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Betancor D, Otal M, Olaguibel JM, Rodrigo-Muñoz JM, Alvarez Puebla JM, Arismendi E, Barranco P, Barroso B, Bobolea I, Cárdaba B, Cruz MJ, Curto E, Del Pozo V, Domínguez-Ortega J, González-Barcala FJ, Luna-Porta JA, Martínez-Rivera C, Mullol J, Muñoz X, Picado C, Plaza V, Quirce S, Rial MJ, Roibás-Veiga I, Soto-Retes L, Valero A, Valverde-Monge M, Sastre J. Global Lung Initiative as diagnostic criteria in Asthma-COPD overlap syndrome. Prevalence and characterization of the syndrome in a real-life asthma cohort. J Investig Allergol Clin Immunol 2023; 34:0. [PMID: 38131661 DOI: 10.18176/jiaci.0966] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Affiliation(s)
- D Betancor
- Servicio de Alergología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - M Otal
- Servicio de Alergología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - J M Olaguibel
- Servicio de Alergología, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - J M Rodrigo-Muñoz
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Inmunología, Instituto de Investigación Sanitaria del Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - J M Alvarez Puebla
- Servicio de Alergología, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - E Arismendi
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Pneumonology and Allergy Department, Hospital Clínic; Universitat de Barcelona, Barcelona, Spain
| | - P Barranco
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Alergia, Hospital Universitario La Paz, Madrid, Spain
| | - B Barroso
- Servicio de Alergología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - I Bobolea
- Servicio de Alergología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- Pneumonology and Allergy Department, Hospital Clínic; Universitat de Barcelona, Barcelona, Spain
| | - B Cárdaba
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Inmunología, Instituto de Investigación Sanitaria del Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - M J Cruz
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Departamento de Biología Celular, Fisiología e Inmunología, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - E Curto
- Servicio de Neumologia y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - V Del Pozo
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Inmunología, Instituto de Investigación Sanitaria del Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - J Domínguez-Ortega
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Alergia, Hospital Universitario La Paz, Madrid, Spain
| | - F J González-Barcala
- Department of Respiratory Medicine, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - J A Luna-Porta
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Alergia, Hospital Universitario La Paz, Madrid, Spain
| | - C Martínez-Rivera
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Neumología, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - J Mullol
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Rhinology Unit & Smell Clinic, ENT Department; Universitat de Barcelona. Barcelona, Spain
| | - X Muñoz
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Neumología, Hospital Vall d'Hebron, Barcelona, Spain
| | - C Picado
- Pneumonology and Allergy Department, Hospital Clínic; Universitat de Barcelona, Barcelona, Spain
| | - V Plaza
- Servicio de Neumologia y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - S Quirce
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Alergia, Hospital Universitario La Paz, Madrid, Spain
| | - M J Rial
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Alergología, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - I Roibás-Veiga
- Servicio de Alergia. Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - L Soto-Retes
- Servicio de Neumologia y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - A Valero
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Pneumonology and Allergy Department, Hospital Clínic; Universitat de Barcelona, Barcelona, Spain
| | - M Valverde-Monge
- Servicio de Alergología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - J Sastre
- Servicio de Alergología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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Arroabarren E, García BE, Anda M, Pesántez C, Zavala MJ, Olaguibel JM. Lessons Learned From Component-Resolved Diagnosis in Anaphylaxis: Analysis of a Case Series Based on the International Anaphylaxis Registry. J Investig Allergol Clin Immunol 2023; 33:483-486. [PMID: 37082894 DOI: 10.18176/jiaci.0912] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Affiliation(s)
- E Arroabarren
- Servicio de Alergología, Hospital Universitario de Navarra (HUN), Pamplona, Spain
| | - B E García
- Servicio de Alergología, Hospital Universitario de Navarra (HUN), Pamplona, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Spain
- IDISNA Health Research Institute (Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain
| | - M Anda
- Servicio de Alergología, Hospital Universitario de Navarra (HUN), Pamplona, Spain
| | - C Pesántez
- Servicio de Alergología, Hospital Universitario de Navarra (HUN), Pamplona, Spain
| | - M J Zavala
- Servicio de Alergología, Hospital Universitario de Navarra (HUN), Pamplona, Spain
| | - J M Olaguibel
- Servicio de Alergología, Hospital Universitario de Navarra (HUN), Pamplona, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Spain
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3
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Barroso B, Valverde-Monge M, Alobid I, Olaguibel JM, Rial MJ, Quirce S, Arismendi E, Barranco P, Betancor D, Bobolea I, Cárdaba B, Cruz Carmona MJ, Curto E, Domínguez-Ortega J, González-Barcala FJ, Martínez-Rivera C, Mahíllo-Fernández I, Muñoz X, Picado C, Plaza V, Rodrigo Muñoz JM, Soto-Retes L, Valero A, Del Pozo V, Mullol J, Sastre J. Reply to "Olfactory Function and Biologic Treatments: A Comment on Available Real-life Studies". J Investig Allergol Clin Immunol 2023; 33:503-504. [PMID: 38095497 DOI: 10.18176/jiaci.0953] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Affiliation(s)
- B Barroso
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - M Valverde-Monge
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - I Alobid
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clinic, Barcelona, Spain
- Clinical and Experimental Respiratory Immunoallergy, FRCB-IDIBAPS, Barcelona, Spain
| | - J M Olaguibel
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Allergy Department, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - M J Rial
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Allergy Department, Hospital Juan Canalejo, A Coruña, Spain
| | - S Quirce
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Department of Allergy, La Paz University Hospital, Madrid, Spain
- Hospital La Paz Institute for Health Research (IDIPAZ), Madrid, Spain
| | - E Arismendi
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Clinical and Experimental Respiratory Immunoallergy, FRCB-IDIBAPS, Barcelona, Spain
- Allergy Unit and Severe Asthma Unit, Pulmonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - P Barranco
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Department of Allergy, La Paz University Hospital, Madrid, Spain
- Hospital La Paz Institute for Health Research (IDIPAZ), Madrid, Spain
| | - D Betancor
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - I Bobolea
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Clinical and Experimental Respiratory Immunoallergy, FRCB-IDIBAPS, Barcelona, Spain
- Allergy Unit and Severe Asthma Unit, Pulmonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - B Cárdaba
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
| | - M J Cruz Carmona
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Pulmonology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - E Curto
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Pulmonology and Allergy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Universidad Autónoma de Barcelona, Barcelona, Spain
| | - J Domínguez-Ortega
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Department of Allergy, La Paz University Hospital, Madrid, Spain
- Hospital La Paz Institute for Health Research (IDIPAZ), Madrid, Spain
| | - F J González-Barcala
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Pulmonology Department, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, La Coruña, Spain
| | - C Martínez-Rivera
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Pulmonology Department, Hospital Germans Trias i Pujol, Badalona, Spain
| | | | - X Muñoz
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Pulmonology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Picado
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Clinical and Experimental Respiratory Immunoallergy, FRCB-IDIBAPS, Barcelona, Spain
- Allergy Unit and Severe Asthma Unit, Pulmonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - V Plaza
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Pulmonology and Allergy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Universidad Autónoma de Barcelona, Barcelona, Spain
| | - J M Rodrigo Muñoz
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
| | - L Soto-Retes
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Pulmonology and Allergy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Universidad Autónoma de Barcelona, Barcelona, Spain
| | - A Valero
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Clinical and Experimental Respiratory Immunoallergy, FRCB-IDIBAPS, Barcelona, Spain
- Allergy Unit and Severe Asthma Unit, Pulmonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - V Del Pozo
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
| | - J Mullol
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clinic, Barcelona, Spain
- Clinical and Experimental Respiratory Immunoallergy, FRCB-IDIBAPS, Barcelona, Spain
| | - J Sastre
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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Betancor D, Olaguibel JM, Rodrigo-Muñoz JM, Alvarez Puebla MJ, Arismendi E, Barranco P, Barroso B, Bobolea I, Cárdaba B, Cruz MJ, Curto E, Del Pozo V, Domínguez-Ortega J, González-Barcala FJ, Luna-Porta JA, Martínez-Rivera C, Mullol J, Muñoz X, Picado C, Plaza V, Quirce S, Rial MJ, Soto-Retes L, Valero A, Valverde-Monge M, Sastre J. Lung Function Abnormalities and Their Correlation With Clinical Characteristics and Inflammatory Markers in Adult Asthma. J Investig Allergol Clin Immunol 2023; 33:294-296. [PMID: 36331127 DOI: 10.18176/jiaci.0866] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023] Open
Affiliation(s)
- D Betancor
- Servicio de Alergología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - J M Olaguibel
- Servicio de Alergología, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - J M Rodrigo-Muñoz
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Inmunología, Instituto de Investigación Sanitaria Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - M J Alvarez Puebla
- Servicio de Alergología, Hospital Universitario de Navarra, Pamplona, Navarra, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - E Arismendi
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Pneumonology and Allergy Department, Hospital Clínic, Barcelona, Spain
- Clinical and Experimental Respiratory Immunoallergy (IDIBAPS), Universitat de Barcelona. Barcelona, Spain
| | - P Barranco
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Alergia, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - B Barroso
- Servicio de Alergología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - I Bobolea
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Pneumonology and Allergy Department, Hospital Clínic, Barcelona, Spain
- Clinical and Experimental Respiratory Immunoallergy (IDIBAPS), Universitat de Barcelona. Barcelona, Spain
| | - B Cárdaba
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Inmunología, Instituto de Investigación Sanitaria Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - M J Cruz
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Departamento de Biología Celular, Fisiología e Inmunología, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - E Curto
- Servicio de Neumologia y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - V Del Pozo
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Inmunología, Instituto de Investigación Sanitaria Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - J Domínguez-Ortega
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Alergia, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - F J González-Barcala
- Servicio de Neumología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, La Coruña, Spain
| | - J A Luna-Porta
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Alergia, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - C Martínez-Rivera
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Neumología, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - J Mullol
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Clinical and Experimental Respiratory Immunoallergy (IDIBAPS), Universitat de Barcelona. Barcelona, Spain
- Rhinology Unit and Smell Clinic, ENT Department Hospital Clínic, Barcelona, Spain
| | - X Muñoz
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Neumología, Hospital Vall d'Hebron, Barcelona, Spain
| | - C Picado
- Pneumonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - V Plaza
- Servicio de Neumologia y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - S Quirce
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Alergia, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - M J Rial
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Servicio de Alergología, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - L Soto-Retes
- Servicio de Neumologia y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - A Valero
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
- Pneumonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - M Valverde-Monge
- Servicio de Alergología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - J Sastre
- Servicio de Alergología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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5
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Domínguez-Ortega J, Luna-Porta JA, Olaguibel JM, Barranco P, Arismendi E, Barroso B, Betancor D, Bobolea I, Caballero ML, Cárdaba B, Cruz MJ, Curto E, González-Barcala FJ, Losantos-García I, Martínez-Rivera C, Mendez-Brea P, Mullol J, Muñoz X, Picado C, Plaza V, Del Pozo V, Rial MJ, Sastre J, Soto L, Valero A, Valverde-Monge M, Quirce S. Exacerbations Among Patients With Asthma Are Largely Dependent on the Presence of Multimorbidity. J Investig Allergol Clin Immunol 2023; 33:281-288. [PMID: 35503227 DOI: 10.18176/jiaci.0816] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Comorbidities can influence asthma control and promote asthma exacerbations (AEs). However, the impact of multimorbidity in AEs, assessed based on long-term follow-up of patients with asthma of different degrees of severity, has received little attention in real-life conditions. To describe the epidemiological and clinical characteristics and predictors of AEs in patients who had presented at least 1 AE in the previous year in the MEchanism of Genesis and Evolution of Asthma (MEGA) cohort. METHODS The work-up included a detailed clinical examination, pulmonary function testing, fractional exhaled nitric oxide (FeNO), blood counts, induced sputum, skin prick-tests, asthma questionnaires, and assessment of multimorbidity. The number of moderate-severe AEs in the preceding year was registered for each patient. RESULTS The study population comprised 486 patients with asthma (23.7% mild, 35% moderate, 41.3% severe). Disease remained uncontrolled in 41.9%, and 47.3% presented ≥1 moderate-severe AE, with a mean (SD) annual exacerbation rate of 0.47 (0.91) vs 2.11 (2.82) in mild and severe asthma, respectively. Comorbidity was detected in 56.4% (66.6% among those with severe asthma). Bronchiectasis, chronic rhinosinusitis with nasal polyps, atopy, psychiatric illnesses, hyperlipidemia, and hypertension were significantly associated with AEs. No associations were found for FeNO, blood eosinophils, or total serum IgE. Sputum eosinophilia and a high-T2 inflammatory pattern were significantly associated with AEs. Multivariable regression analysis showed a significant association with asthma severity, uncontrolled disease, and low prebronchodilator FEV1/FVC. CONCLUSION Our study revealed a high frequency of AE in the MEGA cohort. This was strongly associated with multimorbidity, asthma severity, poor asthma control, airflow obstruction, higher sputum eosinophils, and a very high-T2 inflammatory pattern.
