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Huang J, Zhang W, Xiang R, Tan L, Liu P, Tao Z, Deng Y, Tong H, Xu Y. The early-phase transcriptome and the clinical efficacy analysis in three modes of subcutaneous immunotherapy for allergic rhinitis. World Allergy Organ J 2023; 16:100811. [PMID: 37701629 PMCID: PMC10493265 DOI: 10.1016/j.waojou.2023.100811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 07/24/2023] [Accepted: 08/12/2023] [Indexed: 09/14/2023] Open
Abstract
Background Allergen immunotherapy is the only etiological treatment for allergic rhinitis. Objective To analyze the efficacy, safety, and mechanism of subcutaneous immunotherapy (SCIT). Methods The efficacy, safety, and serum immunological changes of 3 modes of subcutaneous immunotherapy were compared. Peripheral blood mononuclear cells (PBMC) transcriptome changes were obtained on the Illumina sequencing platforms. We confirmed differentially expressed genes (DEGs) by quantitative real-time polymerase chain reaction (PCR). The DEGs were analyzed by gene ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and protein-protein interaction (PPI) networks. The correlation between the common DEGs and clinical indicators was analyzed by Origin 2022. Results The 3 SCITs were all effective after 1 year. The Combined Symptom and Medication Score (CSMS) and Visual Analog Score (VAS) in rush immunotherapy (RIT) are lowest after 24 and 48 weeks of treatment among the 3 groups. After treatment, the levels of sIgE, sIgE/tIgE, Th2 cytokines, Th17 cytokines, and percentage of peripheral eosinophils (EOS%) decreased significantly (P<0.05), while the levels of Th1 type cytokines did not change significantly. Transcriptome analysis identified 24, 24, and 91 DEGs at W3 and 42, 52, 175 DEGs at W7 in conventional immunotherapy (CIT), cluster immunotherapy (CLIT), and RIT groups, respectively. The pathways and functions involved in SCIT include secretion of Th1/2 cytokines, immune cell differentiation. Unlike CIT and CLIT, DEGs are also involved in T cell tolerance induction, T cell anergy, and lymphocyte anergy in RIT. CXCR1, CXCR2, and IER3 had a specific effect on reflecting the improvement of symptoms in allergic rhinitis patients with SCIT. Conclusion The clinical efficacy of RIT appeared earlier than CIT and CLIT. Clinicians can use the highly conserved gene expression profile to evaluate responses to immunotherapy.
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Affiliation(s)
- Jingyu Huang
- Department of Rhinology and Allergy, Otolaryngology-Head and Neck Surgery Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Wei Zhang
- Department of Rhinology and Allergy, Otolaryngology-Head and Neck Surgery Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Rong Xiang
- Department of Rhinology and Allergy, Otolaryngology-Head and Neck Surgery Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lu Tan
- Department of Rhinology and Allergy, Otolaryngology-Head and Neck Surgery Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Peiqiang Liu
- Department of Rhinology and Allergy, Otolaryngology-Head and Neck Surgery Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zezhang Tao
- Department of Rhinology and Allergy, Otolaryngology-Head and Neck Surgery Center, Renmin Hospital of Wuhan University, Wuhan, China
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yuqin Deng
- Department of Rhinology and Allergy, Otolaryngology-Head and Neck Surgery Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Huan Tong
- Wound Repair&Rehabilitation Center Department, Tongren Hospital of Wuhan University (Wuhan Third Hospital), Wuhan, China
| | - Yu Xu
- Department of Rhinology and Allergy, Otolaryngology-Head and Neck Surgery Center, Renmin Hospital of Wuhan University, Wuhan, China
- Hubei Province Key Laboratory of Allergy and Immunology, Wuhan, China
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
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Allergic March in Children: The Significance of Precision Allergy Molecular Diagnosis (PAMD@) in Predicting Atopy Development and Planning Allergen-Specific Immunotherapy. Nutrients 2023; 15:nu15040978. [PMID: 36839334 PMCID: PMC9961516 DOI: 10.3390/nu15040978] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/12/2023] [Accepted: 02/14/2023] [Indexed: 02/18/2023] Open
Abstract
The allergic march is a progression of naturally occurring symptoms whose nature changes with age. The classic allergic march typically begins in infancy and manifests in the form of atopic dermatitis and food allergy. As immune tolerance develops over time, these conditions may resolve by the age of 3-5 years; however, they may evolve into allergic rhinitis and bronchial asthma. Traditional diagnostic assessments, such as skin prick testing or serum allergen-specific immunoglobulin E (sIgE) level testing, are conducted to introduce effective treatment. Recent years saw the emergence of precision allergy molecular diagnosis (PAMD@), which assesses sIgE against allergenic molecules. This new technology helps more accurately evaluate the patient's allergy profile, which helps create more precise dietary specifications and personalize allergen-specific immunotherapy. This review presents possible predictions regarding the allergic march and the means of controlling it based on PAMD@ results.
