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1. Developing a core outcome set for clinical trials in olfactory disorders: a COMET initiative

Author

C Philpott, K Kumaresan, A W Fjaeldstad, A Macchi, G Monti, J Frasnelli, I Konstantinidis, J Pinto, J Mullol, J Boardman, J Vodička, E Holbrook, V R Ramakrishnan, M Lechner, and T Hummel

Subjects
Otorhinolaryngology, General Medicine
Abstract

Statement of problem: Evaluating the effectiveness of the management of Olfactory Dysfunction (OD) has been limited by a paucity of high-quality randomised and/or controlled trials. A major barrier is heterogeneity of outcomes in such studies. Core outcome sets (COS) –standardized sets of outcomes that should be measured/reported as determined by consensus—would help overcome this problem and facilitate future meta-analyses and/or systematic reviews (SRs). We set out to develop a COS for interventions for patients with OD. Methods: A long-list of potential outcomes was identified by a steering group utilising a literature review, thematic analysis of a wide range of stakeholders’ views and systematic analysis of currently available Patient Reported Outcome Measures (PROMs). A subsequent e-Delphi process allowed patients and healthcare practitioners to individually rate the outcomes in terms of importance on a 9-point Likert scale. Results: After 2 rounds of the iterative eDelphi process, the initial outcomes were distilled down to a final COS including subjective questions (visual analogue scores, quantitative and qualitative), quality of life measures, psychophysical testing of smell, baseline psychophysical testing of taste, and presence of side effects along with the investigational medicine/device and patient’s symptom log. Conclusions: Inclusion of these core outcomes in future trials will increase the value of research on clinical interventions for OD. We include recommendations regarding the outcomes that should be measured, although future work will be required to further develop and revalidate existing outcome measures.

Published
2023
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2. Prevalence of asthma in Catalonia (Spain): a retrospective, large-scale population-based study

Author

T Mora, I Sánchez-Collado, J Mullol, P Ribó, R Muñoz-Cano, and A Valero

Subjects
Immunology, Immunology and Allergy
Abstract

Introduction: Asthma epidemiology reports an estimated global prevalence of about 4.3-8.6% in adults, with vast differences among geographical regions. This study analyses a more significant population of asthma patients (473,737 individuals). Objectives: To study the prevalence of medical diagnosis of asthma, overall and by age, gender, and disease severity, as well as comorbidities and type 2 biomarkers, and undergo medical treatments of a retrospective population-based asthma cohort from Catalonia (Spain). Methodology: Individuals with a diagnosis of asthma established by medical records at different healthcare levels (primary, hospital, and emergency) from the Catalan Health System (CHS) were included. Socio-demographic characteristics, prevalence, overall and by age and gender, disease severity, comorbidities, and biomarkers of type-2 inflammation were evaluated, together with appropriate medical treatment. Results: The overall diagnosed asthma prevalence in the population of Catalonia was 6.3%, where patients mainly had mild asthma (5.3%) and were significantly higher in females (6.8%) than males (5.7%). By age groups, asthma was more prevalent in boys and young men adults; however, being more prevalent in females above the age of 30y. The prevalence of severe asthma was 0.4%, 42.6% had uncontrolled asthma, and a high proportion (84.2%) were under systemic corticosteroid prescription. As expected, SABAs were the most prescribed drug (62.6%), followed by systemic corticosteroids (43.3%). More than half (53.8%) of patients showed type 2 inflammation. Conclusions: Asthma prevalence in Catalonia is similar to other areas studied in Spain, with a high prevalence in women and of T2 asthma.

Published
2023
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3. EPOS/EUFOREA update on indication and evaluation of Biologics in Chronic Rhinosinusitis with Nasal Polyps 2023

Author

W J Fokkens, A-S Viskens, V Backer, D Conti, E De Corso, P Gevaert, G K Scadding, M Wagemann, M Bernal-Sprekelsen, A Chaker, E Heffler, J K Han, E Van Staeyen, C Hopkins, J Mullol, A Peters, S Reitsma, B A Senior, and P W Hellings

Subjects
Otorhinolaryngology, General Medicine
Abstract

Severe chronic rhinosinusitis with nasal polyps (CRSwNP) is a debilitating disease with a significant impact on the quality of life (QoL). It is typically characterized by a type 2 inflammatory reaction and by comorbidities such as asthma, allergies and NSAID-Exacerbated Respiratory Disease (N-ERD). Here, the European Forum for Research and Education in Allergy and Airway diseases discusses practical guidelines for patients on biologic treatment. Criteria for the selection of patients who would benefit from biologics were updated. Guidelines are proposed concerning the monitoring of the drug effects that provide recognition of responders to the therapy and, subsequently, the decision about continuation, switching or discontinuation of a biologic. Furthermore, gaps in the current knowledge and unmet needs were discussed.

Published
2023
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5. Prevalence of Atopic Dermatitis in the adult population of Catalonia (Spain): a retrospective, large-scale population-based study

Author

T Mora, I Sánchez-Collado, J Mullol, R Muñoz-Cano, P Ribó, and A Valero

Subjects
Immunology, Immunology and Allergy
Abstract

Introduction: Studies on the prevalence of Atopic Dermatitis (AD) for the adult cohort in general-based populations are scarce worldwide. We performed a retrospective population-based observational cohort study of 537,098 adult patients diagnosed with AD in Catalonia (Spain), a larger population than in previous studies. Objectives: To study the prevalence of AD generally by age, gender, disease severity, multi-morbidities, and serum total Immunoglobin E (tIgE) and undergo appropriate medical treatment (AMT) for the Catalan population. Methods: Adult individuals (≥18 years old) diagnosed with AD by medical records at different health care levels (primary, hospital, emergency) from the Catalan Health System (CHS) were included. Statistical analyses were conducted to evaluate sociodemographic characteristics, prevalence, multi-morbidities, serum tIgE and AMT. Results: The overall diagnosed AD prevalence in the adult Catalan population was 8.7%, being higher for the non-severe (8.5%) than for the severe (0.2%) populations and females (10.1%) than males (7.3%). Topical corticosteroids were the most prescribed drug (66.5%), and the use of all prescribed treatments was higher in severe AD patients, especially systemic corticosteroids (63.8%) and immunosuppressant agents (60.7%). More than half (52.2%) of severe AD patients reported serum tIgE ≥ 100 KU/L, and higher values were observed for those with multi-morbidities. Acute bronchitis (13.7%), allergic rhinitis (12.1%), and asthma (8.6%) were the most frequent comorbid respiratory diseases. Conclusions: Our study provides new and robust evidence of AD's prevalence and related characteristics in adults using a large-scale population-based study and a more significant cohort of individuals.

Published
2023
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7. The EUFOREA pocket guide for chronic rhinosinusitis

Author

P.W. Hellings, W.J. Fokkens, R. Orlandi, G.F. Adriaensen, I. Alobid, F.M. Baroody, L. Bjermer, B.A. Senior, A. Cervin, N.A. Cohen, J. Constantinidis, E. De Corso, M. Desrosiers, Z. Diamant, R.G. Douglas, S. Gane, P. Gevaert, J.K. Han, R.J. Harvey, C. Hopkins, R.C. Kern, B.N. Landis, J.T. Lee, S.E. Lee, A. Leunig, V.J. Lund, B. Manuel-Sprekelsen, J. Mullol, C. Philpott, E. Prokopakis, S. Reitsma, D. Ryan, S. Salmi, G. Scadding, R.J. Schlosser, A. Steinsvik, P.V. Tomazic, E. Van Staeyen, T. Van Zele, O. Vanderveken, A-S. Viskens, D. Conti, and M. Wagenmann

Subjects
Nasal Polyps, Otorhinolaryngology, Chronic Disease, Quality of Life, Hypersensitivity, Humans, General Medicine, Human medicine, Sinusitis, Rhinitis
Abstract

Chronic rhinosinusitis (CRS) is known to affect around 5 % of the total population, with major impact on the quality of life of those severely affected (1). Despite a substantial burden on individuals, society and health economies, CRS often remains underdiagnosed, under-estimated and under-treated (2). International guidelines like the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) (3) and the International Consensus statement on Allergy and Rhinology: Rhinosinusitis 2021 (ICAR) (4) offer physicians insight into the recommended treatment options for CRS, with an overview of effective strategies and guidance of diagnosis and care throughout the disease journey of CRS. ispartof: RHINOLOGY vol:61 issue:1 pages:85-89 ispartof: location:Netherlands status: published

Published
2022
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8. Lung function abnormalities and their correlation with clinical characteristics and inflammatory markers in adult asthma

Author

D Betancor, JM Olaguibel, JM Rodrigo-Muñoz, MJ Alvarez Puebla, E Arismendi, P Barranco, B Barroso, I Bobolea, B Cárdaba, MJ Cruz, E Curto, V Del Pozo, J Domínguez-Ortega, FJ González-Barcala, JA Luna-Port, C Martínez-Rivera, J Mullol, X Miñoz, C Picado, V Plaza, S Quirce, MJ Rial, L Soto-Retes, A Valero, M Valverde-Monge, and J Sastre

