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Chen CC, Buchheit KM, Lee PY, Brodeur KE, Sohail A, Cho L, Baloh C, Balestrieri B, Derakhshan M, Feng C, Boyce JA, Dwyer D, Laidlaw TM. IL-4Rα signaling promotes barrier-altering oncostatin M and IL-6 production in aspirin-exacerbated respiratory disease. J Allergy Clin Immunol 2024:S0091-6749(24)00453-6. [PMID: 38704098 DOI: 10.1016/j.jaci.2024.04.020] [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: 01/31/2024] [Revised: 04/02/2024] [Accepted: 04/16/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Aspirin-exacerbated respiratory disease (AERD) is a severe disease involving dysregulated type 2 inflammation. However, the role other inflammatory pathways play in AERD is poorly understood. OBJECTIVE We sought to broadly define the inflammatory milieu of the upper respiratory tract in AERD and to determine the effects of IL-4Rα inhibition on mediators of nasal inflammation. METHODS Twenty-two AERD patients treated with dupilumab for 3 months were followed over 3 visits and compared to 10 healthy controls. Nasal fluid was assessed for 45 cytokines and chemokines using Olink Target 48. Blood neutrophils and cultured human mast cells, monocytes/macrophages, and nasal fibroblasts were assessed for response to IL-4/13 stimulation in vitro. RESULTS Of the nasal fluid cytokines measured, nearly one-third were higher in AERD patients compared to healthy controls, including IL-6 and the IL-6 family-related cytokine oncostatin M (OSM), both of which correlated with nasal albumin levels, a marker of epithelial barrier dysregulation. Dupilumab significantly decreased many nasal mediators, including OSM and IL-6. IL-4 stimulation induced OSM production from mast cells and macrophages, but not from neutrophils, and OSM and IL-13 stimulation induced IL-6 production from nasal fibroblasts. CONCLUSION In addition to type 2 inflammation, innate and IL-6-related cytokines are also elevated in the respiratory tract in AERD. Both OSM and IL-6 are locally produced in nasal polyps and likely promote pathology by negatively affecting epithelial barrier function. IL-4Rα blockade, though seemingly directed at type 2 inflammation, also decreases mediators of innate inflammation and epithelial dysregulation, which may contribute to dupilumab's therapeutic efficacy in AERD.
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Affiliation(s)
- Chongjia C Chen
- Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts;.
| | - Kathleen M Buchheit
- Department of Medicine, Harvard Medical School, the Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Pui Y Lee
- Division of Immunology, Boston Children's Hospital, Boston, Massachusetts
| | - Kailey E Brodeur
- Division of Immunology, Boston Children's Hospital, Boston, Massachusetts
| | - Aaqib Sohail
- Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Laura Cho
- Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Carolyn Baloh
- Department of Medicine, Harvard Medical School, the Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Barbara Balestrieri
- Department of Medicine, Harvard Medical School, the Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Mina Derakhshan
- Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Chunli Feng
- Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Joshua A Boyce
- Department of Medicine, Harvard Medical School, the Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Daniel Dwyer
- Department of Medicine, Harvard Medical School, the Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Tanya M Laidlaw
- Department of Medicine, Harvard Medical School, the Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Massachusetts
