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Zuberbier T, Abdul Latiff A, Aggelidis X, Augustin M, Balan R, Bangert C, Beck L, Bieber T, Bernstein JA, Bertolin Colilla M, Berardi A, Bedbrook A, Bindslev‐Jensen C, Bousquet J, de Bruin‐Weller M, Bruscky D, Buyuktiryaki B, Canonica GW, Castro C, Chanturidze N, Chong‐Neto HJ, Chu C, Chularojanamontri L, Cork M, Criado RFJ, Barredo LC, Custovic A, Darsow U, Emurlai A, de Pablo A, Del Giacco S, Girolomoni G, Deleva Jovanova T, Deleuran M, Douladiris N, Duarte B, Dubakiene R, Eller E, Engel‐Yeger B, Ensina LF, Filho NR, Flohr C, Fomina D, Francuzik W, Galimberti ML, Giménez‐Arnau AM, Godse K, Mortz CG, Gotua M, Hide M, Hoetzenecker W, Hunzelmann N, Irvine A, Jack C, Kanavarou I, Katoh N, Kinaciyan T, Kocatürk E, Kulthanan K, Lapeere H, Lau S, Machado Forti Nastri M, Makris M, Mansour E, Marsland A, Morelo Rocha Felix M, Moschione Castro AP, Nettis E, Nicolas JF, Nosbaum A, Odemyr M, Papapostolou N, Parisi CAS, Paudel S, Peter J, Pokharel P, Puig L, Quint T, Ramon GD, Regateiro F, Ricci G, Rosario C, Sackesen C, Schmid‐Grendelmeier P, Serra‐Baldrich E, Siemens K, Smith C, Staubach P, Stevanovic K, Su‐Kücük Ö, Sussman G, Tavecchio S, Teovska Mitrevska N, Thaci D, Toubi E, Traidl‐Hoffmann C, Treudler R, Vadasz Z, van Hofman I, Ventura MT, Wang Z, Werfel T, Wollenberg A, Yang A, Weng Yew Y, Zhao Z, Zwiener R, Worm M. A concept for integrated care pathways for atopic dermatitis-A GA 2 LEN ADCARE initiative. Clin Transl Allergy 2023; 13:e12299. [PMID: 37746794 PMCID: PMC10500634 DOI: 10.1002/clt2.12299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 08/23/2023] [Indexed: 09/26/2023] Open
Abstract
INTRODUCTION The integrated care pathways for atopic dermatitis (AD-ICPs) aim to bridge the gap between existing AD treatment evidence-based guidelines and expert opinion based on daily practice by offering a structured multidisciplinary plan for patient management of AD. ICPs have the potential to enhance guideline recommendations by combining interventions and aspects from different guidelines, integrating quality assurance, and describing co-ordination of care. Most importantly, patients can enter the ICPs at any level depending on AD severity, resources available in their country, and economic factors such as differences in insurance reimbursement systems. METHODS The GA2 LEN ADCARE network and partners as well as all stakeholders, abbreviated as the AD-ICPs working group, were involved in the discussion and preparation of the AD ICPs during a series of subgroup workshops and meetings in years 2020 and 2021, after which the document was circulated within all GAL2 EN ADCARE centres. RESULTS The AD-ICPs outline the diagnostic procedures, possible co-morbidities, different available treatment options including differential approaches for the pediatric population, and the role of the pharmacists and other stakeholders, as well as remaining unmet needs in the management of AD. CONCLUSION The AD-ICPs provide a multidisciplinary plan for improved diagnosis, treatment, and patient feedback in AD management, as well as addressing critical unmet needs, including improved access to care, training specialists, implementation of educational programs, assessment on the impact of climate change, and fostering a personalised treatment approach. By focusing on these key areas, the initiative aims to pave the way for a brighter future in the management of AD.
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Agache I, Sampath V, Aguilera J, Akdis CA, Akdis M, Barry M, Bouagnon A, Chinthrajah S, Collins W, Dulitzki C, Erny B, Gomez J, Goshua A, Jutel M, Kizer KW, Kline O, LaBeaud AD, Pali‐Schöll I, Perrett KP, Peters RL, Plaza MP, Prunicki M, Sack T, Salas RN, Sindher SB, Sokolow SH, Thiel C, Veidis E, Wray BD, Traidl‐Hoffmann C, Witt C, Nadeau KC. Climate change and global health: A call to more research and more action. Allergy 2022; 77:1389-1407. [PMID: 35073410 DOI: 10.1111/all.15229] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 01/06/2022] [Accepted: 01/11/2022] [Indexed: 12/15/2022]
Abstract
There is increasing understanding, globally, that climate change and increased pollution will have a profound and mostly harmful effect on human health. This review brings together international experts to describe both the direct (such as heat waves) and indirect (such as vector-borne disease incidence) health impacts of climate change. These impacts vary depending on vulnerability (i.e., existing diseases) and the international, economic, political, and environmental context. This unique review also expands on these issues to address a third category of potential longer-term impacts on global health: famine, population dislocation, and environmental justice and education. This scholarly resource explores these issues fully, linking them to global health in urban and rural settings in developed and developing countries. The review finishes with a practical discussion of action that health professionals around the world in our field can yet take.
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Nadeau KC, Agache I, Jutel M, Annesi Maesano I, Akdis M, Sampath V, D'Amato G, Cecchi L, Traidl‐Hoffmann C, Akdis CA. Climate change: A call to action for the United Nations. Allergy 2022; 77:1087-1090. [PMID: 34476822 DOI: 10.1111/all.15079] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 08/30/2021] [Indexed: 02/02/2023]
Affiliation(s)
- Kari C. Nadeau
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University and Division of Pulmonary and Critical Care Medicine Department of Medicine Stanford University Stanford California USA
| | - Ioana Agache
- Faculty of Medicine Transylvania University Brasov Romania
| | - Marek Jutel
- Department of Clinical Immunology Wrocław Medical University Wrocław Poland
- All‐MED Medical Research Institute Wrocław Poland
| | - Isabella Annesi Maesano
- Desbrest Institute of Epidemiology and Public Health INSERM, and Montpellier University Montpellier France
| | - Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Vanitha Sampath
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University and Division of Pulmonary and Critical Care Medicine Department of Medicine Stanford University Stanford California USA
| | - Gennaro D'Amato
- Division of Respiratory and Allergic Diseases Department of Chest Diseases High Specialty A, Cardarelli Hospital, and Medical School of Specialization in Respiratory Diseases University of Naples Federico II Naples Italy
| | - Lorenzo Cecchi
- Centre of Bioclimatology University of Florence Florence Italy
| | - Claudia Traidl‐Hoffmann
- Department of Environmental Medicine University of Augsburg Augsburg Germany
- Institute of Environmental Medicine Helmholtz Center Munich ‐ German Research Center for Environmental Health Augsburg Germany
| | - Cezmi A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
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Fieten KB, Drijver‐Messelink MT, Cogo A, Charpin D, Sokolowska M, Agache I, Taborda‐Barata LM, Eguiluz‐Gracia I, Braunstahl GJ, Seys SF, den Berge M, Bloch KE, Ulrich S, Cardoso‐Vigueros C, Kappen JH, Brinke AT, Koch M, Traidl‐Hoffmann C, da Mata P, Prins DJ, Pasmans SGMA, Bendien S, Rukhadze M, Shamji MH, Couto M, Oude Elberink H, Peroni DG, Piacentini G, Weersink EJM, Bonini M, Rijssenbeek‐Nouwens LHM, Akdis CA. Alpine altitude climate treatment for severe and uncontrolled asthma: An EAACI position paper. Allergy 2022; 77:1991-2024. [PMID: 35113452 PMCID: PMC9305916 DOI: 10.1111/all.15242] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 01/14/2022] [Accepted: 01/30/2022] [Indexed: 12/30/2022]
Abstract
Currently available European Alpine Altitude Climate Treatment (AACT) programs combine the physical characteristics of altitude with the avoidance of environmental triggers in the alpine climate and a personalized multidisciplinary pulmonary rehabilitation approach. The reduced barometric pressure, oxygen pressure, and air density, the relatively low temperature and humidity, and the increased UV radiation at moderate altitude induce several physiological and immunological adaptation responses. The environmental characteristics of the alpine climate include reduced aeroallergens such as house dust mites (HDM), pollen, fungi, and less air pollution. These combined factors seem to have immunomodulatory effects controlling pathogenic inflammatory responses and favoring less neuro‐immune stress in patients with different asthma phenotypes. The extensive multidisciplinary treatment program may further contribute to the observed clinical improvement by AACT in asthma control and quality of life, fewer exacerbations and hospitalizations, reduced need for oral corticosteroids (OCS), improved lung function, decreased airway hyperresponsiveness (AHR), improved exercise tolerance, and improved sinonasal outcomes. Based on observational studies and expert opinion, AACT represents a valuable therapy for those patients irrespective of their asthma phenotype, who cannot achieve optimal control of their complex condition despite all the advances in medical science and treatment according to guidelines, and therefore run the risk of falling into a downward spiral of loss of physical and mental health. In the light of the observed rapid decrease in inflammation and immunomodulatory effects, AACT can be considered as a natural treatment that targets biological pathways.
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Karlina R, Flexeder C, Musiol S, Bhattacharyya M, Schneider E, Altun I, Gschwendtner S, Neumann AU, Nano J, Schloter M, Peters A, Schulz H, Schmidt‐Weber CB, Standl M, Traidl‐Hoffmann C, Alessandrini F, Ussar S. Differential effects of lung inflammation on insulin resistance in humans and mice. Allergy 2022; 77:2482-2497. [PMID: 35060125 DOI: 10.1111/all.15226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 12/07/2021] [Accepted: 12/24/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND The rates of obesity, its associated diseases, and allergies are raising at alarming rates in most countries. House dust mites (HDM) are highly allergenic and exposure often associates with an urban sedentary indoor lifestyle, also resulting in obesity. The aim of this study was to investigate the epidemiological association and physiological impact of lung inflammation on obesity and glucose homeostasis. METHODS Epidemiological data from 2207 adults of the population-based KORA FF4 cohort were used to test associations between asthma and rhinitis with metrics of body weight and insulin sensitivity. To obtain functional insights, C57BL/6J mice were intranasally sensitized and challenged with HDM and simultaneously fed with either low-fat or high-fat diet for 12 weeks followed by a detailed metabolic and biochemical phenotyping of the lung, liver, and adipose tissues. RESULTS We found a direct association of asthma with insulin resistance but not body weight in humans. In mice, co-development of obesity and HDM-induced lung inflammation attenuated inflammation in lung and perigonadal fat, with little impact on body weight, but small shifts in the composition of gut microbiota. Exposure to HDM improved glucose tolerance, reduced hepatosteatosis, and increased energy expenditure and basal metabolic rate. These effects associate with increased activity of thermogenic adipose tissues independent of uncoupling protein 1. CONCLUSIONS Asthma associates with insulin resistance in humans, but HDM challenge results in opposing effects on glucose homeostasis in mice due to increased energy expenditure, reduced adipose inflammation, and hepatosteatosis.