Subjects
Immunology, Immunology and Allergy
Published
2022

9. Prevalence of Chronic Rhinosinusitis with Nasal Polyps in Catalonia (Spain): a retrospective, large-scale population-based study

Author

I. Sanchez-Collado, T. Mora, R. Munoz-Cano, P. Ribo, J. Mullol, and A. Valero

Subjects
Adult, Inflammation, Male, Adolescent, General Medicine, Middle Aged, Nasal Polyps, Otorhinolaryngology, Spain, Chronic Disease, Prevalence, Humans, Female, Sinusitis, Biomarkers, Retrospective Studies, Rhinitis
Abstract

Background: Studies on the prevalence of chronic rhinosinusitis (CRS) with nasal polyps (NP) in general-based populations are scarce in Europe and worldwide. We performed a retrospective population-based observational cohort study of 30,189 adult patients diagnosed with NP in Catalonia (Spain). Methodology: Adult individuals (≥18 years old) with a diagnosis of NP established by medical records at different health care levels (primary, hospital, and emergency) from the Catalan Health System (CHS) were included. Socio-demographic characteristics, prevalence, overall and by age and gender, disease severity, multi-morbidities, and biomarkers of type-2 inflammation were evaluated, together with appropriate medical treatment (AMT) and Endoscopic Sinus Surgery (ESS). Results: In general population and severity sub-populations, the overall diagnosed NP prevalence was 0.49% and higher for males than females (0.60% vs 0.39%, p less than 0.0016). The prevalence for the severe NP population was 0.12%. The NP prevalence increased with age, the highest being at ≥ 60 years old for both gender and severity groups. Asthma (40.1%), acute rhinosinusitis (41.1%), and allergic rhinitis (32.1%) were among the most frequent comorbid respiratory diseases. ESS was performed in 15.4% of NP patients. Type 2 inflammation was present in 83.8% of the NP population and was more frequent in severe than non-severe (87.1% vs 82.7%, p less than 0.0001) patients and in those with respiratory multi-morbidities (91%). Conclusions: This is the first large-scale population-based NP epidemiology study conducted in Spain, including severity based on undergoing medical and surgical treatment and type 2 inflammation. Although the prevalence data are lower than in previous European studies, the large NP cohort studied represents an essential strength of the results.

Published
2022

10. Weight loss and vitamin D improve hyporesponsiveness to corticosteroids in obese asthma

Author

M, Bantulà, V, Tubita, J, Roca-Ferrer, J, Mullol, A, Valero, I, Bobolea, M, Pascal, A, de Hollanda, J, Vidal, C, Picado, and E, Arismendi

Subjects
Immunology, Immunology and Allergy
Abstract

Obesity negatively impacts on asthma response to inhaled corticosteroids by unknown mechanisms. Objective: To demonstrate that the poor response to inhaled corticosteroids in obese asthma is associated with an impaired anti-inflammatory activity of corticosteroids and vitamin D deficiency, both improved by weight loss.23 obese asthmatics (OA) [18 females; median age (interquartile range) 56 (51-59) years], 14 non-obese asthmatics (NOA) [11 females; 53 (43-60) years], 15 obese (O) [13 females; 47 (45-60) years], and 19 healthy controls (HC) [14 females; 43 (34-56) years] were enrolled. 10 OA and 11 O patients were evaluated at baseline (V1) and six months after (V2) bariatric surgery. Corticosteroid response was measured by dexamethasone inhibition of peripheral blood mononuclear cell (PBMC) proliferation. Lung function, serum levels of leptin, adiponectin, and vitamin D were measured at V1 and V2.We found a reduced response to dexamethasone in PBMCs of O and OA patients with respect to NOA and HC subjects, that inversely correlated with the diponectin/leptin ratio and vitamin D levels. Bariatric surgery improved corticosteroid responses in O and OA patients and normalized adiponectin/leptin ratio and vitamin D levels. Exposure of PBMCs to vitamin D potentiated the antiproliferative effects of corticosteroids. Dexamethasone and vitamin D induced similar MKP-1 expression in O and OA patients.We found a reduced response to dexamethasone in PBMCs of O and OA patients with respect to NOA and HC subjects, that inversely correlated with the adiponectin/leptin ratio and vitamin D levels. Bariatric surgery improved corticosteroid responses in O and OA patients and normalized adiponectin/leptin ratio and vitamin D levels. Exposure of PBMCs to vitamin D potentiated the antiproliferative effects of corticosteroids. Dexamethasone and vitamin D induced similar MKP-1 expression in O and OA patients.

Published
2022
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11. Alpha-1 antitrypsin deficiency associates with asthma exacerbations

Author

E Martín González, J M Hernández-Pérez, M González-Carracedo, J Pérez-García, R González-Pérez, E Mederos-Luis, I Sánchez-Machín, P Poza-Guedes, M Jesús Cruz, F J González-Barcala, C Martínez-Rivera, J Mullol, X Muñoz, J M Olaguibel, V Plaza, S Quirce, A Valero, J Sastre, V Del Pozo, J Villar, J A Pérez, and M Pino-Yanes

Published
2022
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12. Dupilumab reduces systemic corticosteroid use and sinonasal surgery rate in CRSwNP

Author

G W Canonica, Siddhesh Kamat, P W Hellings, Xuezhou Mao, Stella E. Lee, Leda Mannent, Martin Desrosiers, Marcella Ruddy, J Mullol, W. J. Fokkens, Roger Jankowski, M S Rice, Shigeharu Fujieda, Philippe Gevaert, Asif H. Khan, Naimish Patel, C Hopkins, N.M.H. Graham, Seong H. Cho, Claus Bachert, M. Zhang, Nikhil Amin, Joseph K. Han, and Ear, Nose and Throat

Subjects
Adult, medicine.medical_specialty, Chronic rhinosinusitis, sinusitis, CHRONIC RHINOSINUSITIS, Nasal congestion, Placebo, Antibodies, Monoclonal, Humanized, 03 medical and health sciences, rhinitis, 0302 clinical medicine, Double-Blind Method, Adrenal Cortex Hormones, Medicine and Health Sciences, medicine, Nasal polyps, Humans, Sinusitis, RECURRENCE, 030223 otorhinolaryngology, NASAL POLYPOSIS, Rhinitis, TERM USE, HUMANIZATION, nasal polyps, Interleukin-13, business.industry, paranasal sinus diseases, General Medicine, medicine.disease, Dupilumab, Surgery, Treatment Outcome, 030228 respiratory system, Otorhinolaryngology, Chronic Disease, Quality of Life, Paranasal sinus diseases, Corticosteroid use, medicine.symptom, business, ENDOSCOPIC SINUS SURGERY
Abstract

BACKGROUND: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a type 2 inflammatory disease with a high symptom burden and poor quality of life. Treatment options include recurrent surgeries and/or frequent systemic corticosteroids (SCS). Dupilumab, a fully human monoclonal antibody, blocks the shared receptor component for interleukin-4 and interleukin-13, key drivers of type 2-mediated inflammation. We report results of pooled analyses from 2 randomised, double-blind, placebo-controlled phase 3 studies (SINUS 24 [NCT02912468]; SINUS-52 [NCT02898454]) to evaluate dupilumab effect versus placebo in adults with CRSwNP with/without SCS use and sinonasal surgery. METHODOLOGY: SINUS-24 patients were randomised 1:1 to subcutaneous dupilumab 300 mg (n=143) or placebo (n=133) every 2 weeks (q2w) for 24 weeks. SINUS-52 patients were randomised 1:1:1 to 52 weeks of subcutaneous dupilumab 300 mg q2w (n=150), 24 weeks q2w followed by 28 weeks of dupilumab 300 mg every 4 weeks (n=145) or 52 weeks of placebo q2w (n=153). RESULTS: Dupilumab reduced the number of patients undergoing sinonasal surgery (82.6%), the need for in-study SCS use (73.9%), and SCS courses (75.3%). Significant improvements were observed with dupilumab vs placebo regardless of prior sinonasal surgery or SCS use in nasal polyp, nasal congestion, Lund-MacKay, and Sinonasal Outcome Test (22-items) scores, and the University of Pennsylvania Smell Identification Test. CONCLUSIONS: Dupilumab demonstrated significant improvements in disease signs and symptoms and reduced the need for sino-nasal surgery and SCS use versus placebo in patients with severe CRSwNP, regardless of SCS use in the previous 2 years, or prior sinonasal surgery.