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Calise J, DeBerg H, Garabatos N, Khosa S, Bajzik V, Calderon LB, Aldridge K, Rosasco M, Ferslew BC, Zhu T, Smulders R, Wheatley LM, Laidlaw TM, Qin T, Chichili GR, Adelman DC, Farrington M, Robinson D, Jeong D, Jones SM, Sanda S, Larson D, Kwok WW, Baloh C, Nepom GT, Wambre E. Distinct trajectories distinguish antigen-specific T cells in peanut-allergic individuals undergoing oral immunotherapy. J Allergy Clin Immunol 2023; 152:155-166.e9. [PMID: 37003475 PMCID: PMC10330178 DOI: 10.1016/j.jaci.2023.03.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 02/22/2023] [Accepted: 03/07/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Despite similar clinical symptoms, peanut-allergic (PA) individuals may respond quite differently to the same therapeutic interventions. OBJECTIVE This study aimed to determine whether inherent qualities of cell response at baseline could influence response to peanut oral immunotherapy (PnOIT). METHODS We first performed ex vivo T-cell profiling on peanut-reactive CD154+CD137+ T (pTeff) cells from 90 challenge-confirmed PA individuals. We developed a gating strategy for unbiased assessment of the phenotypic distribution of rare pTeff cells across different memory CD4+ T-cell subsets to define patient immunotype. In longitudinal samples of 29 PA participants enrolled onto the IMPACT trial of PnOIT, we determined whether patient immunotype at baseline could influence response to PnOIT. RESULTS Our data emphasize the heterogeneity of pTeff cell responses in PA participants with 2 mutually exclusive phenotypic entities (CCR6-CRTH2+ and CCR6+CRTH2-). Our findings lead us to propose that peanut allergy can be classified broadly into at least 2 discrete subtypes, termed immunotypes, with distinct immunologic and clinical characteristics that are based on the proportion of TH2A pTeff cells. PnOIT induced elimination of TH2A pTeff cells in the context of the IMPACT clinical trial. Only 1 PA patient with a low level of TH2A pTeff cells at baseline experienced long-lasting benefit of remission after PnOIT discontinuation. CONCLUSION Dividing PA patients according to their individual peanut-specific T-cell profile may facilitate patient stratification in clinical settings by identifying which immunotypes might respond best to different therapies.
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Affiliation(s)
- Justine Calise
- Translational Immunology, Benaroya Research Institute at Virginia Mason, Seattle, Wash
| | - Hannah DeBerg
- Systems Immunology, Benaroya Research Institute at Virginia Mason, Seattle, Wash
| | - Nahir Garabatos
- Translational Immunology, Benaroya Research Institute at Virginia Mason, Seattle, Wash
| | - Sugandhika Khosa
- Translational Immunology, Benaroya Research Institute at Virginia Mason, Seattle, Wash
| | - Veronique Bajzik
- Translational Immunology, Benaroya Research Institute at Virginia Mason, Seattle, Wash
| | | | - Kelly Aldridge
- Translational Immunology, Benaroya Research Institute at Virginia Mason, Seattle, Wash
| | - Mario Rosasco
- Systems Immunology, Benaroya Research Institute at Virginia Mason, Seattle, Wash
| | | | - Tong Zhu
- Astellas Pharma Global Development Inc, Northbrook, Ill
| | | | - Lisa M Wheatley
- National Institute of Allergy and Infectious Diseases, Bethesda, Md
| | - Tanya M Laidlaw
- Immune Tolerance Network, Benaroya Research Institute at Virginia Mason, Seattle, Wash; Department of Medicine, Harvard Medical School, Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Mass
| | - Tielin Qin
- Immune Tolerance Network, Benaroya Research Institute at Virginia Mason, Seattle, Wash
| | | | | | | | | | - David Jeong
- Virginia Mason Medical Center, Seattle, Wash
| | - Stacie M Jones
- Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, Ark
| | - Srinath Sanda
- Immune Tolerance Network, UCSF Diabetes Center & UCSF School of Medicine, San Francisco, Calif
| | - David Larson
- Immune Tolerance Network, Benaroya Research Institute at Virginia Mason, Seattle, Wash
| | - William W Kwok
- Translational Immunology, Benaroya Research Institute at Virginia Mason, Seattle, Wash
| | - Carolyn Baloh
- Immune Tolerance Network, Benaroya Research Institute at Virginia Mason, Seattle, Wash; Department of Medicine, Harvard Medical School, Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Mass
| | - Gerald T Nepom
- Immune Tolerance Network, Benaroya Research Institute at Virginia Mason, Seattle, Wash
| | - Erik Wambre
- Translational Immunology, Benaroya Research Institute at Virginia Mason, Seattle, Wash.
