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Petrara MR, Bonfante F, Costenaro P, Cantarutti A, Carmona F, Ruffoni E, Di Chiara C, Zanchetta M, Barzon L, Donà D, Da Dalt L, Bortolami A, Pagliari M, Plebani M, Rossi P, Cotugno N, Palma P, Giaquinto C, De Rossi A. Asymptomatic and Mild SARS-CoV-2 Infections Elicit Lower Immune Activation and Higher Specific Neutralizing Antibodies in Children Than in Adults. Front Immunol 2021; 12:741796. [PMID: 34659235 PMCID: PMC8515185 DOI: 10.3389/fimmu.2021.741796] [Citation(s) in RCA: 18] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/10/2021] [Indexed: 12/24/2022] Open
Abstract
Background The immune response plays a pivotal role in dictating the clinical outcome in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected adults, but it is still poorly investigated in the pediatric population. Methods Of 209 enrolled subjects, 155 patients were confirmed by PCR and/or serology as having coronavirus disease 2019 (COVID-19). Blood samples were obtained at a median of 2.8 (interquartile, 2.1–3.7) and 6.1 (5.3–7.2) months after baseline (symptom onset and/or first positive virus detection). The immune profiles of activation, senescence, exhaustion, and regulatory cells were analyzed by flow cytometry. Neutralizing antibodies (nAbs) were detected by a plaque reduction neutralization test. In available nasopharyngeal swabs at baseline, SARS-CoV-2 levels were quantified by digital droplet PCR (ddPCR). Results Overall, COVID-19 patients had higher levels of immune activation, exhaustion, and regulatory cells compared to non-COVID-19 subjects. Within the COVID-19 group, activated and senescent cells were higher in adults than in children and inversely correlated with the nAbs levels. Conversely, Tregs and Bregs regulatory cells were higher in COVID-19 children compared to adults and positively correlated with nAbs. Higher immune activation still persisted in adults after 6 months of infection, while children maintained higher levels of regulatory cells. SARS-CoV-2 levels did not differ among age classes. Conclusions Adults displayed higher immune activation and lower production of anti-SARS-CoV-2 nAbs than children. The different immune response was not related to different viral load. The higher expression of regulatory cells in children may contribute to reduce the immune activation, thus leading to a greater specific response against the virus.
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Affiliation(s)
- Maria Raffaella Petrara
- Oncology and Immunology Section, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Francesco Bonfante
- Department of Comparative Biomedical Sciences, Istituto Zooprofilattico Sperimentale delle Venezie (IZSVe), Virology Laboratory, Legnaro, Italy
| | - Paola Costenaro
- Division of Pediatric Infectious Diseases, Department for Women's and Children's Health, University of Padova, Padova, Italy
| | - Anna Cantarutti
- Laboratory of Healthcare Research and Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milano, Italy
| | - Francesco Carmona
- Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Elena Ruffoni
- Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Costanza Di Chiara
- Division of Pediatric Infectious Diseases, Department for Women's and Children's Health, University of Padova, Padova, Italy
| | - Marisa Zanchetta
- Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - Luisa Barzon
- Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Daniele Donà
- Division of Pediatric Infectious Diseases, Department for Women's and Children's Health, University of Padova, Padova, Italy
| | - Liviana Da Dalt
- Division of Pediatric Infectious Diseases, Department for Women's and Children's Health, University of Padova, Padova, Italy
| | - Alessio Bortolami
- Department of Comparative Biomedical Sciences, Istituto Zooprofilattico Sperimentale delle Venezie (IZSVe), Virology Laboratory, Legnaro, Italy
| | - Matteo Pagliari
- Department of Comparative Biomedical Sciences, Istituto Zooprofilattico Sperimentale delle Venezie (IZSVe), Virology Laboratory, Legnaro, Italy
| | - Mario Plebani
- Department of Laboratory Medicine, University-Hospital of Padova, Padova, Italy.,Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Paolo Rossi
- Clinical and Research Unit of Clinical Immunology and Vaccinology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.,Chair of Pediatrics, Department of Systems Medicine, University of Rome "Tor Vergata", Roma, Italy
| | - Nicola Cotugno
- Clinical and Research Unit of Clinical Immunology and Vaccinology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.,Chair of Pediatrics, Department of Systems Medicine, University of Rome "Tor Vergata", Roma, Italy
| | - Paolo Palma
- Clinical and Research Unit of Clinical Immunology and Vaccinology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.,Chair of Pediatrics, Department of Systems Medicine, University of Rome "Tor Vergata", Roma, Italy
| | - Carlo Giaquinto
- Division of Pediatric Infectious Diseases, Department for Women's and Children's Health, University of Padova, Padova, Italy
| | - Anita De Rossi
- Oncology and Immunology Section, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.,Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
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2
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Affiliation(s)
- Holly Neale
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA; University of Massachusetts Medical School, Worcester, MA, USA
| | - Elena B Hawryluk
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Boston Children's Hospital, Boston, MA, USA.