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Candeias J, Schmidt-Weber CB, Buters J. Dosing intact birch pollen grains at the air-liquid interface (ALI) to the immortalized human bronchial epithelial cell line BEAS-2B. PLoS One 2021; 16:e0259914. [PMID: 34784380 PMCID: PMC8594808 DOI: 10.1371/journal.pone.0259914] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 10/28/2021] [Indexed: 12/04/2022] Open
Abstract
In real life, humans are exposed to whole pollen grains at the air epithelial barrier. We developed a system for in vitro dosing of whole pollen grains at the Air-Liquid Interface (ALI) and studied their effect on the immortalized human bronchial epithelial cell line BEAS-2B. Pollen are sticky and large particles. Dosing pollen needs resuspension of single particles rather than clusters, and subsequent transportation to the cells with little loss to the walls of the instrumentation i.e. in a straight line. To avoid high speed impacting insults to cells we chose sedimentation by gravity as a delivery step. Pollen was resuspended into single particles by pressured air. A pollen dispersion unit including PTFE coating of the walls and reduced air pressure limited impaction loss to the walls. The loss of pollen to the system was still about 40%. A linear dose effect curve resulted in 327-2834 pollen/cm2 (± 6.1%), the latter concentration being calculated as the amount deposited on epithelial cells on high pollen days. After whole pollen exposure, the largest differential gene expression at the transcriptomic level was late, about 7 hours after exposure. Inflammatory and response to stimulus related genes were up-regulated. We developed a whole pollen exposure air-liquid interface system (Pollen-ALI), in which cells can be gently and reliably dosed.
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Affiliation(s)
- Joana Candeias
- Center Allergy & Environment (ZAUM), Member of the German Center for Lung Research (DZL), Technical University Munich, Helmholtz Center Munich, Munich, Germany
| | - Carsten B. Schmidt-Weber
- Center Allergy & Environment (ZAUM), Member of the German Center for Lung Research (DZL), Technical University Munich, Helmholtz Center Munich, Munich, Germany
| | - Jeroen Buters
- Center Allergy & Environment (ZAUM), Member of the German Center for Lung Research (DZL), Technical University Munich, Helmholtz Center Munich, Munich, Germany
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Papazian D, Hansen S, Würtzen PA. Airway responses towards allergens - from the airway epithelium to T cells. Clin Exp Allergy 2016; 45:1268-87. [PMID: 25394747 DOI: 10.1111/cea.12451] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The prevalence of allergic diseases such as allergic rhinitis is increasing, affecting up to 30% of the human population worldwide. Allergic sensitization arises from complex interactions between environmental exposures and genetic susceptibility, resulting in inflammatory T helper 2 (Th2) cell-derived immune responses towards environmental allergens. Emerging evidence now suggests that an epithelial dysfunction, coupled with inherent properties of environmental allergens, can be responsible for the inflammatory responses towards allergens. Several epithelial-derived cytokines, such as thymic stromal lymphopoietin (TSLP), IL-25 and IL-33, influence tissue-resident dendritic cells (DCs) as well as Th2 effector cells. Exposure to environmental allergens does not elicit Th2 inflammatory responses or any clinical symptoms in nonatopic individuals, and recent findings suggest that a nondamaged, healthy epithelium lowers the DCs' ability to induce inflammatory T-cell responses towards allergens. The purpose of this review was to summarize the current knowledge on which signals from the airway epithelium, from first contact with inhaled allergens all the way to the ensuing Th2-cell responses, influence the pathology of allergic diseases.