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Smeekens JM, Baloh C, Lim N, Larson D, Qin T, Wheatley L, Kim EH, Jones SM, Burks AW, Kulis MD. Peanut-Specific IgG4 and IgA in Saliva Are Modulated by Peanut Oral Immunotherapy. J Allergy Clin Immunol Pract 2022; 10:3270-3275. [PMID: 35944894 PMCID: PMC9742136 DOI: 10.1016/j.jaip.2022.07.030] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/07/2022] [Accepted: 07/27/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Antigen-specific immunoglobulin responses have yet to be studied at the oral mucosal surface during peanut oral immunotherapy (PnOIT). OBJECTIVE We aimed to quantify salivary peanut-specific IgG4 (PNsIgG4) and IgA (PNsIgA) and total IgG4 and IgA in participants from the Immune Tolerance Network's IMPACT study, a phase 2 PnOIT trial. METHODS Peanut-allergic children, aged 12 months to younger than 48 months at screening, were enrolled and randomized to PnOIT or placebo oral immunotherapy (OIT) for 134 weeks. Per-protocol analysis included 69 PnOIT and 23 placebo participants. Double-blind, placebo-controlled food challenges were conducted at weeks 134 and 160 to assess desensitization and remission, respectively. Saliva samples were collected at baseline and 30, 82, 134, and 160 weeks to quantify PNsIgG4, PNsIgA, and total IgG4 and IgA. RESULTS Participants who received PnOIT experienced significant increases in PNsIgG4 in saliva, whereas participants on placebo did not (P < .01 at all time points). The PNsIgA/total IgA ratio was also significantly increased in participants treated with PnOIT when compared with those receiving placebo at 30 and 82 weeks (P < .05). During PnOIT, desensitized participants had increased PNsIgA that plateaued, whereas the not desensitized/no remission group did not change over time. Interestingly, when the PnOIT group was evaluated by clinical outcome, PNsIgA was higher at baseline in the not desensitized/no remission group than in the desensitized/remission group (P < .05). CONCLUSIONS PnOIT induces substantial increases in allergen-specific IgG4 and IgA in saliva. These data provide insight into OIT-induced mucosal responses and suggest the utility of these easily obtained samples for biomarker development.
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Affiliation(s)
- Johanna M Smeekens
- Department of Pediatrics, Division of Allergy and Immunology, UNC School of Medicine, Chapel Hill, NC; UNC Food Allergy Initiative, Department of Pediatrics, UNC School of Medicine, Chapel Hill, NC
| | | | - Noha Lim
- Immune Tolerance Network, Bethesda, Md
| | | | | | - Lisa Wheatley
- National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health, Bethesda, Md
| | - Edwin H Kim
- Department of Pediatrics, Division of Allergy and Immunology, UNC School of Medicine, Chapel Hill, NC; UNC Food Allergy Initiative, Department of Pediatrics, UNC School of Medicine, Chapel Hill, NC
| | - Stacie M Jones
- Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, Ark
| | - A Wesley Burks
- Department of Pediatrics, Division of Allergy and Immunology, UNC School of Medicine, Chapel Hill, NC; UNC Food Allergy Initiative, Department of Pediatrics, UNC School of Medicine, Chapel Hill, NC
| | - Michael D Kulis
- Department of Pediatrics, Division of Allergy and Immunology, UNC School of Medicine, Chapel Hill, NC; UNC Food Allergy Initiative, Department of Pediatrics, UNC School of Medicine, Chapel Hill, NC.