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Affiliation(s)
- Ruth Karlina
- RG Adipocytes & Metabolism, Institute for Diabetes & Obesity Helmholtz Zentrum München Munich Germany
- German Center for Diabetes Research (DZD) Munich Germany
| | - Claudia Flexeder
- Institute of Epidemiology Helmholtz Zentrum München, German Research Center for Environmental Health Munich Germany
- Institute and Clinic for Occupational, Social and Environmental Medicine University Hospital, LMU Munich Munich Germany
- German Center for Lung Research (DZL) Munich Germany
| | - Stephanie Musiol
- German Center for Lung Research (DZL) Munich Germany
- Center of Allergy & Environment (ZAUM) Technical University of Munich and Helmholtz Zentrum München, German Research Center for Environmental Health Munich Germany
| | - Madhumita Bhattacharyya
- Department of Environmental Medicine, Faculty of Medicine University of Augsburg Augsburg Germany
| | - Evelyn Schneider
- German Center for Lung Research (DZL) Munich Germany
- Center of Allergy & Environment (ZAUM) Technical University of Munich and Helmholtz Zentrum München, German Research Center for Environmental Health Munich Germany
| | - Irem Altun
- RG Adipocytes & Metabolism, Institute for Diabetes & Obesity Helmholtz Zentrum München Munich Germany
- German Center for Diabetes Research (DZD) Munich Germany
| | - Silvia Gschwendtner
- Research Unit for Comparative Microbiome Analysis Helmholtz Zentrum München, German Research Center for Environmental Health Neuherberg Germany
| | - Avidan U. Neumann
- Department of Environmental Medicine, Faculty of Medicine University of Augsburg Augsburg Germany
- Institute of Environmental Medicine Helmholtz Zentrum München, German Research Center for Environmental Health Augsburg Germany
| | - Jana Nano
- German Center for Diabetes Research (DZD) Munich Germany
- Institute of Epidemiology Helmholtz Zentrum München, German Research Center for Environmental Health Munich Germany
| | - Michael Schloter
- Research Unit for Comparative Microbiome Analysis Helmholtz Zentrum München, German Research Center for Environmental Health Neuherberg Germany
| | - Annette Peters
- German Center for Diabetes Research (DZD) Munich Germany
- Institute of Epidemiology Helmholtz Zentrum München, German Research Center for Environmental Health Munich Germany
| | - Holger Schulz
- Institute of Epidemiology Helmholtz Zentrum München, German Research Center for Environmental Health Munich Germany
- German Center for Lung Research (DZL) Munich Germany
| | - Carsten B. Schmidt‐Weber
- German Center for Lung Research (DZL) Munich Germany
- Center of Allergy & Environment (ZAUM) Technical University of Munich and Helmholtz Zentrum München, German Research Center for Environmental Health Munich Germany
| | - Marie Standl
- Institute of Epidemiology Helmholtz Zentrum München, German Research Center for Environmental Health Munich Germany
- German Center for Lung Research (DZL) Munich Germany
| | - Claudia Traidl‐Hoffmann
- Department of Environmental Medicine, Faculty of Medicine University of Augsburg Augsburg Germany
- Institute of Environmental Medicine Helmholtz Zentrum München, German Research Center for Environmental Health Augsburg Germany
- Environmental Medicine Technical University Munich Munich Germany
| | - Francesca Alessandrini
- German Center for Lung Research (DZL) Munich Germany
- Center of Allergy & Environment (ZAUM) Technical University of Munich and Helmholtz Zentrum München, German Research Center for Environmental Health Munich Germany
| | - Siegfried Ussar
- RG Adipocytes & Metabolism, Institute for Diabetes & Obesity Helmholtz Zentrum München Munich Germany
- German Center for Diabetes Research (DZD) Munich Germany
- Department of Medicine Technical University of Munich Munich Germany
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Damialis A, Gilles S, Traidl‐Hoffmann C. Adding the variable of environmental complexity into the COVID-19 pandemic equation. Allergy 2022; 77:331-333. [PMID: 34047383 PMCID: PMC8222880 DOI: 10.1111/all.14966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/14/2021] [Accepted: 05/20/2021] [Indexed: 12/13/2022]
Affiliation(s)
- Athanasios Damialis
- Department of Environmental Medicine Faculty of Medicine University of Augsburg Augsburg Germany
| | - Stefanie Gilles
- Department of Environmental Medicine Faculty of Medicine University of Augsburg Augsburg Germany
| | - Claudia Traidl‐Hoffmann
- Department of Environmental Medicine Faculty of Medicine University of Augsburg Augsburg Germany
- CK‐CARE Christine Kühne Center for Allergy Research and Education Davos Switzerland
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Hülpüsch C, Weins AB, Traidl‐Hoffmann C, Reiger M. A new era of atopic eczema research: Advances and highlights. Allergy 2021; 76:3408-3421. [PMID: 34407212 DOI: 10.1111/all.15058] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 05/03/2021] [Accepted: 08/12/2021] [Indexed: 01/09/2023]
Abstract
Atopic eczema (AE) is an inflammatory skin disease with involvement of genetic, immunological and environmental factors. One hallmark of AE is a skin barrier disruption on multiple, highly interconnected levels: filaggrin mutations, increased skin pH and a microbiome dysbiosis towards Staphylococcus aureus overgrowth are observed in addition to an abnormal type 2 immune response. Extrinsic factors seem to play a major role in the development of AE. As AE is a first step in the atopic march, its prevention and appropriate treatment are essential. Although standard therapy remains topical treatment, powerful systemic treatment options emerged in the last years. However, thorough endotyping of the individual patients is still required for ideal precision medicine approaches in future. Therefore, novel microbial and immunological biomarkers were described recently for the prediction of disease development and treatment response. This review summarizes the current state of the art in AE research.
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Affiliation(s)
- Claudia Hülpüsch
- Department of Environmental Medicine Faculty of Medicine University of Augsburg Augsburg Germany
- Institute of Environmental Medicine Helmholtz Zentrum München Augsburg Germany
- CK CARE – Christine Kühne Center for Allergy research and Education Davos Switzerland
| | - Andreas B. Weins
- Department of Dermatology Faculty of Medicine University of Augsburg Augsburg Germany
| | - Claudia Traidl‐Hoffmann
- Department of Environmental Medicine Faculty of Medicine University of Augsburg Augsburg Germany
- Institute of Environmental Medicine Helmholtz Zentrum München Augsburg Germany
- CK CARE – Christine Kühne Center for Allergy research and Education Davos Switzerland
- ZIEL Technical University of Munich Freising Germany
| | - Matthias Reiger
- Department of Environmental Medicine Faculty of Medicine University of Augsburg Augsburg Germany
- Institute of Environmental Medicine Helmholtz Zentrum München Augsburg Germany
- CK CARE – Christine Kühne Center for Allergy research and Education Davos Switzerland
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Rauer D, Gilles S, Wimmer M, Frank U, Mueller C, Musiol S, Vafadari B, Aglas L, Ferreira F, Schmitt‐Kopplin P, Durner J, Winkler JB, Ernst D, Behrendt H, Schmidt‐Weber CB, Traidl‐Hoffmann C, Alessandrini F. Ragweed plants grown under elevated CO 2 levels produce pollen which elicit stronger allergic lung inflammation. Allergy 2021; 76:1718-1730. [PMID: 33037672 DOI: 10.1111/all.14618] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Common ragweed has been spreading as a neophyte in Europe. Elevated CO2 levels, a hallmark of global climate change, have been shown to increase ragweed pollen production, but their effects on pollen allergenicity remain to be elucidated. METHODS Ragweed was grown in climate-controlled chambers under normal (380 ppm, control) or elevated (700 ppm, based on RCP4.5 scenario) CO2 levels. Aqueous pollen extracts (RWE) from control- or CO2 -pollen were administered in vivo in a mouse model for allergic disease (daily for 3-11 days, n = 5) and employed in human in vitro systems of nasal epithelial cells (HNECs), monocyte-derived dendritic cells (DCs), and HNEC-DC co-cultures. Additionally, adjuvant factors and metabolites in control- and CO2 -RWE were investigated using ELISA and untargeted metabolomics. RESULTS In vivo, CO2 -RWE induced stronger allergic lung inflammation compared to control-RWE, as indicated by lung inflammatory cell infiltrate and mediators, mucus hypersecretion, and serum total IgE. In vitro, HNECs stimulated with RWE increased indistinctively the production of pro-inflammatory cytokines (IL-8, IL-1β, and IL-6). In contrast, supernatants from CO2 -RWE-stimulated HNECs, compared to control-RWE-stimulated HNECS, significantly increased TNF and decreased IL-10 production in DCs. Comparable results were obtained by stimulating DCs directly with RWEs. The metabolome analysis revealed differential expression of secondary plant metabolites in control- vs CO2 -RWE. Mixes of these metabolites elicited similar responses in DCs as compared to respective RWEs. CONCLUSION Our results indicate that elevated ambient CO2 levels elicit a stronger RWE-induced allergic response in vivo and in vitro and that RWE increased allergenicity depends on the interplay of multiple metabolites.
