Sapigni T

Skin prick test reactivity to common aeroallergens in relation to total IgE, respiratory symptoms, and smoking in a general population sample of northern Italy.

Skin prick test (SPT) reactivity to common airborne allergens and its relationships to sex, age, smoking habits, and respiratory symptoms/ diseases were evaluated in a general population sample (n= 2841, 8–75 years of age) living in the Po delta area (northern Italy). Subjects completed a standardized questionnaire and underwent prick tests (12 local allergens, a negative and a positive control) and determination of total serum IgE. Atopy was evaluated by measuring the maximal diameter for each allergen, after subtracting that of the negative control. Thirty‐one percent of subjects showed a positive skin response at a 3‐mm threshold. Pollens, Dermatophagoides pteronyssinus, and D. farinae caused the highest frequencies of reactions. Young people and those who had never smoked had higher prevalence rates of SPT reactivity. Asthma, asthma symptoms, and rhinitis were significantly associated with SPT reactivity in both sexes (cough only in females) and with the number of positive reactions. IgE values were also significantly associated with SPT reactivity. In conclusion, our findings indicate that almost one‐third of the general population of an Italian rural area is skin test positive, emphasizing the importance of assessing atopy in respiratory epidemiologic surveys.

The Po River Delta Respiratory Epidemiological Survey: an analysis of factors related to level of total serum IgE

The purpose of the present study was to analyse whether sex, age, skin test reactivity, cigarette smoking and occupational exposure were related to the total serum immunoglobulin (Ig)E concentrations (kU x L[-1]), in a general population sample. We studied 1,905 subjects (915 males, 990 females) of a general population sample (n=2,841, 8-73 yrs) participating in the second cross-sectional respiratory epidemiological survey in the rural Po Delta area (near Venice, North Italy). Distribution of total serum IgE concentrations was skewed, thus a log-transformation was performed to obtain a Gaussian shape. Significantly higher values of IgE were found in males compared to females. In general, a peak of IgE concentration was found at 8-14 yrs. IgE values tended to be lower in older than younger adults. Significantly higher serum IgE levels were shown in subjects with a positive skin-prick test index (ST+) than in those with a negative skin-prick test index (ST-). There was a significant relationship of total IgE levels with skin reactivity to pollens and house-dust mites. In both sexes higher values of IgE were found in current smokers than in ex-nonsmokers, regardless of skin-test reactivity. There was no significant difference in IgE values between ex- and nonsmokers. Passive smoking and occupational exposure were significantly related to increased IgE values. Our results confirm that in a general population sample immunoglobulin E concentrations are related not only to skin-prick test reactivity to common aeroallergens, but also to other risk factors for chronic obstructive lung diseases, such as sex, active/ passive smoking and occupational exposure.

The Po River Delta (north Italy) indoor epidemiological study: Effects of pollutant exposure on acute respiratory symptoms and respiratory function in adults

Abstract The authors studied the effects of relatively low doses of nitrogen dioxide and respirable suspended particulate matter (i.e., < 2.5 μ) on acute respiratory symptoms and on peak expiratory flow in 383 adults (15–72 yr of age) who lived in the Po River Delta area, located near Venice. During 2 wk—1 wk in winter and 1 wk in summer—the authors monitored each participants house to measure nitrogen dioxide (in parts per billion) and respirable suspended particulate (μg/m3) concentration. Information on sex, age, height, weight, daily activity patterns, active and passive smoking, chronic respiratory diseases, daily peak expiratory flow, and presence of acute respiratory symptoms during the weeks monitoring occurred were also collected. Peak expiratory flow variation was studied as mean amplitude percentage (i.e., amplitude/mean) and percentage of diurnal variation (maximum/minimum). The exposure indices to nitrogen dioxide (nitrogen dioxide-index of exposure) and to respirable suspended particulate matter (respirable suspended particulate matter-index of exposure) were computed as the product of pollutant concentration and time of exposure. The authors considered indices as “low” or “high” on the basis of the median value. The median nitrogen dioxide was 20 ppb in winter and 14 ppb in summer; the highest nitrogen dioxide levels occurred in the kitchen in the winter (33 ppb) and summer (20 ppb). The median respirable suspended particulate matter was 68 μg/m3 in winter and 45 μg/m3 in summer. Only in winter were there significant associations between bronchitic/asthmatic symptoms and “high” nitrogen dioxide and respirable suspended particulate matter indices. In subjects who did not smoke, a significant influence of the “high” respirable suspended particulate matter-index of exposure was also observed in summer. With respect to peak expiratory flow and its variability, respirable suspended particulate matter-index of exposure was associated with an increase of both amplitude/mean and maximum/mean; however, with respect to the nitrogen dioxide-index of exposure, the association was significant only in subjects with chronic respiratory diseases (i.e., asthma and bronchitis). These relationships were significant only in winter. In conclusion, the results of the current study indicate that there is an association between relatively low doses of pollutants and acute respiratory symptoms and peak expiratory flow in adults.

