|
1
|
Cherrez-Ojeda I, Bousquet J, Giménez-Arnau A, Godse K, Krasowska D, Bartosińska J, Szczepanik-Kułak P, Wawrzycki B, Kolkhir P, Allenova A, Allenov A, Tkachenko S, Teovska Mitrevska N, Mijakoski D, Stoleski S, Kolacinska-Flont M, Kuprys-Lipinska I, Molinska J, Kasperska-Zając A, Zajac M, Zamlynski M, Mihaltan F, Ulmeanu R, Zalewska-Janowska A, Tomaszewska K, Al-Ahmad M, Al-Nesf MA, Ibrahim T, Aqel S, Pesqué D, Rodríguez-González M, Wakida-Kuzunoki GH, Ramon GD, Ramon GN, Neisinger S, Bonnekoh H, Rukhadze M, Khoshkhui M, Fomina D, Larenas-Linnemann D, Košnik M, Oztas Kara R, Caballero López CG, Liu Q, Ivancevich JC, Ensina LF, Rosario N, Kvedariene V, Ben-Shoshan M, Criado RFJ, Bauer A, Cherrez A, Cherrez S, Chong-Neto H, Rojo-Gutierrez MI, Rudenko M, Larco Sousa JI, Lesiak A, Matos E, Tinoco I, Crespo Shijin C, Hinostroza Logroño R, Sagñay JC, Faytong-Haro M, Robles-Velasco K, Zuberbier T, Maurer M. Usage prevalence of angioedema patient-reported outcome measures: results from the UCARE and ACARE PROMUSE study. J Allergy Clin Immunol Pract 2024:S2213-2198(24)00464-1. [PMID: 38734372 DOI: 10.1016/j.jaip.2024.04.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 04/29/2024] [Accepted: 04/30/2024] [Indexed: 05/13/2024]
Affiliation(s)
- Ivan Cherrez-Ojeda
- Universidad de Especialidades Espíritu Santo, School of Medicine, Samborondón, Ecuador; RespiraLab, Research, Guayaquil, Ecuador.
| | - Jean Bousquet
- Charité - Universitätsmedizin Berlin, Institute of Allergology, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany.
| | - Ana Giménez-Arnau
- Dermatology Department, Hospital del Mar Research Institute, Universitat Pompeu Fabra, Barcelona, Spain.
| | - Kiran Godse
- Department of Dermatology, D Y. Patil University School of Medicine, Navi Mumbai, India.
| | - Dorota Krasowska
- Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland.
| | - Joanna Bartosińska
- Department of Cosmetology and Aestetic Medicine Medical University of Lublin Poland; Department of Dermatology, Venereology and Pediatric Dermatology Medical University of Lublin, Poland.
| | - Paulina Szczepanik-Kułak
- Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland.
| | - Bartłomiej Wawrzycki
- Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland.
| | - Pavel Kolkhir
- Charité - Universitätsmedizin Berlin, Institute of Allergology, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany.
| | - Anastasiia Allenova
- Laboratory of Immune-mediated skin diseases, Institute of Regenerative; Medicine, Biomedical Science & Technology Park, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation.
| | - Andrey Allenov
- Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation; State Budgetary Healthcare Institution of the City of Moscow "City Polyclinic No. 2 10 of the Department of Health of the City of Moscow", Moscow, Russian Federation; Federal State Budgetary Scientific Institution "N.A. Semashko National Research Institute of Public Health", Moscow, Russian Federation.
| | - Sergey Tkachenko
- Russian Medical Academy of Сontinuous Professional Education of the Ministry of Health of the Russian Federation, Moscow, Russian Federation.
| | - Natasa Teovska Mitrevska
- Remedika general hospital dermatology department, Skopje Republic of North Macedonia; International Balkan University (IBU), Skopje Republic of North Macedonia.
| | - Dragan Mijakoski
- Institute of Occupational health of RNM-Skopje, Republic of North Macedonia; Faculty of Medicine, SS Cyril and Methodius, University in Skopje, Skopje Republic of North Macedonia.
| | - Sasho Stoleski
- Institute of Occupational health of RNM-Skopje, Republic of North Macedonia; Faculty of Medicine, SS Cyril and Methodius, University in Skopje, Skopje Republic of North Macedonia.
| | - Marta Kolacinska-Flont
- Department of Internal Medicine, Asthma and Allergy, Barlicki Memorial Hospital, Medical University of Lodz, Poland.
