Background. Despite the presence of robust evidence, very sparse data are available on the efficacy of allergen immunotherapy (AIT) on selected patients in  real-life. Moreover, the obtained data does not ever fit with the general population; thus, the translation and the use of data obtained from randomized clinical trials (RCTs) in  real-practice can be questionable. Accordingly, we aimed to evaluate in  real-life efficacy and perceived satisfaction of 3-year sublingual immunotherapy (SLIT) in a pediatric population with with allergic rhinitis and/or asthma. Methods. A pilot, monocenter, retrospective cohort,  real-life study was performed. 153 children who fulfilled the criteria for allergic rhinitis and asthma and mono- or poly-sensitized were enrolled. A standardized questionnaire on perceived efficacy, rescue medication, disease control, number of exacerbations, quality of life, and perceived satisfaction was administered to each patient. Results. 70 patients (49 males, 21 females; mean age, 14.3±1.9 years) were included in the final analysis. All 70 patients received SLIT for up to three years, with 100% treatment adherence throughout the study duration. Significant improvement in symptoms and quality of life was reported (p<0.01). A significant decrease in disease severity, rescue medication use, and sleep disturbances was reported (p<0.01). A significant improvement was also recorded in school performance (p<0.01).  60/70 (85.7%) of all enrolled patients declared themselves  very  satisfied, 6/70 (8.57%)  much satisfied, and 4/60 (5.71%)  satisfied.  Conclusions. We firstly showed the efficacy and perceived satisfaction of 3-year SLIT in a paediatric population, with 100% treatment adherence throughout the study duration, in  real-life.

Introduction Childhood cancer survivors (CSs) might face an increased lifelong risk of lung function impairment. The Lung Clearance Index (LCI) has been described as being more sensitive than spirometry in the early stages of some lung diseases. The aim of this study was to evaluate this index in a cohort of patients with a history of childhood cancer for the first time. Materials and Methods We evaluated 57 off-treatment CSs aged 0–18 years old and 50 healthy controls (HCs). We used the multiple breath washout (MBW) method to study LCI and spirometry. Results CSs did not show any differences from the controls in ventilation homogeneity (LCI 6.78 ± 1.35 vs. 6.32 ± 0.44, P: ns) or lung function (FEV1 99.9 ± 11.3% vs. 103.0 ± 5.9% of predicted, P: ns; FVC 98.2 ± 10.3% vs. 101.1 ± 3.3% of predicted). LCI significantly correlated with the number of years since the last chemotherapy (r = 0.35, P < 0.05). Conclusions Our study describes the trend of LCI in a cohort of CSs and compares it with the results obtained from healthy controls. The results show that patients maintain both good values of respiratory function and good homogeneity of ventilation during childhood. Moreover, the LCI identifies the tendency toward pulmonary fibrosis, which is typical of adult CSs, at an earlier time than spirometry.

Allergic bronchopulmonary aspergillosis (ABPA) is a pulmonary disease caused by Aspergillus induced hypersensitivity that occurs in immunocompetent but susceptible patients with asthma and/or cystic fibrosis (CF). In children, ABPA remains mostly undiagnosed, resulting in one of the most common causes of poorly controlled asthma and highly significant morbidity in children with CF. Currently, no specific diagnostic criteria of ABPA for children are available. Corticosteroids and itraconazole are the mainstays of therapy, althoughthere is a lack of randomized clinical trials regarding their usefulness for ABPA in children. Several monoclonal antibodies, such asomalizumab and mepolizumab, may be potential therapies for refractory ABPA in pediatric patients; however, further data are required to clarify the optimal dose and duration of therapy as a routine treatment approach.