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Huffaker MF, Kanchan K, Bahnson HT, Ruczinski I, Shankar G, Leung DYM, Baloh C, Du Toit G, Lack G, Nepom GT, Mathias RA. Epidermal Differentiation Complex Genetic Variation in Atopic Dermatitis and Peanut Allergy. J Allergy Clin Immunol 2022; 151:1137-1142.e4. [PMID: 36403663 DOI: 10.1016/j.jaci.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Deleterious variation in the epidermal differentiation complex (EDC) on chromosome 1 is a well-known genetic determinant of atopic dermatitis (AD) and has been associated with risk of peanut allergy (PA) in population-based studies. OBJECTIVE Our aim was to determine the effect of genetic variation in the EDC on AD trajectory and risk of PA in early life. METHODS Genome sequencing was used to measure genetic variation in the EDC in the Learning Early about Peanut Allergy (LEAP) study participants. Association tests were done to identify gene- and variant-level predicted deleterious variation associated with AD severity by using the Scoring Atopic Dermatitis (SCORAD) tool (n = 559) at baseline and each follow-up visit, as well as PA and food allergy in peanut avoiders (n = 275). Predicted deleterious variants included missense variants that were frameshift insertions, frameshift deletions, stop-gain mutations, or stop-loss mutations. Associations between variant load, SCORAD score, and PA were tested by using linear and generalized linear regression models. RESULTS The genes FLG, FLG2, HRNR, and TCHH1 harbored the most predicted deleterious variation (30, 6, 3, and 1 variant, respectively). FLG variants were associated with SCORAD score at all time points; 4 variants (R1798X, R501X, S126X, and S761fs) drove the association with SCORAD score at each time point, and higher variant load was associated with greater AD severity over time. There was an association between these variants and PA, which remained significant independent of baseline AD severity (odds ratio = 2.63 [95% CI = 1.11-6.01] [P = .02]). CONCLUSIONS Variation in FLG predicted to be deleterious is associated with AD severity at baseline and longitudinally and has an association with PA independent of baseline severity.
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Affiliation(s)
| | - Kanika Kanchan
- Division of Allergy and Clinical Immunology, Department of Medicine, School of Medicine, Baltimore, Md
| | - Henry T Bahnson
- Immune Tolerance Network, Seattle, Wash; Benaroya Research Institute at Virginia Mason, Seattle, Wash
| | - Ingo Ruczinski
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Md
| | - Gautam Shankar
- Division of Allergy and Clinical Immunology, Department of Medicine, School of Medicine, Baltimore, Md
| | - Donald Y M Leung
- Division of Pediatric Allergy and Immunology, National Jewish Health, Denver, Colo
| | - Carolyn Baloh
- Immune Tolerance Network, San Francisco, Calif; Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Mass
| | - George Du Toit
- Department of Pediatric Allergy, Division of Asthma, Allergy and Lung Biology, King's College London, and Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Gideon Lack
- Department of Pediatric Allergy, Division of Asthma, Allergy and Lung Biology, King's College London, and Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Gerald T Nepom
- Immune Tolerance Network, Seattle, Wash; Benaroya Research Institute at Virginia Mason, Seattle, Wash
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Foong RX, Du Toit G, Bahnson H, Huffaker M, Baloh C, van Ree R, Roberts G, Lack G. The kinetics of peanut allergy development and resolution in the EAT, LEAP, and PAS cohorts. J Allergy Clin Immunol 2022. [DOI: 10.1016/j.jaci.2021.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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6
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Huffaker M, Kanchan K, Bahnson H, Ruczinski I, Shankar G, Leung D, Baloh C, Du Toit G, Lack G, Nepom G, Mathias R. Multiple FLG variants drive eczema severity in the LEAP study participants. J Allergy Clin Immunol 2022. [DOI: 10.1016/j.jaci.2021.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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7
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Shingleton J, Wang J, Baloh C, Dave T, Davis N, Happ L, Jadi O, Kositsky R, Li X, Love C, Panea R, Qin Q, Reddy A, Singhi N, Smith E, Thakkar D, Dave SS. Non-Hodgkin Lymphomas: Malignancies Arising from Mature B Cells. Cold Spring Harb Perspect Med 2021; 11:cshperspect.a034843. [PMID: 32152246 PMCID: PMC7919396 DOI: 10.1101/cshperspect.a034843] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Non-Hodgkin lymphomas (NHLs) are a diverse group of entities, both clinically and molecularly. Here, we review the evolution of classification schemes in B-cell lymphoma, noting the now standard WHO classification system that is based on immune cell-of-origin and molecular phenotypes. We review how lymphomas arise throughout the B-cell development process as well as the molecular and clinical features of prominent B-cell lymphomas. We provide an overview of the major progress that has occurred over the past decade in terms of our molecular understanding of these diseases. We discuss treatment options available and focus on a number of the diverse research tools that have been employed to improve our understanding of these diseases. We discuss the problem of heterogeneity in lymphomas and anticipate that the near future will bring significant advances that provide a measurable impact on NHL outcomes.
