[Synthetic salmon calcitonin suppositories for the short-term treatment of involutive osteoporosis]. / La calcitonina sintetica di salmone in supposte nel trattamento a breve termine dell'osteoporosi involutiva.

Intramuscular and intranasal synthetic salmon calcitonin (sCT) has long been used in the treatment of involutional osteoporosis. A new suppository formulation was developed and many studies demonstrated that rectally administered sCT is efficacious and well tolerated. Thirty postmenopausal women, who had a bone mineral density at the lumbar spine below the mean of age-matched women, were enrolled in this study. Using an open balanced, randomized design, the patients were allocated to two groups of treatment: sCT suppositories at the dose of 100 UI/day or 200 UI every other day for six months. Treatment with sCT suppositories caused a statistically significant decrease of pain in both study groups. Bone mineral density at lumbar spine showed an increase in both study groups with significant difference respect the basal value for the patients treated with sCT on alternate day. Based on the results of this study, we can thus conclude that sCT in suppository formulation is effective in reducing pain sintomatology, bone loss and turnover in involutional osteoporosis.

Effects of salmon calcitonin suppositories in the prevention of bone loss in oophorectomized women.

To evaluate the efficacy of salmon calcitonin (sCT) suppositories in inhibiting postmenopausal bone demineralization and the tolerability of this formulation, we treated ten women oophorectomized in reproductive age with intrarectal sCT at the dose of 200 IU/day for 12 months postoperatively. Modifications of calcium and phosphate metabolism were quantified by measurements of vertebral and peripheral bone mineral content, serum alkaline phosphatase, and hydroxyprolinuria at baseline and at 6 and 12 months of treatment. Tolerability was assessed by recording the appearance of local or systemic side-effects. sCT suppositories were demonstrated to inhibit post-oophorectomy calcium loss, and tolerability was good.

IgE-mediated food allergy.

The behaviour of some immunologic parameters was studied in order to explain the presence or the lack of symptomatology in subjects with IgE specific to foods. In particular, we compared the levels of serum and salivary IgA and IgE antibody specific to apple in 33 patients allergic to birch and with anti-apple IgE, of whom 24 had oral allergy syndrome after eating apple and nine were apple tolerants. We found no differences in the IgE-related parameters such as levels of anti-apple IgE antibody in serum and secretions, mean size of apple skin prick test, and number of patients with a positive histamine release from peripheral basophils stimulated by apple. Similarly, we detected no statistically significant differences in serum and salivary total IgG and total anti-apple IgA antibody of the two groups. We could, however, observe a significantly higher anti-apple salivary IgA/anti-apple serum IgE and anti-apple salivary IgA/anti-apple serum IgA ratios and a significant correlation between the same parameters in tolerant patients when compared with the intolerants. These results seem to suggest that the presence of appropriate levels of secretory anti-apple IgA associated to anti-apple IgE might be one of the factors playing a key role in the prevention of clinical symptoms in atopic subjects.

IgG subclass antibody response to hymenoptera venom.

Venom immunotherapy provides clinical protection against hymenoptera stings in almost all treated allergic patients. Venom specific IgG antibodies often rise during immunotherapy and some studies found an association between their levels and clinical protection in subjects treated with Yellow Jacket venom. It is interesting to report that, among IgG subclasses, venom specific IgG4 show the most significant increase but IgG1 could represent a relevant immunological mechanism, exerting a regulatory function on venom specific IgE levels. We observed in patients submitted to Honey Bee venom immunotherapy a significant increase of venom specific IgG1 and IgG4 antibodies, while IgG2 showed an insignificant increase only in some patients. Persistent high levels of IgG4 with respect to decreasing levels of IgG1 were observed only after prolonged treatment.

Allergen specific IgG subclass antibody response in hyposensitization with Dermatophagoides pteronyssinus extract.

Most of the controlled trials of specific immunotherapy (SIT) with house dust mite showed a good clinical efficacy of different kinds of extract after variable periods of treatment. However, few of them looked at all the parameters available to monitor this therapy, such as threshold dose of specific provocation test, end point titration and immunological variations. In particular, the behaviour of specific IgE antibodies is not completely known, while, in more recent studies, mite specific IgG antibodies have been shown to increase even in the early stages of treatment. Few data are available on mite specific IgG1-4 subclasses. The preliminary results of a double blind placebo controlled trial we performed with alginate conjugated Dermatophagoides pteronyssinus extract seem to indicate a good clinical and immunological response to this kind of extract. Moreover, we observed a significant increase of specific IgG antibodies, total and subclasses IgG1.2.4, with a prevalence of IgG4 subclass after three months of SIT. After two years of SIT mite specific IgG1 antibodies showed a tendency to decrease, while IgG4 antibodies maintained a constantly high level.