| | - Izabela Kuprys-Lipinska
- Department of Internal Medicine, Asthma and Allergy, Barlicki Memorial Hospital, Medical University of Lodz, Poland.
| | - Joanna Molinska
- Department of Internal Medicine, Asthma and Allergy, Medical University of Lodz, Poland.
| | - Alicja Kasperska-Zając
- European Center for Diagnosis and Treatment of Urticaria/Angioedema (GA2LEN UCARE /ACARE Network) & Department of Clinical Allergology and Urticaria of Medical University of Silesia, Poland.
| | - Magdalena Zajac
- European Center for Diagnosis and Treatment of Urticaria/Angioedema (GA2LEN UCARE /ACARE Network) & Department of Clinical Allergology and Urticaria of Medical University of Silesia, Poland.
| | - Mateusz Zamlynski
- European Center for Diagnosis and Treatment of Urticaria/Angioedema (GA2LEN UCARE /ACARE Network) & Department of Clinical Allergology and Urticaria of Medical University of Silesia, Poland.
| | | | | | - Anna Zalewska-Janowska
- Medical University of Lodz, Chair of Clinical Immunology and Rheumatology, Department of Psychodermatology, Lodz, Poland.
| | - Katarzyna Tomaszewska
- Medical University of Lodz, Chair of Clinical Immunology and Rheumatology, Department of Psychodermatology, Lodz, Poland.
| | - Mona Al-Ahmad
- Microbiology Department, College of Medicine, Kuwait University, Kuwait.
| | - Maryam Ali Al-Nesf
- Allergy and Immunology Division, Medicine Department, Hamad Medical Corporation, Doha, Qatar.
| | - Tayseer Ibrahim
- Allergy and Immunology Division, Medicine department, Hamad Medical Corporation, Doha, Qatar.
| | - Sami Aqel
- Allergy and Immunology Division, Medicine department, Hamad Medical Corporation, Doha, Qatar.
| | - David Pesqué
- Department of Dermatology, Hospital del Mar, Barcelona, Spain; Universitat Autònoma de Barcelona (UAB). Barcelona (Spain).
| | | | | | - German D Ramon
- Instituto de Alergia e Inmunologia del Sur, Bahia Blanca, Argentina, GA2LEN Ucare/Adcare/Acare center.
| | - Gonzalo N Ramon
- Instituto de Alergia e Inmunologia del Sur, Bahia Blanca, Argentina, GA2LEN Ucare/Adcare/Acare center.
| | - Sophia Neisinger
- Charité - Universitätsmedizin Berlin, Institute of Allergology, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany.
| | - Hanna Bonnekoh
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany.
| | - Maia Rukhadze
- Center Allergy&Immunology, Tbilisi, Georgia / Geomedi Teaching University, Faculty of Medicine, Tbilisi, Georgia.
| | - Maryam Khoshkhui
- Allergy Research Center, Mashhad University of Medical Science(MUMS), Mashhad, Iran.
| | - Daria Fomina
- Moscow Practical and Research Center of Allergy and Immunology, Clinical City Hospital, Moscow, Russian Federation; Moscow Department of Clinical Immunology and Allergology, Sechenov First Moscow State Medical University, Astana Medical University, Moscow, Russian Federation.
| | | | - Mitja Košnik
- University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia; Medical Faculty, University of Ljubljana, Slovenia.
| | - Rabia Oztas Kara
- Department of Dermatology, Sakarya University Faculty of Medicine, Sakarya, Turkey.
| | | | - Qiang Liu
- 2nd Hospital of Hebei Medical University, Shijiazhuang City, Hebei Province, China.
| | | | - Luis Felipe Ensina
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo and CPAlpha Clinical Research Center., São Paulo, Brazil.
| | - Nelson Rosario
- Urticaria Center of Reference and Excellence (UCARE), Federal University of Parana, Rua General Carneiro, Curitiba, Brazil.
| | - Violeta Kvedariene
- Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania; Institute of Clinical Medicine, Clinic of Chest diseases, Immunology and Allergology, Faculty of Medicine, Vilnius, Lithuania.
| | - Moshe Ben-Shoshan
- Division of Allergy, Immunology and Dermatology, Department of Pediatrics, McGill University Health Center, Montreal, QC, Canada.
| | | | - Andrea Bauer
- Department of Dermatology, University Allergy Center, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany.
| | - Annia Cherrez
- Department of Dermatology, Venerology, and Allergology, Charité Universitätsmedizin Berlin.