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Affiliation(s)
- Jennifer Shingleton
- Department of Medicine and Center for Genomic and Computational Biology, Duke Cancer Institute, Duke University, Durham, North Carolina 27707, USA
| | - Jie Wang
- Department of Medicine and Center for Genomic and Computational Biology, Duke Cancer Institute, Duke University, Durham, North Carolina 27707, USA
| | - Carolyn Baloh
- Department of Medicine and Center for Genomic and Computational Biology, Duke Cancer Institute, Duke University, Durham, North Carolina 27707, USA
| | - Tushar Dave
- Department of Medicine and Center for Genomic and Computational Biology, Duke Cancer Institute, Duke University, Durham, North Carolina 27707, USA
| | - Nicholas Davis
- Department of Medicine and Center for Genomic and Computational Biology, Duke Cancer Institute, Duke University, Durham, North Carolina 27707, USA
| | - Lanie Happ
- Department of Medicine and Center for Genomic and Computational Biology, Duke Cancer Institute, Duke University, Durham, North Carolina 27707, USA
| | - Othmane Jadi
- Department of Medicine and Center for Genomic and Computational Biology, Duke Cancer Institute, Duke University, Durham, North Carolina 27707, USA
| | - Rachel Kositsky
- Department of Medicine and Center for Genomic and Computational Biology, Duke Cancer Institute, Duke University, Durham, North Carolina 27707, USA
| | - Xiang Li
- Department of Medicine and Center for Genomic and Computational Biology, Duke Cancer Institute, Duke University, Durham, North Carolina 27707, USA
| | - Cassandra Love
- Department of Medicine and Center for Genomic and Computational Biology, Duke Cancer Institute, Duke University, Durham, North Carolina 27707, USA
| | - Razvan Panea
- Department of Medicine and Center for Genomic and Computational Biology, Duke Cancer Institute, Duke University, Durham, North Carolina 27707, USA
| | - Qiu Qin
- Department of Medicine and Center for Genomic and Computational Biology, Duke Cancer Institute, Duke University, Durham, North Carolina 27707, USA
| | - Anupama Reddy
- Department of Medicine and Center for Genomic and Computational Biology, Duke Cancer Institute, Duke University, Durham, North Carolina 27707, USA
| | - Naina Singhi
- Department of Medicine and Center for Genomic and Computational Biology, Duke Cancer Institute, Duke University, Durham, North Carolina 27707, USA
| | - Eileen Smith
- Department of Medicine and Center for Genomic and Computational Biology, Duke Cancer Institute, Duke University, Durham, North Carolina 27707, USA
| | - Devang Thakkar
- Department of Medicine and Center for Genomic and Computational Biology, Duke Cancer Institute, Duke University, Durham, North Carolina 27707, USA
| | - Sandeep S. Dave
- Department of Medicine and Center for Genomic and Computational Biology, Duke Cancer Institute, Duke University, Durham, North Carolina 27707, USA
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Baloh C, Markert ML, Shashi V, Sleasman J. Predicting Autoimmunity Development in 22q11.2DS. J Allergy Clin Immunol 2020. [DOI: 10.1016/j.jaci.2019.12.679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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West LJ, Baloh C, Chong H, Larkin AS, Nash DR, Broyles J, Winger DG, Wang L, Green TD. Infant and Young Child Peanut Challenges, a Clinical Application of the Learning Early About Peanut Allergy Study. J Allergy Clin Immunol 2017. [DOI: 10.1016/j.jaci.2016.12.424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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