The Po River Delta epidemiological survey: Reference values of total serum IgE levels in a normal population sample of North Italy (8-78 yrs)

The aim of this paper was to define, for the first time in Italy, normal levels of total serum IgE in a general population sample of North Italy. Total serum IgE in 1905 subjects, living in Po Delta area (near Venice), were measured by PRIST method. Normal values were derived from 558 subjects without asthma and/or asthmatic/rhinitic symptoms, noncurrent smokers, skin prick-test negatives (‘normals’). Cut-off values to differentiate ‘normals’ from the remaining part of the sample (‘others’), from asthmatic, and from rhinitic subjects, were established with the IgE value midway between the upper limit of the 95% confidence intervals (CI) of the geometric mean for ‘normals’ and the lower limit for ‘others’, asthmatics, and rhinitics, respectively. Geometric mean of normal children–adolescents was 45 kU/L (SD: 2.6; 95% CI: 38–63). In normal adults geometric mean was 29 kU/L (SD: 3.3; 95% CI: 25–40) in males and 19 kU/L (SD: 3.8; 95% CI: 16–22) in females. The diagnostic sensitivity of IgE test was low, while the specificity was very high. A good positive predictive value in discriminating ‘normals’ from ‘others’ was found, on the contrary, we found a good negative predictive value in discriminating ‘normals’ from asthmatics or from rhinitics. In conclusion, our results confirm that it is necessary to provide separate total serum IgE reference values for what concerns age in children–adolescents and in adults, and gender, in adults. Low level of total serum IgE are helpful to exclude allergic asthma or rhinitis.

The Po River Delta epidemiological study: use of medicines in a general population sample of north Italy.

Purpose—To provide information on the actual use of medicines in a general population sample.

Effects of some indoor environmental factors on respiratory symptoms and lung function in a sample of young non smokers in North Italy

SummaryWe evaluated the effects of some indoor environmental factors in a non smoking subsample (n=381, age 8–19 years) of the general population living in the Po River Delta. Each subject completed an interviewer-administered standardized questionnaire on respiratory symptoms and risk factors. Acceptable maneuvers of forced vital capacity and slope of alveolar plateau of nitrogen were obtained in 96% and 59% of the subjects, respectively. In the houses there were more frequently natural gas for cooking (86%) than bottled gas (14%) and central heating (82%) than stove (18%). As regards passive smoking exposure, 18% of subjects had both parents smoking, 50% had one parent smoking. Significantly higher prevalence rates of wheeze, dyspnea, diagnosis of asthma were found in subjects of both sexes using bottled gas for cooking in comparison to those using natural gas, when also exposed to passive smoking. An insignificant trend towards higher symptom rates was shown by those using stove, instead of central heating. Lung function was affected only in females: those with both parents smoking had reduced forced expirograms, those with bottled gas for cooking or stove for heating had a decreased peak expiratory flow. Interactions of stove and passive smoking on peak expiratory flow and on slope of alveolar plateau were statistically significant. These findings confirm the mild adverse respiratory effects of certain home environment factors shown by other epidemiologic surveys in North Europe and in the USA. They have been a basis for the implementation, under the auspices of National Research Council and Electric Energy Authority, of future specific studies in which continuous monitoring of indoor pollutants and repeated recording of symptoms and lung function in North and Central Italy will be performed.

Lowered resistance to lytic agents in sucrose vacuolation.

SummaryVacuolation in fibroblasts cultivated in the presence of sucrose is associated with progressive accumulation of the undigestible sugar. In radioisotope experiments the process lasted several days, and when the cells were subcultured back into a medium devoid of sucrose the label was also lost after several days.This type of vacuolated cell is more fragile when it is challenged with lytic agents.51Cr-labelled LS fibroblasts released more radioactivity when they had been growing in the presence of sucrose, whether they were suspended in media of decreasing osmolarity, in dilutions of various surfactants, exposed to high temperatures, or subjected to mechanical stress. It is concluded that these cells exhibit a lower resistance when exposed to unfavourable environments, but retain their viability in growth media despite some morphological and biochemical alterations.