PEDRO FRANCISCO GIAVINA-BIANCHI JUNIOR
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Clínica Médica, Faculdade de Medicina - Docente
LIM/60 - Laboratório de Imunologia Clínica e Alergia, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/60 - Laboratório de Imunologia Clínica e Alergia, Hospital das Clínicas, Faculdade de Medicina - Líder
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- Editorial: The Role of Mast Cells in Immediate Hypersensitivity Reactions(2021) AUN, Marcelo Vivolo; BLANCA-LOPEZ, Natalia; CASTELLS, Mariana C.; GIAVINA-BIANCHI, Pedro
- A WAO - ARIA - GA(2)LEN consensus document on molecular-based allergy diagnosis (PAMD@): Update 2020(2020) ANSOTEGUI, Ignacio J.; MELIOLI, Giovanni; CANONICA, Giorgio Walter; GOMEZ, R. Maximiliano; JENSEN-JAROLIM, Erika; EBISAWA, Motohiro; LUENGO, Olga; CARABALLO, Luis; PASSALACQUA, Giovanni; POULSEN, Lars K.; SAVI, Eleonora; ZUBERBIER, Torsten; VILLA, Elisa; OPPENHEIMER, John; ASERO, Riccardo; BERNSTEIN, Jonathan; BOUSQUET, Jean; CARDONA, Victoria; COX, Lindo; DEMOLY, Pascal; FERREIRA, Fatima; BIANCHI, Pedro Giavina; DIAZ, Sandra Gonzalez; JAKOB, Thilo; TANNO, Luciana Kase; KLEINE-TEBBE, Jorg; LEVIN, Michael; MARTIN, Bryan; MATRICARDI, Paolo Maria; ORTEGA, Olga Patricia Monge; ALMEIDA, Mario Morais; NUNES, Carlos; MARTELL, Jose Antonio Ortega; RENZ, Harald; ROSARIO FILHO, Nelson; ROUADI, Philip; RUIBA, Alessia; SAMPSON, Hugh; BORGES, Mario Sanchez; SCALA, Enrico; SCHMID-GRENDELMEIER, Peter; SENNA, Gian-Enrico; SISUL, Juan Carlos; TANG, Mimi L. K.; VALENTA, Rudolf; HAGE, Marianne van; WONG, Gary W. K.; YANEZ, AnahiPrecision allergy molecular diagnostic applications (PAMD@) is increasingly entering routine care. Currently, more than 130 allergenic molecules from more than 50 allergy sources are commercially available for in vitro specific immunoglobulin E (sIgE) testing. Since the last publication of this consensus document, a great deal of new information has become available regarding this topic, with over 100 publications in the last year alone. It thus seems quite reasonable to publish an update. It is imperative that clinicians and immunologists specifically trained in allergology keep abreast of the new and rapidly evolving evidence available for PAMD@. PAMD@ may initially appear complex to interpret; however, with increasing experience, the information gained provides relevant information for the allergist. This is especially true for food allergy, Hymenoptera allergy, and for the selection of allergen immunotherapy. Nevertheless, all sIgE tests, including PAMD@, should be evaluated within the framework of a patient's clinical history, because allergen sensitization does not necessarily imply clinical relevant allergies.
- Drug-induced anaphylaxis in children: Nonsteroidal anti-inflammatory drugs and drug provocation test REPLY(2014) AUN, Marcelo Vivolo; BLANCA, Miguel; GARRO, Laila Sabino; RIBEIRO, Marisa Rosimeire; KALIL, Jorge; MOTTA, Antonio Abilio; CASTELLS, Mariana; GIAVINA-BIANCHI, Pedro
- Open Latin American anaphylaxis registry(2023) JARES, Edgardo J.; CARDONA, Victoria; GOME, R. Maximiliano; BERNSTEIN, Jonathan A.; FILHO, Nelson A. Rosario; CHERREZ-OJEDA, Ivan; ENSINA, Luis Felipe; FALCO, Alicia De; DIAZ, Maria C.; VEREAU, Pierre A. Chavez; FELIX, Mara M. Rocha; LAVRUT, Jorge; LAFLOR, Oscar I. Moreno; STAFFELD, Patricia Latour; PIRAINO, Pedro; DUARTE, Perla Alacaraz; IVANCEVICH, Juan C.; DABOVE, Fabian; GIAVINA-BIANCHI, Pedro; MORAN, Ivan O. Tinoco; OLIVIERA, Fabiana A. Nunes; MONSELL, Silvana; SOUZA, Maria V.; CEPEDA, Alfonso M.; SLULLITEL, Pablo D.; MORFIN-MACIEL, Blanca M.Background: Recent data about clinical features, triggers and management of anaphylaxis in Latin America is lacking.Objective: To provide updated and extended data on anaphylaxis in this region.Method: An online questionnaire was used, with 67 allergy units involved from 12 Latin-American countries and Spain. Among data recorded, demographic information, clinical features, severity, triggering agents, and treatment were received.Results: Eight hundred and seventeen anaphylactic reactions were recorded. No difference in severity, regardless of pre-existing allergy or asthma history was found. Drug induced anaphylaxis (DIA) was most frequent (40.6%), followed by food induced anaphylaxis (FIA) (32.9%) and venom induced anaphylaxis (VIA) (12%). FIA and VIA were more common in children-adolescents. Non -steroidal anti-inflammatory drugs (NSAIDs) and beta-lactam antibiotics (BLA) were the most frequent drugs involved. Milk (61.1% of FIA) and egg (15.4% of FIA) in children, and shellfish (25.5% of FIA), fresh fruits (14.2% of FIA), and fish (11.3% of FIA) in adults were the most common FIA triggers. Fire ants were the most frequent insect triggers, and they induced more severe re-actions than triggers of FIA and DIA (p < 0.0001). Epinephrine was used in 43.8% of anaphylaxis episodes. After Emergency Department treatment, epinephrine was prescribed to 13% of patients.Conclusions: Drugs (NSAIDs and BLA), foods (milk and egg in children and shellfish, fruits and fish in adults) and fire ants were the most common inducers of anaphylaxis. Epinephrine was used in less than half of the episodes emphasizing the urgent need to improve dissemination and implementation of anaphylaxis guidelines.
