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Dive into the research topics where Roberto Bernardini is active.

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Featured researches published by Roberto Bernardini.


Annals of Allergy Asthma & Immunology | 2002

Efficacy and safety of cyclosporine eyedrops in vernal keratoconjunctivitis

Neri Pucci; Elio Novembre; A. Cianferoni; Enrico Lombardi; Roberto Bernardini; Roberto Caputo; Luciana Campa; A. Vierucci

BACKGROUND Corticosteroids have been the only effective topically administered treatment for severe vernal keratoconjunctivitis (VKC), but their prolonged use is often associated with complications. Topical cyclosporine therapy has been used in the past decade, but few controlled trials have been conducted, and conflicting results have been reported. OBJECTIVE This study sought to evaluate the efficacy and safety of ocular administration of cyclosporine in VKC. METHODS Twenty-four children with severe VKC were treated with cyclosporine 2% eyedrops. The treatment began in spring and lasted 4 months. One eye was treated with cyclosporine (Cs-eye); the fellow eye received the vehicle as placebo (Pl-Cs-eye) during the first 2 weeks in a double-blind, placebo-controlled trial and thereafter was treated with cyclosporine (open trial). Patients were instructed to protect their eyes against sunlight. Ocular symptoms and signs were scored at entry and at 2 weeks, 4 weeks, and 4 months after the beginning of treatment. All children underwent biochemical and immunologic evaluations. RESULTS Compared with baseline, scores for ocular signs and symptoms at 2 weeks decreased significantly in the Cs-eyes (P < 0.001), and signs improved in the Pl-Cs-eyes (P = 0.001). A significant difference was noted between Cs-eyes and Pl-Cs-eyes at 2 weeks for both subjective (P < 0.005) and objective (P < 0.001) scores. At 4 weeks, scores for signs (P < 0.001) and symptoms (P = 0.01) were reduced in the Pl-Cs-eyes, with no further improvement in the Cs-eyes. At 4 months, clinical scores had declined further, and serum eosinophil cationic protein levels were significantly lower than at entry (P = 0.009). Most patients reported mild burning sensation and tearing after administration of cyclosporine. Four patients (17%) required an additional brief period of topical corticosteroid therapy. CONCLUSIONS Cyclosporine eyedrops were effective and safe for treating severe VKC, without causing major side effects. Most of the therapeutic effect was achieved after 2 weeks. The initial therapeutic effect was maintained during the next 3 months, with a further slow decrease in the symptoms.


Allergy | 2001

Natural history of “intrinsic” atopic dermatitis

Elio Novembre; A. Cianferoni; Enrico Lombardi; Roberto Bernardini; Neri Pucci; A. Vierucci