Published
2021
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13. COVID-19 pandemic

Author

W. J. Fokkens, Jürgen Schwarze, Cezmi A. Akdis, J Mullol, W. Czarlewski, Claudia Traidl-Hoffmann, Claus Bachert, D. Larenas-Linnemann, Tomas Chivato, M. Gotua, Mateo Bonini, Ludger Klimek, Vincenzo Patella, A. A. Cruz, Stephanie Dramburg, Kari C. Nadeau, H W Fritsch, K. Ohta, Thomas Eiwegger, Robert M. Naclerio, Antti Lauerma, A. Yorgancioglu, Aslı Gelincik, Piotr Kuna, Oliver Pfaar, Carmen Riggioni, Violeta Kvedariene, Markus Ollert, Sinthia Bosnic-Anticevich, V. Cardona, S. Del Giacco, Sanna Toppila-Salmi, Helen A. Brough, Heimo Breiteneder, Valérie Hox, B. Samolinski, Zuzana Diamant, G.W. Canonica, Lihong Zhang, María José Torres, Y. Okamoto, Liam O'Mahony, Radosław Gawlik, Jolanta Walusiak-Skorupa, Sharon Chinthrajah, Winfried Rief, T. Haatela, M. Morais-Almeida, Ioana Agache, Manfred Schedlowski, I Skypala, R. Brehler, D. Y. Wang, João Fonseca, I. J. Ansotegui, Robyn E O'Hehir, Oscar Palomares, Charlotte G. Mortz, J. C. Ivancevich, C. Suppli Ulrik, M. T. Ventura, P M Matricardi, S Untersmayr, Gabrielle L. Onorato, Amir Hamzah Abdul Latiff, Frederico S. Regateiro, Vanitha Sampath, Arũnas Valiulis, Marek Jutel, Luisa Brussino, Pedro Carreiro-Martins, Jean Bousquet, Nikolaos G. Papadopoulos, A. Bedbrook, Torsten Zuberbier, Karin Hoffmann-Sommergruber, Edward F. Knol, Ear, Nose and Throat, AII - Inflammatory diseases, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, Philipps Universität Marburg = Philipps University of Marburg, Allergologie, Stimm und Sprachstörungen [Wiesbaden, Germany], Zentrum für Rhinologie und Allergologie [Wiesbaden, Germany], University of Wrocław [Poland] (UWr), ALL-MED, Swiss Institute of Allergy and Asthma Research (SIAF), Universität Zürich [Zürich] = University of Zurich (UZH), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Medizinische Universität Wien = Medical University of Vienna, Stanford University, Skane University Hospital [Malmo], Lund University [Lund], Charles University [Prague] (CU), University Medical Center Groningen [Groningen] (UMCG), Univ Toronto, Hosp Sick Children, Peter Gilgan Ctr Res & Learning, Mol Med, Toronto, ON M5G 0A4, Canada, The Hospital for sick children [Toronto] (SickKids), University of Toronto, Amsterdam UMC - Amsterdam University Medical Center, Alfred Health, Victoria University [Melbourne], University College Cork (UCC), Sean N. Parker Center for Allergy and Asthma Research [Stanford], Stanford Medicine, Stanford University-Stanford University, University Clinics of Essen, University of Essen, Allergy Unit [Malaga, Spain] (National Network ARADyAL), Hospital Regional Universitario de Málaga = Regional University Hospital of Malaga [Spain], Helmholtz Zentrum München = German Research Center for Environmental Health, University Hospital Augsburg, National University of Singapore (NUS), Beijing Tongren Hospital, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, National Heart and Lung Institute [London] (NHLI), Imperial College London-Royal Brompton and Harefield NHS Foundation Trust, University Hospital Münster - Universitaetsklinikum Muenster [Germany] (UKM), Evelina London Children's Hospital, King‘s College London, CEU-San Pablo University and HM-Hospitals School of Medicine, University of Cagliari, Medical University of Silesia (SUM), Istanbul University, Cliniques Universitaires Saint-Luc [Bruxelles], University Medical Center [Utrecht], Helsinki University Central Hospital, University of Helsinki, Odense University Hospital (OUH), Luxembourg Institute of Health (LIH), Universidad Complutense de Madrid = Complutense University of Madrid [Madrid] (UCM), Hospital Sant Joan de Déu [Barcelona], Institut de Recerca Pediàtrica Hospital Sant Joan de Déu [Barcelona, Spain], University of Edinburgh, NHS Foundation Trust [London], The Royal Marsden, Nofer Institute of Occupational Medicine (NIOM), Hospital Quirónsalud Bizkaia [Bilbao], Ghent University Hospital, Sun Yat-Sen University [Guangzhou] (SYSU), Karolinska Institutet [Stockholm], Woolcock Institute of Medical Research [Sydney], The University of Sydney, University of Turin, Mauriziano Umberto I Hospital, Humanitas University [Milan] (Hunimed), Vall d'Hebron University Hospital [Barcelona], Hospital de Dona Estefania, NOVA Medical School - Faculdade de Ciências Médicas (NMS), Universidade Nova de Lisboa = NOVA University Lisbon (NOVA), Federal University of Bahia School of Medicine, Global Alliance Against Chronic Respiratory Diseases (GARD-WHO), Medical Consulting Czarlewski, Faculdade de Medicina da Universidade do Porto (FMUP), Universidade do Porto = University of Porto, MEDIDA, Lda, David Tvildiani Medical University (DTMU), Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Servicio de Alergia e ImmunologiaBuenos Aires (Clinica Santa Isabel), Barlicki University Hospital, Vilnius University [Vilnius], Hospital Medica Sur [Mexico City, Mexico], Pantai Hospital [Kuala Lumpur], Hospital CUF Descobertas, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona (UB), CIBER de Epidemiología y Salud Pública (CIBERESP), Johns Hopkins University School of Medicine [Baltimore], Fukujuji Hospital, Tokyo National Hospital, Chiba Rosai Hospital, Chiba University Hospital, Royal Manchester Children's Hospital, University of Manchester [Manchester], General Children's Hospital of Athens P & A Kyriakou, 'Santa Maria della Speranza' Hospital, Centro Hospitalar e Universitário [Coimbra], Coimbra Institute for Clinical and Biomedical Research [Coimbra, Portugal] (iCBR - Faculty of Medicine), University of Coimbra [Portugal] (UC), Medical University of Warsaw - Poland, Hvidovre Hospital, University of Copenhagen = Københavns Universitet (UCPH), Università degli studi di Bari Aldo Moro = University of Bari Aldo Moro (UNIBA), Manisa Celal Bayar University, Transilvania University of Brasov, Salvy-Córdoba, Nathalie, Department of Dermatology, Allergology and Venereology, and HUS Inflammation Center

Subjects
0301 basic medicine, viruses, Eaaci Position Paper, Medizin, Cochrane Library, GUIDELINES, FOOD ALLERGY, allergen immunotherapy, allergy clinic, anaphylaxis, asthma, clinical trials, COVID-19, Position Paper, psychological impact, SARS-CoV-2, Allergists, Health Personnel, Humans, Hypersensitivity, Information Technology, Patient Care Team, Triage, SARS‐CoV‐2, DESENSITIZATION, 0302 clinical medicine, MESH: Patient Care Team, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, HDE ALER, Pandemic, Health care, Immunology and Allergy, ATOPIC-DERMATITIS, MESH: COVID-19, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, allergen immunotherapy (AIT), virus diseases, DRUG HYPERSENSITIVITY REACTIONS, 3. Good health, INFECTIONS, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH: Triage, [SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology, Allergen immunotherapy, medicine.medical_specialty, MESH: Information Technology, MESH: Hypersensitivity, Immunology, education, MEDLINE, DIAGNOSIS, psychological COVID, 03 medical and health sciences, MESH: Allergists, COVID‐19, medicine, MESH: SARS-CoV-2, ddc:610, RHINOSINUSITIS, MESH: Humans, business.industry, Clinical trial, Coronavirus, EXACERBATIONS, 030104 developmental biology, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Family medicine, 3121 General medicine, internal medicine and other clinical medicine, Position paper, MESH: Health Personnel, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract

BackgroundThe Coronavirus disease 2019 (COVID‐19) has evolved as a pandemic infectious disease transmitted by the severe acute respiratory syndrome coronavirus (SARS‐CoV‐)2. Allergists and other health care providers (HCPs) in the field of allergies and associated airway diseases are in the front line, taking care of patients potentially infected with SARS‐CoV‐2. Hence, strategies and practices to minimize risks of infection for both HCPs and treated patients have to be developed and followed by allergy clinics.MethodThe scientific information on COVID‐19 was analyzed by a literature search in Medline, Pubmed, national and international guidelines from the European Academy of Allergy and Clinical Immunology (EAACI), the Cochrane Library and the Internet.ResultsBased on diagnostic and treatment standards developed by EAACI, on international information regarding COVID‐19, on guidelines of the World Health Organization (WHO) and other international organizations as well as on previous experience, a panel of experts including clinicians, psychologists, IT experts and basic scientists along with EAACI and the “Allergic Rhinitis and its Impact on Asthma (ARIA)” inititiative have developed recommendations for the optimal management of allergy clinics during the current COVID‐19 pandemic. These recommendations are grouped into nine sections on different relevant aspects for the care of patients with allergies.ConclusionsThis international Position Paper provides recommendations on operational plans and procedures to maintain high standards in the daily clinical care of allergic patients whilst ensuring necessary safety in the current COVID‐19 pandemic.