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Affiliation(s)
- J Domínguez-Ortega
- Department of Allergy, La Paz University Hospital, Madrid, Spain
- Institute for Health Research IdiPAZ, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - J A Luna-Porta
- Department of Allergy, La Paz University Hospital, Madrid, Spain
- Institute for Health Research IdiPAZ, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - J M Olaguibel
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Severe Asthma Unit, Department of Allergy, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - P Barranco
- Department of Allergy, La Paz University Hospital, Madrid, Spain
- Institute for Health Research IdiPAZ, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - E Arismendi
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Clinical and Experimental Respiratory Immunoallergy (IDIBAPS), Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
- Allergy Unit and Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - B Barroso
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Allergy, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - D Betancor
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Allergy, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - I Bobolea
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Clinical and Experimental Respiratory Immunoallergy (IDIBAPS), Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
- Allergy Unit and Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - M L Caballero
- Department of Allergy, La Paz University Hospital, Madrid, Spain
- Institute for Health Research IdiPAZ, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - B Cárdaba
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Immunology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - M J Cruz
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Biología Celular, Fisiología e Inmunología, Universitat Autónoma de Barcelona, Barcelona, Spain
- Pneumology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - E Curto
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Respiratory Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Barcelona, Spain
- Universidad Autónoma de Barcelona, Departamento de Medicina, Barcelona, Spain
| | - F J González-Barcala
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Pneumology Department, Complejo Hospitalario Universitario de Santiago, La Coruña, Spain
- Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), La Coruña, Spain
- Universidad de Santiago de Compostela, La Coruña, Spain
| | - I Losantos-García
- Institute for Health Research IdiPAZ, Madrid, Spain
- Biostatistics Department, La Paz University Hospital, Madrid, Spain
| | - C Martínez-Rivera
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Universidad Autónoma de Barcelona, Departamento de Medicina, Barcelona, Spain
- Pneumology Department, Hospital Germans Trias i Pujol, Barcelona, Spain
- Institut d'Investigacio Germans Trias I Pujol (IGTP), Badalona, Barcelona, Spain
| | - P Mendez-Brea
- Department of Allergy, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, La Coruña, Spain
| | - J Mullol
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Clinical and Experimental Respiratory Immunoallergy (IDIBAPS), Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, Barcelona, Spain
| | - X Muñoz
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Pneumology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - C Picado
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Clinical and Experimental Respiratory Immunoallergy (IDIBAPS), Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
- Allergy Unit and Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - V Plaza
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Respiratory Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Barcelona, Spain
- Universidad Autónoma de Barcelona, Departamento de Medicina, Barcelona, Spain
| | - V Del Pozo
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Immunology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - M J Rial
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Allergy, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - J Sastre
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Allergy, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - L Soto
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Respiratory Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Barcelona, Spain
- Universidad Autónoma de Barcelona, Departamento de Medicina, Barcelona, Spain
| | - A Valero
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Clinical and Experimental Respiratory Immunoallergy (IDIBAPS), Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
- Allergy Unit and Severe Asthma Unit, Pneumonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - M Valverde-Monge
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Allergy, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - S Quirce
- Department of Allergy, La Paz University Hospital, Madrid, Spain
- Institute for Health Research IdiPAZ, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
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6
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Barroso B, Valverde-Monge M, Alobid I, Olaguibel JM, Rial MJ, Quirce S, Arismendi E, Barranco P, Betancor D, Bobolea I, Cárdaba B, Cruz Carmona MJ, Curto E, Domínguez-Ortega J, González-Barcala FJ, Martínez-Rivera C, Mahíllo-Fernández I, Muñoz X, Picado C, Plaza V, Rodrigo Muñoz JM, Soto-Retes L, Valero A, Del Pozo V, Mullol J, Sastre J. Improvement in Olfaction in Patients With CRSwNP and Severe Asthma Taking Anti-IgE and Anti-IL-5 Biologics: A Real-Life Study. J Investig Allergol Clin Immunol 2023; 33:37-44. [PMID: 35416154 DOI: 10.18176/jiaci.0812] [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] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Chronic rhinosinusitis with nasal polyps (CRSwNP), which is characterized by partial loss of smell (hyposmia) or total loss of smell (anosmia), is commonly associated with asthma and/or nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (N-ERD). CRSwNP worsens disease severity and quality of life. The objective of this real-world study was to determine whether biological treatments prescribed for severe asthma can improve olfaction in patients with CRSwNP. A further objective was to compare the improvement in in olfaction in N-ERD and non-N-ERD subgroups. METHODS We performed a multicenter, noninterventional, retrospective, observational study of 206 patients with severe asthma and CRSwNP undergoing biological treatment (omalizumab, mepolizumab, benralizumab, or reslizumab). RESULTS Olfaction improved after treatment with all 4 monoclonal antibodies (omalizumab [35.8%], mepolizumab [35.4%], reslizumab [35.7%], and benralizumab [39.1%]), with no differences between the groups. Olfaction was more likely to improve in patients with atopy, more frequent use of short-course systemic corticosteroids, and larger polyp size. The proportion of patients whose olfaction improved was similar between the N-ERD (37%) and non-N-ERD (35.7%) groups. CONCLUSIONS This is the first real-world study to compare improvement in olfaction among patients undergoing long-term treatment with omalizumab, mepolizumab, reslizumab, or benralizumab for severe asthma and associated CRSwNP. Approximately 4 out of 10 patients reported a subjective improvement in olfaction (with nonsignificant differences between biologic drugs). No differences were found for improved olfaction between the N-ERD and non-N-ERD groups.
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Affiliation(s)
- B Barroso
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - M Valverde-Monge
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - I Alobid
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Rhinology Unit and Smell Clinic, ENT Department, Hospital Clinic, Barcelona, Spain.,Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain
| | - J M Olaguibel
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Allergy Department, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - M J Rial
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Allergy Department, Hospital Juan Canalejo, A Coruña, Spain
| | - S Quirce
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Department of Allergy, La Paz University Hospital, Madrid, Spain.,Hospital La Paz Institute for Health Research (IDIPAZ), Madrid, Spain
| | - E Arismendi
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain.,Allergy Unit and Severe Asthma Unit, Pulmonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - P Barranco
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Department of Allergy, La Paz University Hospital, Madrid, Spain.,Hospital La Paz Institute for Health Research (IDIPAZ), Madrid, Spain
| | - D Betancor
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - I Bobolea
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain.,Allergy Unit and Severe Asthma Unit, Pulmonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - B Cárdaba
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
| | - M J Cruz Carmona
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Pulmonology Department, Hospital Universitari Vall d´Hebron, Barcelona, Spain
| | - E Curto
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Pulmonology and Allergy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Universidad Autónoma de Barcelona, Barcelona, Spain
| | - J Domínguez-Ortega
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Department of Allergy, La Paz University Hospital, Madrid, Spain.,Hospital La Paz Institute for Health Research (IDIPAZ), Madrid, Spain
| | - F J González-Barcala
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Pulmonology Department, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, La Coruña, Spain
| | - C Martínez-Rivera
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Pulmonology Department, Hospital Germans Trias i Pujol, Badalona, Spain
| | | | - X Muñoz
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Pulmonology Department, Hospital Universitari Vall d´Hebron, Barcelona, Spain.,Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Picado
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain.,Allergy Unit and Severe Asthma Unit, Pulmonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - V Plaza
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Pulmonology and Allergy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Universidad Autónoma de Barcelona, Barcelona, Spain
| | - J M Rodrigo Muñoz
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
| | - L Soto-Retes
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Pulmonology and Allergy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Universidad Autónoma de Barcelona, Barcelona, Spain
| | - A Valero
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain.,Allergy Unit and Severe Asthma Unit, Pulmonology and Allergy Department, Hospital Clínic, Barcelona, Spain
| | - V Del Pozo
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
| | - J Mullol
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Rhinology Unit and Smell Clinic, ENT Department, Hospital Clinic, Barcelona, Spain.,Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain
| | - J Sastre
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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7
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Pérez de Llano L, Cisneros C, Domínguez-Ortega J, Martínez-Moragón E, Olaguibel JM, Plaza V, Quirce S, Dávila I. Response to Monoclonal Antibodies in Asthma: Definitions, Potential Reasons for Failure, and Therapeutic Options for Suboptimal Response. J Investig Allergol Clin Immunol 2023; 33:1-13. [PMID: 36040046 DOI: 10.18176/jiaci.0857] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Real-life data reveal that more than half of severe asthma patients treated with monoclonal antibodies (mAbs) do not achieve a complete response. Response to mAbs must be assessed holistically, considering all the clinically meaningful therapeutic goals, not only reduction of exacerbations and oral corticosteroids. There are 2 different ways of measuring the response to mAbs. One, qualitative, classifies patients according to the degree of disease control they have achieved, without explaining how much a given patient improves relative to the baseline (pre-mAb) clinical situation; the other, quantitative, scores the changes occurring after treatment. Both methods are complementary and essential to making clinical decisions on whether to continue treatment. The various potential causes of suboptimal response to mAbs include incorrect identification of the specific T2 pathways, comorbidities that reduce the room for improvement, insufficient dose, autoimmune phenomena, infections, change in the initial inflammatory endotype, and adverse events. Once a suboptimal response has been confirmed, a well-structured and multifaceted assessment of the potential causes of failure should be performed, with emphasis on the resulting inflammatory process of the airway after mAb therapy and the presence of chronic or recurrent infection. This investigation should guide the decision on the best therapeutic approach. The present review aims to help clinicians gain insights into how to measure response to mAbs and proceed in cases of suboptimal response.
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Affiliation(s)
- L Pérez de Llano
- Respiratory Medicine Department, Hospital Universitario Lucus Augusti, EOXI Lugo, Monforte, Cervo, Spain
| | - C Cisneros
- Respiratory Medicine Department, Hospital La Princesa, Madrid, Spain.,Instituto de Investigación Sanitaria Princesa (IIS-IP), Madrid, Spain
| | - J Domínguez-Ortega
- Department of Allergy, La Paz University Hospital, IdiPAZ, Madrid, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - E Martínez-Moragón
- Respiratory Medicine Department, Hospital Universitario Dr Peset, Valencia, Spain
| | - J M Olaguibel
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Allergy Department, Hospital Universitario de Navarra, Pamplona, Spain.,Instituto de Investigaciones de Navarra (IDISNA), Pamplona, Spain
| | - V Plaza
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.,Respiratory Medicine Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Institut de Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain.,Facultad de Medicina, Universitat Autònoma Barcelona, Spain
| | - S Quirce
- Department of Allergy, La Paz University Hospital, IdiPAZ, Madrid, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - I Dávila
- Allergy Department, Hospital Universitario de Salamanca, Spain.,Instituto de Investigación Biosanitaria de Salamanca (IBSAL), Salamanca, Spain.,Departamento de Ciencias Biomédicas y del Diagnóstico, Facultad de Medicina, Universidad de Salamanca, Salamanca, Spain
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8
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Aleman EA, Garcia B, Anda M, Pesantez C, Zavala MJ, Olaguibel JM. Usefulness of Component Resolved Diagnosis in anaphylaxis. Review of a series of cases included in the International Registry of Anaphylaxis. J Allergy Clin Immunol 2023. [DOI: 10.1016/j.jaci.2022.12.035] [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: 02/05/2023]
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9
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Betancor D, Olaguibel JM, Sastre J. The Discrepant Role of Fractional Exhaled Nitric Oxide in SARS-CoV-2 Infection. J Investig Allergol Clin Immunol 2022; 32:417-418. [PMID: 36219551 DOI: 10.18176/jiaci.0842] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Affiliation(s)
- D Betancor
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - J M Olaguibel
- Allergy Department, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - J Sastre
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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10
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Olaguibel JM, Sastre J, Rodríguez JM, Del Pozo V. Eosinophilia induced by blocking the IL-4/IL-13 pathway. Potential mechanisms and clinical outcomes. J Investig Allergol Clin Immunol 2022; 32:165-180. [PMID: 35522053 DOI: 10.18176/jiaci.0823] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Currently, five biological drugs for uncontrolled severe asthma treatment are marketed. They all block type 2 inflammatory pathways, either by targeting IgE (omalizumab), the IL-5 pathway (mepolizumab, reslizumab, benralizumab), or the IL-4/13 pathway (dupilumab). Hypereosinophilia has been observed in between 4% and 25% of patients treated with dupilumab, being transient in most cases, but persistent cases of symptomatic hypereosinophilia consistent with eosinophil granulomatosis with polyangiitis (EGPA), eosinophilic pneumonia, eosinophilic vasculitis or sudden worsening of asthma symptoms have been described. Cases of EGPA have been described with all biologics, including anti-IL-5, and with leukotriene receptors antagonists in publications or in the Eudravigilance database. In many cases of EGPA, it appears during systemic steroids tapering or after switching from an anti-IL-5 biologic to Dupilumab, suggesting that systemic steroids or the anti IL-5 were masking the vasculitis. This review aims to substantiate the plausible mechanisms of dupilumab-induced hypereosinophilia and review symptomatic hypereosinophilia cases associated with dupilumab therapy. Blockade of the IL-4/IL-13 pathway cause a reduction of eosinophil migration and blood accumulation by inhibiting eotaxin-3, VCAM-1, and TARC without simultaneously inhibiting eosinophilopoiesis in the bone marrow. When choosing the optimal biologic, it seems necessary to consider the presence of hypereosinophilia (>1,500/mL), where an anti-IL-5/IL-5R is preferable. Also, when changing from an anti-IL-5/5R to an anti-IL-4/13R. Close monitoring of blood eosinophils and clinical evolution seems justified in these situations. Nevertheless, dual therapy with anti-IL-5/5R and anti-IL4/IL-13R may be needed for optimal control since both IL-5, and IL-4/13 pathways can simultaneously contribute to airway inflammation.