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Affiliation(s)
- D Papazian
- Department of Cancer & Inflammation Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark.,ALK, Hørsholm, Denmark
| | - S Hansen
- Department of Cancer & Inflammation Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
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Abstract
PURPOSE OF REVIEW The aim of the present review was to discuss the effects of pollen components on innate immune responses. RECENT FINDINGS Pollens contain numerous factors that can stimulate an innate immune response. These include intrinsic factors in pollens such as nicotinamide adenine dinucleotide phosphate oxidases, proteases, aqueous pollen proteins, lipids, and antigens. Each component stimulates innate immune response in a different manner. Pollen nicotinamide adenine dinucleotide phosphate oxidases induce reactive oxygen species generation and recruit neutrophils that stimulate subsequent allergic inflammation. Pollen proteases damage epithelial barrier function and increase antigen uptake. Aqueous pollen extract proteins and pollen lipids modulate dendritic cell function and induce Th2 polarization. Clinical studies have shown that modulation of innate immune response to pollens with toll-like receptor 9- and toll-like receptor 4-stimulating conjugates is well tolerated and induces clear immunological effects, but is not very effective in suppressing primary clinical endpoints of allergic inflammation. SUMMARY Additional research on innate immune pathways induced by pollen components is required to develop novel strategies that will mitigate the development of allergic inflammation.
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Gandhi VD, Vliagoftis H. Airway epithelium interactions with aeroallergens: role of secreted cytokines and chemokines in innate immunity. Front Immunol 2015; 6:147. [PMID: 25883597 PMCID: PMC4382984 DOI: 10.3389/fimmu.2015.00147] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 03/18/2015] [Indexed: 11/13/2022] Open
Abstract
Airway epithelial cells are the first line of defense against the constituents of the inhaled air, which include allergens, pathogens, pollutants, and toxic compounds. The epithelium not only prevents the penetration of these foreign substances into the interstitium, but also senses their presence and informs the organism’s immune system of the impending assault. The epithelium accomplishes the latter through the release of inflammatory cytokines and chemokines that recruit and activate innate immune cells at the site of assault. These epithelial responses aim to eliminate the inhaled foreign substances and minimize their detrimental effects to the organism. Quite frequently, however, the innate immune responses of the epithelium to inhaled substances lead to chronic and high level release of pro-inflammatory mediators that may mediate the lung pathology seen in asthma. The interactions of airway epithelial cells with allergens will be discussed with particular focus on interactions-mediated epithelial release of cytokines and chemokines and their role in the immune response. As pollutants are other major constituents of inhaled air, we will also discuss how pollutants may alter the responses of airway epithelial cells to allergens.