Published
2021
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14. Update about Oralair® as a treatment for grass pollen allergic rhinitis

Author

L. Klimek, R. Brehler, R. Mösges, P. Demoly, J. Mullol, D. Y. Wang, R. E. O’Hehir, A. Didier, M. Kopp, C. Bos, E. Karagiannis, Centre for Rhinology and Allergy, University Hospital Münster - Universitaetsklinikum Muenster [Germany] (UKM), University of Cologne, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Médecine de précision par intégration de données et inférence causale (PREMEDICAL), Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Epidemiology of Allergic and Respiratory Diseases Department [iPlesp] (EPAR), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), National University of Singapore (NUS), Monash Central Clinical School [Melbourne] (CCS), Faculty of Medicine, Nursing and Health Sciences - Monash university [Victoria], Monash university-Monash university, Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Universität zu Lübeck = University of Lübeck [Lübeck], and Stallergenes Greer (France, Antony)

Subjects
MESH: Allergens, Immunology, Administration, Sublingual, MESH: Plant Extracts, Poaceae, sublingual immunotherapy, MESH: Poaceae, Humans, Immunology and Allergy, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, MESH: Treatment Outcome, Pharmacology, MESH: Humans, MESH: Antigens, Plant, Plant Extracts, allergic rhinoconjunctivitis, MESH: Quality of Life, 5-Grass pollen tablet, [SDV.IMM.IMM]Life Sciences [q-bio]/Immunology/Immunotherapy, Allergens, Antigens, Plant, asthma, Rhinitis, Allergic, Treatment Outcome, MESH: Administration, Sublingual, MESH: Pollen, Quality of Life, allergen immunotherapy, MESH: Rhinitis, Allergic, MESH: Tablets, Pollen, Tablets, MESH: Sublingual Immunotherapy
Abstract

International audience; Sublingual immunotherapy (SLIT) is a well-tolerated, safe, and effective approach to treating allergic rhinitis (AR). Oralair® is a five-grass pollen SLIT tablet containing natural pollen allergens from five of the major grass species responsible for seasonal AR due to grass pollen allergy. Recommended use is in a pre-coseasonal regimen, starting daily treatment approximately 4 months before the start of the pollen season, with treatment then continued daily throughout the season; treatment should continue for 3-5 y. Clinical efficacy and safety of Oralair® in patients with grass pollen-induced AR has been demonstrated in a comprehensive clinical development program of randomized controlled trials. Effectiveness has been substantiated in subsequent observational studies with sustained efficacy following treatment cessation and a favorable level of adherence, quality of life, benefit, and satisfaction for the patients. Supportive evidence for a benefit in reducing the risk or delaying the development of allergic asthma is emerging.

Published
2022
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15. Functional Examination of the Upper and Lower Airways in Asthma and Respiratory Allergic Diseases: Considerations in the Post–SARS-CoV-2 Era

Author

José María Olaguibel, Francisco García-Río, María Jesús Rojas-Lechuga, J Mullol, Vicente Plaza, M Valvere-Monge, Santiago Quirce, Isam Alobid, Astrid Crespo-Lessmann, J Domínguez Ortega, Javier Sastre, Adriana Izquierdo-Domínguez, and M J Alvarez Puebla

Subjects
medicine.medical_specialty, Health Personnel, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Respiratory System, Immunology, Psychological intervention, Disease, 03 medical and health sciences, 0302 clinical medicine, Pandemic, Respiratory Hypersensitivity, medicine, Humans, Mass Screening, Immunology and Allergy, 030212 general & internal medicine, Intensive care medicine, Occupational Health, Asthma, SARS-CoV-2, Transmission (medicine), business.industry, COVID-19, Respiratory allergy, medicine.disease, Ventilation, Respiratory Function Tests, 030228 respiratory system, Patient Safety, Airway, business
Abstract

Airway examination techniques are procedures that can potentially transmit infectious diseases to both patients and healthcare professionals who perform them, by various mechanisms. The pandemic situation due to the COVID-19 disease has practically halted most of the activity of the clinics and laboratories of pulmonary and nasal function, with clear recommendations in this regard. Being already in the early stages after the peak of the pandemic, we still do not know for sure what its consequences will be in the short or long term, since there are important gaps in the knowledge of aspects as fundamental as the transmission mechanisms of the virus, its pathophysiology and immune response or its diagnosis. In this review we will examine the different examination techniques available on the assessment of patients suffering from respiratory allergy, asthma and associated diseases, int the postpandemic momentum, highlighting their possible advantages and disadvantages. For this reason, we wanted to focus on exploring the entire upper and lower airways, from the perspective of the safety of both the healthcare professionals and patients and their specific characteristics. And at the same time we will approach the analysis of the intrinsic value that these interventions provide from the point of view of both diagnosis and management of these patients. The changing situation of this disease may cause some modifications of the assertions presented in this review in the future.While this guidance seeks to ensure a consistent wide approach, some differences in operational details may be applied due to local regulations.

Published
2021
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16. Leukotriene receptor antagonist addition to intranasal steroid: systematic review and meta-analysis

Author

Kornkiat Snidvongs, Kachorn Seresirikachorn, K Limitlaohaphan, V Asvapoositkul, and J Mullol

Subjects
medicine.medical_specialty, Leukotriene receptor, business.industry, Antagonist, General Medicine, Rhinitis, Allergic, law.invention, Otorhinolaryngology, Quality of life, Randomized controlled trial, Adrenal Cortex Hormones, law, Internal medicine, Meta-analysis, Quality of Life, Humans, Leukotriene Antagonists, Nasal steroid, Medicine, Steroids, Nasal administration, business, Adverse effect, Administration, Intranasal
Abstract

Background: Intranasal corticosteroids (INCS) and leukotriene receptor antagonist (LTRA) have different mechanisms of action. The combination of INCS and LTRA (INCS+LTRA) are utilized to control the allergic rhinitis (AR) symptoms. The effects of this com- bination have not been made evident yet. Methodology: Randomized controlled trials studying the effects of INCS+LTRA vs INCS in monotherapy on rhinoconjunctivitis symptoms in patients with AR were included. Data were pooled for meta-analysis. The outcomes were nasal symptoms, ocular symptoms, disease-specific quality of life (QOL), and adverse events. Results: Six studies (358 participants) met the inclusion criteria. There were no differences between INCS+LTRA and INCS mono- therapy on composite nasal symptom score, total daytime symptom score, total night time symptom score, disease-specific QOL and adverse events. The results favoured the effects of INCS-LTRA on ocular symptoms. Conclusions: The effects of the INCS+LTRA combination are not different from INCS in monotherapy in the improvement of both nasal symptoms and patient's QOL. The combination may, however, be better on improving ocular symptoms.

Published
2021
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17. Pediatric Barcelona Olfactory Test ̶ 6 (pBOT-6): Validation of a Combined Odor Identification and Threshold Screening Test in Healthy Spanish Children and Adolescents

Author

Claudio Fragola, A Aguirre, M J Rojas Lechuga, J Valero, G de Los Santos, Ignacio Cobeta, Isam Alobid, Meritxell Valls-Mateus, Jordi Alonso, J Mullol, Amparo Santamaría, and Franklin Mariño-Sánchez

Subjects
Male, Olfactometria, medicine.medical_specialty, Adolescent, Screening test, Intraclass correlation, Immunology, Olfaction, Audiology, Sensitivity and Specificity, Reference Values, Olfactometry, medicine, Humans, Immunology and Allergy, In patient, Child, Children, Diagnostic Tests, Routine, Two-alternative forced choice, business.industry, Age Factors, Reproducibility of Results, Healthy Volunteers, Test (assessment), Smell, Odor, Spain, Sensory Thresholds, Odorants, Female, business, Infants, Pediatric population
Abstract

Background: Few odor tests have been developed for children. Objectives: The aim of the present study was to develop and validate a simple and quick olfactory test to evaluate odor identification and threshold in a Spanish pediatric population. Methods: The Pediatric Barcelona Olfactory Test-6 (pBOT-6) consisted of a set of 6 odorants for a forced choice identification test and a 6-dilution phenyl ethyl alcohol geometric series for the threshold test. The pBOT-6 was compared with the Universal Sniff test (a validated international pediatric smell test) in 131 healthy Spanish volunteers aged 6-17 years. A Bland-Altman plot was used to determine the agreement between the 2 tests. Reliability was analyzed in 15 volunteers using the intraclass correlation coefficient. Normative data were obtained, and 8 children diagnosed with subjective loss of smell were tested for validation. Results: The Bland-Altman analysis demonstrated a minimal bias of –1.71% with upper and lower limits of agreement of –31.1% and 27.6%, respectively. The intraclass correlation coefficient was 0.83 (95%CI, 0.6-0.96) for the identification test and 0.73 (95%CI, 0.36-0.9) for the threshold test, with excellent and good consistency between measurements over time. Mean pBOT-6 scores were significantly higher in healthy volunteers than in patients with loss of smell. Discrimination between normosmia and loss of smell was achieved with a sensitivity of 96.9% and a specificity of 100%. Conclusions: pBOT-6 offers an effective and fast method that is useful in clinical routine to distinguish, with high sensitivity and specificity, between pediatric patients with normosmia and those with loss of smell.