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Affiliation(s)
- Denise Rauer
- Chair and Institute of Environmental Medicine UNIKA‐T, Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
| | - Stefanie Gilles
- Chair and Institute of Environmental Medicine UNIKA‐T, Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
| | - Maria Wimmer
- Center of Allergy & Environment (ZAUM) Technical University of Munich (TUM) and Helmholtz Zentrum München Munich Germany
- Members of the German Center of Lung Research (DZL) Munich Germany
| | - Ulrike Frank
- Institute of Biochemical Plant Pathology (BIOP) Helmholtz Zentrum München Neuherberg Germany
| | - Constanze Mueller
- BGC Research Unit Analytical BioGeoChemistry Helmholtz Zentrum München Neuherberg Germany
| | - Stephanie Musiol
- Center of Allergy & Environment (ZAUM) Technical University of Munich (TUM) and Helmholtz Zentrum München Munich Germany
- Members of the German Center of Lung Research (DZL) Munich Germany
| | - Behnam Vafadari
- Chair and Institute of Environmental Medicine UNIKA‐T, Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
| | - Lorenz Aglas
- Department of Biosciences University of Salzburg Salzburg Austria
| | - Fatima Ferreira
- Department of Biosciences University of Salzburg Salzburg Austria
| | | | - Jörg Durner
- Institute of Biochemical Plant Pathology (BIOP) Helmholtz Zentrum München Neuherberg Germany
| | - Jana Barbro Winkler
- Research Unit Environmental Simulation Institute of Biochemical Plant Pathology Helmholtz Zentrum München Neuherberg Germany
| | - Dieter Ernst
- Institute of Biochemical Plant Pathology (BIOP) Helmholtz Zentrum München Neuherberg Germany
| | - Heidrun Behrendt
- Center of Allergy & Environment (ZAUM) Technical University of Munich (TUM) and Helmholtz Zentrum München Munich Germany
| | - Carsten B. Schmidt‐Weber
- Center of Allergy & Environment (ZAUM) Technical University of Munich (TUM) and Helmholtz Zentrum München Munich Germany
- Members of the German Center of Lung Research (DZL) Munich Germany
| | - Claudia Traidl‐Hoffmann
- Chair and Institute of Environmental Medicine UNIKA‐T, Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
- Outpatient Clinic for Environmental Medicine University Clinic Augsburg Augsburg Germany
- Christine‐Kühne Center for Allergy Research and Education (CK‐Care) Davos Switzerland
| | - Francesca Alessandrini
- Center of Allergy & Environment (ZAUM) Technical University of Munich (TUM) and Helmholtz Zentrum München Munich Germany
- Members of the German Center of Lung Research (DZL) Munich Germany
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Speidel JD, Gilles S, Steer B, Vafadari B, Rauer D, Traidl‐Hoffmann C, Adler H. Pollen induces reactivation of latent herpesvirus and differentially affects infected and uninfected murine macrophages. Allergy 2021; 76:1539-1542. [PMID: 32905616 DOI: 10.1111/all.14587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 08/24/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Jan Dominik Speidel
- Research Unit Lung Repair and Regeneration Comprehensive Pneumology Center Helmholtz Zentrum München ‐ German Research Center for Environmental Health (GmbH); Member of the German Center of Lung Research (DZL) Munich Germany
| | - Stefanie Gilles
- Chair and Institute of Environmental Medicine UNIKA‐TTechnical University of Munich and Helmholtz Zentrum München Augsburg Germany
| | - Beatrix Steer
- Research Unit Lung Repair and Regeneration Comprehensive Pneumology Center Helmholtz Zentrum München ‐ German Research Center for Environmental Health (GmbH); Member of the German Center of Lung Research (DZL) Munich Germany
| | - Behnam Vafadari
- Chair and Institute of Environmental Medicine UNIKA‐TTechnical University of Munich and Helmholtz Zentrum München Augsburg Germany
| | - Denise Rauer
- Chair and Institute of Environmental Medicine UNIKA‐TTechnical University of Munich and Helmholtz Zentrum München Augsburg Germany
| | - Claudia Traidl‐Hoffmann
- Chair and Institute of Environmental Medicine UNIKA‐TTechnical University of Munich and Helmholtz Zentrum München Augsburg Germany
| | - Heiko Adler
- Research Unit Lung Repair and Regeneration Comprehensive Pneumology Center Helmholtz Zentrum München ‐ German Research Center for Environmental Health (GmbH); Member of the German Center of Lung Research (DZL) Munich Germany
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Pfaar O, Klimek L, Jutel M, Akdis CA, Bousquet J, Breiteneder H, Chinthrajah S, Diamant Z, Eiwegger T, Fokkens WJ, Fritsch H, Nadeau KC, O’Hehir RE, O’Mahony L, Rief W, Sampath V, Schedlowski M, Torres MJ, Traidl‐Hoffmann C, Wang DY, Zhang L, Bonini M, Brehler R, Brough HA, Chivato T, Del Giacco SR, Dramburg S, Gawlik R, Gelincik A, Hoffmann‐Sommergruber K, Hox V, Knol EF, Lauerma A, Matricardi PM, Mortz CG, Ollert M, Palomares O, Riggioni C, Schwarze J, Skypala I, Untersmayr E, Walusiak‐Skorupa J, Ansotegui IJ, Bachert C, Bedbrook A, Bosnic‐Anticevich S, Brussino L, Canonica GW, Cardona V, Carreiro‐Martins P, Cruz AA, Czarlewski W, Fonseca JA, Gotua M, Haahtela T, Ivancevich JC, Kuna P, Kvedariene V, Larenas‐Linnemann DE, Abdul Latiff AH, Mäkelä M, Morais‐Almeida M, Mullol J, Naclerio R, Ohta K, Okamoto Y, Onorato GL, Papadopoulos NG, Patella V, Regateiro FS, Samoliński B, Suppli Ulrik C, Toppila‐Salmi S, Valiulis A, Ventura M, Yorgancioglu A, Zuberbier T, Agache I. COVID-19 pandemic: Practical considerations on the organization of an allergy clinic-An EAACI/ARIA Position Paper. Allergy 2021; 76:648-676. [PMID: 32531110 PMCID: PMC7323448 DOI: 10.1111/all.14453] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/08/2020] [Accepted: 06/10/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) has evolved into a pandemic infectious disease transmitted by the severe acute respiratory syndrome coronavirus (SARS-CoV-2). Allergists and other healthcare providers (HCPs) in the field of allergies and associated airway diseases are on the front line, taking care of patients potentially infected with SARS-CoV-2. Hence, strategies and practices to minimize risks of infection for both HCPs and treated patients have to be developed and followed by allergy clinics. METHOD The scientific information on COVID-19 was analysed by a literature search in MEDLINE, PubMed, the National and International Guidelines from the European Academy of Allergy and Clinical Immunology (EAACI), the Cochrane Library, and the internet. RESULTS Based on the diagnostic and treatment standards developed by EAACI, on international information regarding COVID-19, on guidelines of the World Health Organization (WHO) and other international organizations, and on previous experience, a panel of experts including clinicians, psychologists, IT experts, and basic scientists along with EAACI and the "Allergic Rhinitis and its Impact on Asthma (ARIA)" initiative have developed recommendations for the optimal management of allergy clinics during the current COVID-19 pandemic. These recommendations are grouped into nine sections on different relevant aspects for the care of patients with allergies. CONCLUSIONS This international Position Paper provides recommendations on operational plans and procedures to maintain high standards in the daily clinical care of allergic patients while ensuring the necessary safety measures in the current COVID-19 pandemic.
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Affiliation(s)
- Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery Section of Rhinology and Allergy University Hospital Marburg Philipps‐Universität Marburg Marburg Germany
| | - Ludger Klimek
- Center for Rhinology and Allergology Wiesbaden Germany
| | - Marek Jutel
- Department of Clinical Immunology Wrocław Medical Universityand ALL‐MED Medical Research Institute Wrocław Poland
| | - Cezmi A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Jean Bousquet
- Department of Dermatology and Allergy Comprehensive Allergy Center Charité Charité Universitaetsmedizin Berlin a Member of GA2LEN Berlin Germany
- University Hospital Montpellier Montpellier France
- MACVIA‐France Montpellier France
| | - Heimo Breiteneder
- Institute of Pathophysiology and Allergy Research Center of Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - Sharon Chinthrajah
- Sean N. Parker Center for Allergy and Asthma Research Stanford University School of Medicine Stanford CA USA
| | - Zuzana Diamant
- Department of Respiratory Medicine & Allergology Institute for Clinical Science Skane University Hospital Lund University Lund Sweden
- Department of Respiratory Medicine First Faculty of Medicine Charles University and Thomayer Hospital Prague Czech Republic
- Department of Clinical Pharmacy and Pharmacology University Medical Center Groningen University of Groningen Groningen The Netherlands
| | - Thomas Eiwegger
- Translational Medicine Program Peter Gilgan Centre for Research and Learning Hospital for Sick Children Toronto ON Canada
- Departments of Paediatrics and Immunology Division of Immunology and Allergy Food Allergy and Anaphylaxis Program The Hospital for Sick Children University of Toronto Toronto ON Canada
- Department of Immunology University of Toronto Toronto ON Canada
| | - Wytske J. Fokkens
- Department of Otorhinolaryngology Amsterdam University Medical Centres Amsterdam The Netherlands
| | - Hans‐Walter Fritsch
- Department of Information‐Technology (IT) University Hospital Marburg Marburg Germany
| | - Kari C. Nadeau
- Sean N. Parker Center for Allergy and Asthma Research Stanford University School of Medicine Stanford CA USA
| | - Robyn E. O’Hehir
- Allergy, Asthma & Clinical Immunology Alfred Health Melbourne VIC Australia
- Department of Allergy, Immunology and Respiratory Medicine Central Clinical School Monash University and Alfred Health Melbourne VIC Australia
| | - Liam O’Mahony
- Departments of Medicine and Microbiology APC Microbiome Ireland University College Cork Cork Ireland
| | - Winfried Rief
- Department of Clinical Psychology and Psychotherapy Philipps‐University of Marburg Marburg Germany
| | - Vanitha Sampath
- Sean N. Parker Center for Allergy and Asthma Research Stanford University School of Medicine Stanford CA USA
| | - Manfred Schedlowski
- Institute of Medical Psychology and Behavioral Immunobiology University Clinic Essen Essen Germany
| | - María José Torres
- Allergy Unit Malaga Regional University Hospital‐UMA‐ARADyAL Málaga Spain
| | - Claudia Traidl‐Hoffmann
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
- Outpatient Clinic for Environmental Medicine University Hospital Augsburg Germany
| | - De Yun Wang
- Department of Otolaryngology National University of Singapore Singapore Singapore
| | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery Beijing Tongren Hospital Beijing China
- Department of Allergy Beijing Tongren Hospital Beijing China
| | - Matteo Bonini
- Department of Cardiovascular and Thoracic Sciences Fondazione Policlinico Universitario A. Gemelli ‐ IRCCS Università Cattolica del Sacro Cuore Rome Italy
- National Heart and Lung Institute (NHLI) Imperial College London London UK
| | - Randolf Brehler
- Department of Allergology, Occupational Dermatology and Environmental Medicine University Hospital Münster Münster Germany
| | - Helen Annaruth Brough
- Children's Allergy Service Evelina Children's Hospital Guy's and St. Thomas' Hospital NHS Foundation Trust London UK
- Paediatric Allergy Group Department of Women and Children's Health School of Life Course Sciences King's College London London UK
| | - Tomás Chivato
- School of Medicine University CEU San Pablo Madrid Spain
| | - Stefano R. Del Giacco
- Department of Medical Sciences and Public Health University of Cagliari Cagliari Italy
| | - Stephanie Dramburg
- Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine Charité Universitaetsmedizin Berlin Germany
| | - Radoslaw Gawlik
- Department of Internal Medicine, Allergology Clinical Immunology Medical University of Silesia Katowice Poland
| | - Aslı Gelincik
- Department of Internal Medicine Division of Immunology and Allergic Diseases Istanbul Faculty of Medicine Istanbul University Istanbul Turkey
| | - Karin Hoffmann‐Sommergruber
- Institute of Pathophysiology and Allergy Research Center of Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - Valerie Hox
- Department of Otorhinolaryngology Cliniques Universitaires Saint‐Luc Brussels Belgium
| | - Edward F. Knol
- Departments of Immunology and Dermatology/Allergology University Medical Center Utrecht Utrecht The Netherlands
| | - Antti Lauerma
- Department of Dermatology and Allergology Helsinki University Hospital Inflammation Centre University of Helsinki Helsinki Finland
| | - Paolo M. Matricardi
- Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine Charité Universitaetsmedizin Berlin Germany
| | - Charlotte G. Mortz