. IT is well known that allergy plays a pathogenic role in the development of atopic dermatitis (AD) (1). However, approximately 20% of AD patients suffer from a skin disease that clinically resembles the skin lesions and the distribution pattern of AD, but is not associated with atopic status. This kind of ‘‘intrinsic’’ AD (iAD) seems to differ from the classical or ‘‘extrinsic’’ form (eAD) both in the T-cell cytokine production and in the immunohistology (2, 3), but no data are available about its natural history. In this study, we investigated the persistence of AD and the development of respiratory allergic diseases in a group of children seen at the ages of 2 and 11 years according to the skin prick test (SPT) reactivity to allergens at those ages. The parents of 111 children with AD evaluated at our allergy unit in 1989–90 were asked for re-evaluation of the children about 9 years later. Seventy percent of the children (77/111) underwent clinical history, and SPTs to food (egg white, wheat, milk, tomato, codfish, and soy [Lofarma, Milan, Italy]) and inhalant allergens (dust mite, cat, dog, Alternaria, grass pollen, Parietaria, mugwort, olive pollen, and Cupressus sempervires [Lofarma]). AD was diagnosed according to Hanifin & Rajka (4). The presence of asthma and SPT reactivity was studied as previously described (5, 6). According to the SPT results, we defined the following groups: 1) ‘‘early atopic’’, i.e., those children who were already SPT positive at age 2 and were still SPT positive at age 11 2) ‘‘late-onset atopic’’, i.e., those who were negative at age 2 but became SPT positive by the age of 11 3) ‘‘nonatopic’’, i.e., those who were SPT negative at the ages of both 2 and 11. We considered patients SPT negative at age 2 as having iAD. The data were analyzed by the statistical program SPSS 6.0 for Windows with the chi-square and chi-square for trend tests. A two-sided type 1 error lower than 0.05 was considered statistically significant. Seventy-seven AD patients, with a mean age (uSE) of 24.1u2.28 months at the first evaluation, and 132u3.24 months at the second evaluation, were identified. At diagnosis, all of them had AD (77/77), 22% (17/77) had asthma, and 64% (49/77) had at least one positive SPT. At 11 years of age, 46% of them had AD (36/77), 43% (33/77) had asthma, and 84% had (65/77) at least one positive SPT. Forty-nine out of the 77 (64%) studied children had early atopy, 16/77 (21%) had late-onset atopy, and 12/77 (15%) were nonatopic. None of the nonatopic children developed asthma by age 11 (0/12), compared with the 25% (4/16) and the 59% (29/49) of the late-onset and early atopic children, respectively (chi square for trend, P,0.0002). AD was still present by age 11 in 67% (8/12) of nonatopic AD as compared with 44% (7/16) and 43% (21/49) of the late-onset and early atopic children (Fig. 1). Altogether, the 28 AD children ALLERGY 2001: 56 :452^463 . COPYRIGHT G MUNKSGAARD 2001 . ISSN 0105-4538 . ALL RIGHTS RESERVED . CONTRIBUTIONS TO THIS SECTION WILL NOT UNDERGO PEER REVIEW, BUT WILL BE REVIEWED BY THE ASSOCIATE EDITORS .


Annals of Allergy Asthma & Immunology | 2001

Clinical features of acute anaphylaxis in patients admitted to a university hospital: an 11-year retrospective review (1985–1996)

A. Cianferoni; Elio Novembre; Luca Mugnaini; Enrico Lombardi; Roberto Bernardini; Neri Pucci; A. Vierucci

BACKGROUND Although anaphylaxis is considered a life-threatening event, there is a lack of information on the clinical characteristics at presentation, both in adults and in children. OBJECTIVE To describe in a nonselected population the clinical characteristics and the treatments of acute anaphylaxis triggered by different agents. METHODS This is a retrospective review of the clinical features of 113 episodes of acute anaphylaxis resulting in admission to a university hospital. Initially, the 107 patients visited the emergency room and were then admitted to the hospital. RESULTS Most anaphylactic events (63%) occurred at home. The most frequent symptoms involved the respiratory system (78%) and the skin (90%). Drugs, especially nonsteroidal anti-inflammatory drugs and antibiotics, were the most frequent cause of anaphylaxis in adults (49%). Patients with drug-induced anaphylaxis were older and more often had cardiovascular symptoms (hypotension and tachycardia) (P = 0.0064). Hymenoptera venom was the second most frequent cause of anaphylaxis (29%). Most of the patients with hymenoptera venom anaphylaxis were male (80%) and more frequently they had no history of atopy (P = 0.012). In food-induced anaphylaxis, the cardiovascular system was less likely to be involved (P < 0.05) (39%). Seafood seems to be frequently involved in food-induced anaphylaxis in our area. Specific immunotherapy-induced anaphylaxis occurred more often in younger patients (P = 0.032). Epinephrine seems to be underused in Italy (only 15% of patients received it), especially for respiratory symptoms. CONCLUSIONS Anaphylaxis triggered by different agents may have different clinical presentations and may occur in different types of patients. In Italy, the inadequate use of epinephrine for anaphylaxis treatment needs to be publicized to both physicians and the general population.