Published
2020
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18. Olfactory Dysfunction in the COVID-19 Outbreak

Author

J Mullol, Adriana Izquierdo-Domínguez, María Jesús Rojas-Lechuga, and Isam Alobid

Subjects
Male, medicine.medical_specialty, Pneumonia, Viral, Immunology, Anosmia, Disease, medicine.disease_cause, Disease Outbreaks, Betacoronavirus, Olfaction Disorders, 03 medical and health sciences, 0302 clinical medicine, Pandemic, medicine, Sore throat, Humans, Immunology and Allergy, 030223 otorhinolaryngology, Intensive care medicine, Pandemics, Coronavirus, SARS-CoV-2, business.industry, Public health, COVID-19, Outbreak, Olfactory Bulb, Smell, Taste disorder, Female, medicine.symptom, Coronavirus Infections, business, 030217 neurology & neurosurgery
Abstract

The first cases of coronavirus 2019 disease (COVID-19) occurred in Wuhan, China, and the disease rapidly become a public health emergency of international proportions. COVID-19 can cause mild-to-severe acute respiratory syndrome (SARS) and is caused by the SARS-CoV-2 coronavirus. The clinical manifestations of COVID-19 include fever, dry cough, fatigue, sputum production, shortness of breath, sore throat, and headache. We performed this narrative review to analyze the current literature on postviral olfactory dysfunction related to the SARSCoV- 2 pandemic. Since the initial anecdotal reports from China, increasingly frequent international reports on COVID-19 indicate that 5% to 85% of affected patients lose their sense of smell, thus highlighting the very heterogeneous nature of the literature in this area. Therefore, we advise home isolation measures and/or social distancing, as well as tests to detect SARS-CoV-2 when possible, in patients with sudden and severe loss of smell who cannot be promptly evaluated.

Published
2020
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19. The 8-Odorant Barcelona Olfactory Test (BOT-8): Validation of a New Test in the Spanish Population During the COVID-19 Pandemic

Author

MJ Rojas-Lechuga, JC Ceballos, M Valls-Mateus, P Mackers, A Izquierdo-Domínguez, M López-Chacón, C Langdon, F Mariño-Sánchez, J Valero, J Mullol, I Alobid, [Rojas-Lechuga MJ, López-Chacón M] Rhinology Unit and Smell Clinic, Department of Otorhinolaryngology, Hospital Clinic, Universitat de Barcelona, Spain. Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain. CIBER Respiratory Diseases (CIBERES), Spain. [Ceballos JC] Rhinology Unit and Smell Clinic, Department of Otorhinolaryngology, Hospital Clinic, Universitat de Barcelona, Spain. Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain. [Valls-Mateus M] Department of Otorhinolaryngology, Hospital Universitari Son Espases, Mallorca, Spain. [Mackers P] Department of Otorhinolaryngology, Hospital del Mar, Barcelona, Spain. [Izquierdo-Domínguez A] Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain. Servei d’Alergologia, Hospital de Terrassa, Consorci Sanitari de Terrassa, Terrassa, Spain. Unidad Alergo Rino, Centro Médico Teknon, Barcelona, Spain, and Consorci Sanitari de Terrassa

Subjects
Olfactometria, Adult, Anosmia, Trastorns olfactius, Immunology, COVID-19, Reproducibility of Results, Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES], Nervous System Diseases::Neurologic Manifestations::Sensation Disorders::Olfaction Disorders [DISEASES], Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Techniques, Neurological::Olfactometry [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], COVID-19 (Malaltia), diagnóstico::técnicas y procedimientos diagnósticos::técnicas diagnósticas neurológicas::olfatometría [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Smell, Olfaction Disorders, Odorants, virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES], Immunology and Allergy, Humans, enfermedades del sistema nervioso::manifestaciones neurológicas::trastornos sensoriales::trastornos del olfato [ENFERMEDADES], Pandemics
Abstract

COVID-19; Pèrdua d'olfacte; Prova de l'olfacte COVID-19; Loss of smell; Smell test COVID-19; Pérdida de olfato; Prueba del olfato Background and objective: Most smell tests are difficult to implement in daily clinical practice owing to their long duration. The aim of the present study was to develop and validate a short, easy-to-perform, and reusable smell test to be implemented during the COVID-19 pandemic. Methods: The study population comprised 120 healthy adults and 195 patients with self-reported olfactory dysfunction (OD). The 8-Odorant Barcelona Olfactory Test (BOT-8) was used for detection, memory/recognition, and forced-choice identification. In addition, a rose threshold test was performed, and a visual analog scale was applied. The Smell Diskettes Olfaction Test (SDOT) was used for correlation in healthy volunteers, and the University of Pennsylvania Smell Identification Test (UPSIT) was used for patients with OD to establish cut-offs for anosmia and hyposmia. In order to take account of the COVID-19 pandemic, disposable cotton swabs with odorants were compared with the original test. Results: In healthy persons, the mean (SD) BOT-8 score was 100% for detection, 94.5% (1.07) for memory/recognition, and 89.6% (0.86) for identification. In patients with OD, the equivalent values were 86% (32.8), 73.2% (37.9), and 77.1% (34.2), respectively. BOT-8 demonstrated good test-retest reliability, with agreement of 96.7% and a quadratic k of 0.84 (P

Published
2022

20. Twelve-year long-term postoperative outcomes in patients with chronic rhinosinusitis with nasal polyps

Author

C, Arancibia, C, Langdon, J, Mullol, and I, Alobid

Subjects
Nasal Polyps, Otorhinolaryngology, Chronic Disease, otorhinolaryngologic diseases, Humans, Endoscopy, General Medicine, Sinusitis, Rhinitis
Abstract

Background: Evidence regarding long-term postoperative follow-up of chronic rhinosinusitis with nasal polyps (CRSwNP) patients is scarce in the literature. The objective of the present study was to report long-term 12-year postoperative outcomes for CRSwNP patients. Methods: CRSwNP patients were prospectively followed after endoscopic sinus surgery. Sinonasal symptoms, nasal polyp score (NPS), Barcelona Smell Test 24 (BAST-24), Lund-Mackay Score (LMS), and Medical Outcome Study Short Form-36 (SF-36) questionnaire were assessed before and 12 years after surgery. Results: At long-term follow-up (median, 12 years), a strong improvement was noted for all patients (N=76) in nasal symptoms score, NPS, BAST-24, and LMS scores compared with baseline. No long-term improvement in SF-36 was found. Conclusion: Patients with CRSwNP have a long-term 12-year postoperative improvement in nasal symptoms, polyp size, computed tomography, and olfaction.

Published
2022
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22. Self-perception of olfactory dysfunction is associated with history of Traumatic Brain Injury: post-hoc analysis from the OLFACAT survey

Author

Concepció Marin, Cristobal Langdon, A Valero, J Mullol, César Picado, Llorenç Quintó, and Isam Alobid

Subjects
Adult, Male, medicine.medical_specialty, Traumatic brain injury, Cross-sectional study, Population, Diagnostic Self Evaluation, Olfaction Disorders, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, Brain Injuries, Traumatic, Epidemiology, Post-hoc analysis, Humans, Medicine, 030223 otorhinolaryngology, education, education.field_of_study, business.industry, Incidence (epidemiology), General Medicine, Middle Aged, medicine.disease, Self perception, Cross-Sectional Studies, Otorhinolaryngology, Population study, Female, business, psychological phenomena and processes, Clinical psychology
Abstract

BACKGROUND: Traumatic brain injury (TBI) is one of the main causes of smell loss. However, epidemiological studies evaluating the incidence in general population are scarce. The aim of this analysis is to investigate the prevalence of TBI-induced olfactory dysfunction (OD) in a general-based population study. METHODOLOGY: A cross-sectional population-based survey was distributed to general population (260,000 households) through the newspaper. The survey included four microencapsulated odorants (smell test) to assess smell loss and two self-administered questionnaires (odour description and epidemiology/health status). Participants were divided into two groups, with or without a history of TBI. RESULTS: From 10,783 returned surveys, 9,348 were analysed. The survey profile was a 43-year old woman with medium-high educational level, living in a city. The overall prevalence of TBI was 5% (N=464, 44.5±14.1 years old, 57% females). Recorded causes of TBI were traffic, domestic, or work accidents. Subjects with TBI reported a poorer subjective smell self-perception compared to non-TBI participants, and a decreases ability to identify mercaptan (odour added to gas used in cities). Although, using the smell test, both groups showed similar smell capacities. CONCLUSIONS: Subjects with TBI history report a higher frequency of self-perceived OD, and a decrease ability to smell the odour added to domestic gas. Having said that, the prevalence of OD, according to the smell test, was similar in both groups.