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Affiliation(s)
- J M Olaguibel
- Servicio de Alergología, Hospital Universitario de Navarra. CIBER de Enfermedades Respiratorias (CIBERES). Pamplona, Spain
| | - J Sastre
- Allergy Service, Fundación Jiménez Díaz. CIBER de Enfermedades Respiratorias (CIBERES). Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - J M Rodríguez
- Department of Immunology, IIS-Fundación Jiménez Díaz and CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - V Del Pozo
- Department of Immunology, IIS-Fundación Jiménez Díaz; CIBER de Enfermedades Respiratorias (CIBERES) and Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
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11
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Betancor D, Valverde-Mongue M, Gomez-Lopez A, Barroso B, Ruete L, Olaguibel JM, Sastre J. Evaluation of fractional exhaled nitric oxide during SARS-CoV-2 infection. J Investig Allergol Clin Immunol 2021; 32:301-303. [PMID: 34755657 DOI: 10.18176/jiaci.0762] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- D Betancor
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - M Valverde-Mongue
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - A Gomez-Lopez
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - B Barroso
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - L Ruete
- Eversens, Pamplona, Navarra, Spain
| | - J M Olaguibel
- Allergy Department, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - J Sastre
- Allergy Department, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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12
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Gil-Martínez M, Rodrigo-Muñoz JM, Sastre B, Cañas JA, García-Latorre R, Redondo N, de la Fuente L, Mínguez P, Mahíllo-Fernández I, Sastre J, Quirce S, Caballero ML, Olaguibel JM, Pozo V. Serum microRNAs catalog asthmatic patients by phenotype. J Investig Allergol Clin Immunol 2021; 32:471-478. [PMID: 34489228 DOI: 10.18176/jiaci.0753] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Asthma is a chronic inflammatory condition of the airways with a complex pathophysiology. Stratification of asthma subtypes into phenotypes and endotypes should move the field forward, making treatment more effective and personalized. Eosinophils are the key inflammatory cells involved in severe eosinophilic asthma. Due to the health threat posed by eosinophilic asthma, there is a need for reliable biomarkers to identify patients and treat them properly with novel biologics. A promising tool for diagnosis are microRNAs (miRNAs). Objective: The aim of this study was to find serum miRNAs that can phenotype asthmatic patients. MATERIAL AND METHODS Serum miRNAs of eosinophilic (N=40) and non-eosinophilic (N=36) asthmatic individuals were evaluated by next-generation sequencing (NGS), specifically miRNAs-seq, and selected miRNAs were validated by RT-qPCR. Pathways enrichment analysis of deregulated miRNAs was performed. RESULTS NGS analysis revealed 15 differentially expressed miRNAs between eosinophilic and non-eosinophilic asthmatic patients, while did not show differences in the miRNome between atopic and non-atopic asthmatic individuals. Of the 15 differentially expressed miRNAs between eosinophilic and non-eosinophilic asthmatics, hsa-miR-26a-1-3p and hsa-miR-376a-3p were validated by RT-qPCR. Expression levels of these two miRNAs were higher in eosinophilic than in non-eosinophilic asthmatics. Furthermore, expression values of hsa-miR-26a-1-3p inversely correlated with peripheral blood eosinophil count and hsa-miR-376a-3p expression values with FeNO values and exacerbations number. Additionally, in silico pathway enrichment analysis revealed that these two miRNAs regulate signaling pathways related with asthma pathogenesis. CONCLUSIONS Hsa-miR-26a-1-3p and hsa-miR-376a-3p could be used to distinguish eosinophilic and non-eosinophilic asthmatic patients.
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Affiliation(s)
- M Gil-Martínez
- Immunoallergy Laboratory, Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Madrid, Spain
| | - J M Rodrigo-Muñoz
- Immunoallergy Laboratory, Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Madrid, Spain.,Center for Biomedical Network of Respiratory Diseases (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - B Sastre
- Immunoallergy Laboratory, Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Madrid, Spain.,Center for Biomedical Network of Respiratory Diseases (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - J A Cañas
- Immunoallergy Laboratory, Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Madrid, Spain.,Center for Biomedical Network of Respiratory Diseases (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - R García-Latorre
- Immunoallergy Laboratory, Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Madrid, Spain
| | - N Redondo
- Immunoallergy Laboratory, Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Madrid, Spain
| | - L de la Fuente
- Genetics and Genomics Department, Bioinformatics Unit, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Madrid, Spain
| | - P Mínguez
- Genetics and Genomics Department, Bioinformatics Unit, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Madrid, Spain.,Center for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - I Mahíllo-Fernández
- Biostatistics and Epidemiology Unit, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Madrid, Spain
| | - J Sastre
- Center for Biomedical Network of Respiratory Diseases (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Allergy Unit, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - S Quirce
- Center for Biomedical Network of Respiratory Diseases (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Allergy, Hospital Universitario La Paz, Madrid, Spain
| | - M L Caballero
- Center for Biomedical Network of Respiratory Diseases (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Allergy, Hospital Universitario La Paz, Madrid, Spain
| | - J M Olaguibel
- Center for Biomedical Network of Respiratory Diseases (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Allergy Unit, Complejo Hospitalario de Navarra, Navarra, Spain
| | - V Pozo
- Immunoallergy Laboratory, Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Madrid, Spain.,Center for Biomedical Network of Respiratory Diseases (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Universidad Autónoma de Madrid, Madrid, Spain
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13
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Gerth van Wijk R, Mülleneisen N, Demoly P, Olaguibel JM, Popov TA, Schmid‐Grendelmeier P, Tsilochristou O. The roadmap for allergology in Europe: The European training requirements for the specialty of allergology. Allergy 2021; 76:1588-1591. [PMID: 33032359 PMCID: PMC8247307 DOI: 10.1111/all.14614] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 09/21/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Roy Gerth van Wijk
- Department of Internal Medicine Section of Allergology and Clinical Immunology Erasmus MC Rotterdam The Netherlands
| | | | - Pascal Demoly
- Division of Allergy Department of Pulmonology Hôpital Arnaud de Villeneuve University Hospital of Montpellier Montpellier France
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14
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Ibáñez-Sandin MD, Rodríguez Del Río P, Alvarado MI, García BE, Garriga-Baraut T, Reche Frutos M, Escudero C, Ramirez A, Vila L, Lasa EM, Blasco C, Marchán-Martin E, Martorell A, Sanchez-García S, Rodríguez-Álvarez M, Infante S, Rodríguez Vazquez V, Olaguibel JM, Labrador-Horrillo M, Carrillo T. Onset of nut allergy in a pediatric cohort: clinical and molecular patterns. AFRUSEN study. J Investig Allergol Clin Immunol 2021; 32:270-281. [PMID: 33884956 DOI: 10.18176/jiaci.0696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Nut Allergy, Peanut, Walnut, Allergy Onset, Sensitization Profile, Component Resolved Diagnosis, Anaphylaxis, Food Allergy.
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Affiliation(s)
- M D Ibáñez-Sandin
- Allergy Department, Hospital Infantil Universitario Niño Jesus, Madrid, Spain.,Health Research Institute Princesa, Madrid; cARADyAL RD16/0006/0026, Spain
| | - P Rodríguez Del Río
- Allergy Department, Hospital Infantil Universitario Niño Jesus, Madrid, Spain.,Health Research Institute Princesa, Madrid; cARADyAL RD16/0006/0026, Spain
| | - M I Alvarado
- Servicio de Alergología, Complejo Hospitalario Universitario de Cáceres, Cáceres, Spain
| | - B E García
- Service of Alergology, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - T Garriga-Baraut
- Unitat d´Al·lergologia Pediàtrica, Hospital Universitari Vall d´Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.,Grup d'Investigació "Creixement i Desenvolupament", Institut de Recerca de l'Hospital Universitari Vall d'Hebron (VHIR), Barcelona, Spain
| | - M Reche Frutos
- Servicio de Alergología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain
| | - C Escudero
- Allergy Department, Hospital Infantil Universitario Niño Jesus, Madrid, Spain.,Health Research Institute Princesa, Madrid; cARADyAL RD16/0006/0026, Spain
| | - A Ramirez
- Unidad de Alergia alimentaria, Unidad de Alergología, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - L Vila
- Complexo Hospitalario Universitario A Coruña, Spain
| | - E M Lasa
- Unidad de Alergología Infantil, Servicio de Alergología, Hospital Universitario Donostia, Spain
| | - C Blasco
- Unidad de Alergología Pediátrica, Hospital Universitario Vall d´Hebron de Barcelona, Spain
| | - E Marchán-Martin
- Complejo Hospitalario Universitario de Toledo, Servicio de Alergología, Toledo, Spain
| | - A Martorell
- Allergy Service, University General Hospital, Valencia, Spain
| | - S Sanchez-García
- Allergy Department, Hospital Infantil Universitario Niño Jesus, Madrid, Spain.,Health Research Institute Princesa, Madrid; cARADyAL RD16/0006/0026, Spain
| | - M Rodríguez-Álvarez
- Allergy Department, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - S Infante
- Paediatric Allergy Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - J M Olaguibel
- Servicio de Alergología, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - M Labrador-Horrillo
- Sección de Alergia, Vall d'Hebron Hospital Universitari, Barcelona, Spain, Vall d'Hebron Institut de Recerca (VHIR), Barcelona Spain, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain, ARADyAL research network, Instituto de Salud Carlos III (ISCII
| | - T Carrillo
- Servicio de Alergología, Hospital Universitario de Gran Canaria Dr. Negrin, Spain
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15
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Olaguibel A, Oleaga M, Iraola A, Cortaberría R, Corcuera A, Alvarez-Puebla MJ, Tabar A, Ruete L, Botas A, Olaguibel JM. Exhaled Nitric Oxide (eNO) Measurements With the New evernoa Device Are Valid and Reproducible Through an Extended Range of eNO Levels. J Investig Allergol Clin Immunol 2021; 30:147-149. [PMID: 32327404 DOI: 10.18176/jiaci.0465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- A Olaguibel
- NavarraBioMed, Gobierno de Navarra, Navarra, Spain
| | - M Oleaga
- NavarraBioMed, Gobierno de Navarra, Navarra, Spain
| | - A Iraola
- NavarraBioMed, Gobierno de Navarra, Navarra, Spain.,Unidad de Asma Grave, Servicio de Alergología, Complejo Hospitalario de Navarra, Navarra, Spain
| | - R Cortaberría
- NavarraBioMed, Gobierno de Navarra, Navarra, Spain.,Unidad de Asma Grave, Servicio de Alergología, Complejo Hospitalario de Navarra, Navarra, Spain
| | - A Corcuera
- Unidad de Asma Grave, Servicio de Alergología, Complejo Hospitalario de Navarra, Navarra, Spain
| | - M J Alvarez-Puebla
- NavarraBioMed, Gobierno de Navarra, Navarra, Spain.,Unidad de Asma Grave, Servicio de Alergología, Complejo Hospitalario de Navarra, Navarra, Spain.,CIBER Respiratorio
| | - A Tabar
- NavarraBioMed, Gobierno de Navarra, Navarra, Spain.,Unidad de Asma Grave, Servicio de Alergología, Complejo Hospitalario de Navarra, Navarra, Spain
| | - L Ruete
- Eversens, Pamplona, Navarra, Spain
| | - A Botas
- Eversens, Pamplona, Navarra, Spain
| | - J M Olaguibel
- NavarraBioMed, Gobierno de Navarra, Navarra, Spain.,Unidad de Asma Grave, Servicio de Alergología, Complejo Hospitalario de Navarra, Navarra, Spain.,CIBER Respiratorio
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16
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Olaguibel JM, Alobid I, Alvarez Puebla M, Crespo-Lessmann A, Domínguez Ortega J, García-Rio F, Izquierdo-Domínguez A, Mullol J, Plaza V, Quirce S, Rojas-Lechuga MJ, Valvere-Monge M, Sastre J. Functional Examination of the Upper and Lower Airways in Asthma and Respiratory Allergic Diseases: Considerations in the Post-SARS-CoV-2 Era. J Investig Allergol Clin Immunol 2020; 31:17-35. [PMID: 32540791 DOI: 10.18176/jiaci.0625] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Airway examination procedures can potentially transmit infectious diseases to patients and to the health care professionals who perform them via various mechanisms. The COVID-19 pandemic has halted most of the activity of the clinics and laboratories involved in assessment of lung and nasal function, and clear recommendations in this regard have been made. Today, we still do not know for sure what its consequences will be in the short or long term, since important gaps remain in our knowledge of aspects as fundamental as virus transmission mechanisms, pathophysiology, immune response, and diagnosis. In this review, we study the examination techniques used to assess patients with respiratory allergy, asthma, and associated diseases during this period and highlight their possible advantages and disadvantages. Therefore, we focus on exploring the entire upper and lower airways, from the perspective of the safety of both health professionals and patients and their specific characteristics. We also analyze the intrinsic value of these interventions in terms of diagnosis and patient management. The changing situation of COVID-19 may mean that some of the assertions presented in this review will have to be modified in the future. While we seek to ensure a consistently broad approach, some differences in operational details may apply owing to local regulations.