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Affiliation(s)
- Vivek D Gandhi
- Pulmonary Research Group, Department of Medicine, University of Alberta , Edmonton, AB , Canada
| | - Harissios Vliagoftis
- Pulmonary Research Group, Department of Medicine, University of Alberta , Edmonton, AB , Canada
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Gavrovic-Jankulovic M, Willemsen LE. Epithelial models to study food allergen-induced barrier disruption and immune activation. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.ddmod.2016.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Golebski K, Luiten S, van Egmond D, de Groot E, Röschmann KIL, Fokkens WJ, van Drunen CM. High degree of overlap between responses to a virus and to the house dust mite allergen in airway epithelial cells. PLoS One 2014; 9:e87768. [PMID: 24498371 PMCID: PMC3912021 DOI: 10.1371/journal.pone.0087768] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 12/30/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Airway epithelium is widely considered to play an active role in immune responses through its ability to detect changes in the environment and to generate a microenvironment for immune competent cells. Therefore, besides its role as a physical barrier, epithelium affects the outcome of the immune response by the production of various pro-inflammatory mediators. METHODS We stimulated airway epithelial cells with viral double stranded RNA analogue poly(I:C) or with house dust mite in a time course of 24 hours. In order to determine cytokines production by stimulated cells, we performed multiplex enzyme linked immunosorbant assay (ELISA). RESULTS We demonstrate that the temporal pattern of the genes that respond to virus exposure in airway epithelium resembles to a significant degree their pattern of response to HDM. The gene expression pattern of EGR1, DUSP1, FOSL1, JUN, MYC, and IL6 is rather similar after viral (poly(I:C)) and HDM exposure. However, both triggers also induce a specific response (e.g. ATF3, FOS, and NFKB1). We confirmed these data by showing that epithelial cells produce a variety of similar mediators in response to both poly(I:C) and HDM challenge (IL1-RA, IL-17, IFN-α and MIP1-α), sometimes with a quantitative difference in response (IL2-R, IL-6, IL-8, MCP-1, MIG, and HGF). Interestingly, only four mediators (IL-12, IP-10, RANTES and VEGF) where up-regulated specifically by poly(I:C) and not by HDM. Additionally, we report that pre-exposure to HDM deregulates production of cytokines and mediators in response to poly(I:C). CONCLUSIONS Epithelial cells responses to the HDM-allergen and a virus strongly resemble both in gene expression and in protein level explaining why these two responses may affect each other.
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Affiliation(s)
- Korneliusz Golebski
- Department of Otorhinolaryngology, Academic Medical Center, University of Amsterdam, the Netherlands
- * E-mail:
| | - Silvia Luiten
- Department of Otorhinolaryngology, Academic Medical Center, University of Amsterdam, the Netherlands
| | - Danielle van Egmond
- Department of Otorhinolaryngology, Academic Medical Center, University of Amsterdam, the Netherlands
| | - Esther de Groot
- Department of Otorhinolaryngology, Academic Medical Center, University of Amsterdam, the Netherlands
| | | | - Wytske Johanna Fokkens
- Department of Otorhinolaryngology, Academic Medical Center, University of Amsterdam, the Netherlands
| | - Cornelis Maria van Drunen
- Department of Otorhinolaryngology, Academic Medical Center, University of Amsterdam, the Netherlands
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Gentile D, Bartholow A, Valovirta E, Scadding G, Skoner D. Current and future directions in pediatric allergic rhinitis. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2013; 1:214-26; quiz 227. [PMID: 24565478 DOI: 10.1016/j.jaip.2013.03.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 03/22/2013] [Accepted: 03/23/2013] [Indexed: 01/20/2023]
Abstract
BACKGROUND Allergic rhinitis (AR) is a common pediatric problem that significantly affects sleep, learning, performance, and quality of life. In addition, it is associated with significant comorbidities and complications. OBJECTIVE The aim was to provide an update on the epidemiology, comorbidities, pathophysiology, current treatment, and future direction of pediatric AR. METHODS Literature reviews in each of these areas were conducted, and the results were incorporated. RESULTS The prevalence of AR is increasing in the pediatric population and is associated with significant morbidity, comorbidities, and complications. The mainstay of current treatment strategies includes allergen avoidance, pharmacotherapy, and allergen specific immunotherapy. CONCLUSIONS In the future, diagnosis will be improved by microarrayed recombinant allergen testing and therapy will be expanded to include emerging treatments such as sublingual immunotherapy and combination products.
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Affiliation(s)
- Deborah Gentile
- Division of Allergy, Asthma and Immunology, Department of Medicine, Allegheny General Hospital, Pittsburgh, Pa
| | - Ashton Bartholow
- Division of Allergy, Asthma and Immunology, Department of Medicine, Allegheny General Hospital, Pittsburgh, Pa
| | | | - Glenis Scadding
- The Royal National Throat, Nose and Ear Hospital, London, United Kingdom
| | - David Skoner
- Division of Allergy, Asthma and Immunology, Department of Medicine, Allegheny General Hospital, Pittsburgh, Pa.