- Department of Dermatology and Allergy Centre Odense Research Centre for Anaphylaxis (ORCA) Odense University Hospital University of Southern Denmark Odense Denmark
| | - Markus Ollert
- Department of Dermatology and Allergy Centre Odense Research Centre for Anaphylaxis (ORCA) Odense University Hospital University of Southern Denmark Odense Denmark
- Department of Infection and Immunity Luxembourg Institute of Health Esch‐sur‐Alzette Luxembourg
| | - Oscar Palomares
- Department of Biochemistry and Molecular Biology Chemistry School Complutense University of Madrid Spain
| | - Carmen Riggioni
- Pediatric Allergy and Clinical Immunology Department Hospital Sant Joan de Déu Barcelona Spain
- Institut de Recerca Sant Joan de Déu Barcelona Spain
| | - Jürgen Schwarze
- Centre for Inflammation Research and Child Life and Heath the University of Edinburgh Edinburgh UK
| | - Isabel Skypala
- National Heart and Lung Institute (NHLI) Imperial College London London UK
- Royal Brompton and Harefield NHS Foundation Trust London UK
| | - Eva Untersmayr
- Institute of Pathophysiology and Allergy Research Center of Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - Jolanta Walusiak‐Skorupa
- Department of Occupational Diseases and Environmental Health Nofer Institute of Occupational Medicine Lodz Poland
| | | | - Claus Bachert
- ENT Department Upper Airways Research Laboratory Ghent University Hospital Ghent Belgium
- International Airway Research Center First Affiliated Hospital Guangzou Sun Yat‐sen University Guangzou China
- Division of ENT Diseases CLINTEC, Karolinska Institutet Stockholm Sweden
| | | | - Sinthia Bosnic‐Anticevich
- Woolcock Institute of Medical Research Woolcock Emphysema Centre University of Sydney Glebe NSW Australia
| | - Luisa Brussino
- Department of Medical Sciences Allergy and Clinical Immunology Unit University of Torino & Mauriziano Hospital Torino Italy
| | - Giorgio Walter Canonica
- Personalized Medicine Asthma & Allergy Clinic Humanitas University & Research Hospital‐IRCCS Milano Italy
| | - Victoria Cardona
- Department of Internal Medicine, Allergy Section Hospital Vall d'Hebron & ARADyAL Research Network Barcelona Spain
| | - Pedro Carreiro‐Martins
- Serviço de Imunoalergologia, Hospital de Dona Estefânia Centro Hospitalar de Lisboa Central Lisbon Portugal
- NOVA Medical School/Comprehensive Health Research Center (CHRC) Universidade Nova de Lisboa Lisbon Portugal
| | - Alvaro A. Cruz
- ProAR – Nucleo de Excelencia em Asma Federal University of Bahia Bahia Brasil
- GARD/WHO Executive Committee Bahia Brazil
| | | | - João A. Fonseca
- Faculdade de Medicina da Universidade do Porto CINTESIS Center for Research in Health Technologies and Information Systems Porto Portugal
- MEDIDA, Lda Porto Portugal
| | - Maia Gotua
- Center of Allergy and Immunology Tbilisi Georgia
- David Tvildiani Medical University in Tbilisi Tbilisi Georgia
| | - Tari Haahtela
- Skin and Allergy Hospital Helsinki University Hospital and University of Helsinki Helsinki Finland
| | | | - Piotr Kuna
- Division of Internal Medicine, Asthma and Allergy Barlicki University Hospital Medical University of Lodz Lodz Poland
| | - Violeta Kvedariene
- Department of Pathology Faculty of Medicine Institute of Biomedical Sciences Vilnius University Vilnius Lithuania
- Faculty of Medicine Institute of Clinical medicine Clinic of Chest Diseases and Allergology Vilnius University Vilnius Lithuania
| | | | | | - Mika Mäkelä
- Skin and Allergy Hospital Helsinki University Hospital and University of Helsinki Helsinki Finland
| | | | - Joaquim Mullol
- ENT Department Rhinology Unit & Smell Clinic Hospital Clinic ‐ Clinical & Experimental Respiratory Immunoallergy IDIBAPSCIBERESUniversity of Barcelona Barcelona Catalonia Spain
| | | | - Ken Ohta
- Japan Anti‐Tuberculosis Association (JATA) Fukujuji Hospital, and National Hospital Organization (NHO)Tokyo National Hospital Tokyo Japan
| | | | | | - Nikolaos G. Papadopoulos
- Division of Infection Immunity & Respiratory Medicine Royal Manchester Children's Hospital University of Manchester Manchester UK
- Allergy Department 2nd Pediatric Clinic Athens General Children's Hospital "P&A Kyriakou” University of Athens Athens Greece
| | - Vincenzo Patella
- Allergy and Clinical Immunology, Department of Internal Medicine Santa Maria della Speranza Hospital Salerno Italy
| | - Frederico S. Regateiro
- Allergy and Clinical Immunology Unit Centro Hospitalar e Universitário de Coimbra Coimbra Portugal
- Institute of Immunology Faculty of Medicine University of Coimbra Coimbra Portugal
- ICBR ‐ Coimbra Institute for Clinical and Biomedical Research CIBB Faculty of Medicine University of Coimbra Coimbra Portugal
| | - Bolesław Samoliński
- Department of Prevention of Environmental Hazards and Allergology Medical University of Warsaw Warsaw Poland
| | - Charlotte Suppli Ulrik
- Department of Respiratory Medicine Hvidovre Hospital Hvidovre Denmark
- Faculty of Health Sciences Institute of Clinical Medicine University of Copenhagen Denmark
| | - Sanna Toppila‐Salmi
- Skin and Allergy Hospital Helsinki University Hospital and University of Helsinki Helsinki Finland
| | - Arunas Valiulis
- Faculty of Medicine Institute of Clinical Medicine & Institute of Health Sciences Vilnius University Vilnius Lithuania
| | - Maria‐Teresa Ventura
- Interdisciplinary Department of Medicine Unit of Geriatric Immunoallergology University of Bari Medical School Bari Italy
| | - Arzu Yorgancioglu
- Department of Pulmonary Diseases Faculty of Medicine Celal Bayar University Manisa Turkey
| | - Torsten Zuberbier
- Department of Dermatology and Allergy Comprehensive Allergy Center Charité Charité Universitaetsmedizin Berlin a Member of GA2LEN Berlin Germany
| | - Ioana Agache
- Transylvania University Brasov Romania
- Theramed Medical Center Brasov Romania
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11
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Breiteneder H, Peng Y, Agache I, Diamant Z, Eiwegger T, Fokkens WJ, Traidl‐Hoffmann C, Nadeau K, O'Hehir RE, O'Mahony L, Pfaar O, Torres MJ, Wang D, Zhang L, Akdis CA. Biomarkers for diagnosis and prediction of therapy responses in allergic diseases and asthma. Allergy 2020; 75:3039-3068. [PMID: 32893900 PMCID: PMC7756301 DOI: 10.1111/all.14582] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/25/2020] [Accepted: 08/27/2020] [Indexed: 02/06/2023]
Abstract
Modern health care requires a proactive and individualized response to diseases, combining precision diagnosis and personalized treatment. Accordingly, the approach to patients with allergic diseases encompasses novel developments in the area of personalized medicine, disease phenotyping and endotyping, and the development and application of reliable biomarkers. A detailed clinical history and physical examination followed by the detection of IgE immunoreactivity against specific allergens still represents the state of the art. However, nowadays, further emphasis focuses on the optimization of diagnostic and therapeutic standards and a large number of studies have been investigating the biomarkers of allergic diseases, including asthma, atopic dermatitis, allergic rhinitis, food allergy, urticaria and anaphylaxis. Various biomarkers have been developed by omics technologies, some of which lead to a better classification of distinct phenotypes or endotypes. The introduction of biologicals to clinical practice increases the need for biomarkers for patient selection, prediction of outcomes and monitoring, to allow for an adequate choice of the duration of these costly and long‐lasting therapies. Escalating healthcare costs together with questions about the efficacy of the current management of allergic diseases require further development of a biomarker‐driven approach. Here, we review biomarkers in diagnosis and treatment of asthma, atopic dermatitis, allergic rhinitis, viral infections, chronic rhinosinusitis, food allergy, drug hypersensitivity and allergen immunotherapy with a special emphasis on specific IgE, the microbiome and the epithelial barrier. In addition, EAACI guidelines on biologicals are discussed within the perspective of biomarkers.
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Affiliation(s)
- Heimo Breiteneder
- Institute of Pathophysiology and Allergy Research Medical University of Vienna Vienna Austria
| | - Ya‐Qi Peng
- Swiss Institute of Allergy and Asthma Research (SIAF) University Zurich Davos Switzerland
- CK CARE Christine Kühne Center for Allergy Research and Education Davos Switzerland
- Otorhinolaryngology Hospital The First Affiliated Hospital Sun Yat‐Sen University Guangzhou China
| | - Ioana Agache
- Department of Allergy and Clinical Immunology Faculty of Medicine Transylvania University of Brasov Brasov Romania
| | - Zuzana Diamant
- Department of Respiratory Medicine & Allergology Institute for Clinical Science Skane University Hospital Lund University Lund Sweden
- Department of Respiratory Medicine First Faculty of Medicine Charles University and Thomayer Hospital Prague Czech Republic
- Department of Clinical Pharmacy & Pharmacology University of GroningenUniversity Medical Center Groningen Groningen Netherlands
| | - Thomas Eiwegger
- Translational Medicine Program, Research Institute Hospital for Sick Children Toronto ON Canada
- Department of Immunology University of Toronto Toronto ON Canada
- Division of Immunology and Allergy Food Allergy and Anaphylaxis Program The Hospital for Sick Children Departments of Paediatrics and Immunology University of Toronto Toronto ON Canada
| | - Wytske J. Fokkens
- Department of Otorhinolaryngology Amsterdam University Medical Centres Amsterdam The Netherlands
| | - Claudia Traidl‐Hoffmann
- CK CARE Christine Kühne Center for Allergy Research and Education Davos Switzerland
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
- ZIEL ‐ Institute for Food & Health Technical University of Munich Freising‐Weihenstephan Germany
| | - Kari Nadeau
- Sean N. Parker Center for Allergy & Asthma Research Stanford University Stanford CA USA
| | - Robyn E. O'Hehir
- Department of Allergy, immunology and Respiratory Medicine Central Clinical School Monash University Melbourne Vic. Australia
- Allergy, Asthma and Clinical Immunology Service Alfred Health Melbourne Vic. Australia
| | - Liam O'Mahony
- Departments of Medicine and Microbiology APC Microbiome Ireland National University of Ireland Cork Ireland
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery Section of Rhinology and Allergy University Hospital MarburgPhilipps‐Universität Marburg Marburg Germany
| | - Maria J. Torres
- Allergy Unit Regional University Hospital of Malaga‐IBIMA‐UMA‐ARADyAL Malaga Spain
| | - De‐Yun Wang
- Department of Otolaryngology Yong Loo Lin School of Medicine National University of Singapore Singapore Singapore
| | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery and Department of Allergy Beijing TongRen Hospital Beijing China
| | - Cezmi A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University Zurich Davos Switzerland
- CK CARE Christine Kühne Center for Allergy Research and Education Davos Switzerland
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12
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Alkotob SS, Cannedy C, Harter K, Movassagh H, Paudel B, Prunicki M, Sampath V, Schikowski T, Smith E, Zhao Q, Traidl‐Hoffmann C, Nadeau KC. Advances and novel developments in environmental influences on the development of atopic diseases. Allergy 2020; 75:3077-3086. [PMID: 33037680 DOI: 10.1111/all.14624] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 10/05/2020] [Accepted: 10/05/2020] [Indexed: 12/12/2022]
Abstract
Although genetic factors play a role in the etiology of atopic disease, the rapid increases in the prevalence of these diseases over the last few decades suggest that environmental, rather than genetic factors are the driving force behind the increasing prevalence. In modern societies, there is increased time spent indoors, use of antibiotics, and consumption of processed foods and decreased contact with farm animals and pets, which limit exposure to environmental allergens, infectious parasitic worms, and microbes. The lack of exposure to these factors is thought to prevent proper education and training of the immune system. Increased industrialization and urbanization have brought about increases in organic and inorganic pollutants. In addition, Caesarian birth, birth order, increased use of soaps and detergents, tobacco smoke exposure and psychosomatic factors are other factors that have been associated with increased rate of allergic diseases. Here, we review current knowledge on the environmental factors that have been shown to affect the development of allergic diseases and the recent developments in the field.