| | - Sofia Cherrez
- Gemeinschaftspraxis PD Dr. Jung & Kollegen, Krämpferstr. 6, Erfurt.
| | - Herberto Chong-Neto
- Department of Pediatrics, Hospital de Clínicas, Federal University of Paraná (UFPR), Curitiba, Brazil.
| | | | - Michael Rudenko
- London Allergy and Immunology Centre, London United Kingdom.
| | | | - Aleksandra Lesiak
- Department of Dermatology, Pediatric Dermatology and Dermatological Oncology, Medical University of Lodz, Poland.
| | - Edgar Matos
- Instituto Nacional de Salud del Nino, Lima, Peru.
| | | | | | | | | | - Marco Faytong-Haro
- Sociology and Demography Department, The Pennsylvania State University, University Park, PA, USA; Ecuadorian Development Research Lab, Daule, Guayas, Ecuador; Universidad Espíritu Santo, Samborondon, Ecuador; Respiralab Research Group, Guayaquil, Ecuador.
| | - Karla Robles-Velasco
- Universidad Espíritu Santo, Samborondon, Ecuador; Respiralab Research Group, Guayaquil, Ecuador.
| | - Torsten Zuberbier
- Charité - Universitätsmedizin Berlin, Institute of Allergology, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany.
| | - Marcus Maurer
- Charité - Universitätsmedizin Berlin, Institute of Allergology, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany.
| |
Collapse
|
|
2
|
Cherrez-Ojeda I, Bousquet J, Giménez-Arnau A, Godse K, Krasowska D, Bartosińska J, Szczepanik-Kułak P, Wawrzycki B, Kolkhir P, Allenova A, Allenov A, Tkachenko S, Teovska Mitrevska N, Mijakoski D, Stoleski S, Kolacinska-Flont M, Kuprys-Lipinska I, Molinska J, Kasperska-Zając A, Zajac M, Zamlynski M, Mihaltan F, Ulmeanu R, Zalewska-Janowska A, Tomaszewska K, Al-Ahmad M, Al-Nesf MA, Ibrahim T, Aqel S, Pesqué D, Rodríguez-González M, Wakida-Kuzunoki GH, Ramon GD, Ramon GN, Neisinger S, Bonnekoh H, Rukhadze M, Khoshkhui M, Fomina D, Larenas-Linnemann D, Košnik M, Oztas Kara R, Caballero López CG, Liu Q, Ivancevich Juan C, Ensina LF, Rosario N, Kvedariene V, Ben-Shoshan M, Criado RFJ, Bauer A, Cherrez A, Chong-Neto H, Rojo-Gutierrez MI, Rudenko M, Larco Sousa JI, Lesiak A, Matos E, Muñoz N, Tinoco I, Moreno J, Crespo Shijin C, Hinostroza Logroño R, Sagñay JC, Faytong-Haro M, Robles-Velasco K, Zuberbier T, Maurer M. Patient-Reported Outcome Measures in Atopic Dermatitis and Chronic Urticaria are Underused in Clinical Practice. J Allergy Clin Immunol Pract 2024:S2213-2198(24)00349-0. [PMID: 38604531 DOI: 10.1016/j.jaip.2024.03.050] [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] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) are validated and standardized tools that complement physician evaluations and guide treatment decisions. PROMs are crucial for monitoring atopic dermatitis (AD) and chronic urticaria (CU) in clinical practice, but there are unmet needs and knowledge gaps regarding their use in clinical practice. OBJECTIVE We investigated the global real-world use of AD and CU PROMs in allergology and dermatology clinics as well as their associated local and regional networks. METHODS Across 72 specialized allergy and dermatology centers and their local and regional networks, 2,534 physicians in 73 countries completed a 53-item questionnaire on the use of PROMs for AD and CU. RESULTS Of 2,534 physicians, 1,308 were aware of PROMs. Of these, 14% and 15% used PROMs for AD and CU, respectively. Half of physicians who use PROMs do so only "rarely" or "sometimes". AD and CU PROM usage is associated with being female, younger, and a dermatologist. POSCORAD and UAS were the most utilized PROMs for AD and CU, respectively. Monitoring disease control and activity are the main drivers of the use of PROMs. Time constraints were the primary obstacle to using PROMs, followed by the impression that patients dislike PROMs. AD and CU PROM users would like training in selecting the proper PROM. CONCLUSION Even though PROMs offer several benefits, their use in routine practice is suboptimal, and physicians perceive barriers to their use. It is essential to attain higher levels of PROM implementation in accordance with national and international standards.