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3
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Ouarradi AE, Chekhlabi N, Elharras M, Bensahi I, Oualim S, Merzouk F, Abdeladim S, Sabry M, Dini N. Acute pulmonary embolism in a child following SARS-CoV-2 infection: a case report. Pan Afr Med J 2021; 38:125. [PMID: 33912295 PMCID: PMC8051227 DOI: 10.11604/pamj.2021.38.125.27954] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 01/22/2021] [Indexed: 01/21/2023] Open
Abstract
In children, coronavirus disease 2019 infection is rarely symptomatic. Severe forms with respiratory distress are rare, thromboembolic complications are exceptional. We report a rare case of a 14 years old girl with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who was admitted to the hospital for bilateral pulmonary embolism with intracardiac thrombus. The girl progressed well on anticoagulation.
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Affiliation(s)
- Amal El Ouarradi
- Cardiology Department, Mohammed VI University of Health Sciences, Cheikh Khalifa Hospital, Casablanca, Morocco
| | - Nabila Chekhlabi
- Pediatrics Department, Mohammed VI University of Health Sciences, Cheikh Khalifa Hospital, Casablanca , Morocco
| | - Mahassine Elharras
- Cardiology Department, Mohammed VI University of Health Sciences, Cheikh Khalifa Hospital, Casablanca, Morocco
| | - Ilham Bensahi
- Cardiology Department, Mohammed VI University of Health Sciences, Cheikh Khalifa Hospital, Casablanca, Morocco
| | - Sara Oualim
- Cardiology Department, Mohammed VI University of Health Sciences, Cheikh Khalifa Hospital, Casablanca, Morocco
| | - Fatimazahr Merzouk
- Cardiology Department, Mohammed VI University of Health Sciences, Cheikh Khalifa Hospital, Casablanca, Morocco
| | - Salma Abdeladim
- Cardiology Department, Mohammed VI University of Health Sciences, Cheikh Khalifa Hospital, Casablanca, Morocco
| | - Mohammed Sabry
- Cardiology Department, Mohammed VI University of Health Sciences, Cheikh Khalifa Hospital, Casablanca, Morocco
| | - Nouzha Dini
- Pediatrics Department, Military University Hospital Center, Mohammed V University of Medicine of Rabat, Rabat, Morocco
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4
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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 DOI: 10.1101/2020.05.14.090332] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 05/20/2020] [Accepted: 05/25/2020] [Indexed: 05/19/2023]
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 Zurich, ETH 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 Hospital, The First Affiliated Hospital, Sun 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 Hospital, Capital Medical University and the Beijing Key Laboratory of Nasal Diseases, Beijing 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 Research, Oslo 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-T, Technical University of Munich and Helmholtz Zentrum Munchen, Augsburg, Germany
| | - Avidan U Neumann
- Chair and Institute of Environmental Medicine, UNIKA-T, Technical 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-T, Technical 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 Ireland, National 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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5
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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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