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Affiliation(s)
- Shifaa Suhayl Alkotob
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University and Division of Pulmonary and Critical Care Medicine Department of Medicine Stanford University Stanford CA USA
| | - Cade Cannedy
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University and Division of Pulmonary and Critical Care Medicine Department of Medicine Stanford University Stanford CA USA
| | - Katharina Harter
- Chair and Institute of Environmental Medicine UNIKA‐TTechnical University of Munich and Helmholtz Zentrum München Augsburg Germany
| | - Hesam Movassagh
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University and Division of Pulmonary and Critical Care Medicine Department of Medicine Stanford University Stanford CA USA
| | - Bibek Paudel
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University and Division of Pulmonary and Critical Care Medicine Department of Medicine Stanford University Stanford CA USA
| | - Mary Prunicki
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University and Division of Pulmonary and Critical Care Medicine Department of Medicine Stanford University Stanford CA USA
| | - Vanitha Sampath
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University and Division of Pulmonary and Critical Care Medicine Department of Medicine Stanford University Stanford CA USA
| | - Tamara Schikowski
- IUF‐Leibniz Institute for Environmental Medicine Duesseldorf Germany
| | - Eric Smith
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University and Division of Pulmonary and Critical Care Medicine Department of Medicine Stanford University Stanford CA USA
| | - Qi Zhao
- IUF‐Leibniz Institute for Environmental Medicine Duesseldorf Germany
| | - Claudia Traidl‐Hoffmann
- Chair and Institute of Environmental Medicine UNIKA‐TTechnical University of Munich and Helmholtz Zentrum München Augsburg Germany
- CK‐CARE Christine Kühne Center for Allergy Research and Education Davos Switzerland
| | - Kari C. Nadeau
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University and Division of Pulmonary and Critical Care Medicine Department of Medicine Stanford University Stanford CA USA
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13
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Bieber T, Traidl‐Hoffmann C, Schäppi G, Lauener R, Akdis C, Schmid‐Grendlmeier P. Unraveling the complexity of atopic dermatitis: The CK-CARE approach toward precision medicine. Allergy 2020; 75:2936-2938. [PMID: 31967657 DOI: 10.1111/all.14194] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Thomas Bieber
- Department of Dermatology and Allergy University Hospital Rheinische Friedrich‐Wilhelms University of Bonn Bonn Germany
- Christine Kühne‐Center for Allergy Research and Education (Davos) Davos Switzerland
| | - Claudia Traidl‐Hoffmann
- Christine Kühne‐Center for Allergy Research and Education (Davos) Davos Switzerland
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
| | - Georg Schäppi
- Christine Kühne‐Center for Allergy Research and Education (Davos) Davos Switzerland
| | - Roger Lauener
- Christine Kühne‐Center for Allergy Research and Education (Davos) Davos Switzerland
- Children's Hospital of Eastern Switzerland St. Gallen Switzerland
| | - Cezmi Akdis
- Christine Kühne‐Center for Allergy Research and Education (Davos) Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Zurich Switzerland
| | - Peter Schmid‐Grendlmeier
- Christine Kühne‐Center for Allergy Research and Education (Davos) Davos Switzerland
- Allergy Unit Department of Dermatology University Hospital of Zürich Zürich Switzerland
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14
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Hülpüsch C, Tremmel K, Hammel G, Bhattacharyya M, Tomassi A, Nussbaumer T, Neumann AU, Reiger M, Traidl‐Hoffmann C. Skin pH-dependent Staphylococcus aureus abundance as predictor for increasing atopic dermatitis severity. Allergy 2020; 75:2888-2898. [PMID: 32562575 DOI: 10.1111/all.14461] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/12/2020] [Accepted: 06/01/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Atopic eczema (atopic dermatitis, AD) is characterized by disrupted skin barrier associated with elevated skin pH and skin microbiome dysbiosis, due to high Staphylococcus aureus loads, especially during flares. Since S aureus shows optimal growth at neutral pH, we investigated the longitudinal interplay between these factors and AD severity in a pilot study. METHOD Emollient (with either basic pH 8.5 or pH 5.5) was applied double-blinded twice daily to 6 AD patients and 6 healthy (HE) controls for 8 weeks. Weekly, skin swabs for microbiome analysis (deep sequencing) were taken, AD severity was assessed, and skin physiology (pH, hydration, transepidermal water loss) was measured. RESULTS Physiological, microbiome, and clinical results were not robustly related to the pH of applied emollient. In contrast to longitudinally stable microbiome in HE, S aureus frequency significantly increased in AD over 8 weeks. High S aureus abundance was associated with skin pH 5.7-6.2. High baseline S aureus frequency predicted both increase in S aureus and in AD severity (EASI and local SCORAD) after 8 weeks. CONCLUSION Skin pH is tightly regulated by intrinsic factors and limits the abundance of S aureus. High baseline S aureus abundance in turn predicts an increase in AD severity over the study period. This underlines the importance and potential of sustained intervention regarding the skin pH and urges for larger studies linking skin pH and skin S aureus abundance to understand driving factors of disease progression.
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Affiliation(s)
- Claudia Hülpüsch
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
| | - Karolina Tremmel
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
| | - Gertrud Hammel
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
| | - Madhumita Bhattacharyya
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
| | - Amedeo Tomassi
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
| | - Thomas Nussbaumer
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
| | - Avidan U. Neumann
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
| | - Matthias Reiger
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
- CK CARE – Christine Kühne Center for Allergy research and Education Davos Switzerland
| | - Claudia Traidl‐Hoffmann
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
- ZIEL Technical University of Munich Freising Germany
- CK CARE – Christine Kühne Center for Allergy research and Education Davos Switzerland
- Outpatient Clinic for Environmental Medicine Universitätsklinikum Augsburg Augsburg Germany
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15
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Radzikowska U, Ding M, Tan G, Zhakparov D, Peng Y, Wawrzyniak P, Wang M, Li S, Morita H, Altunbulakli C, Reiger M, Neumann AU, Lunjani N, Traidl‐Hoffmann C, Nadeau KC, O’Mahony L, Akdis C, Sokolowska M. Distribution of ACE2, CD147, CD26, and other SARS-CoV-2 associated molecules in tissues and immune cells in health and in asthma, COPD, obesity, hypertension, and COVID-19 risk factors. Allergy 2020; 75:2829-2845. [PMID: 32496587 PMCID: PMC7300910 DOI: 10.1111/all.14429] [Citation(s) in RCA: 340] [Impact Index Per Article: 85.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 05/20/2020] [Accepted: 05/25/2020] [Indexed: 02/06/2023]
Abstract
Background Morbidity and mortality from COVID‐19 caused by novel coronavirus SARS‐CoV‐2 is accelerating worldwide, and novel clinical presentations of COVID‐19 are often reported. The range of human cells and tissues targeted by SARS‐CoV‐2, its potential receptors and associated regulating factors are still largely unknown. The aim of our study was to analyze the expression of known and potential SARS‐CoV‐2 receptors and related molecules in the extensive collection of primary human cells and tissues from healthy subjects of different age and from patients with risk factors and known comorbidities of COVID‐19. Methods We performed RNA sequencing and explored available RNA‐Seq databases to study gene expression and co‐expression of ACE2, CD147 (BSG), and CD26 (DPP4) and their direct and indirect molecular partners in primary human bronchial epithelial cells, bronchial and skin biopsies, bronchoalveolar lavage fluid, whole blood, peripheral blood mononuclear cells (PBMCs), monocytes, neutrophils, DCs, NK cells, ILC1, ILC2, ILC3, CD4+ and CD8+ T cells, B cells, and plasmablasts. We analyzed the material from healthy children and adults, and from adults in relation to their disease or COVID‐19 risk factor status. Results ACE2 and TMPRSS2 were coexpressed at the epithelial sites of the lung and skin, whereas CD147 (BSG), cyclophilins (PPIA andPPIB), CD26 (DPP4), and related molecules were expressed in both epithelium and in immune cells. We also observed a distinct age‐related expression profile of these genes in the PBMCs and T cells from healthy children and adults. Asthma, COPD, hypertension, smoking, obesity, and male gender status generally led to the higher expression of ACE2‐ and CD147‐related genes in the bronchial biopsy, BAL, or blood. Additionally, CD147‐related genes correlated positively with age and BMI. Interestingly, we also observed higher expression of CD147‐related genes in the lesional skin of patients with atopic dermatitis. Conclusions Our data suggest different receptor repertoire potentially involved in the SARS‐CoV‐2 infection at the epithelial barriers and in the immune cells. Altered expression of these receptors related to age, gender, obesity and smoking, as well as with the disease status, might contribute to COVID‐19 morbidity and severity patterns.