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Affiliation(s)
- J M Olaguibel
- Department of Allergy, Complejo Hospitalario de Navarra, Pamplona, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Spain
| | - I Alobid
- Unidad Alergo-Rino, Centro Médico Teknon, Barcelona, Spain.,Unitat de Rinologia & Clínica de l'Olfacte, Servei d'Oto-rino-laringologia, Hospital Clinic Barcelona; Immunoalèrgia Respiratòria Clínica i Experimental, IDIBAPS; Universitat de Barcelona, Barcelona, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Spain
| | - M Alvarez Puebla
- Department of Allergy, Complejo Hospitalario de Navarra, Pamplona, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Spain
| | - A Crespo-Lessmann
- Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau; Institut d'Investigació Biomédica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Department of Medicine, Barcelona, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Spain
| | - J Domínguez Ortega
- Department of Allergy, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Spain
| | - F García-Rio
- Department of Respiratry Medicine. Hospital Universitario La Paz-IdiPAZ, Madrid, Spain; Departamento de Medicina, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Spain
| | - A Izquierdo-Domínguez
- Unidad Alergo-Rino, Centro Médico Teknon, Barcelona, Spain.,Department of Allergy, Consorci Sanitari de Terrassa; Clínica Diagonal, Barcelona, Spain
| | - J Mullol
- Unitat de Rinologia & Clínica de l'Olfacte, Servei d'Oto-rino-laringologia, Hospital Clinic Barcelona; Immunoalèrgia Respiratòria Clínica i Experimental, IDIBAPS; Universitat de Barcelona, Barcelona, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Spain
| | - V Plaza
- Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau; Institut d'Investigació Biomédica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Department of Medicine, Barcelona, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Spain
| | - S Quirce
- Department of Allergy, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Spain
| | - M J Rojas-Lechuga
- Unitat de Rinologia & Clínica de l'Olfacte, Servei d'Oto-rino-laringologia, Hospital Clinic Barcelona; Immunoalèrgia Respiratòria Clínica i Experimental, IDIBAPS; Universitat de Barcelona, Barcelona, Spain
| | - M Valvere-Monge
- Department of Allergy, Fundación Jiménez Díaz, Madrid, Spain
| | - J Sastre
- Department of Allergy, Fundación Jiménez Díaz, Madrid, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Spain
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17
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Arroabarren E, Echechipía S, Galbete A, Lizaso MT, Olaguibel JM, Tabar AI. Association Between Component-Resolved Diagnosis of House Dust Mite Allergy and Efficacy and Safety of Specific Immunotherapy. J Investig Allergol Clin Immunol 2019; 29:164-167. [PMID: 31017124 DOI: 10.18176/jiaci.0359] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- E Arroabarren
- Servicio de Alergologia, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - S Echechipía
- Servicio de Alergologia, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - A Galbete
- Navarrabiomed- Centro Hospitalario de Navarra-UPNA, Pamplona, Spain
| | - M T Lizaso
- Servicio de Alergologia, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - J M Olaguibel
- Servicio de Alergologia, Complejo Hospitalario de Navarra, Pamplona, Spain.,CIBER Respiratorio
| | - A I Tabar
- Servicio de Alergologia, Complejo Hospitalario de Navarra, Pamplona, Spain.,Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.,RETIC de Asma, Reacciones adversas y Alérgicas (ARADYAL)
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18
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Agache I, Annesi‐Maesano I, Bonertz A, Branca F, Cant A, Fras Z, Ingenrieth F, Namazova‐Baranova L, Odemyr M, Spanevello A, Vieths S, Yorgancioglu A, Alvaro‐Lozano M, Barber Hernandez D, Chivato T, Del Giacco S, Diamant Z, Eguiluz‐Gracia I, Wijk RG, Gevaert P, Graessel A, Hellings P, Hoffmann‐Sommergruber K, Jutel M, Lau S, Lauerma A, Maria Olaguibel J, O'Mahony L, Ozdemir C, Palomares O, Pfaar O, Sastre J, Scadding G, Schmidt‐Weber C, Schmid‐Grendelmeier P, Shamji M, Skypala I, Spinola M, Spranger O, Torres M, Vereda A, Bonini S. Prioritizing research challenges and funding for allergy and asthma and the need for translational research-The European Strategic Forum on Allergic Diseases. Allergy 2019; 74:2064-2076. [PMID: 31070805 DOI: 10.1111/all.13856] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [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: 04/11/2019] [Revised: 05/02/2019] [Accepted: 05/05/2019] [Indexed: 02/07/2023]
Abstract
The European Academy of Allergy and Clinical Immunology (EAACI) organized the first European Strategic Forum on Allergic Diseases and Asthma. The main aim was to bring together all relevant stakeholders and decision-makers in the field of allergy, asthma and clinical Immunology around an open debate on contemporary challenges and potential solutions for the next decade. The Strategic Forum was an upscaling of the EAACI White Paper aiming to integrate the Academy's output with the perspective offered by EAACI's partners. This collaboration is fundamental for adapting and integrating allergy and asthma care into the context of real-world problems. The Strategic Forum on Allergic Diseases brought together all partners who have the drive and the influence to make positive change: national and international societies, patients' organizations, regulatory bodies and industry representatives. An open debate with a special focus on drug development and biomedical engineering, big data and information technology and allergic diseases and asthma in the context of environmental health concluded that connecting science with the transformation of care and a joint agreement between all partners on priorities and needs are essential to ensure a better management of allergic diseases and asthma in the advent of precision medicine together with global access to innovative and affordable diagnostics and therapeutics.
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Affiliation(s)
| | - Isabella Annesi‐Maesano
- Department of Epidemiology of Allergic and Respiratory Diseases Medical School Saint Antoine, IPLESP, INSERM and Sorbonne Université Paris France
| | - Andreas Bonertz
- Federal Agency for Vaccines and Biomedicines Paul‐Ehrlich‐Institut Langen Germany
| | - Francesco Branca
- Department of Nutrition for Health and Development Geneva Switzerland
- WHO/HQ Geneva Switzerland
| | - Andrew Cant
- University of Newcastle Upon Tyne Newcastle upon Tyne UK
- European Society for Immunodeficiencies Geneva Switzerland
| | - Zlatko Fras
- Division of Medicine University Medical Centre Ljubljana Ljubljana Slovenia
- Medical Faculty University of Ljubljana Ljubljana Slovenia
- UEMS ‐ Union Europeenne des Medecins Specialistes/European Union of Medical Specialists Brussels Belgium
| | | | - Leyla Namazova‐Baranova
- Department of Pediatrics Russian National Research Medical University of MoH RF Moscow Russia
- Department of Pediatrics Central Clinical Hospital of MoSHE (Ministry of Science and High Education) Moscow Russian Federation
| | - Mikaela Odemyr
- European Federation of Allergy and Airways Diseases Patients’ Associations (EFA) Brussels Belgium
| | - Antonio Spanevello
- Dipartimento di Medicina e Chirurgia, Malattie dell'Apparato Respiratorio Università degli Studi dell'Insubria Varese – Como Italy
- Dipartimento di Medicina e Riabilitazione Cardio Respiratoria, U.O. di Pneumologia Riabilitativa Istituti Clinici Scientifici Maugeri, IRCCS Tradate Tradate Italy
| | - Stefan Vieths
- Federal Agency for Vaccines and Biomedicines Paul‐Ehrlich‐Institut Langen Germany
| | - Arzu Yorgancioglu
- Department of Pulmonology Celal Bayar University School of Medicine Manisa Turkey
| | - Montserat Alvaro‐Lozano
- Pediatric Allergy and Clinical Immunology Department Hospital Sant Joan de Déu Barcelona Barcelona Spain
| | - Domingo Barber Hernandez
- Department of Basic Medical Sciences, School of Medicine Universidad CEU San Pablo Madrid Spain
- RETIC ARADYAL RD16/0006/0015, Instituto de Salud Carlos III Madrid Spain
| | - Tomás Chivato
- School of Medicine University CEU San Pablo Madrid Spain
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health University of Cagliari Cagliari Italy
| | - 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
| | - Ibon Eguiluz‐Gracia
- Allergy Unit IBIMA, Regional University Hospital of Malaga, UMA Malaga Spain
- ARADyAL Network RD16/0006/0001, Carlos III Health Institute Madrid Spain
| | - Roy Gert Wijk
- Section of Allergology, Department of Internal Medicine Erasmus Medical Center Rotterdam the Netherlands
| | - Philippe Gevaert
- Department of Otorhinolaryngology‐Head and Neck Surgery, Upper Airways Research Laboratory Ghent University Ghent Belgium
| | - Anke Graessel
- Allergy Therapeutics Worthing UK
- Bencard Allergie GmbH Munich Germany
| | - Peter Hellings
- Department of Otorhinolaryngology‐Head and Neck Surgery, Upper Airways Research Laboratory Ghent University Ghent Belgium
- Department of Otorhinolaryngology‐Head and Neck Surgery UZ Leuven Leuven Belgium
- Department of Otorhinolaryngology Academic Medical Center Amsterdam The Netherlands
| | | | - Marek Jutel
- Department of Clinical Immunology Wroclaw Medical University Wroclaw Poland
- “ALL‐MED” Medical Research Institute Wroclaw Poland
| | - Susanne Lau
- Department for Pediatric Pneumology, Immunology and Intensive Care Charité Universität Medizin Berlin Germany
| | - Antti Lauerma
- Dermatology and Allergology Helsinki University Hospital and University of Helsinki Helsinki Finland
| | | | - Liam O'Mahony
- Departments of Medicine and Microbiology APC Microbiome Ireland, National University of Ireland Cork Ireland
| | - Cevdet Ozdemir
- Department of Pediatric Basic Sciences, Institute of Child Health Istanbul University Istanbul Turkey
- Department of Pediatrics, Division of Pediatric Allergy & Immunology, Istanbul Faculty of Medicine Istanbul University Istanbul Turkey
| | - Oscar Palomares
- Department of Biochemistry and Molecular Biology, School of Chemistry Complutense University of Madrid Madrid Spain
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg Philipps‐Universität Marburg Marburg Germany