Thorax | 2001

Reference values of interrupter respiratory resistance in healthy preschool white children

E Lombardi; Peter D. Sly; G Concutelli; Elio Novembre; G Veneruso; G Frongia; Roberto Bernardini; A Vierucci

BACKGROUND Interrupter respiratory resistance (Rint) is reported to be useful in evaluating lung function in poorly collaborating patients. However, no reference values are available from large samples of preschool children using the standard interrupter method. The aim of this study was to define reference Rint values in a population of healthy preschool children. METHODS Rint was assessed without supporting the cheeks in children with no history of wheeze from six kindergartens. To evaluate the effects of upper airway compliance on Rint in healthy children, an additional group of preschool children with either no history of wheeze or no respiratory symptoms at the time of testing underwent Rint measurements in our lung function laboratory with and without supporting the cheeks. Short term (about 1 minute apart) and long term (mean 2.5 months apart) repeatability of Rint measurements (2 SDs of the mean paired difference between measurements) was also assessed in children referred for cough or wheeze. RESULTS A total of 284 healthy white children (age range 3.0–6.4 years) were evaluated. Mean inspiratory and expiratory Rint (Rinti and Rinte) did not differ significantly in boys and girls. Age, height, and weight showed a significant inverse correlation with both Rinti and Rinte in the univariate analysis with linear regression. Multiple regression with age, height, and weight as the independent variables showed that all three variables were significantly and independently correlated with Rinti, whereas only height was significantly and independently correlated with Rinte. Supporting the cheeks had no significant effect on Rinti (n=29, median 0.673 v0.660 kPa/l.s, p=0.098) or Rinte (n=39, median 0.702v 0.713 kPa/l.s, p=0.126). Short term repeatability was 0.202 kPa/l.s for Rinti (n=50) and 0.242 kPa/l.s for Rinte (n=69). Long term repeatability was 0.208 kPa/l.s for Rinte (n=26). CONCLUSIONS We have reported reference Rint values in preschool white children and have demonstrated the usefulness of this technique in assessing lung function in this age group.


The Journal of Allergy and Clinical Immunology | 2014

The effect of component-resolved diagnosis on specific immunotherapy prescription in children with hay fever

Giovanna Stringari; Salvatore Tripodi; Carlo Caffarelli; Arianna Dondi; Riccardo Asero; Andrea Di Rienzo Businco; Annamaria Bianchi; Paolo Candelotti; Giampaolo Ricci; Federica Bellini; Nunzia Maiello; Michele Miraglia del Giudice; Tullio Frediani; Simona Sodano; Iride Dello Iacono; Francesco Macrì; Ilaria Peparini; Carlotta Povesi Dascola; Maria Francesca Patria; Elena Varin; Diego Peroni; Pasquale Comberiati; L Chini; Viviana Moschese; Sandra Lucarelli; Roberto Bernardini; Giuseppe Pingitore; Umberto Pelosi; Mariangela Tosca; Anastasia Cirisano

BACKGROUND Sensitization to profilins and other cross-reacting molecules might hinder proper specific immunotherapy (SIT) prescription in polysensitized patients with pollen-related allergic rhinitis (AR). In these patients, component-resolved diagnosis (CRD) might modify SIT prescription by improving the identification of the disease-eliciting pollen sources. OBJECTIVES We sought to measure the effect of CRD on SIT prescription in children with pollen-related AR. METHODS Children (n = 651) with moderate-to-severe pollen-related AR were recruited between May 2009 and June 2011 in 16 Italian outpatient clinics. Skin prick test (SPT) reactivity to grass, cypress, olive, mugwort, pellitory, and/or Betulaceae pollen was considered clinically relevant if symptoms occurred during the corresponding peak pollen season. IgE sensitization to Phl p 1, Phl p 5, Bet v 1, Cup a 1, Art v 1, Ole e 1, Par j 2, and Phl p 12 (profilin) was measured by using ImmunoCAP. SIT prescription was modeled on SPT responses first and then remodeled considering also CRD according to GA(2)LEN-European Academy of Allergology and Clinical Immunology guidelines and the opinions of 14 pediatric allergists. RESULTS No IgE to the respective major allergens was detected in significant proportions of patients with supposed clinically relevant sensitization to mugwort (45/65 [69%]), Betulaceae (146/252 [60%]), pellitory (78/257 [30%]), olive (111/390 [28%]), cypress (28/184 [15%]), and grass (56/568 [10%]). IgE to profilins, polcalcins, or both could justify 173 (37%) of 464 of these SPT reactions. After CRD, the SPT-based decision on SIT prescription or composition was changed in 277 (42%) of 651 or 315 (48%) of 651 children according to the European or American approach, respectively, and in 305 (47%) of 651 children according to the opinion of the 14 local pediatric allergists. CONCLUSIONS In children with pollen-related AR, applying CRD leads to changes in a large proportion of SIT prescriptions as opposed to relying on clinical history and SPT alone. The hypothesis that CRD-guided prescription improves SIT efficacy deserves to be tested.