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Affiliation(s)
- Urszula Radzikowska
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Christine Kühne – Center for Research and Education (CK‐CARE) Davos Switzerland
- Department of Regenerative Medicine and Immune Regulation Medical University of Bialystok Bialystok Poland
| | - Mei Ding
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Christine Kühne – Center for Research and Education (CK‐CARE) Davos Switzerland
- Department of Allergology Zhongnan Hospital of Wuhan University Wuhan China
| | - Ge Tan
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Functional Genomic Centre ZurichETH Zurich/University of Zurich Zurich Switzerland
| | - Damir Zhakparov
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Yaqi Peng
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Christine Kühne – Center for Research and Education (CK‐CARE) Davos Switzerland
- Otorhinolaryngology HospitalThe First Affiliated HospitalSun Yat‐sen University Guangzhou China
| | - Paulina Wawrzyniak
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Christine Kühne – Center for Research and Education (CK‐CARE) Davos Switzerland
- Division of Clinical Chemistry and Biochemistry University Children`s Hospital Zurich Zurich Switzerland
- Children`s Research Center University Children`s Hospital Zurich Zurich Switzerland
| | - Ming Wang
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Christine Kühne – Center for Research and Education (CK‐CARE) Davos Switzerland
- Department of Otolaryngology, Head and Neck Surgery Beijing TongRen HospitalCapital Medical University and the Beijing Key Laboratory of Nasal DiseasesBeijing Institute of Otolaryngology Beijing China
| | - Shuo Li
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Department of Cancer Immunology Institute for Cancer ResearchOslo University Hospital Oslo Norway
| | - Hideaki Morita
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Department of Allergy and Clinical Immunology National Research Institute for Child Health and Development Tokyo Japan
| | - Can Altunbulakli
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Christine Kühne – Center for Research and Education (CK‐CARE) Davos Switzerland
| | - Matthias Reiger
- Chair and Institute of Environmental Medicine UNIKA‐TTechnical University of Munich and Helmholtz Zentrum Munchen Augsburg Germany
| | - Avidan U. Neumann
- Chair and Institute of Environmental Medicine UNIKA‐TTechnical University of Munich and Helmholtz Zentrum Munchen Augsburg Germany
- Institute of Computational Biology (ICB) Helmholtz Zentrum Munchen Munich Germany
- Institute of Experimental Medicine (IEM) Czech Academy of Sciences Prague Czech Republic
| | - Nonhlanhla Lunjani
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Christine Kühne – Center for Research and Education (CK‐CARE) Davos Switzerland
| | - Claudia Traidl‐Hoffmann
- Christine Kühne – Center for Research and Education (CK‐CARE) Davos Switzerland
- Chair and Institute of Environmental Medicine UNIKA‐TTechnical University of Munich and Helmholtz Zentrum Munchen Augsburg Germany
| | - Kari C. Nadeau
- Sean N Parker Centre for Allergy and Asthma Research at Stanford University Department of Medicine Stanford University School of Medicine Stanford USA
| | - Liam O’Mahony
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Department of Medicine and School of Microbiology APC Microbiome IrelandNational University of Ireland Cork Ireland
| | - Cezmi Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Christine Kühne – Center for Research and Education (CK‐CARE) Davos Switzerland
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Christine Kühne – Center for Research and Education (CK‐CARE) Davos Switzerland
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16
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Fairweather V, Hertig E, Traidl‐Hoffmann C. A brief introduction to climate change and health. Allergy 2020; 75:2352-2354. [PMID: 32779793 DOI: 10.1111/all.14511] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 07/14/2020] [Accepted: 07/15/2020] [Indexed: 12/25/2022]
Affiliation(s)
- Victoria Fairweather
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich Munich Germany
- Helmholtz ZentrumMünchen – German Research Center for Environmental Health Augsburg Germany
| | - Elke Hertig
- Faculty of Medicine University of Augsburg Augsburg Germany
| | - Claudia Traidl‐Hoffmann
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich Munich Germany
- Helmholtz ZentrumMünchen – German Research Center for Environmental Health Augsburg Germany
- CK‐CARE Christine Kühne Center for Allergy Research and Education Davos Switzerland
- Outpatient clinic for Environmental Medicine University Hospital Augsburg Augsburg Germany
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17
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Buhl T, Beissert S, Gaffal E, Goebeler M, Hertl M, Mauch C, Reich K, Schmidt E, Schön MP, Sticherling M, Sunderkötter C, Traidl‐Hoffmann C, Werfel T, Wilsman‐Theis D, Worm M. COVID‐19 und Auswirkungen auf dermatologische und allergologische Erkrankungen. J Dtsch Dermatol Ges 2020; 18:815-825. [PMID: 32881343 PMCID: PMC7461475 DOI: 10.1111/ddg.14195_g] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Die durch das Coronavirus SARS‐CoV‐2 verursachte Krankheit COVID‐19 hat sich zu einer Pandemie entwickelt. Bei der Betrachtung von dermatologischen und allergologischen Krankheiten, die potenziell von COVID‐19 betroffen sind, stehen wir vor komplexen Herausforderungen, die Pathogenese und Beeinflussung verschiedener immunologischer Signalwege einschließen. Medizinische Behandlungen müssen daher im Zusammenhang mit dieser Infektion oft neu bewertet und in Frage gestellt werden. Dieser Übersichtsartikel fasst den aktuellen Wissensstand zu COVID‐19 hinsichtlich der wichtigsten dermatologischen und allergologischen Erkrankungen zusammen. Es werden aber auch die medizinischen Bereiche beschrieben, für die keine ausreichenden Daten vorliegen. Unter Zusammenfassung der publizierten Daten und grundsätzlicher pathophysiologischer Überlegungen werden hier Schlussfolgerungen für das Management unserer Patienten während der Pandemie gezogen. Wir konzentrieren uns auf häufige Hauterkrankungen mit komplexer immunologischer Pathogenese: Psoriasis, Ekzeme einschließlich atopischer Dermatitis, Typ‐I‐Allergien, blasenbildende Autoimmundermatosen, Kollagenosen, Vaskulitiden und Hautkrebserkrankung. Da viele weitere Hauterkrankungen verwandte oder vergleichbare immunologische Reaktionsmuster aufweisen, können pathophysiologisch ähnliche entzündliche Dermatosen möglicherweise auch mit ähnlichen therapeutischen Überlegungen und Schlussfolgerungen während der Pandemie behandelt werden. Daher soll diese Übersicht Behandlungsempfehlungen auf der Basis bisher publizierter Daten und Empfehlungen zu Therapieentscheidungen auch über die hier diskutierten, häufigsten Erkrankungen hinaus liefern.
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Affiliation(s)
- Timo Buhl
- Klinik für DermatologieVenerologie und AllergologieUniversitätsklinikum GöttingenDeutschland
- Niedersächsisches Institut für BerufsdermatologieUniversitätsklinikum GöttingenDeutschland
| | - Stefan Beissert
- Klinik für DermatologieUniversitätsklinikum Carl Gustav CarusTU DresdenDeutschland
| | - Evelyn Gaffal
- Klinik für DermatologieUniversitätsklinikum MagdeburgDeutschland
| | - Matthias Goebeler
- Klinik für DermatologieVenerologie und AllergologieUniversitätsklinik WürzburgDeutschland
| | - Michael Hertl
- Klinik für DermatologiePhilipps‐UniversitätMarburgDeutschland
| | - Cornelia Mauch
- Klinik für DermatologieUniversitätsklinik KölnDeutschland
| | - Kristian Reich
- Translational Research in Inflammatory Skin DiseasesIVDPUniversitätsklinikum Hamburg‐EppendorfDeutschland
| | - Enno Schmidt
- Klinik für DermatologieUniversität zu LübeckDeutschland
- Lübecker Institut für Experimentelle Dermatologie (LIED)Universität zu LübeckDeutschland
| | - Michael P. Schön
- Klinik für DermatologieVenerologie und AllergologieUniversitätsklinikum GöttingenDeutschland
- Niedersächsisches Institut für BerufsdermatologieUniversitätsklinikum GöttingenDeutschland
| | - Michael Sticherling
- Klinik für DermatologieFAU Erlangen‐Nürnberg und Universitätsklinikum ErlangenDeutsches Zentrum für Immuntherapie (DZI)ErlangenDeutschland
| | - Cord Sunderkötter
- Klinik für Dermatologie und VenerologieUniversitätsklinikum Halle‐WittenbergHalle (Saale)Deutschland
| | - Claudia Traidl‐Hoffmann
- Institut für UmweltmedizinUNIKA‐T AugsburgTechnische Universität München und Helmholtz Zentrum MünchenDeutsches Forschungszentrum für Gesundheit und UmweltDeutschland
- Ambulanz für UmweltmedizinUniversitätsklinikum AugsburgDeutschland
| | - Thomas Werfel
- Abteilung für Immundermatologie und AllergieforschungKlinik für Dermatologie und AllergologieMedizinische Hochschule HannoverDeutschland
| | - Dagmar Wilsman‐Theis
- Klinik für Dermatologie und AllergologieUniversitätsklinikumFriedrich‐Wilhelms‐UniversitätBonnDeutschland
| | - Margitta Worm
- Abteilung für Allergologie und ImmunologieKlinik für DermatologieVenerologie und AllergologieCharité ‐ Universitätsmedizin BerlinDeutschland
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18
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Gökkaya M, Schwierzeck V, Thölken K, Knoch S, Gerstlauer M, Hammel G, Traidl‐Hoffmann C, Gilles S. Nasal specific IgE correlates to serum specific IgE: First steps towards nasal molecular allergy diagnostic. Allergy 2020; 75:1802-1805. [PMID: 32056220 DOI: 10.1111/all.14228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/31/2020] [Accepted: 02/10/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Mehmet Gökkaya
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich Augsburg Germany
- Helmholtz Zentrum München ‐ German Research Center for Environmental Health Augsburg Germany
| | - Vera Schwierzeck
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich Augsburg Germany
- Helmholtz Zentrum München ‐ German Research Center for Environmental Health Augsburg Germany
| | - Karisa Thölken
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich Augsburg Germany
- Helmholtz Zentrum München ‐ German Research Center for Environmental Health Augsburg Germany
| | - Stephan Knoch
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich Augsburg Germany
- Helmholtz Zentrum München ‐ German Research Center for Environmental Health Augsburg Germany
| | - Michael Gerstlauer
- Pediatric Pneumology and Allergology Unit Medical University of Augsburg Augsburg Germany
| | - Gertrud Hammel
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich Augsburg Germany
- Helmholtz Zentrum München ‐ German Research Center for Environmental Health Augsburg Germany
| | - Claudia Traidl‐Hoffmann
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich Augsburg Germany
- Helmholtz Zentrum München ‐ German Research Center for Environmental Health Augsburg Germany
- CK‐CARE Christine Kühne Center for Allergy Research and Education Davos Switzerland
| | - Stefanie Gilles
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich Augsburg Germany
- Helmholtz Zentrum München ‐ German Research Center for Environmental Health Augsburg Germany
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19
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Jensen‐Jarolim E, Bachmann MF, Bonini S, Jacobsen L, Jutel M, Klimek L, Mahler V, Mösges R, Moingeon P, O´Hehir RE, Palomares O, Pfaar O, Renz H, Rhyner C, Roth‐Walter F, Rudenko M, Savolainen J, Schmidt‐Weber CB, Traidl‐Hoffmann C, Kündig T. State-of-the-art in marketed adjuvants and formulations in Allergen Immunotherapy: A position paper of the European Academy of Allergy and Clinical Immunology (EAACI). Allergy 2020; 75:746-760. [PMID: 31774179 DOI: 10.1111/all.14134] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 11/07/2019] [Accepted: 11/10/2019] [Indexed: 02/06/2023]
Abstract
Since the introduction of allergen immunotherapy (AIT) over 100 years ago, focus has been on standardization of allergen extracts, with reliable molecular composition of allergens receiving the highest attention. While adjuvants play a major role in European AIT, they have been less well studied. In this Position Paper, we summarize current unmet needs of adjuvants in AIT citing current evidence. Four adjuvants are used in products marketed in Europe: aluminium hydroxide (Al(OH)3 ) is the most frequently used adjuvant, with microcrystalline tyrosine (MCT), monophosphoryl lipid A (MPLA) and calcium phosphate (CaP) used less frequently. Recent studies on humans, and using mouse models, have characterized in part the mechanisms of action of adjuvants on pre-existing immune responses. AIT differs from prophylactic vaccines that provoke immunity to infectious agents, as in allergy the patient is presensitized to the antigen. The intended mode of action of adjuvants is to simultaneously enhance the immunogenicity of the allergen, while precipitating the allergen at the injection site to reduce the risk of anaphylaxis. Contrasting immune effects are seen with different adjuvants. Aluminium hydroxide initially boosts Th2 responses, while the other adjuvants utilized in AIT redirect the Th2 immune response towards Th1 immunity. After varying lengths of time, each of the adjuvants supports tolerance. Further studies of the mechanisms of action of adjuvants may advise shorter treatment periods than the current three-to-five-year regimens, enhancing patient adherence. Improved lead compounds from the adjuvant pipeline are under development and are explored for their capacity to fill this unmet need.