| | - Joaquin Sastre
- Department of Allergy Fundación Jimenez Diaz Madrid Spain
- Department of Medicine, Instituto Carlos III CIBERES, Universidad Autónoma de Madrid Madrid Spain
| | | | - Carsten Schmidt‐Weber
- Zentrums Allergie & Umwelt (ZAUM) Technische Universität und Helmholtz Zentrum München Germany
| | - Peter Schmid‐Grendelmeier
- Allergy Unit, Department of Dermatology University Hospital of Zurich Zurich Switzerland
- Christine‐Kühne Center for Allergy Research and Education CK‐CARE Davos Davos Switzerland
| | - Mohamed Shamji
- Allergy & Clinical Immunology, Inflammation, Repair and Development, Imperial College, National Heart and Lung Institute Immunomodulation and Tolerance Group London UK
- Asthma UK Centre in Allergic Mechanisms of Asthma London UK
| | - Isabel Skypala
- Royal Brompton & Harefield NHS Foundation Trust London UK
- Imperial College London UK
| | | | - Otto Spranger
- Global Allergy and Asthma Patient Platform Vienna Austria
| | - Maria Torres
- Allergy Unit IBIMA, Regional University Hospital of Malaga, UMA Malaga Spain
- ARADyAL Network RD16/0006/0001, Carlos III Health Institute Madrid Spain
| | | | - Sergio Bonini
- Institute of Translational Pharmacology Italian National Research Council Rome Italy
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19
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Ojeda P, Sastre J, Olaguibel JM, Chivato T. Alergológica 2015: A National Survey on Allergic Diseases in the Adult Spanish Population. J Investig Allergol Clin Immunol 2019; 28:151-164. [PMID: 29939133 DOI: 10.18176/jiaci.0264] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND AND OBJETIVE The frequency of allergic diseases is increasing worldwide, particularly in industrialized countries. From a clinical, management, and public heath perspective, it is important to determine the reasons for consulting an allergist, the distribution by frequency of allergic diseases, and how health care is provided. Objective: Alergológica 2015 was carried out to obtain information on clinical practice in allergy departments in Spain, and compare it with the previous study editions. METHODS The data cover the year 2014 and the first quarter of 2015. The target sample was 6000 patients seen at public and private centers throughout Spain. A total of 500 allergists were invited to participate. Data were collected on an electronic case report form. Data were compared with the Alergológica surveys for 1992 and 2005 to identify differences. RESULTS The final study population comprised 2914 patients (mean age 33.6 [18.9] years, 58% women, 17% children), of whom 6.1% were foreign-born. The frequency distribution was as follows: rhinitis, 62%; asthma, 23.4%; drug allergy, 17.7%; urticaria/angioedema, 11.5%; food allergy, 10.4%; contact dermatitis, 4%; atopic dermatitis, 3%; insect venom allergy, 2%. A statistically significant increase was observed between data from 2005 and from 2015 with respect to the prevalence for allergic rhinitis, food allergy and drug hypersensitivity. An increase in the prevalence of a personal history of asthma, rhinitis, conjunctivitis, and eczema/atopic dermatitis were also observed. Besides, the number of relevant allergens in the same patient also increased. Most patients were referred from primary care, although a considerable percentage were referred by ENT specialists and dermatologists. CONCLUSIONS Increasing trends were observed for allergic rhinitis, drug allergy, and food allergy, and a decreasing trend was observed for asthma. Findings for other diseases remained practically unchanged. Allergic patients are increasingly complex and present with a myriad of atopic manifestations.
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Affiliation(s)
- P Ojeda
- Clínica de Asma y Alergia Dres. Ojeda, Madrid, Spain
| | - J Sastre
- Servicio de Alergia, Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - J M Olaguibel
- Servicio de Alergia, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - T Chivato
- Facultad de Medicina, Universidad San Pablo CEU, Madrid, Spain
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20
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Ojeda P, Ibáñez MD, Olaguibel JM, Sastre J, Chivato T. Alergológica 2015: A National Survey on Allergic Diseases in the Spanish Pediatric Population. J Investig Allergol Clin Immunol 2019; 28:321-329. [PMID: 30350783 DOI: 10.18176/jiaci.0308] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Allergic diseases are highly prevalent in industrialized populations. In Spain, children suspected of having an allergic disease are usually referred by their primary care pediatrician to an allergy unit at a general hospital or a children's hospital. We report data from a subanalysis of the pediatric population in Alergológica 2015. METHODS Data were collected from pediatric patients (age, ≤14 years) consulting an allergist for the first time in 2014 and the first quarter of 2015 in order to determine variations compared with data reported in Alergológica 2005. RESULTS Alergológica 2015 included fewer pediatric patients than Alergológica 2005. The study population comprised 481 patients aged ≤14 years from more than 200 centers throughout Spain. Males accounted for 56.5%. Rhinoconjunctivitis was the main reason for consulting an allergist (53.8% vs 46.3% in 2005), followed by asthma (30.2% vs 34.6%), and food allergy (20.0% vs 14.5%). CONCLUSIONS The findings of Alergológica 2015 show a notable increased frequency of allergic rhinitis, drug allergy, and food allergy. The frequency of other allergic conditions remained unchanged, except for asthma, whose frequency decreased, as in adult patients.
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Affiliation(s)
- P Ojeda
- Clínica de Asma y Alergia Dres. Ojeda, Madrid, Spain
| | - M D Ibáñez
- Servicio de Alergia, Hospital Infantil del Niño Jesús, Madrid, Spain
| | - J M Olaguibel
- Servicio de Alergia, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - J Sastre
- Servicio de Alergia, Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - T Chivato
- Facultad de Medicina, Universidad San Pablo CEU, Madrid, Spain
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21
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Alvarez-Puebla MJ, Arroabarren E, Zavala MJ, Corcuera A, Olaguibel A, Olaguibel JM. Responses to Biological Therapy in Severe Eosinophilic Asthma. J Investig Allergol Clin Immunol 2019; 29:335-337. [PMID: 30990776 DOI: 10.18176/jiaci.0403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M J Alvarez-Puebla
- Unidad de Asma Grave, Complejo Hospitalario de Navarra, Pamplona, Spain.,Servicio de Alergología, Complejo Hospitalario de Navarra, Pamplona, Spain.,NavarraBioMed, Gobierno de Navarra, Pamplona, Spain.,CIBER Respiratorio
| | - E Arroabarren
- Servicio de Alergología, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - M J Zavala
- Servicio de Alergología, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - A Corcuera
- Servicio de Alergología, Complejo Hospitalario de Navarra, Pamplona, Spain.,NavarraBioMed, Gobierno de Navarra, Pamplona, Spain
| | - A Olaguibel
- NavarraBioMed, Gobierno de Navarra, Pamplona, Spain
| | - J M Olaguibel
- Unidad de Asma Grave, Complejo Hospitalario de Navarra, Pamplona, Spain.,Servicio de Alergología, Complejo Hospitalario de Navarra, Pamplona, Spain.,NavarraBioMed, Gobierno de Navarra, Pamplona, Spain.,CIBER Respiratorio
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22
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Dávila I, Quirce S, Olaguibel JM. Selection of Biologics in Severe Asthma: A Multifaceted Algorithm. J Investig Allergol Clin Immunol 2019; 29:325-328. [PMID: 30969172 DOI: 10.18176/jiaci.0398] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- I Dávila
- Hospital Universitario de Salamanca, Salamanca, Department of Biomedical and Diagnostic Sciences, Faculty of Medicine, University of Salamanca, Institute for Biomedical Research of Salamanca, Salamanca, Spain. RETIC ARADyAL
| | - S Quirce
- Department of Allergy, Hospital La Paz Institute for Health Research (IdIPAZ), Madrid, Spain and CIBER of Respiratory Diseases (CIBERES)
| | - J M Olaguibel
- Severe Asthma Unit, Complejo Hospitalario de Navarra, Pamplona, Spain and CIBER of Respiratory Diseases (CIBERES)
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23
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Garcia-Rio F, Alvarez-Puebla MJ, Esteban-Gorgojo I, Barranco P, Olaguibel JM. Obesity and Asthma: Key Clinical Questions. J Investig Allergol Clin Immunol 2018; 29:262-271. [PMID: 30222113 DOI: 10.18176/jiaci.0316] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Obesity is a common comorbidity of asthma that is associated not only with development of the disease, but also with poorer disease control and greater severity. Recent prospective evidence supports the idea that body weight gain precedes the development of asthma, although the debate is far from over. The objective of this document is to conduct a systematic review of 3 clinical questions related to asthma and obesity: (a) Obesity and asthma: the chicken or the egg? Clinical insights from epidemiological and phenotyping studies. (b) Is obesity a confounding factor in the diagnosis and management of asthma, especially in severe or difficult-to-control asthma? (c) How do obese asthma patients respond to pharmacological treatments and to biological drugs? Do we have effective specific interventions? Revised epidemiological, pathological, and mechanistic evidence combined with data from interventional clinical trials prevent us from clearly stating that obesity causes asthma. However, the complexity and heterogeneity of both illnesses make several clinical scenarios possible. Furthermore, asthma represents an additional clinical challenge in the obese patient. Physicians need to be aware of the confounding effects created by the more marked perception of symptoms, alterations in lung function, and the various comorbidities that obese persons present. Exhaustive phenotyping of the obese asthma patient should enable us to develop a rational therapeutic plan, including both the pharmacological approach and specific antiobesity therapies such as combining diet and exercise and, in extreme cases, bariatric surgery.