The Journal of Allergy and Clinical Immunology | 2000

Urinary eosinophil protein X and serum eosinophil cationic protein in infants and young children with atopic dermatitis: Correlation with disease activity ☆ ☆☆ ★

Neri Pucci; Enrico Lombardi; Elio Novembre; S. Farina; Roberto Bernardini; Elisabetta Rossi; Tania Favilli; A. Vierucci

BACKGROUND Eosinophil cationic protein (ECP) and eosinophil protein X (EPX) or eosinophil-derived neurotoxin (EDN) are released by eosinophil granulocytes in allergic diseases. Serum ECP (s-ECP) levels have been correlated with disease activity in atopic dermatitis (AD) in adults and young patients, and high urinary EPX (u-EPX) levels in asthmatic patients seem to reflect active disease. A relationship between AD severity and u-EPX concentration in young children has not been previously studied. OBJECTIVE This study was performed to evaluate whether the severity of AD in infants and young children was correlated with s-ECP and u-EPX levels. METHODS Fifty-four infants and children (mean age, 17.7 months; range, 4-48 months) with AD and without other allergic conditions were evaluated. The severity of AD was measured by using the SCORAD index. S-ECP, serum total IgE, serum-specific IgE for common allergens, and peripheral blood eosinophil counts (PBECs) were determined. In forty-two children u-EPX was also measured. Seven age-matched control patients underwent the same determinations. RESULTS S-ECP and u-EPX were significantly higher in children with AD than in control children (mean, 23.9 vs 3.5 microg/dL [P <.001] and 57.7 vs 6.0 microg/mmol creatinine [P <.001]). A significant correlation was found between SCORAD and s-ECP (P =.002), u-EPX (P =.01), and PBECs (P =.01) and between symptom index and uEPX (P =.0004). PBECs were strongly correlated to s-ECP and u-EPX (P <.0001). However, 5 patients with moderate and severe AD (11.9%) showed low levels of s-ECP, u-EPX, and PBECs. CONCLUSION S-ECP and u-EPX were useful markers of AD activity in infants and young children. When taken together, the two determinations could give more information about the clinical course of the illness. Some patients seemed to have clinical exacerbations without an involvement of eosinophils and their products.


The Journal of Allergy and Clinical Immunology | 1998

Prevalence and risk factors of latex sensitization in an unselected pediatric population.

Roberto Bernardini; Elio Novembre; Anna Ingargiola; Marinella Veltroni; Luca Mugnaini; Antonella Cianferoni; Enrico Lombardi; A. Vierucci

BACKGROUND The prevalence of latex sensitization has been investigated in population groups considered at high risk, but it has not been systematically surveyed among the general population. OBJECTIVE We sought to determine the prevalence of and the risk factors associated with latex sensitization in a general pediatric population. METHODS We investigated 1175 children (mean age +/- SD, 105 +/- 17.5 months) in 11 elementary schools in Tuscany (Italy). All parents answered a questionnaire, and children underwent skin prick tests (SPTs) with latex, six aeroallergens (Dermatophagoides pteronyssinus, D. farinae, cat, grass pollen, Alternaria tenuis, and Parietaria judaica), three food allergens (milk, egg white, and wheat), and three insect venoms (honeybee, wasp, and Polistes). RESULTS Eight subjects (0.7%; mean age +/- SD, 123 +/- 9.28 months) had positive SPT responses to latex. No children showed allergic reactions to latex. One or more positive SPT responses to aeroallergens were present in 340 children (28.9%); one or more positive SPT responses to food allergens were present in 26 (2.2%); one or more positive SPT responses to aeroallergens, food allergens, or both were present in 353 (30.0%); and one or more positive SPT responses to one or more insect venoms were present in 43 subjects (3.7%). Significant (p < 0.05) risk factors associated with latex sensitization included: positive SPT responses to aeroallergens, food allergens, or both; a positive response to one or more insect venoms; a positive response to mite, milk, egg white, wheat, honeybee venom, wasp venom, Polistes venom, or a combination thereof; and increased age. CONCLUSION This report shows a very low prevalence of latex sensitization with an absence of clinical symptoms to latex. This study demonstrates a significant association between latex sensitization and the presence of one or more positive SPT responses to aeroallergens, food allergens, or both; one or more positive SPT responses to one or more insect venoms; and increased age.


