynor A. Campbell; Marco Maglione; Sergio Koo; Louise Fleming; Lisa G. Gregory; Robert J. Snelgrove; Andrew Bush; Sejal Saglani

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Renato Cutrera

Boston Children's Hospital

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Andrew Bush

National Institutes of Health

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Cara Bossley

National Institutes of Health

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Gaynor A. Campbell

National Institutes of Health

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Martino Pavone

Boston Children's Hospital

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Rebekah Sherburn

National Institutes of Health

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Simone A. Walker

National Institutes of Health

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Teresa Salerno

Boston Children's Hospital

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Timothy Oates

National Institutes of Health

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