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Affiliation(s)
- Erika Jensen‐Jarolim
- Institute of Pathophysiology & Allergy Research Center of Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
- The Interuniversity Messerli Research Institute University of Veterinary Medicine Vienna Medical University of Vienna University of Vienna Vienna Austria
| | - Martin F. Bachmann
- Institute of Immunology Inselspital University of Berne Bern Switzerland
| | - Sergio Bonini
- Institute of Translational Pharmacology Italian National Research Council Rome Italy
| | - Lars Jacobsen
- ALC, Allergy Learning & Consulting Copenhagen Denmark
| | - Marek Jutel
- Department of Clinical Immunology Wroclaw Medical University Wrocław Poland
- ALL‐MED Medical Research Institute Wroclaw Poland
| | - Ludger Klimek
- Center of Rhinology and Allergology Wiesbaden Germany
| | - Vera Mahler
- Division of Allergology Paul‐Ehrlich‐Institut Federal Institute for Vaccines and Biomedicines Langen Germany
| | - Ralph Mösges
- CRI‐Clinical Research International Ltd Hamburg Germany
- Institute of Medical Statistics and Bioinformatics University of Cologne Cologne Germany
| | - Philippe Moingeon
- Center for Therapeutic Innovation – Immuno‐Inflammatory Disease Servier Suresnes France
| | - Robyn E. O´Hehir
- Department of Respiratory Medicine, Allergy and Clinical Immunology (Research) Central Clinical School Monash University and Alfred Hospital Melbourne Vic. Australia
| | - Oscar Palomares
- Department of Biochemistry and Molecular Biology Chemistry School Complutense University of Madrid Madrid Spain
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery Section of Rhinology and Allergy University Hospital MarburgPhilipps‐Universität Marburg Marburg Germany
| | - Harald Renz
- Institute of Laboratory Medicine Universities of Giessen and Marburg Lung Center (UGMLC) German Center for Lung Research (DZL) Philipps Universität Marburg Marburg Germany
| | - Claudio Rhyner
- SIAF – Swiss Institute of Allergy and Asthma Research Davos Switzerland
| | - Franziska Roth‐Walter
- The Interuniversity Messerli Research Institute University of Veterinary Medicine Vienna Medical University of Vienna University of Vienna Vienna Austria
| | | | - Johannes Savolainen
- Department of Pulmonary Diseases and Clinical Allergology University of Turku and Turku University Hospital Turku Finland
| | - Carsten B. Schmidt‐Weber
- Center of Allergy and Environment (ZAUM) German Center of Lung Research (DZL) and Helmholtz I&I Initiative Technical University, and Helmholtz Center Munich Munich Germany
| | - Claudia Traidl‐Hoffmann
- Institute of Environmental Medicine (IEM) Technical University Munich and Helmholtz Center Munich Munich Germany
| | - Thomas Kündig
- Department of Dermatology University Hospital Zurich Zurich Switzerland
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20
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Gilles S, Blume C, Wimmer M, Damialis A, Meulenbroek L, Gökkaya M, Bergougnan C, Eisenbart S, Sundell N, Lindh M, Andersson L, Dahl Å, Chaker A, Kolek F, Wagner S, Neumann AU, Akdis CA, Garssen J, Westin J, Land B, Davies DE, Traidl‐Hoffmann C. Pollen exposure weakens innate defense against respiratory viruses. Allergy 2020; 75:576-587. [PMID: 31512243 DOI: 10.1111/all.14047] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 06/13/2019] [Accepted: 06/24/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND Hundreds of plant species release their pollen into the air every year during early spring. During that period, pollen allergic as well as non-allergic patients frequently present to doctors with severe respiratory tract infections. Our objective was therefore to assess whether pollen may interfere with antiviral immunity. METHODS We combined data from real-life human exposure cohorts, a mouse model and human cell culture to test our hypothesis. RESULTS Pollen significantly diminished interferon-λ and pro-inflammatory chemokine responses of airway epithelia to rhinovirus and viral mimics and decreased nuclear translocation of interferon regulatory factors. In mice infected with respiratory syncytial virus, co-exposure to pollen caused attenuated antiviral gene expression and increased pulmonary viral titers. In non-allergic human volunteers, nasal symptoms were positively correlated with airborne birch pollen abundance, and nasal birch pollen challenge led to downregulation of type I and -III interferons in nasal mucosa. In a large patient cohort, numbers of rhinoviruspositive cases were correlated with airborne birch pollen concentrations. CONCLUSION The ability of pollen to suppress innate antiviral immunity, independent of allergy, suggests that high-risk population groups should avoid extensive outdoor activities when pollen and respiratory virus seasons coincide.
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Affiliation(s)
- Stefanie Gilles
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
| | - Cornelia Blume
- Faculty of Medicine Academic Unit of Clinical and Experimental Sciences University of Southampton Southampton UK
- Southampton NIHR Respiratory Biomedical Research Unit University Hospital Southampton Southampton UK
| | - Maria Wimmer
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
- Division of Pharmacology Department of Pharmaceutical Sciences Faculty of Science Utrecht University Utrecht The Netherlands
| | - Athanasios Damialis
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
| | - Laura Meulenbroek
- Division of Pharmacology Department of Pharmaceutical Sciences Faculty of Science Utrecht University Utrecht The Netherlands
- Department of Immunology Nutricia Research Utrecht The Netherlands
| | - Mehmet Gökkaya
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
| | - Carolin Bergougnan
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
| | - Selina Eisenbart
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
| | - Nicklas Sundell
- Department of Infectious Diseases/Clinical Virology University of Gothenburg Gothenburg Sweden
| | - Magnus Lindh
- Department of Infectious Diseases/Clinical Virology University of Gothenburg Gothenburg Sweden
| | - Lars‐Magnus Andersson
- Department of Infectious Diseases/Clinical Virology University of Gothenburg Gothenburg Sweden
| | - Åslög Dahl
- Department of Biological and Environmental Sciences Faculty of Sciences University of Gothenburg Gothenburg Sweden
| | - Adam Chaker
- ENT Department Klinikum Rechts der Isar Technical University of Munich Munich Germany
| | - Franziska Kolek
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
| | - Sabrina Wagner
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
| | - Avidan U. Neumann
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
| | - Cezmi A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University Zurich Davos Switzerland
- Christine‐Kühne‐Center for Allergy Research and Education (CK‐Care) Davos Switzerland
| | - Johan Garssen
- Division of Pharmacology Department of Pharmaceutical Sciences Faculty of Science Utrecht University Utrecht The Netherlands
- Department of Immunology Nutricia Research Utrecht The Netherlands
| | - Johan Westin
- Department of Infectious Diseases/Clinical Virology University of Gothenburg Gothenburg Sweden
| | - Belinda Land
- Department of Immunology Nutricia Research Utrecht The Netherlands
- Laboratory of Translational Immunology The Wilhelmina Children's Hospital University Medical Center Utrecht Utrecht The Netherlands
| | - Donna E. Davies
- Faculty of Medicine Academic Unit of Clinical and Experimental Sciences University of Southampton Southampton UK
- Southampton NIHR Respiratory Biomedical Research Unit University Hospital Southampton Southampton UK
| | - Claudia Traidl‐Hoffmann
- Chair and Institute of Environmental Medicine UNIKA‐T Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
- Christine‐Kühne‐Center for Allergy Research and Education (CK‐Care) Davos Switzerland
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21
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Breiteneder H, Diamant Z, Eiwegger T, Fokkens WJ, Traidl‐Hoffmann C, Nadeau K, O’Hehir RE, O’Mahony L, Pfaar O, Torres MJ, Wang DY, Zhang L, Akdis CA. Future research trends in understanding the mechanisms underlying allergic diseases for improved patient care. Allergy 2019; 74:2293-2311. [PMID: 31056763 PMCID: PMC6973012 DOI: 10.1111/all.13851] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 03/28/2019] [Accepted: 04/12/2019] [Indexed: 12/16/2022]
Abstract
The specialties of allergy and clinical immunology have entered the era of precision medicine with the stratification of diseases into distinct disease subsets, specific diagnoses, and targeted treatment options, including biologicals and small molecules. This article reviews recent developments in research and patient care and future trends in the discipline. The section on basic mechanisms of allergic diseases summarizes the current status and defines research needs in structural biology, type 2 inflammation, immune tolerance, neuroimmune mechanisms, role of the microbiome and diet, environmental factors, and respiratory viral infections. In the section on diagnostic challenges, clinical trials, precision medicine and immune monitoring of allergic diseases, asthma, allergic and nonallergic rhinitis, and new approaches to the diagnosis and treatment of drug hypersensitivity reactions are discussed in further detail. In the third section, unmet needs and future research areas for the treatment of allergic diseases are highlighted with topics on food allergy, biologics, small molecules, and novel therapeutic concepts in allergen‐specific immunotherapy for airway disease. Unknowns and future research needs are discussed at the end of each subsection.