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Gandhi VD, Davidson C, Asaduzzaman M, Nahirney D, Vliagoftis H. House Dust Mite Interactions with Airway Epithelium: Role in Allergic Airway Inflammation. Curr Allergy Asthma Rep 2013; 13:262-70. [DOI: 10.1007/s11882-013-0349-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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11
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Golebski K, Röschmann KIL, Toppila-Salmi S, Hammad H, Lambrecht BN, Renkonen R, Fokkens WJ, van Drunen CM. The multi-faceted role of allergen exposure to the local airway mucosa. Allergy 2013; 68:152-60. [PMID: 23240614 DOI: 10.1111/all.12080] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2012] [Indexed: 12/13/2022]
Abstract
Airway epithelial cells are the first to encounter aeroallergens and therefore have recently become an interesting target of many studies investigating their involvement in the modulation of allergic inflammatory responses. Disruption of a passive structural barrier composed of epithelial cells by intrinsic proteolytic activity of allergens may facilitate allergen penetration into local tissues and additionally affect chronic and ongoing inflammatory processes in respiratory tissues. Furthermore, the ability of rhinoviruses to disrupt and interfere with epithelial tight junctions may alter the barrier integrity and enable a passive passage of inhaled allergens through the airway epithelium. On the other hand, epithelial cells are no longer considered to act only as a physical barrier toward inhaled allergens, but also to actively contribute to airway inflammation by detecting and responding to environmental factors. Epithelial cells can produce mediators, which may affect the recruitment and activation of more specialized immune cells to the local tissue and also create a microenvironment in which these activated immune cells may function and propagate the inflammatory processes. This review presents the dual role of epithelium acting as a passive and active barrier when encountering an inhaled allergen and how this double role contributes to the start of local immune responses.
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Affiliation(s)
- K. Golebski
- Department of Otorhinolanyngology; Academic Medical Center, University of Amsterdam; Amsterdam; The Netherlands
| | - K. I. L. Röschmann
- Department of Otorhinolanyngology; Academic Medical Center, University of Amsterdam; Amsterdam; The Netherlands
| | - S. Toppila-Salmi
- Helsinki University Central Hospital, Skin and Allergy Hospital & Transplantation Laboratory, Haartman Institute, University of Helsinki; Helsinki; Finland
| | | | | | - R. Renkonen
- Transplantation Laboratory, Haartman Institute, University of Helsinki & Helsinki University Central Hospital, HUSLAB; Helsinki; Finland
| | - W. J. Fokkens
- Department of Otorhinolanyngology; Academic Medical Center, University of Amsterdam; Amsterdam; The Netherlands
| | - C. M. van Drunen
- Department of Otorhinolanyngology; Academic Medical Center, University of Amsterdam; Amsterdam; The Netherlands
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12
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Röschmann KIL, van Kuijen AM, Luiten S, Jonker MJ, Breit TM, Fokkens WJ, Petersen A, van Drunen CM. Comparison of Timothy grass pollen extract- and single major allergen-induced gene expression and mediator release in airway epithelial cells: a meta-analysis. Clin Exp Allergy 2012; 42:1479-90. [DOI: 10.1111/j.1365-2222.2012.04033.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- K. I. L. Röschmann
- Department of Otorhinolaryngology; Academic Medical Center; Amsterdam; The Netherlands
| | - A.-M. van Kuijen
- Department of Otorhinolaryngology; Academic Medical Center; Amsterdam; The Netherlands
| | - S. Luiten
- Department of Otorhinolaryngology; Academic Medical Center; Amsterdam; The Netherlands
| | - M. J. Jonker
- Microarray Department and Integrative Bioinformatics Unit; University of Amsterdam; Amsterdam; The Netherlands
| | - T. M. Breit
- Microarray Department and Integrative Bioinformatics Unit; University of Amsterdam; Amsterdam; The Netherlands
| | - W. J. Fokkens
- Department of Otorhinolaryngology; Academic Medical Center; Amsterdam; The Netherlands
| | - A. Petersen
- Division of Clinical and Molecular Allergology; Research Center Borstel; Borstel; Germany
| | - C. M. van Drunen
- Department of Otorhinolaryngology; Academic Medical Center; Amsterdam; The Netherlands
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