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Affiliation(s)
- F Garcia-Rio
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES).,Servicio de Neumología, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain.,Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
| | - M J Alvarez-Puebla
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES).,Unidad de Asma Grave, Servicio de Alergia, Complejo Hospitalario de Navarra, Pamplona, Spain
| | | | - P Barranco
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES).,Servicio de Alergia, Unidad de Asma Grave, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
| | - J M Olaguibel
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES).,Unidad de Asma Grave, Servicio de Alergia, Complejo Hospitalario de Navarra, Pamplona, Spain
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Quirce S, Delgado J, Entrenas LM, Grande M, Llorente C, López Viña A, Martínez Moragón E, Mascarós E, Molina J, Olaguibel JM, Pérez de Llano LA, Perpiñá Tordera M, Quintano JA, Rodríguez M, Román-Rodriguez M, Sastre J, Trigueros JA, Valero AL, Zoni AC, Plaza V. Quality Indicators of Asthma Care Derived From the Spanish Guidelines for Asthma Management (GEMA 4.0): A Multidisciplinary Team Report. J Investig Allergol Clin Immunol 2017; 27:69-73. [PMID: 28211351 DOI: 10.18176/jiaci.0121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- S Quirce
- Servicio de Alergología, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - J Delgado
- Unidad de Gestión Clínica de Alergología, Hospital Virgen Macarena, Sevilla, Spain
| | - L M Entrenas
- Unidad de Gestión Clínica de Neumología, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - M Grande
- Servicio de Medicina Preventiva y Gestión de Calidad, Hospital General Universitario Gregorio Marañón, SERMAS, Madrid, Spain
| | - C Llorente
- Servicio de Medicina Preventiva y Gestión de Calidad, Hospital General Universitario Gregorio Marañón, SERMAS, Madrid, Spain
| | - A López Viña
- Servicio de Neumología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - E Martínez Moragón
- Servicio de Neumología, Hospital Universitario Dr. Peset, Valencia, Spain
| | - E Mascarós
- Medicina de Atención Primaria, Centro de Salud Fuente de San Luis, Valencia, Spain; Departamento de Salud, Hospital Dr. Peset, Valencia, Spain
| | - J Molina
- Medicina de Atención Primaria, EAP Francia, Fuenlabrada, Madrid, Spain
| | - J M Olaguibel
- Servicio de Alergología, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - L A Pérez de Llano
- Servicio de Neumología, Hospital Universitario Lucus Agusti, Lugo, Spain
| | - M Perpiñá Tordera
- Servicio de Neumología, Hospital Universitario Politécnico La Fe, Valencia, Spain
| | - J A Quintano
- Medicina de Atención Primaria, Lucena, Córdoba, Spain
| | - M Rodríguez
- Servicio de Alergología, Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - M Román-Rodriguez
- Medicina de Atención Primaria, Centro de Salud Son Pisá, Instituto de Investigación de Palma de Mallorca (IdisPa), Palma de Mallorca, Spain
| | - J Sastre
- Servicio de Alergología, Fundación Jiménez Díaz, CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Universidad Autónoma de Madrid, Madrid, Spain
| | - J A Trigueros
- Medicina de Atención Primaria, Centro de Salud Menasalbas, Toledo, Spain
| | - A L Valero
- Servicio de Neumología, Intitut Clinic Respiratori, Hospital Clinic, Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), Spain
| | - A C Zoni
- Área de Epidemiología, Subdirección de Promoción y Prevención de la Salud, Consejería de Salud de la Comunidad de Madrid, Madrid, Spain
| | - V Plaza
- Departmento of Medicina Respiratoria, Hospital de la Santa Creu i Sant Pau. Institut d'Investigació Biomédica Sant Pau (IIB Sant Pau), Universitat Autònoma de Barcelona, Departmento de Medicina, Barcelona, Spain
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Ruiz Hornillos J, Nevot Falcó S, Olaguibel JM, Ibáñez MD. Training of Spanish Allergology Residents in Pediatric Allergology: A Survey of the Current Situation. J Investig Allergol Clin Immunol 2017; 27:203. [DOI: 10.18176/jiaci.0153] [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: 11/20/2022] Open
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Sánchez-García S, Olaguibel JM, Quirce S, Ibáñez MD. Measurement of Lung Function and Bronchial Inflammation in Children Is Underused by Spanish Allergists. J Investig Allergol Clin Immunol 2016; 26:126-8. [PMID: 27164634 DOI: 10.18176/jiaci.0028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- S Sánchez-García
- Allergy Section, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - J M Olaguibel
- Allergy Department, Complejo Hospitalario Universitario de Navarra, Pamplona, Spain
| | - S Quirce
- Allergy Department, Hospital Universitario La Paz, Madrid, Spain
| | - M D Ibáñez
- Allergy Section, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
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27
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Arroabarren E, Rodriguez A, Olaguibel JM, Garcia B, Aldunate MT, Alvarez‐Puebla M, Garrido S, Echechipía S, Lizaso MT, Anda M, Gomez B, Tabar A. Acute tryptase determinations in NSAID‐induced anaphylaxis: could we avoid drug challenges? Clin Transl Allergy 2015. [PMCID: PMC4412612 DOI: 10.1186/2045-7022-5-s3-p144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Marta Anda
- Complejo Hospitalario de NavarraPamplonaSpain
| | | | - Ana Tabar
- Complejo Hospitalario de NavarraPamplonaSpain
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Abstract
Eosinophilic asthma phenotype predicts good response to corticosteroids and associates to asthmatic exacerbations. Sputum induction by hypertonic saline (HS) inhalation is technically demanding. Bronchial hyperresponsiveness (BHR) to osmotic agents indirectly mirrors active airway inflammation. We compared the safety and ability of HS and mannitol to induce sputum and measure BHR. We evaluated the stability of inflammatory phenotypes. We studied 35 non-smoking asthmatics randomized to undergo HS and mannitol challenges on 2 days 1 week apart. Sputum was sampled for cell analysis and phenotyped as eosinophilic (≥3% eosinophils) and non-eosinophilic (<3%) asthma. Nineteen subjects had BHR to mannitol and nine of them also had BHR to HS. Drops in forced expiratory volume in 1 s were higher from HS challenge than from mannitol challenge. Adequate sputum samples were obtained from 80% subjects (68% mannitol and 71% HS). Eosinophils and macrophages from both challenges correlated. Neutrophils were higher in sputum from HS. Ninety percent samples were equally phenotyped with HS and mannitol. Fractional exhaled nitric oxide, sputum eosinophils and BHR correlated in both challenges. HS and mannitol showed similar capacity to produce valuable sputum samples. BHR to both osmotic stimuli partially resembled airway eosinophilic inflammation but mannitol was more sensitive than HS to assess BHR. Eosinophilic phenotype remained stable in most patients with both stimuli.
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Affiliation(s)
- MJ Alvarez-Puebla
- Departamento de Alergología, NavarraBiomed, Complejo Hospitalario de Navarra, Pamplona, Spain
- CIBERES, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - JM Olaguibel
- Departamento de Alergología, NavarraBiomed, Complejo Hospitalario de Navarra, Pamplona, Spain
- CIBERES, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - E Almudevar
- Departamento de Anatomía Patológica, NavarraBiomed, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - AA Echegoyen
- Departamento de Anatomía Patológica, NavarraBiomed, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - C Vela
- Departamento de Alergología, NavarraBiomed, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - B de Esteban
- Departamento de Alergología, NavarraBiomed, Complejo Hospitalario de Navarra, Pamplona, Spain
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Campo P, Rodríguez F, Sánchez-García S, Barranco P, Quirce S, Pérez-Francés C, Gómez-Torrijos E, Cárdenas R, Olaguibel JM, Delgado J. Phenotypes and endotypes of uncontrolled severe asthma: new treatments. J Investig Allergol Clin Immunol 2013; 23:76-88. [PMID: 23654073] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
Severe asthma is a heterogeneous disease that affects only 5%-10% of asthmatic patients, although it accounts for a significant percentage of the consumption of health care resources. Severe asthma is characterized by the need for treatment with high doses of inhaled corticosteroids and includes several clinical and pathophysiological phenotypes. To a large extent, this heterogeneity restricts characterization of the disease and, in most cases, hinders the selection of appropriate treatment. In recent years, therefore, emphasis has been placed on improving our understanding of the various phenotypes of severe asthma and the identification of biomarkers for each of these phenotypes. Likewise, the concept of the endotype has been gaining acceptance with regard to the various subtypes of the disease, which are classified according to their unique functional or pathophysiological mechanism. This review discusses the most relevant aspects of the clinical and inflammatory phenotypes of severe asthma, including severe childhood asthma and the various endotypes of severe asthma. The main therapeutic options available for patients with uncontrolled severe asthma will also be reviewed.
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Affiliation(s)
- P Campo
- UGC Allergy, Hospital General de Málaga, Málaga, Spain.
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30
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Barranco P, Pérez-Francés C, Quirce S, Gómez-Torrijos E, Cárdenas R, Sánchez-García S, Rodríguez-Fernández F, Campo P, Olaguibel JM, Delgado J. Consensus document on the diagnosis of severe uncontrolled asthma. J Investig Allergol Clin Immunol 2012; 22:460-475. [PMID: 23397668] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND The concepts of asthma severity, control, and exacerbation are important in the evaluation of patients and their response to treatment. However, terminology is not standardized, and terms are often used interchangeably. Patients with uncontrolled severe asthma pose a major health care problem. Over the last decade, it has become increasingly clear that, in order to facilitate the development of novel targeted therapies, patients must be further characterized and classified. OBJECTIVE To draft a consensus statement on the diagnosis, management, and treatment of severe uncontrolled asthma. The statement is meant to serve as a guideline for health professionals and clinical researchers. METHODS The consensus was led by the Severe Asthma Working Group of the Spanish Society of Allergology and Clinical ImmunologyAsthma Committee. A review was conducted of the best available scientific evidence (until December 2011) on severe asthma in adults and children. RESULTS Definitions for severe asthma, level of control, and exacerbation are developed. Different phenotypes and endophenotypes of severe uncontrolled asthma and new specific therapeutic interventions are presented. A systematic algorithm for the evaluation of patients presenting with severe persistent asthma symptoms is proposed. CONCLUSIONS A consensus statement on the diagnosis, management, and treatment of severe uncontrolled asthma is presented.
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Affiliation(s)
- P Barranco
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.
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Olaguibel JM, Garcia Figueroa B, Alvarez Puebla MJ, Ezquieta F, Mina C, del Amo C. Control of asthma and utilization of medical resources: results from a community pharmacies study in the Navarre region of Spain. J Investig Allergol Clin Immunol 2007; 17:419-421. [PMID: 18088031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Affiliation(s)
- J M Olaguibel
- Sección de Alergología, Hospital Virgen del Camino, Pamplona, Spain.
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García BE, Lombardero M, Echechipía S, Olaguibel JM, Díaz-Perales A, Sánchez-Monge R, Barber D, Salcedo G, Tabar AI. Respiratory allergy to peach leaves and lipid-transfer proteins. Clin Exp Allergy 2004; 34:291-5. [PMID: 14987310 DOI: 10.1111/j.1365-2222.2004.01871.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Several lipid-transfer proteins (LTPs) have been identified as important food allergens, especially in fruits of the Rosaceae family. The major peach (Prunus persica) allergen has been identified, sequenced and designated Pru p 3. OBJECTIVE To present Pru p 3 as an aeroallergen able to induce occupational asthma. METHODS A thorough investigation was performed in a fruit grower with occupational asthma. Skin prick-prick tests with peach leaves and prick tests with perennial respiratory allergens and pollens, fruits and peach leaf extracts were done. Serum-specific IgE was tested for peach leaf, peach fruit, peach skin and respiratory allergens that were positive in skin prick tests. Specific bronchial provocation tests (BPTs) with extracts of peach leaf were also done. Before and 24 h after the BPT, BPTs with methacholine and sputum induction were done. The IgE reactivity pattern to peach leaf and fruit extracts and to Pru p 3 was identified by using SDS-PAGE and immunoblotting. Blotting inhibition of peach leaf extract by Pru p 3 was also performed. The putative allergen was quantified in leaf and fruit skin extracts with ELISA based on an anti-Pru p 3 antibody. RESULTS Skin tests were positive for peach leaf and fruit. The BPT was positive, with immediate and delayed response. This test induced a decrease in PD20 (dose of agonist that induces a 20% fall in FEV1) methacholine and an increase in eosinophils and eosinophil cationic protein in sputum. Peach leaf extract contained concentrations of Pru p 3 similar to those found in peach skin. Specific IgE immunodetection showed that patient's sera reacted with Pru p 3, and with a single major band from the peach leaf extract fully inhibited by Pru p 3. CONCLUSION Pru p 3 from peach leaves can act as a respiratory allergen and cause occupational rhinoconjunctivitis and asthma.
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Affiliation(s)
- B E García
- Sección de Alergología, Hospital Virgen del Camino, Pamplona, Spain.
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Tabar AI, Alvarez-Puebla MJ, Gomez B, Sanchez-Monge R, García BE, Echechipia S, Olaguibel JM, Salcedo G. Diversity of asparagus allergy: clinical and immunological features. Clin Exp Allergy 2004; 34:131-6. [PMID: 14720273 DOI: 10.1111/j.1365-2222.2004.01856.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Asparagus (Asparagus officinalis) is an extensively grown and consumed vegetable. To a lesser extent than other Liliaceae vegetables, allergic contact dermatitis (ACD) due to asparagus has been reported. However, only a few case reports of asparagus IgE-mediated allergy have been published. In a previous study, we demonstrated that two lipid transfer proteins (LTPs) (Aspa o 1.01 and Aspa o 1.02) were relevant allergens of asparagus. OBJECTIVE We retrospectively analysed the 27 patients diagnosed with asparagus allergy during the last 5 years. All of them reported adverse symptoms after either asparagus ingestion or handling. We describe their clinical features and evaluate whether they were associated to immunological findings (immunoblot pattern and skin reactivity to LTPs). METHODS Patients underwent skin prick and patch tests with standard panels of vegetables and aeroallergens. Besides crude asparagus extract, two purified LTPs were prick and patch tested. Total and specific IgE measurements and asparagus extract IgE immunoblotting were performed. Patients reporting asthma symptoms underwent specific inhalation challenge to asparagus. RESULTS Of the 27 subjects, eight had ACD, 17 had IgE-mediated allergy and two had both ACD- and IgE-mediated allergy. Positive patch tests with the crude asparagus extract but not with LTPs were observed in subjects with ACD (n=10). Of 19 patients with IgE-mediated disease, 10 had contact urticaria after asparagus handling. Of them, five subjects and five others without skin allergy showed respiratory symptoms; of them, eight were diagnosed with occupational asthma confirmed by positive asparagus inhalation challenge, whereas the remaining two had isolated rhinitis. Four patients suffered from immediate allergic reactions related to asparagus ingestion (food allergy); three of them reported anaphylaxis whereas the other had oral allergic syndrome. Positive IgE immunoblotting (bands of 15 and 45-70 kDa) was observed in 10 subjects. Of 10 subjects with positive prick test to LTPs, six showed bands at 15 kDa. Either IgE-binding bands or positive prick tests to LTPs were observed in asthma (62%) and anaphylaxis (67%). CONCLUSION Asparagus is a relevant source of occupational allergy inducing ACD and also IgE-mediated reactions. Severe disease (anaphylaxis or asthma) is common and LTPs seem to play a major role. The clinical relevance of LTP sensitization among patients with mild disease or symptom-free subjects should be addressed in prospective studies.