Collapse
Affiliation(s)
- Ivan Cherrez-Ojeda
- Universidad de Especialidades Espíritu Santo, School of Medicine, Samborondón, Ecuador; RespiraLab, Research, Guayaquil, Ecuador.
| | - Jean Bousquet
- Charité - Universitätsmedizin Berlin, Institute of Allergology, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany.
| | - Ana Giménez-Arnau
- Department of Dermatology, Hospital del Mar, IMIM, Universitat Pompeu Fabra, Barcelona, Spain.
| | - Kiran Godse
- Department of Dermatology, D Y. Patil University School of Medicine, Mumbai, India.
| | - Dorota Krasowska
- Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland.
| | - Joanna Bartosińska
- Department of Cosmetology and Aestetic Medicine Medical University of Lublin Poland; Department of Dermatology, Venereology and Pediatric Dermatology Medical University of Lublin, Poland.
| | - Paulina Szczepanik-Kułak
- Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland.
| | - Bartłomiej Wawrzycki
- Department of Dermatology, Venereology and Pediatric Dermatology, Medical University of Lublin, Lublin, Poland.
| | - Pavel Kolkhir
- Charité - Universitätsmedizin Berlin, Institute of Allergology, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany.
| | - Anastasiia Allenova
- Laboratory of Immune-mediated skin diseases, Institute of Regenerative Medicine, Biomedical Science & Technology Park, I.M. Sechenov First Moscow State Medical University (SechenovUniversity), Moscow, Russian Federation; Medical Research and Education Center, M.V. Lomonosov Moscow State University, Moscow, Russian Federation.
| | - Andrey Allenov
- Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation; State Budgetary Healthcare Institution of the City of Moscow "City Polyclinic No. 2 10 of the Department of Health of the City of Moscow", Moscow, Russian Federation; Federal State Budgetary Scientific Institution "N.A. Semashko National Research Institute of Public Health", Moscow, Russian Federation.
| | - Sergey Tkachenko
- Russian Medical Academy of Сontinuous Professional Education of the Ministry of Health of the Russian Federation, Moscow, Russian Federation.
| | - Natasa Teovska Mitrevska
- Remedika general hospital dermatology department, Skopje Republic of North Macedonia; International Balkan University (IBU), Skopje Republic of North Macedonia.
| | - Dragan Mijakoski
- Institute of Occupational health of RNM-Skopje, Republic of North Macedonia; Faculty of Medicine, SS Cyril and Methodius, University in Skopje, Skopje Republic of North Macedonia.
| | - Sasho Stoleski
- Institute of Occupational health of RNM-Skopje, Republic of North Macedonia; Faculty of Medicine, SS Cyril and Methodius, University in Skopje, Skopje Republic of North Macedonia.
| | - Marta Kolacinska-Flont
- Department of Internal Medicine, Asthma and Allergy, Barlicki Memorial Hospital, Medical University of Lodz, Poland.
| | - Izabela Kuprys-Lipinska
- Department of Internal Medicine, Asthma and Allergy, Barlicki Memorial Hospital, Medical University of Lodz, Poland.
| | - Joanna Molinska
- Department of Internal Medicine, Asthma and Allergy, Medical University of Lodz, Poland.
| | - Alicja Kasperska-Zając
- European Center for Diagnosis and Treatment of Urticaria/Angioedema (GA2LEN UCARE /ACARE Network) & Department of Clinical Allergology and Urticaria of Medical University of Silesia, Poland.
| | - Magdalena Zajac
- European Center for Diagnosis and Treatment of Urticaria/Angioedema (GA2LEN UCARE /ACARE Network) & Department of Clinical Allergology and Urticaria of Medical University of Silesia, Poland.
| | - Mateusz Zamlynski
- European Center for Diagnosis and Treatment of Urticaria/Angioedema (GA2LEN UCARE /ACARE Network) & Department of Clinical Allergology and Urticaria of Medical University of Silesia, Poland.
| | | | | | - Anna Zalewska-Janowska
- Medical University of Lodz, Chair of Clinical Immunology and Rheumatology, Department of Psychodermatology, Lodz, Poland.
| | - Katarzyna Tomaszewska
- Medical University of Lodz, Chair of Clinical Immunology and Rheumatology, Department of Psychodermatology, Lodz, Poland.
| | - Mona Al-Ahmad
- Microbiology Department, Faculty of Medicine, Kuwait University, Safat, Kuwait.