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Affiliation(s)
- Heimo Breiteneder
- Institute of Pathophysiology and Allergy Research Medical University of Vienna Vienna Austria
| | - Zuzana Diamant
- Department of Respiratory Medicine & Allergology, Institute for Clinical Science, Skane University Hospital Lund University Lund Sweden
- Department of Respiratory Medicine, First Faculty of Medicine Charles University and Thomayer Hospital Prague Czech Republic
| | - Thomas Eiwegger
- Division of Immunology and Allergy Food Allergy and Anaphylaxis Program The Department of Pediatrics The Hospital for Sick Children Toronto Ontario Canada
- Research Institute, The Hospital for Sick Children, Translational Medicine Program Toronto Ontario Canada
- Department of Immunology The University of Toronto Toronto Ontario Canada
| | - Wytske J. Fokkens
- Department of Otorhinolaryngology Amsterdam University Medical Centres, Location AMC Amsterdam The Netherlands
| | - Claudia Traidl‐Hoffmann
- Chair and Institute of Environmental Medicine UNIKA‐T, Technical University of Munich and Helmholtz Zentrum München Augsburg Germany
- Christine Kühne Center for Allergy Research and Education Davos Switzerland
| | - Kari Nadeau
- Sean N. Parker Center for Allergy & Asthma Research Stanford University Stanford California
| | - Robyn E. O’Hehir
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Central Clinical School Monash University Melbourne Victoria Australia
- Allergy, Asthma and Clinical Immunology Service Alfred Health Melbourne Victoria Australia
| | - Liam O’Mahony
- Departments of Medicine and Microbiology, APC Microbiome Ireland National University of Ireland Cork Ireland
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy University Hospital Marburg, Philipps‐Universität Marburg Marburg Germany
| | - Maria J. Torres
- Allergy Unit Regional University Hospital of MalagaIBIMA‐UMA‐ARADyAL Malaga Spain
| | - De Yun Wang
- Department of Otolaryngology Yong Loo Lin School of Medicine National University of Singapore Singapore
| | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery and Department of Allergy Beijing Tongren Hospital Beijing China
| | - Cezmi A. Akdis
- Christine Kühne Center for Allergy Research and Education Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF), University Zurich Davos Switzerland
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22
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Soh WT, Aglas L, Mueller GA, Gilles S, Weiss R, Scheiblhofer S, Huber S, Scheidt T, Thompson PM, Briza P, London RE, Traidl‐Hoffmann C, Cabrele C, Brandstetter H, Ferreira F. Multiple roles of Bet v 1 ligands in allergen stabilization and modulation of endosomal protease activity. Allergy 2019; 74:2382-2393. [PMID: 31230350 PMCID: PMC6910946 DOI: 10.1111/all.13948] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 04/30/2019] [Indexed: 12/21/2022]
Abstract
Background Over 100 million people worldwide suffer from birch pollen allergy. Bet v 1 has been identified as the major birch pollen allergen. However, the molecular mechanisms of birch allergic sensitization, including the roles of Bet v 1 and other components of the birch pollen extract, remain incompletely understood. Here, we examined how known birch pollen–derived molecules influence the endolysosomal processing of Bet v 1, thereby shaping its allergenicity. Methods We analyzed the biochemical and immunological interaction of ligands with Bet v 1. We then investigated the proteolytic processing of Bet v 1 by endosomal extracts in the presence and absence of ligands, followed by a detailed kinetic analysis of Bet v 1 processing by individual endolysosomal proteases as well as the T‐cell epitope presentation in BMDCs. Results We identified E1 phytoprostanes as novel Bet v 1 ligands. Pollen‐derived ligands enhanced the proteolytic resistance of Bet v 1, affecting degradation kinetics and preferential cleavage sites of the endolysosomal proteases cathepsin S and legumain. E1 phytoprostanes exhibited a dual role by stabilizing Bet v 1 and inhibiting cathepsin protease activity. Conclusion Bet v 1 can serve as a transporter of pollen‐derived, bioactive compounds. When carried to the endolysosome, such compounds can modulate the proteolytic activity, including its processing by cysteine cathepsins. We unveil a paradigm shift from an allergen‐centered view to a more systemic view that includes the host endolysosomal enzymes.
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Affiliation(s)
- Wai Tuck Soh
- Department of Biosciences University of Salzburg Salzburg Austria
| | - Lorenz Aglas
- Department of Biosciences University of Salzburg Salzburg Austria
| | - Geoffrey A. Mueller
- Department of Health and Human Services, Genome Integrity and Structural Biology Laboratory National Institute of Environmental Health Sciences, National Institutes of Health Research Triangle Park North Carolina
| | - Stefanie Gilles
- Institute of Environmental Medicine UNIKA‐T, Technical University Munich and Helmholtz Zentrum München Augsburg Germany
- Christine‐Kühne‐Center for Allergy Research and Education (CK CARE) Davos Switzerland
| | - Richard Weiss
- Department of Biosciences University of Salzburg Salzburg Austria
| | | | - Sara Huber
- Department of Biosciences University of Salzburg Salzburg Austria
| | - Tamara Scheidt
- Department of Biosciences University of Salzburg Salzburg Austria
| | - Peter M. Thompson
- Department of Health and Human Services, Genome Integrity and Structural Biology Laboratory National Institute of Environmental Health Sciences, National Institutes of Health Research Triangle Park North Carolina
| | - Peter Briza
- Department of Biosciences University of Salzburg Salzburg Austria
| | - Robert E. London
- Department of Health and Human Services, Genome Integrity and Structural Biology Laboratory National Institute of Environmental Health Sciences, National Institutes of Health Research Triangle Park North Carolina
| | - Claudia Traidl‐Hoffmann
- Institute of Environmental Medicine UNIKA‐T, Technical University Munich and Helmholtz Zentrum München Augsburg Germany
- Christine‐Kühne‐Center for Allergy Research and Education (CK CARE) Davos Switzerland
| | - Chiara Cabrele
- Department of Biosciences University of Salzburg Salzburg Austria
| | | | - Fatima Ferreira
- Department of Biosciences University of Salzburg Salzburg Austria
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23
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Baur X, Akdis CA, Budnik LT, Cruz MJ, Fischer A, Förster‐Ruhrmann U, Göen T, Goksel O, Heutelbeck AR, Jones M, Lux H, Maestrelli P, Munoz X, Nemery B, Schlünssen V, Sigsgaard T, Traidl‐Hoffmann C, Siegel P. Immunological methods for diagnosis and monitoring of IgE-mediated allergy caused by industrial sensitizing agents (IMExAllergy). Allergy 2019; 74:1885-1897. [PMID: 30953599 PMCID: PMC6851709 DOI: 10.1111/all.13809] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 02/20/2019] [Accepted: 03/26/2019] [Indexed: 02/06/2023]
Abstract
Industrial sensitizing agents (allergens) in living and working environments play an important role in eliciting type 1 allergic disorders including asthma and allergic rhinitis. Successful management of allergic diseases necessitates identifying their specific causes (ie, identify the causative agent(s) and the route of contact to allergen: airborne, or skin contact) to avoid further exposure. Identification of sensitization by a sensitive and validated measurement of specific IgE is an important step in the diagnosis. However, only a limited number of environmental and occupational allergens are available on the market for use in sIgE testing. Accordingly, specific in‐house testing by individual diagnostic and laboratory centers is often required. Currently, different immunological tests are in use at various diagnostic centers that often produce considerably divergent results, mostly due to lack of standardized allergen preparation and standardized procedures as well as inadequate quality control. Our review and meta‐analysis exhibited satisfactory performance of sIgE detection test for most high molecular weight (HMW) allergens with a pooled sensitivity of 0.74 and specificity of 0.71. However, for low molecular weight (LMW) allergens, pooled sensitivity is generally lower (0.28) and specificity higher (0.89) than for HMW tests. Major recommendations based on the presented data include diagnostic use of sIgE to HMW allergens. A negative sIgE result for LMW agents does not exclude sensitization. In addition, the requirements for full transparency of the content of allergen preparations with details on standardization and quality control are underlined. Development of standard operating procedures for in‐house sIgE assays, and clinical validation, centralized quality control and audits are emphasized. There is also a need for specialized laboratories to provide a custom service for the development of tests for the measurement of putative novel occupational allergens that are not commercially available.
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Affiliation(s)
- Xaver Baur
- European Society for Environmental and Occupational Medicine Berlin Germany
| | - Cezmi A. Akdis
- Swiss Institute of Allergy and Asthma Research, UZH Christine Kühne‐Center for Allergy Research and Education Davos Switzerland
| | - Lygia Therese Budnik
- Translational Toxicology and Immunology Unit, Institute for Occupational and Maritime Medicine University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | | | - Axel Fischer
- Clinical Research Unit of Allergy Charité–Universitätsmedizin Berlin Berlin Germany
| | | | - Thomas Göen
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine Friedrich‐Alexander‐University Erlangen‐Nurnberg Erlangen Germany
| | - Ozlem Goksel
- Pulmonary, Immunology and Allergy, Laboratory of Occupational & Environmental Respiratory Diseases and Asthma EGE University Izmir Turkey
| | - Astrid R. Heutelbeck
- Institute for Occupational, Environmental and Social Medicine Friedrich Schiller University Jena Jena Germany
| | - Meinir Jones
- Imperial College London National Heart and Lung Institute London UK
| | - Harald Lux
- Institute for Occupational, Environmental and Social Medicine Friedrich Schiller University Jena Jena Germany
- Charité Comprehensive Allergy Center, Institute of Occupational Medicine Charité–Universitätsmedizin Berlin Berlin Germany
| | - Piero Maestrelli
- Department of Cardiologic, Thoracic and Vascular Sciences University of Padova Padova Italy
| | - Xavier Munoz
- Pneumology Department Vall d'Hebron Hospital Barcelona Spain
| | - Benoit Nemery
- Department of Public Health and Primary Care, KU Leuven Centre for Environment and Health Leuven Belgium
| | - Vivi Schlünssen
- National Research Center for the Working Environment Copenhagen Denmark
- Department of Public Health, Environment, Occupation & Health, & Danish Ramazzini Centre Aarhus University Aarhus Denmark
| | - Torben Sigsgaard
- Department of Public Health, Environment, Occupation & Health, & Danish Ramazzini Centre Aarhus University Aarhus Denmark
| | - Claudia Traidl‐Hoffmann
- Swiss Institute of Allergy and Asthma Research, UZH Christine Kühne‐Center for Allergy Research and Education Davos Switzerland
- The Christine Kühne Center for Allergy Research and Education (CK‐CARE) Augsburg Germany
- UNIKA Technical University Munich Munich Germany
| | - Paul Siegel
- Division Morgantown, Health Effects Laboratory, Centers for Disease Control and Prevention National Institute for Occupational Safety and Health Morgantown West Virginia
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24
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Kolios A, Maul J, Meier B, Kerl K, Traidl‐Hoffmann C, Hertl M, Zillikens D, Röcken M, Ring J, Facchiano A, Mondino C, Yawalkar N, Contassot E, Navarini A, French L. Canakinumab in adults with steroid‐refractory pyoderma gangrenosum. Br J Dermatol 2015; 173:1216-23. [DOI: 10.1111/bjd.14037] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2015] [Indexed: 12/30/2022]
Affiliation(s)
- A.G.A. Kolios
- Department of Dermatology Zürich University Hospital Gloriastraße 31 8091 Zürich Switzerland
- Department of Immunology Zürich University Hospital Gloriastraße 31 8091 Zürich Switzerland
| | - J.‐T. Maul
- Department of Dermatology Zürich University Hospital Gloriastraße 31 8091 Zürich Switzerland
| | - B. Meier
- Department of Dermatology Zürich University Hospital Gloriastraße 31 8091 Zürich Switzerland
| | - K. Kerl
- Department of Dermatology Zürich University Hospital Gloriastraße 31 8091 Zürich Switzerland
| | - C. Traidl‐Hoffmann
- Department of Dermatology and Allergy Biederstein Technische Universität Mönchen Munich Germany
| | - M. Hertl
- Departments of Dermatology and Allergology Philipps University Marburg Marburg Germany
| | - D. Zillikens
- Department of Dermatology University of Lübeck Lübeck Germany
| | - M. Röcken
- Department of Dermatology Eberhard Karls University of Tübingen Tübingen Germany
| | - J. Ring
- Department of Dermatology and Allergy Biederstein Technische Universität Mönchen Munich Germany
| | - A. Facchiano
- Istituto Dermopatico dell'Immacolata IDI‐IRCCS Rome Italy
| | - C. Mondino
- Ospedale Regionale di Bellinzona e Valli Bellinzona Switzerland
| | - N. Yawalkar
- Department of Dermatology Bern University Hospital Bern Switzerland
| | - E. Contassot
- Department of Dermatology Zürich University Hospital Gloriastraße 31 8091 Zürich Switzerland
| | - A.A. Navarini
- Department of Dermatology Zürich University Hospital Gloriastraße 31 8091 Zürich Switzerland
| | - L.E. French
- Department of Dermatology Zürich University Hospital Gloriastraße 31 8091 Zürich Switzerland
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