Published
2019
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23. High Frequency of Smell and Taste Dysfunction in Health Care Professionals With COVID-19 Working in Allergy Departments

Author

Darío Antolín-Amérigo, J L Cubero, Antonio Valero, J Mullol, Isam Alobid, and Carlos Colás

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, Allergy, Health Personnel, education, Immunology, Anosmia, Anorexia, urologic and male genital diseases, 03 medical and health sciences, Olfaction Disorders, Taste Disorders, 0302 clinical medicine, Hyposmia, Surveys and Questionnaires, Health care, medicine, Hypersensitivity, Immunology and Allergy, Humans, 030212 general & internal medicine, 030223 otorhinolaryngology, Aged, business.industry, SARS-CoV-2, Hypogeusia, COVID-19, Ageusia, Middle Aged, medicine.disease, Hospitalization, Female, Allergists, medicine.symptom, business
Abstract

Introduction: Since the early stages of the novel coronavirus 2019 (SARS-CoV-2) outbreak, smell and/or taste dysfunction (STD) has been reported in 5% to 88% of COVID-19 patients. Objective: We aimed to assess STD in health care professionals (HCPs), mainly allergists, affected by COVID-19. We carried out a survey to evaluate the association between STD and its severity and demographic characteristics, symptoms, comorbidities, and hospital admission. Methods: We designed a 15-item questionnaire comprising various sections, as follows: demographics, diagnostic characteristics, STD patterns, medication use, and comorbidities. The questionnaire was developed using Google forms. It was distributed to members of the Spanish Society of Allergology and Clinical Immunology (SEAIC) and sent via social media to be completed by HCPs with COVID-19. Results: The survey was completed by HCPs (n=234), of whom 76.5% were aged ≤55 years and 73.5% were female. STD was detected in 74.4% of respondents, of whom 95.6% reported moderate-severe impairment. Mean time until recovery of taste dysfunction was 21.6 (24.0) days in HCPs aged ≤55 years and 33.61±26.2 days in those aged >55 years (P=.019). Analysis stratified by severity of STD showed that more than a half of COVID-19 patients presented severe loss of smell. Older age (>55 years) was associated with fever, anorexia, lower frequency of headache, and longer persistence of taste dysfunction. Conclusion: STD is a common symptom in COVID-19, even as a unique or preceding symptom. HCPs who reported smell dysfunction were younger than those not affected with STD. Taste dysfunction may imply more systemic involvement in COVID-19–positive HCPs.

Published
2021

24. High frequency of smell and taste dysfunctions in allergy health care professionals suffering from COVID-19

Author

D, Antolín-Amérigo, J L, Cubero, C, Colás, I, Alobid, J, Mullol, and A, Valero

Abstract

Since the first stages of the novel coronavirus 2019 (SARS-CoV-2) outbreak smell and/or taste dysfunction (STD), has been described from 5% to 88% in COVID-19 patients. Objective: we aimed to assess STD in healthcare professionals (HCP), mainly allergists, affected with COVID-19, by means of a survey, and to evaluate the association of STD and their severity with demographic characteristics, symptoms, comorbidities, and hospital admission.A 15-item questionnaire was designed including different sections as follows: demographics, diagnostic characteristics, STD patterns, medication use as well as comorbidities. The questionnaire was developed using Google forms, implemented and distributed to members of the Spanish Society of Allergology and Clinical Immunology (SEAIC) and spread via Social Media to be completed by HCP affected with COVID-19.HCP (n=234), 76.5% ≤55 yrs, 73.5% female, completed the survey. There was STD in up to 74.4% of the respondents, 95.6% reporting a moderate-severe impairment. Mean recovery time of taste dysfunction was 21.6±24.0 days in HCP ≤55 yrs and 33.61±26.2 days in55 yrs (p=0.019). Stratified analysis by severity of STD showed that more than a half of COVID-19 subjects presented severe loss of smell. An older age (55 yrs) was associated with fever, anorexia, less headache and with a longer persistence of taste dysfunction.STD is a common symptom in COVID-19, even as a unique or preceding symptom. HCP who declared smell dysfunction (SD) were younger than those not affected with STD. Taste dysfunction (TD) may imply more systemic involvement in COVID-19-positive HCP.

Published
2021

25. Clinical characteristics in 545 patients with severe asthma on biological treatment during the COVID-19 outbreak

Author

Victoria del Pozo, César Picado, Pilar Barranco, Francisco-Javier González-Barcala, Irina Bobolea, J. Mullol, Vicente Plaza, Elena Curto, José María Olaguibel, Joaquín Sastre, Antonio Valero, Javier Domínguez-Ortega, Ebymar Arismendi, Marcela Valverde, Carlos Martínez-Rivera, Manuel J Rial, Xavier Muñoz, Santiago Quirce, and Paula Ribó

Subjects
Adult, Male, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Severe asthma, MEDLINE, Comorbidity, Severity of Illness Index, Disease Outbreaks, Cohort Studies, Internal medicine, Severity of illness, medicine, Humans, Immunology and Allergy, Retrospective Studies, Biological Products, SARS-CoV-2, business.industry, COVID-19, Outbreak, Clinical Communications, Retrospective cohort study, Middle Aged, medicine.disease, Asthma, Spain, Female, business, Cohort study
Published
2021
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26. Proposal of 0.5 mg of protein/100 g of processed food as threshold for voluntary declaration of food allergen traces in processed food—A first step in an initiative to better inform patients and avoid fatal allergic reactions: A GA²LEN position paper

Author

Zuberbier, T. Dörr, T. Aberer, W. Alvaro, M. Angier, E. Arasi, S. Arshad, H. Ballmer-Weber, B. Bartra, J. Beck, L. Bégin, P. Bindslev-Jensen, C. Bislimovska, J. Bousquet, J. Brockow, K. Bush, A. Cianferoni, A. Cork, M.J. Custovic, A. Darsow, U. de Jong, N. Deleanu, D. Del Giacco, S. Deschildre, A. Dunn Galvin, A. Ebisawa, M. Fernández-Rivas, M. Ferrer, M. Fiocchi, A. Gerth van Wijk, R. Gotua, M. Grimshaw, K. Grünhagen, J. Heffler, E. Hide, M. Hoffmann-Sommergruber, K. Incorvaia, C. Janson, C. Malte John, S. Jones, C. Jutel, M. Katoh, N. Kendziora, B. Kinaciyan, T. Knol, E. Kurbacheva, O. Lau, S. Loh, R. Lombardi, C. Mäkelä, M. Marchisotto, M.J. Makris, M. Maurer, M. Meyer, R. Mijakoski, D. Minov, J. Mullol, J. Nilsson, C. Nowak–Wegrzyn, A. Nwaru, B.I. Odemyr, M. Pajno, G.B. Paudel, S. Papadopoulos, N.G. Renz, H. Ricci, G. Ring, J. Rogala, B. Sampson, H. Senna, G. Sitkauskiene, B. Smith, P.K. Stevanovic, K. Stoleski, S. Szajewska, H. Tanaka, A. Todo-Bom, A. Topal, F.A. Valovirta, E. Van Ree, R. Venter, C. Wöhrl, S. Wong, G.W.K. Zhao, Z. Worm, M.

Subjects
digestive, oral, and skin physiology
Abstract

Background: Food anaphylaxis is commonly elicited by unintentional ingestion of foods containing the allergen above the tolerance threshold level of the individual. While labeling the 14 main allergens used as ingredients in food products is mandatory in the EU, there is no legal definition of declaring potential contaminants. Precautionary allergen labeling such as “may contain traces of” is often used. However, this is unsatisfactory for consumers as they get no information if the contamination is below their personal threshold. In discussions with the food industry and technologists, it was suggested to use a voluntary declaration indicating that all declared contaminants are below a threshold of 0.5 mg protein per 100 g of food. This concentration is known to be below the threshold of most patients, and it can be technically guaranteed in most food production. However, it was also important to assess that in case of accidental ingestion of contaminants below this threshold by highly allergic patients, no fatal anaphylactic reaction could occur. Therefore, we performed a systematic review to assess whether a fatal reaction to 5mg of protein or less has been reported, assuming that a maximum portion size of 1kg of a processed food exceeds any meal and thus gives a sufficient safety margin. Methods: MEDLINE and EMBASE were searched until 24 January 2021 for provocation studies and case reports in which one of the 14 major food allergens was reported to elicit fatal or life-threatening anaphylactic reactions and assessed if these occurred below the ingestion of 5mg of protein. A Delphi process was performed to obtain an expert consensus on the results. Results: In the 210 studies included, in our search, no reports of fatal anaphylactic reactions reported below 5 mg protein ingested were identified. However, in provocation studies and case reports, severe reactions below 5 mg were reported for the following allergens: eggs, fish, lupin, milk, nuts, peanuts, soy, and sesame seeds. Conclusion: Based on the literature studied for this review, it can be stated that cross-contamination of the 14 major food allergens below 0.5 mg/100 g is likely not to endanger most food allergic patients when a standard portion of food is consumed. We propose to use the statement “this product contains the named allergens in the list of ingredients, it may contain traces of other contaminations (to be named, e.g. nut) at concentrations less than 0.5 mg per 100 g of this product” for a voluntary declaration on processed food packages. This level of avoidance of cross-contaminations can be achieved technically for most processed foods, and the statement would be a clear and helpful message to the consumers. However, it is clearly acknowledged that a voluntary declaration is only a first step to a legally binding solution. For this, further research on threshold levels is encouraged. © 2021 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.