Allergy | 1995

Skin‐prick‐test‐induced anaphylaxis

Elio Novembre; Roberto Bernardini; G. Bertini; G. Massai; A. Vierucci

An anaphylactic reaction occurred in a 57‐year‐old man after a prick by prick test with fresh kiwi and in a 29‐year‐old man after prick tests with some species offish. Both patients had a history of anaphylaxis after ingestion of kiwi and fish, respectively. These cases suggest that, especially in patients with a history of anaphylaxis, all efforts should be made to minimize the risk of systemic reactions, and skin prick testing should be performed only in places equipped to treat anaphylaxis.


Allergy | 1997

The prevalence of latex allergy in children seen in a university hospital allergy clinic

Elio Novembre; Roberto Bernardini; I. Brizzi; G. Bertini; Luca Mugnaini; Chiara Azzari; A. Vierucci

Natural rubber latex allergy is responsible for a wide spectrum of clinical symptoms, ranging from rhinoconjunctivitis to severe anaphylaxis, in both adults and children. An association between allergy to latex and allergy to various fruits has been reported. This study investigated the prevalence and clinical significance of latex sensitization in children seen in a university hospital allergy clinic. A total of 453 consecutive children were screened in a 7‐month period. A detailed clinical history with particular attention to the past surgical history and the eventual presence of latex‐ or food‐induced allergic symptoms was obtained. Skin prick tests (SPT) for the more important inhalant allergens and foods were performed on all children. In patients with positive latex SPT, latex challenge and additional SPT for some fresh foods (avocado, pineapple, apricot, grape, banana, pear, apple, orange, almond, and chestnut) were also performed. RAST for the same food antigens, as well as patch test with latex and a standard battery of contact allergens, was also done. Of 326 atopic children, 10 (3%) presented positive skin test to latex, but only five (1.5%) also had a positive clinical history to latex exposure. Latex challenge was positive in 3/9 positive‐latex‐SPT children. None of the nonatopic children had positive skin test to latex or symptoms to latex exposure. A history of previous surgery was found in 5/10 positive‐latex‐SPT children, in 63/316 negative‐latex‐SPT atopic children (P<0.05), and in 23/127 nonatopic children. RAST to latex was positive in 5/10 positive‐latex‐SPT children. Associated fruit‐specific IgE (SPT and/or RAST) were found in all latex‐symptomatic children and in 2/5 latex‐asymptomatic children. Apple, kiwi, and chestnut were the most common SPT‐positive foods. Only one patient with clinical allergy to latex and positive skin tests to fruits had a history of clinical symptoms after ingestion of kiwi and orange. The natural history of the positive‐latex‐SPT children without clinical reactions to latex exposure and the clinical significance of the association of latex and fruit sensitivity require further studies.


Allergy | 2003

Effects on inflammation parameters of a double-blind, placebo controlled one-year course of SLIT in children monosensitized to mites.

Francesco Marcucci; L. Sensi; Franco Frati; Roberto Bernardini; Elio Novembre; A. Barbato; S. Pecora

Background: Clinical documentation about effects on local markers of inflammation of sublingual immunotherapy (SLIT) in children is still poor.

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A. Vierucci

University of Florence

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Neri Pucci

University of Florence

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