- Nonsteroidal Anti-Inflammatory Drugs are Major Causes of Drug-Induced Anaphylaxis(2014) AUN, Marcelo Vivolo; BLANCA, Miguel; GARRO, Laila Sabino; RIBEIRO, Marisa Rosimeire; KALIL, Jorge; MOTTA, Antonio Abilio; CASTELLS, Mariana; GIAVINA-BIANCHI, PedroBACKGROUND: Drugs are responsible for 40% to 60% of anaphylactic reactions treated in the emergency department. A global research agenda to address uncertainties in anaphylaxis includes studies that identify factors associated with morbidity and mortality. OBJECTIVE: The present study investigated drug-induced anaphylaxis, etiologies, aggravating factors, and treatment. METHODS: A total of 806 patients with adverse drug reactions were screened, and those who had a clinical diagnosis of anaphylaxis were included in the study. Clinical and demographic characteristics of anaphylaxis were described, including etiologies, pathophysiologic mechanisms involved in the reactions, and a personal history of atopy and asthma. Factors associated with disease severity also were identified. RESULTS: Anaphylaxis was diagnosed in 117 patients (14.5%). The etiologies were defined in 76% of the cases, nonsteroidal anti-inflammatory drugs being the most frequent. Seventy-eight patients (66.7%) reported a previous reaction to the drug involved in the current reaction or to a drug from the same class and/or group. Epinephrine was used to treat 34.2% of patients who presented with anaphylaxis, and 40.8% of those with anaphylactic reactions with cardiovascular involvement. IgE-mediated reactions were associated with greater severity, manifested by the rates of cardiovascular dysfunction, hospitalization, and use of epinephrine. CONCLUSIONS: The prevalence of anaphylaxis is high in patients who seek medical assistance for drug reactions, but its diagnosis is missed in emergency services, and adrenaline is underused. Drugs were prescribed to many patients despite a history of previous reaction. Nonsteroidal anti-inflammatory drugs were implicated in most cases of anaphylaxis induced by drugs, and IgE-mediated reactions were less frequent but more severe. (C) 2014 American Academy of Allergy, Asthma & Immunology
- Multistep IgE Mast Cell Desensitization Is a Dose- and Time-Dependent Process Partially Regulated by SHIP-1(2023) ADNAN, Ather; ACHARYA, Shree; ALENAZY, Leila A.; VECILLAS, Leticia de las; BIANCHI, Pedro Giavina; PICARD, Matthieu; CALBACHE-GIL, Lucia; ROMERO-PINEDO, Salvador; ABADIA-MOLINA, Ana Clara; KERR, William; PEDICONE, Chiara; NAGAI, Jun; HOLLERS, Eleanor; DWYER, Daniel; CASTELLS, MarianaMultistep mast cell desensitization blocks the release of mediators following IgE crosslinking with increasing doses of Ag. Although its in vivo application has led to the safe reintroduction of drugs and foods in IgE-sensitized patients at risk for anaphylaxis, the mechanisms of the inhibitory process have remained elusive. We sought to investigate the kinetics, membrane, and cytoskeletal changes and to identify molecular targets. IgE-sensitized wild-type murine (WT) and FcERIa humanized (h) bone marrow mast cells were activated and desensitized with DNP, nitrophenyl, dust mites, and peanut Ags. The movements of membrane receptors, FcERI/ IgE/Ag, actin, and tubulin and the phosphorylation of Syk, Lyn, P38-MAPK, and SHIP-1 were assessed. Silencing SHIP-1 protein was used to dissect the SHIP-1 role. Multistep IgE desensitization of WT and transgenic human bone marrow mast cells blocked the release of 13-hexosaminidase in an Ag-specific fashion and prevented actin and tubulin movements. Desensitization was regulated by the initial Ag dose, number of doses, and time between doses. FcERI, IgE, Ags, and surface receptors were not internalized during desensitization. Phosphorylation of Syk, Lyn, p38 MAPK, and SHIP-1 increased in a dose -response manner during activation; in contrast, only SHIP-1 phosphorylation increased in early desensitization. SHIP-1 phosphatase function had no impact on desensitization, but silencing SHIP-1 increased 13-hexoxaminidase release, preventing desensitization. Multistep IgE mast cell desensitization is a dose-and time-regulated process that blocks 13-hexosaminidase, impacting membrane and cytoskeletal movements. Signal transduction is uncoupled, favoring early phosphorylation of SHIP-1. Silencing SHIP-1 impairs desensitization without implicating its phosphatase function.