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Affiliation(s)
- A I Tabar
- Servicio de Alergología, Hospital Virgen del Camino, Pamplona, Spain and Unidad de Bioquímica, Dept. Biotecnología, ETS Ingenieros Agrónomos, Ciudad Universitaria, Madrid, Spain.
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Acero S, Alvarez MJ, García BE, Echechipía S, Olaguibel JM, Tabar AI. Occupational asthma from natural rubber latex. Specific inhalation challenge test and evolution. J Investig Allergol Clin Immunol 2003; 13:155-61. [PMID: 14635464] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Natural rubber latex (NRL) is the most frequent cause of occupational respiratory problems in hospital workers. OBJECTIVE To describe the diagnostic methodology, including the specific inhalation challenge (SIC), used on patients diagnosed as having occupational asthma due to NRL in our Allergy Department during a 6-year period from 1989 to 1995. METHODS In 19 patients diagnosed as having occupational asthma due to NRL, clinical severity was assessed with a combined score for symptoms and medication use. Skin prick tests with aeroallergens, latex, papain, kiwi and chestnut, total IgE, serum-specific latex IgE, respiratory function study, methacholine test, specific conjunctival test, and SIC test with latex were done. RESULTS All but three patients worked in hospitals. All presented urticaria and rhinoconjunctivitis, and six also suffered anaphylaxis, usually preceded by asthma. Clinical fruit allergy was present in eight patients. The latency period was variable (0.25-27 years). The intensity of symptoms was low to moderate. Specific IgE, skin prick, and conjunctival tests to latex were positive in all cases. SICs were done in 12 patients. All of them presented isolated immediate reactions. No adverse reactions were observed. Duration of follow-up ranged from 1 to 7 years. Twenty-six percent of the patients kept their job, 26% changed jobs but remained in health care, and 48% switched to jobs unrelated to health care. Only 16% were free of symptoms without treatment, while 32% needed bronchodilators and 52% needed inhaled steroids. The specific bronchial challenge test was safe, but it did not predict the course of the illness. Duration of exposure and intensity of symptoms did correlate with prognosis, however. CONCLUSIONS NRL acts as a common aerollergen. Minor symptoms often precede occupational asthma. The SIC test was safe in the hands of trained technicians. Occupational asthma due to NRL seems to have a poor prognosis.
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Affiliation(s)
- S Acero
- Sección Alergología, Hospital Virgen del Camino, Pamplona, Spain
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Alvarez MJ, Echechipía S, García B, Tabar AI, Martín S, Rico P, Olaguibel JM. Liposome-entrapped D. pteronyssinus vaccination in mild asthma patients: effect of 1-year double-blind, placebo-controlled trial on inflammation, bronchial hyperresponsiveness and immediate and late bronchial responses to the allergen. Clin Exp Allergy 2002; 32:1574-82. [PMID: 12569977 DOI: 10.1046/j.1365-2222.2002.01514.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Allergen vaccination is effective in mite-allergic asthma. Liposomes are immunological adjuvants that can act as allergen carriers. OBJECTIVE To evaluate the immunological and functional effects of a liposome-entrapped D. pteronyssinus vaccine on mite monosensitive, mild asthma patients. METHODS A double-blind, placebo-controlled trial was conducted on 26 asthma patients who randomly received vaccination or placebo for 1 year. The levels of exposure to Der p 1 allergen were constant during the study. Allergen bronchial challenge was made at the beginning (T0) and after 1 year of treatment (T12). The day before and 24 h after the allergen provocation, patients were challenged with methacholine (Mth) (until FEV1 fell by 40%) and blood and sputum samples were obtained. Dose-response curves to Mth were evaluated in terms of Mth-PD20 (dose of Mth that induced 20% drop in FEV1), slope (Mth-DRS) and level of plateau. Blood and sputum eosinophils and serum levels of eosinophil cationic protein (ECP) and intercellular adhesion molecule-1 (ICAM-1) were measured. RESULTS Groups were comparable at the start of the trial. At TI2, previous to the allergen challenge, the active group showed higher values of both FEV1 and Mth-PD20 and lower values of Mth-DRS. The number of patients presenting a level of plateau increased in the active group (from two to four) and decreased in the placebo group (from two to one). At T12, before the allergen challenge, serum ECP levels increased in the placebo group and blood eosinophils showed a trend towards lower numbers in the active one. The immediate response and the changes in Mth-DRS values, sputum eosinophils and serum ECP levels following the allergen challenge were attenuated in the active group. CONCLUSION Liposome-entrapped D. Pteronyssinus vaccination: (i) protects mild asthma patients from the worsening of asthma due to sustained mite exposure; and (ii) reduces the functional and inflammatory changes induced by allergen bronchial provocation.
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Affiliation(s)
- M J Alvarez
- Department of Allergy, Hospital Virgen del Camino, Pamplona, Spain
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36
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Olaguibel JM, Garcia BE, Echechipia S, Tabar AI. Adherence to and safety of a high dose sublingual immunotherapy regimen with a standardized grass pollen extract. J Allergy Clin Immunol 2002. [DOI: 10.1016/s0091-6749(02)81738-9] [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: 10/24/2022]
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Tabar AI, Lizaso MT, García BE, Echechipía S, Olaguibel JM, Rodríguez A. Tolerance of immunotherapy with a standardized extract of Alternaria tenuis in patients with rhinitis and bronchial asthma. J Investig Allergol Clin Immunol 2000; 10:327-33. [PMID: 11206932] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
We studied the safety of immunotherapy with an Alternaria extract in patients with rhinitis and bronchial asthma. The few studies that have investigated immunotherapy with mold allergens suggest that they cause adverse reactions more frequently than do other extracts. All treatments prescribed by our allergology service with Alternaria immunotherapy between 1988 and 1996 were recorded and analyzed. In all cases a biologically standardized depot extract of Alternaria tenuis containing 5 BU/ml was used according to a conventional immunotherapy schedule. During the study period 129 patients received immunotherapy with Alternaria extract. Of the 3,892 doses given, 1.95% led to adverse reactions, which occurred in 39.5% of the patients. Most of the adverse reactions were systemic and mild, and reproduced the underlying disease. The risk of adverse reactions was significantly higher in children, patients with asthma, and during the initial phase of treatment. Patients who suffered from adverse reactions had a significantly higher level of total and specific IgE. It was concluded that tolerance of Alternaria mold extract was worse than for other allergenic extracts, although most reactions recorded were mild. The risk of adverse reactions was greater in children and patients with asthma, and during the initial phase of immunotherapy.
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Affiliation(s)
- A I Tabar
- Department of Allergy, Hospital Virgen del Camino, Pamplona, Navarra, Spain
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Alvarez MJ, Olaguibel JM, Garcia BE, Tabar AI, Urbiola E. Comparison of allergen-induced changes in bronchial hyperresponsiveness and airway inflammation between mildly allergic asthma patients and allergic rhinitis patients. Allergy 2000; 55:531-9. [PMID: 10858983 DOI: 10.1034/j.1398-9995.2000.00534.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Bronchial eosinophilic inflammation and bronchial hyperresponsiveness (BHR) are the main features of allergic asthma (AA), but they have also been demonstrated in allergic rhinitis (AR), suggesting a continuity between both diseases. In spite of not fully reproducing natural allergenic exposure, the allergen bronchial provocation test (A-BPT) has provided important knowledge of the pathophysiology of AA. Our aim was to verify the existence of a behavior of AA and AR airways different from the allergen bronchial challenge-induced airway eosinophilic inflammation and BHR changes. We studied a group of 31 mild and short-evolution AA and 15 AR patients, sensitized to Dermatophagoides pteronyssinus. The A-BPT was performed with a partially biologically standardized D. pteronyssinus extract, and known quantities of Der p 1 were inhaled. Peripheral blood (eosinophils and ECP) and induced sputum (percentage cell counts, ECP, albumin, tryptase, and interleukin [IL]-5) were analyzed, before and 24 h after A-BPT. Methacholine BHR, assessed before and 32 h after the A-BPT, was defined by M-PD20 values and, when possible, by maximal response plateau (MRP). The A-BPT was well tolerated by all the patients. AA presented a lower Der p 1 PD20 and a higher occurrence of late-phase responses (LPR). M-PD20 values decreased in AA, but not in AR, patients. MRP values increased in both groups. Eosinophils numbers and ECP levels increased in blood and sputum from both AA and AR, but only the absolute increment of sputum ECP levels was higher in AA than AR patients (P = 0.025). The A-BPT induced no change in sputum albumin, tryptase, or IL-5 values. We conclude as follows: 1) In spite of presenting a lower degree of bronchial sensitivity to allergen, AR patients responded to allergen inhalation with an eosinophilic inflammation enhancement very similar to that observed among AA. 2) MRP levels increased in both AA and AR patients after allergen challenge; however, M-PD20 values significantly changed only in the AA group, suggesting that the components of the airway response to methacholine were controlled by different mechanisms. 3) It is possible that the differences between AR and AA lie only in the quantitative bronchial response to allergen inhalation.
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Affiliation(s)
- M J Alvarez
- Servicio de Alergología, Hospital de León, Spain
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Alvarez MJ, Olaguibel JM, García BE, Rodríquez A, Tabar AI, Urbiola E. Airway inflammation in asthma and perennial allergic rhinitis. Relationship with nonspecific bronchial responsiveness and maximal airway narrowing. Allergy 2000; 55:355-62. [PMID: 10782520 DOI: 10.1034/j.1398-9995.2000.00312.x] [Citation(s) in RCA: 87] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Eosinophilic airway inflammation is the hallmark of asthma, but it has also been reported in other conditions such as allergic rhinitis. We have tested whether the analysis of cells and chemicals in sputum can distinguish between patients with mild allergic asthma, those with allergic rhinitis, and healthy controls. The relationship between inflammation markers in sputum and nonspecific bronchial hyperresponsiveness to methacholine (BHR) (PD20 and maximal response plateau [MRP] values) was also evaluated. METHODS We selected 31 mild asthmatics and 15 rhinitis patients sensitized to house-dust mite. As a control group, we studied 10 healthy subjects. Every subject underwent the methacholine bronchial provocation test (M-BPT) and sputum induction. Blood eosinophils and serum ECP levels were measured. Sputum cell differentials were assessed, and eosinophil cationic protein (ECP), tryptase, albumin, and interleukin (IL)-5 levels were measured in the entire sputum supernatant. RESULTS Blood eosinophils and serum ECP levels were higher in asthma patients and rhinitis than in healthy controls, but no difference between asthma patients and rhinitis patients was found. Asthmatics had higher eosinophil counts and higher ECP and tryptase levels in sputum than rhinitis patients or control subjects. Sputum albumin levels were higher in asthmatics than in controls. Rhinitis patients exhibited higher sputum eosinophils than healthy controls. An association between sputum eosinophil numbers and MPR values (r= -0.57) was detected, and a trend toward correlation between sputum ECP levels and PD20 values (r= -0.47) was found in the rhinitis group, but not in asthmatics. No correlation between blood eosinophilic inflammation and lung functional indices was found. CONCLUSIONS Induced sputum is an accurate method to study bronchial inflammation, allowing one to distinguish between rhinitis patients and mildly asthmatic patients. The fact that no relationship was detected between sputum inflammation and BHR suggests that other factors, such as airway remodeling, may be at least partly responsible for BHR in asthma.