Published
2021

27. Treatment of allergic rhinitis during and outside the pollen season using mobile technology. a MASK study

Author

Sietze Reitsma, Josep M. Antó, Dermot Ryan, C. Stellato, W. Czarlewski, S. Shamai, G. De Vries, Elísio Costa, E. Melen, Esben Eller, Tari Haahtela, Carsten Bindslev-Jensen, Dana Wallace, Ricardo Pio Monti, P. V. Tomazic, A. Yorgancioglu, Oliver Pfaar, Michel Thibaudon, B. Samolinski, Asiyah Sheikh, Daniel Laune, J. C. Ivancevich, M. Morais-Almeida, Niels H. Chavannes, Ralph Mösges, Lorenzo Cecchi, Susan Waserman, Regina Roller-Wirnsberger, V. Cardona, Piotr Kuna, P. Devillier, M. van Eerd, Mikhail Sofiev, Rute Almeida, I. Kull, Isabelle Bosse, J Mullol, A Valero, Ioana Agache, João Fonseca, Violeta Kvedariene, J. F. Fontaine, A. Bedbrook, Sylvie Arnavielhe, Fotis Psarros, Jean Bousquet, Peter Schmid-Grendelmeier, A. A. Cruz, Ludger Klimek, Ruta Dubakiene, Nhân Pham-Thi, Judith Garcia-Aymerich, Benoit Pugin, G. De Feo, Thomas B. Casale, Ruth Murray, Nikolaos G. Papadopoulos, Annabelle Bédard, I. J. Ansotegui, Claus Bachert, Magnus Wickman, Michael Makris, J. Correia da Sousa, Emmanuel P. Prokopakis, Ana Todo-Bom, Enrica Menditto, Xavier Basagaña, W. J. Fokkens, Peter Hellings, Gabrielle L. Onorato, Sinthia Bosnic-Anticevich, D. Larenas-Linnemann, François Spertini, A. Valiulis, R. Emuzyte, M. T. Ventura, Sanna Toppila-Salmi, I. Annesi-Maesano, Maddalena Illario, Erkka Valovirta, Bedard, A., Basagana, X., Anto, J. M., Garcia-Aymerich, J., Devillier, P., Arnavielhe, S., Bedbrook, A., Onorato, G. L., Czarlewski, W., Murray, R., Almeida, R., Fonseca, J. A., Correia da Sousa, J., Costa, E., Morais-Almeida, M., Todo-Bom, A., Cecchi, L., De Feo, G., Illario, M., Menditto, E., Monti, R., Stellato, C., Ventura, M. T., Annesi-Maesano, I., Bosse, I., Fontaine, J. F., Pham-Thi, N., Thibaudon, M., Schmid-Grendelmeier, P., Spertini, F., Chavannes, N. H., Fokkens, W. J., Reitsma, S., Dubakiene, R., Emuzyte, R., Kvedariene, V., Valiulis, A., Kuna, P., Samolinski, B., Klimek, L., Mosges, R., Pfaar, O., Shamai, S., Roller-Wirnsberger, R. E., Tomazic, P. V., Ryan, D., Sheikh, A., Haahtela, T., Toppila-Salmi, S., Valovirta, E., Cardona, V., Mullol, J., Valero, A., Makris, M., Papadopoulos, N. G., Prokopakis, E. P., Psarros, F., Bachert, C., Hellings, P. W., Pugin, B., Bindslev-Jensen, C., Eller, E., Kull, I., Melen, E., Wickman, M., De Vries, G., van Eerd, M., Agache, I., Ansotegui, I. J., Bosnic-Anticevich, S., Cruz, A. A., Casale, T., Ivancevich, J. C., Larenas-Linnemann, D. E., Sofiev, M., Wallace, D., Waserman, S., Yorgancioglu, A., Laune, D., Bousquet, J., Laboratoire de recherche sur les mécanismes moléculaires et pharmacologiques de l’obstruction bronchique (LOBIP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), KYomed INNOV [Montpellier], CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Département Centre de Soins d'enseignement et de recherche dentaires [CHU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université de Montpellier (UM), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Allergist [La Rochelle], Allergist [Reims], Institut de Recherche Biomédicale des Armées, Département Neurosciences et Contraintes Opérationnelles, Unité de Neurophysiologie du Stress, 92123 Brétignysur- Orge cedex, France (IRBA), Institut de Recherche Biomédicale des Armées, Département Neurosciences et Contraintes Opérationnelles, Unité de Neurophysiologie du Stress, Réseau National de Surveillance Aérobiologique (RNSA), Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)

Subjects
Allergy, IMPACT, Respiratory Medicine and Allergy, Review, Allergic rhinitis, 0302 clinical medicine, Anti-histamines, Corticosteroids, ICT, MASK, Mobile health, Treatment, Allergic symptoms, Medicine and Health Sciences, Immunology and Allergy, Medicine, Corticosteroid, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, Lungmedicin och allergi, 0303 health sciences, Anti-histamine, IMPAIRMENT, 3. Good health, Life Sciences & Biomedicine, medicine.drug, Pulmonary and Respiratory Medicine, Immunology, AZELASTINE/FLUTICASONE, Mometasone furoate, PERSON-CENTERED CARE, Fluticasone propionate, 03 medical and health sciences, INTERMITTENT, Allergic rhiniti, 030304 developmental biology, Asthma, Science & Technology, Pollen season, business.industry, GUIDANCE, AIR-POLLUTION, medicine.disease, SEVERITY, 030228 respiratory system, ASTHMA, Observational study, business, Demography
Abstract

Background The analysis of mobile health (mHealth) data has generated innovative insights into improving allergic rhinitis control, but additive information is needed. A cross-sectional real-world observational study was undertaken in 17 European countries during and outside the estimated pollen season. The aim was to collect novel information including the phenotypic characteristics of the users. Methods The Allergy Diary–MASK-air–mobile phone app, freely available via Google Play and App, was used to collect the data of daily visual analogue scales (VASs) for overall allergic symptoms and medication use. Fluticasone Furoate (FF), Mometasone Furoate (MF), Azelastine Fluticasone Proprionate combination (MPAzeFlu) and eight oral H1-antihistamines were studied. Phenotypic characteristics were recorded at entry. The ARIA severity score was derived from entry data. This was an a priori planned analysis. Results 9037 users filled in 70,286 days of VAS in 2016, 2017 and 2018. The ARIA severity score was lower outside than during the pollen season. Severity was similar for all treatment groups during the pollen season, and lower in the MPAzeFlu group outside the pollen season. Days with MPAzeFlu had lower VAS levels and a higher frequency of monotherapy than the other treatments during the season. Outside the season, days with MPAzeFlu also had a higher frequency of monotherapy. The number of reported days was significantly higher with MPAzeFlu during and outside the season than with MF, FF or oral H1-antihistamines. Conclusions This study shows that the overall efficacy of treatments is similar during and outside the pollen season and indicates that medications are similarly effective during the year.

Published
2020
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28. Direct Costs of Acute Rhinosinusitis in Spain: A Prospective and Observational Study (PROSINUS)

Author

J Mullol, Llorenç Quintó, Isam Alobid, and F Jaume

Subjects
medicine.medical_specialty, education.field_of_study, business.industry, Incidence (epidemiology), Immunology, Population, Common cold, Disease, Diagnostic tools, medicine.disease, Indirect costs, Nasal Polyps, Spain, Emergency medicine, Acute rhinosinusitis, medicine, Immunology and Allergy, Humans, Observational study, Prospective Studies, Sinusitis, business, education, Rhinitis
Abstract

Background: The incidence of acute rhinosinusitis (ARS) is high throughout the world. Although diagnosis is clinical and disease course is mostly self-limiting, diagnostic tools and medications are overused by physicians, thus increasing the direct medical costs of the disease. Objective: The aim of the PROSINUS study was to quantify the direct medical costs of management of ARS in Spain. Methods: We performed a prospective observational study of 1610 patients with a clinical diagnosis of nonbacterial, uncomplicated ARS. According to the duration of symptoms by the European Position Paper on Rhinosinusitis and Nasal Polyps, patients were classified as having viral or postviral ARS with different levels of severity. Direct medical costs were calculated based on medical visits, use of diagnostic tools, and medications prescribed. Results: Overall, the mean (SD) direct medical costs per episode were €322.3 (301.2) vs €441.1 (344.3) for viral and postviral ARS episodes, respectively (P