| | - Maryam Ali Al-Nesf
- Allergy and Immunology Division, Medicine Department, Hamad Medical Corporation, Doha, Qatar.
| | - Tayseer Ibrahim
- Allergy and Immunology Division, Medicine department, Hamad Medical Corporation, Doha, Qatar.
| | - Sami Aqel
- Allergy and Immunology Division, Medicine department, Hamad Medical Corporation, Doha, Qatar.
| | - David Pesqué
- Department of Dermatology, Hospital del Mar, Barcelona, Spain; Universitat Autònoma de Barcelona (UAB). Barcelona (Spain).
| | | | | | - German D Ramon
- Instituto de Alergia e Inmunologia del Sur, Bahia Blanca, Argentina, GA2LEN Ucare/Adcare/Acare center.
| | - Gonzalo N Ramon
- Instituto de Alergia e Inmunologia del Sur, Bahia Blanca, Argentina, GA2LEN Ucare/Adcare/Acare center.
| | - Sophia Neisinger
- Charité - Universitätsmedizin Berlin, Institute of Allergology, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany.
| | - Hanna Bonnekoh
- Charité - Universitätsmedizin Berlin, Institute of Allergology, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany.
| | - Maia Rukhadze
- Center Allergy&Immunology, Tbilisi, Georgia / Geomedi Teaching University, Faculty of Medicine, Tbilisi, Georgia.
| | - Maryam Khoshkhui
- Allergy Research Center, Mashhad University of Medical Science(MUMS), Mashhad, Iran.
| | - Daria Fomina
- Moscow Practical and Research Center of Allergy and Immunology, Clinical City Hospital, Moscow, Russian Federation; Moscow Department of Clinical Immunology and Allergology, Sechenov First Moscow State Medical University, Astana Medical University, Moscow, Russian Federation.
| | | | - Mitja Košnik
- Allergy University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia Medical Faculty, University of Ljubljana, Slovenia.
| | - Rabia Oztas Kara
- Department of Dermatology, Sakarya University Faculty of Medicine, Sakarya, Turkey.
| | | | - Qiang Liu
- 2nd Hospital of Hebei Medical University, Shijiazhuang City, Hebei Province, China.
| | | | - Luis Felipe Ensina
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo and CPAlpha Clinical Research Center., São Paulo, Brazil.
| | - Nelson Rosario
- Urticaria Center of Reference and Excellence (UCARE), Federal University of Parana, Rua General Carneiro, Curitiba, Brazil.
| | - Violeta Kvedariene
- Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania; Institute of Clinical Medicine, Clinic of Chest diseases, Immunology and Allergology, Faculty of Medicine, Vilnius, Lithuania.
| | - Moshe Ben-Shoshan
- Division of Allergy, Immunology and Dermatology, Department of Pediatrics, McGill University Health Center, Montreal, QC, Canada.
| | | | - Andrea Bauer
- Department of Dermatology, University Allergy Center, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany.
| | - Annia Cherrez
- Department of Dermatology and Allergy, Charité- Universitätsmedizin Berlin, Berlin, Germany.
| | - Herberto Chong-Neto
- Department of Pediatrics, Hospital de Clínicas, Federal University of Paraná (UFPR), Curitiba, Brazil.
| | | | - Michael Rudenko
- London Allergy and Immunology Centre, London United Kingdom.
| | | | - Aleksandra Lesiak
- Department of Dermatology, Pediatric Dermatology and Dermatological Oncology, Medical University of Lodz, Poland.
| | - Edgar Matos
- Instituto Nacional de Salud del Nino, Lima, Peru.
| | - Nelson Muñoz
- Specialist Centre: Muñoz Alergias y Pediatría, Riobamba - Ecuador.
| | | | | | | | | | | | - Marco Faytong-Haro
- Sociology and Demography Department, The Pennsylvania State University, University Park, PA, USA; Ecuadorian Development Research Lab, Daule, Guayas, Ecuador; Universidad Espíritu Santo, Samborondon, Ecuador; Respiralab Research Group, Guayaquil, Ecuador.
| | - Karla Robles-Velasco
- Universidad Espíritu Santo, Samborondon, Ecuador; Respiralab Research Group, Guayaquil, Ecuador.
| | - Torsten Zuberbier
- Charité - Universitätsmedizin Berlin, Institute of Allergology, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany.
| | - Marcus Maurer
- Charité - Universitätsmedizin Berlin, Institute of Allergology, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany.
| |
Collapse
|