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Affiliation(s)
- M J Alvarez
- Servicio de Alergología, Hospital Virgen del Camino, Pamplona, Spain
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Alvarez MJ, Olaguibel JM, Acero S, García BE, Tabar AI, Urbiola E. Effect of current exposure to Der p 1 on asthma symptoms, airway inflammation, and bronchial hyperresponsiveness in mite-allergic asthmatics. Allergy 2000; 55:185-90. [PMID: 10726735 DOI: 10.1034/j.1398-9995.2000.00398.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The existence of a dose-response relationship between indoor allergen exposure and sensitization has been widely described, but the effect of allergen exposure on asthma activity (symptoms, bronchial hyperresponsiveness [BHR], and inflammation) is not clear. Our aim was to determine the existence of an association among current exposure to mite allergens and symptoms, BHR, and airway inflammation assessed in blood and sputum from asthmatic patients sensitized to Dermatophagoides pteronyssinus. We selected 31 mild and recently diagnosed (12-24 months) asthma patients sensitized to D. pteronyssinus. Allergenic exposure (Der p 1, Der 2) was assessed by a commercial assay based on monoclonal antibodies (mAb), carried out on the dust samples collected from patients' beds in a standardized way. Patients completed an asthma symptom questionnaire and underwent skin tests, methacholine bronchial challenge, and sputum induction. Sputum cell profile was analyzed and eosinophil cationic protein (ECP), tryptase, albumin, and interleukin(IL)-5 levels were quantified in sputum supernatant. Total eosinophil numbers and ECP levels were measured in blood samples. Most patients were exposed to Der p 1 levels under 2 microg/g of dust. Der p 1 exposure was higher among the subjects with positive sputum tryptase detection (P = 0.020). Der p 1 levels showed a trend toward correlation with asthma symptoms (P = 0.066, r = 0.36) and correlated with sputum tryptase levels (P = 0.032, r = 0.42). No relationship between BHR, eosinophilic inflammation, and allergenic exposure was found. Our results suggest that asthma symptoms and lung mast-cell activation are at least partially dependent on current allergen exposure. The lack of correlation between mite exposure, eosinophilic inflammation, and BHR supports the role of other factors that enhance the immunologic response initiated by allergen, increasing the activity of asthma.
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Affiliation(s)
- M J Alvarez
- Servicio de Alergología, Hospital Virgen del Camino, Pamplona, Spain
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Abstract
BACKGROUND The differential diagnosis of eosinophilic gastroenteritis (EG) includes, among other diseases, parasitic infections such as anisakiasis, which has acquired worldwide importance. METHODS We reviewed all patients referred to our allergy service who had been diagnosed as having primary EG to determine the possible role of Anisakis simplex in the etiopathology of the disease. All patients (n = 10) were studied and diagnosed as having primary EG between 1989 and 1996, inclusive. Two different groups of subjects were used as controls: group A (149 subjects without digestive disorder) and group B (10 subjects with digestive disorder different from EG). Cutaneous prick tests were performed with the main foods, aeroallergens, and commercial extract of A. simplex. Total and specific serum IgE was measured in all patients. Gastric or gut histologic specimens were re-examined in five cases. RESULTS Peripheral eosinophilia was detected in 40% of the patients with EG, and sensitization to A. simplex was detected in 80% of these. In both control groups, the rate of sensitization to A. simplex was 10%. Sensitization to A. simplex in EG patients with respect to control groups A and B showed odds ratios (OR) of 36 and 40, respectively. In one case, serialization of the histologic section allowed us to observe a whole Anisakis larva. CONCLUSIONS Immunologic methods to detect specific antibodies against Anisakis should be used routinely before diagnosing EG as primary disorder. Preventive measures are of capital importance.
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Affiliation(s)
- B Gómez
- Allergology Section, Hospital Virgen del Camino, Pamplona, Spain
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Abstract
Carmine (E120), a natural red dye extracted from the dried females of the insect Dactylopius coccus var. Costa (cochineal), has been reported to cause hypersensitivity reactions. We report a case of occupational asthma and food allergy due to carmine in a worker not engaged in dye manufacturing. A 35-year-old nonatopic man, who had worked for 4 years in a spice warehouse, reported asthma and rhinoconjunctivitis for 5 months, related to carmine handling in his work. Two weeks before the visit, he reported one similar episode after the ingestion of a red-colored sweet containing carmine. Peak flow showed drops higher than 25% related to carmine exposure. Prick tests with the cochineal insect and carmine were positive, but negative to common aeroallergens, several mites, foods, and spices. The methacholine test was positive. Specific bronchial challenge test with a cochineal extract was positive with a dual pattern (20% and 24% fall in FEV1). Double-blind oral challenge with E120 was positive. The patient's sera contained specific IgE for various high-molecular-weight proteins from the cochineal extract, as shown by immunoblotting. Carmine proteins can induce IgE-mediated food allergy and occupational asthma in workers using products where its presence could be easily overlooked, as well as in dye manufacture workers.
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Affiliation(s)
- S Acero
- Seccion Alergología, Hospital Virgen del Camino, Pamplona, Spain
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Alvarez MJ, Olaguibel JM, Acero S, Quirce S, García BE, Carrillo T, Cortés C, Tabar AI. Indoor allergens and dwelling characteristics in two cities in Spain. J Investig Allergol Clin Immunol 1997; 7:572-7. [PMID: 9491197] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Indoor allergens are common causes of sensitization and asthma. Climatic and home conditions can modify their levels. OBJECTIVE We studied the influence of climatic conditions and home characteristics on the exposure to indoor allergens of mite allergic asthmatic subjects in two Spanish cities with different climates (Las Palmas and Pamplona). METHODS We included 65 subjects diagnosed with asthma caused by Dermatophagoides pteronyssinus. A questionnaire about their dwellings was completed. Home dust samples were collected. Mite (Der p1, Der f1, Der 2) and cat (Fel d1) allergens were measured by a monoclonal-antibodies based ELISA. RESULTS Characteristics of dwellings were similar in both areas. Der p1 was the main allergen (0-44 micrograms/g). Der p1, Der f1 and Der 2 levels were higher in the homes in Las Palmas (p < 0.001, p < 0.01 and p < 0.001, respectively). Damp homes in Pamplona had higher Der p1 levels, similar to those detected in homes in Las Palmas. Fel d1 levels (0-78.90 micrograms/g) were only related to the presence of cats in the dwelling (p < 0.001). CONCLUSIONS D. pteronyssinus allergen exposure was influenced by climatic conditions and dampness in homes in temperate regions. Humidity in homes can generate an ideal environment for mite growth despite unfavorable outdoor climatic conditions. Fel d1 levels were only related to the presence of a cat in the house.
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Affiliation(s)
- M J Alvarez
- Allergology Section, Hospital Virgen del Camino, Pamplona, Spain
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Olaguibel JM, Alvarez Puebla MJ, Acero S, García Figueroa BE, Rodríguez Barrera A, Tabar AI. Utility of the study of non-specific bronchial response for monitoring bronchial asthma. J Investig Allergol Clin Immunol 1997; 7:284-5. [PMID: 9416519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- J M Olaguibel
- Allergology Section, Hospital Virgen del Camino, Pamplona, Spain
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Olaguibel JM, Tabar AI, García Figueroa BE, Cortés C. Immunotherapy with standardized extract of Dermatophagoides pteronyssinus in bronchial asthma: a dose-titration study. Allergy 1997; 52:168-78. [PMID: 9105521 DOI: 10.1111/j.1398-9995.1997.tb00971.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
According to the maximum tolerated dose (MTD) achieved, we assessed the changes in clinical and laboratory parameters, induced by specific immunotherapy (SIT), in a group of 43 asthmatic patients sensitized to Dermatophagoides pteronyssinus, over a period of 18 months. A standardized extract (100 Bu/ml; 40 micrograms/ml of Der p 1; 20 micrograms/ml of Der p 2) was used. The patients were divided into two groups: the high-dose immunotherapy (HDI) group (MTD > or = 4 micrograms Der p I) and the conventional immunotherapy (CI) group (MTD < 4 micrograms Der p 1). Changes in clinical severity index, medication, and symptom scores; in cutaneous and conjunctival reactivity; and in the levels of specific IgE, IgG, IgG1, and IgG4 to D. pteronyssinus (Der p 1 and Der p 2) were measured (ELISA monoclonal antibodies). Safety was monitored according to the EAACI guidelines. The range of the MTD was 0.8-16 micrograms of Der p 1. Ninety percent of the patients tolerated a dose of 3.2 micrograms, but only 18% of the patients reached a maintenance dose of 16 micrograms. The medians of the accumulated dose were 197 micrograms of Der p 1 for the HDI group, and 50 micrograms for the CI group. Conjunctival and cutaneous reactivity was significantly lowered (P < 0.001) after SIT, as were the clinical severity score and medication score in both groups, without significant differences between the groups, except for cutaneous reactivity. Levels of specific IgE decreased significantly (P < 0.01) in both groups, again without significant differences between the groups. The range of the increase in medians of specific IgG, IgG1, and IgG4 was 4.4-120-fold for the HDI group and 3-24-fold for the CI group (P < 0.01). The increase in the levels of Der p 1 and Der p 2 IgG4 were correlated to the changes in cutaneous and conjunctival reactivity (P < 0.01). These results show that a maintenance dose of 3.2 micrograms Der p 1 (8 BU) can induce pronounced clinical and immunologic changes with an excellent safety profile.
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Affiliation(s)
- J M Olaguibel
- Sección de Alergología, Hospital Virgen del Camino, Pamplona, Spain
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Affiliation(s)
- S Quirce
- Allergy Department, Hospital Virgen del Camino, Pamplona, Spain
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Abstract
7 subjects, each giving a history of scaly or vesicular dermatitis in light-exposed areas after going for strolls to the park, the forest or the country during warm weather, were evaluated. Patch testing was carried out with Frullania dilatata and Frullania tamarisci as well as with 2 common members of the Compositae and to alantolactone and the sesquiterpene lactone mix. All the patients were positive to F. dilatata, 3 reacted to F. tamarisci as well, and 2 to florists' chrysanthemum. All of them except 1 gave positive responses to the sesquiterpene lactone mix, but only 3 reacted to alantolactone. Airborne contact dermatitis from these species of Frullania was considered to be the cause of their eczema. Patch testing with the sesquiterpene lactone mix seems to be a good screen for Frullania sensitivity; however, a variable pattern of response to these sesquiterpene-lactone-containing materials was observed, suggesting individual immunologic responses to them.
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Affiliation(s)
- S Quirce
- Section of Allergology, Hospital Virgen del Camino, Pamplona, Spain
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Quirce S, Cuevas M, Olaguibel JM, Tabar AI. Occupational asthma and immunologic responses induced by inhaled carmine among employees at a factory making natural dyes. J Allergy Clin Immunol 1994; 93:44-52. [PMID: 8308181 DOI: 10.1016/0091-6749(94)90231-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Carmine is a natural red dye widely used as a food coloring agent and for cosmetic manufacture. It is extracted from the dried females of the insect Dactylopius coccus var. Costa (cochineal). Although it has been reported that inhalation of carmine may give rise to occupational asthma and extrinsic allergic alveolitis, there is little evidence of its immunogenic capacity. We studied nine current employees at a factory making natural dyes and one former employee who had left this plant after occupational asthma developed. A current employee had work-related symptoms of rhinitis and asthma that were confirmed by bronchial provocation tests, and another worker had rhinitis. Immunologic sensitization to carmine and cochineal was evaluated by means of skin testing and determination of serum-specific IgE and IgG subclass antibodies by RAST and ELISA, respectively. The specificity of the RAST assay was investigated by RAST inhibition with different fractions of carmine. The three workers with respiratory symptoms had positive skin prick test reactions to both carmine and cochineal. An immediate response to the bronchial provocation test with carmine and cochineal was observed in the current employee with asthma. Specific IgE antibodies against carmine and cochineal were found only in this worker. RAST inhibition studies indicated that the main allergen had a molecular weight between 10 and 30 kd. Specific IgG antibodies against carmine and cochineal, mainly the subclasses IgG1, IgG3, and IgG4, were found in the 10 subjects surveyed. These findings suggest that carmine may induce immunologic responses, most likely IgE mediated in workers with symptoms of occupational asthma.
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Affiliation(s)
- S Quirce
- Department of Allergy, Hospital Virgen del Camino, Pamplona, Spain
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Affiliation(s)
- S Quirce
- Section of Allergology, C.S. Conde Oliveto, Pamplona, Spain
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Tabar AI, Quirce S, García BE, Rodríguez A, Olaguibel JM. Primula dermatitis: versatility in its clinical presentation and the advantages of patch tests with synthetic primin. Contact Dermatitis 1994; 30:47-8. [PMID: 8156769 DOI: 10.1111/j.1600-0536.1994.tb00734.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- A I Tabar
- Sección Alergología, Hospital Virgen Del Camino, Pamplona, Spain
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