Published
2020

29. Dupilumab Improves Sense of Smell in Patients With Chronic Rhinosinusitis With Nasal Polyps Regardless of Sinonasal Surgery History – Pooled Results From SINUS-24 and SINUS-52 Phase 3 Trials

Author

Nikhil Amin, J Mullol, I Niemann, Claus Bachert, Jk. Han, and Lp. Mannent

Subjects
medicine.medical_specialty, medicine.anatomical_structure, business.industry, Chronic rhinosinusitis, medicine, In patient, Nasal polyps, Olfaction, business, medicine.disease, Dupilumab, Sinus (anatomy), Surgery
Published
2020
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30. Executive summary of EPOS 2020 including integrated care pathways

Author

Manuel Bernal-Sprekelsen, Claire Hopkins, W. J. Fokkens, Valerie J Lund, Robert C. Kern, J Mullol, P W Hellings, Sietze Reitsma, Sanna Toppila-Salmi, Ear, Nose and Throat, and AII - Inflammatory diseases

Subjects
Medical education, Executive summary, Evidence-based practice, business.industry, Outcome measurements, Delivery of Health Care, Integrated, MEDLINE, General Medicine, Guideline, Sinus surgery, 3. Good health, Integrated care, 03 medical and health sciences, 0302 clinical medicine, Nasal Polyps, Otorhinolaryngology, Chronic Disease, Medicine, Position paper, Humans, Sinusitis, 030223 otorhinolaryngology, business, Rhinitis
Abstract

The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012 (1-3). The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an update on the literature published and studies undertaken in the eight years since the EPOS2012 position paper was published and addresses areas not extensively covered in EPOS2012 such as paediatric CRS and sinus surgery. EPOS2020 also involves new stakeholders, including pharmacists and patients, and addresses new target users who have become more involved in the management and treatment of rhinosinusitis since the publication of the last EPOS document, including pharmacists, nurses, specialised care givers and indeed patients themselves, who employ increasing self-management of their condition using over the counter treatments. The document provides suggestions for future research in this area and offers updated guidance for definitions and outcome measurements in research in different settings. EPOS2020 contains chapters on definitions and classification where we have defined a large number of terms and indicated preferred terms. A new classification of CRS into primary and secondary CRS and further division into localized and diffuse disease, based on anatomic distribution is proposed. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, allergic rhinitis, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. All available evidence for the management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is systematically reviewed and integrated care pathways based on the evidence are proposed. Despite considerable increases in the amount of quality publications in recent years, a large number of practical clinical questions remain. It was agreed that the best way to address these was to conduct a Delphi exercise which is a structured communication technique, originally developed as a systematic, interactive forecasting method which relies on a panel of experts. The EPOS2020 group firstly prioritised the areas for consideration as a result of which we have concentrated on diagnostic issues in the first instance. The results have been integrated into the respective sections. Last but not least, advice for patients and pharmacists and a new list of research needs are included.

Published
2020

31. Clivus Rathke cleft cyst: case report of a rare disease and literature review

Author

C. Langdon, I. Alobid, J. Mullol, M.J. Rojas-Lechuga, and Alfonso Santamaría-Gadea

Subjects
sinonasal tumors, endonasal approaches, business.industry, General Medicine, Anatomy, medicine.anatomical_structure, Otorhinolaryngology, RF1-547, Clivus, clivus, rathke's cleft cyst, Medicine, endoscopic skull base surgery, Rathke cleft cyst, business, endoscopic sinus surgery, Rare disease
Abstract

Background: Rathke's cleft cysts (RCCs) are nonneoplastic epithelial lesions derived from true remnants of the embryological Rathke's pouch. They are commonly located in the sellar and suprasellar region and usually appear as an asymptomatic mass. Case: A 56-year-old male with a clivus centered isodense mass shown on a CT scan, no bone erosions on the lateral or posterior walls of the clivus, and no compromise of the sella turcica floor. Based on the radiological findings, the most likely diagnosis proposed were chordoma, mucocele, metastatic tumor, Rathke's cyst, Tornwald's cyst or ectopic craniopharyngioma. An endoscopic endonasal trans-sphenoidal approach was done for resection of the lesion. The histopathologic exam revealed a Rathke's cyst. The patient has had an uncomplicated course and remains symptom-free after 12 months follow up. Conclusion: Rathke's cleft cysts (RCCs) are rare exclusive clival lesions , which should be taken into account in the differential diagnosis of clival lesions. It can be surgically treated by an endoscopic conservative way.

Published
2018
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32. EUFOREA Rhinology Research Forum 2017: report of the brainstorming sessions on endotype-driven treatment, patient empowerment and digital future in airways care

Author

I. Koren, K. Talavera-Perez, J.A. Castillo, Valerie J. Lund, N.S. Seyed-Tabib, J.A.M. Claes, Ruth Murray, M. Koennecke, B Lange, C. Bachert, K. Sleurs, G. De Carlo, Guy Joos, I. Kortekaas-Krohn, A. Van Hoolst, M. Akdis, S.K. Chung, R. Boscke, C. Akdis, Ph. Rombaux, B. Verhaeghe, Maria Doulaptsi, S. Vaitkus, D. O'Sullivan, T. Zuberbier, Sven Seys, Benoit Pugin, V. Boeva, P. Gevaert, Brecht Steelant, J. Staikuniene, K. Golebski, C. Rondon, S. Gallo, Michel Djandji, A.-J. Tasman, J. Lee, J. Feijen, I. Kloeck, G.W. Canonica, J Mullol, C. Taube, W.J. Fokkens, A. Jagerschmidt, T.A. Popov, Sanna Toppila-Salmi, T. Tran-Le, S Vlaminck, Jean Bousquet, K. van Gool, G.Y. Ban, K. Biswas, Claire Hopkins, J. Vaitkus, Anette Drøhse Kjeldsen, Simon B. Gane, Olga Krysko, Leen Cools, Kato Speleman, R. Verbrugge, Martin Wagenmann, Thomas Hummel, O. Kokorina, E. De Corso, P W Hellings, D. Morghenti, Katleen Martens, Emmanuel P. Prokopakis, Carl Philpott, I. Izquierdo, Leda Mannent, S. Halewyck, N. Launders, L. Van Gerven, Basile Nicolas Landis, P.J. Rowe, G. Lekakis, Ear, nose & throat, and Ear, Nose and Throat

Subjects
Rhinology, medicine.medical_specialty, Medical education, Endotype, business.industry, Patient Empowerment, ehealth, precision medicine, education, General Medicine, Precision medicine, patient empowerment, rhinitis, Otorhinolaryngology, RF1-547, Brainstorming, medicine, eHealth, endotype, business, rhinosinusitis, health care economics and organizations
Abstract

The second European Rhinology Reserach Forum organized by the European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA) was held on 9-10th November 2017, combined with a specific symposium on air pollution and mobile Health technology (mHealth) with the GARD (Global Alliance against Chronic Respiratory Diseases) initiative of WHO (World Health Organization). Physicians from different specialities, researchers, as well as patients and industry representatives from more than 40 countries took part in the Forum. Relevant topics were debated with the aim of allowing the implementation of precision medicine (PM) in daily respiratory care. All debates started with positioning the current state of the art: identification of current gaps in practice, the current consensus and the need for implementation of novel approaches such as endotype-driven treatment, patient empowerment and eHealth tools. This report provides a summry of the outcomes of the brainstorming sessions of the European Rhinology Research Forum 2017, highlighting the research needs in PM, with personalized care, prediction of success of treatment, participation of the patient and prevention of disease as key drivers for improving current clinical practice.

Published
2018

33. Assessment of the Control of Allergic Rhinitis and Asthma Test (CARAT) using MASK-air

Author

Bernardo Sousa-Pinto, Ana Sá-Sousa, Rita Amaral, Wienczyslawa Czarlewski, Anna Bedbrook, Josep M. Anto, Jean Bousquet, João Almeida Fonseca, I. Agache, X. Basagaña, A. Bédard, K.C. Bergmann, C. Bindslev-Jensen, H. Blain, S. Bosnic-Anticevich, I. Bosse, L.P. Boulet, L. Brussino, P. Camargos, G.W. Canonica, P. Carreiro-Martins, V. Cardona, L. Cecchi, D. Chu, E. Costa, A.A. Cruz, J. da Silva, G. De Vries, P. Devillier, W.J. Fokkens, J.F. Fontaine, J.-M. Fuentes-Pérez, B. Gemicioğlu, T. Haahtela, Y.R. Huerta-Villalobos, J.C. Ivancevich, M. Jutel, I. Kaidashev, M. Khaitov, L. Klimek, H. Kraxner, P. Kuna, V. Kvedariene, D.E.S. Larenas-Linnemann, D. Laune, B. Lipworth, P. Manning, M. Makris, E. Melén, M. Morais-Almeida, R. Mösges, J. Mullol, K. Nekam, M. Niedoszytko, R.E. O'Hehir, Y. Okamoto, N.G. Papadopoulos, V. Patella, O. Pfaar, N. Pham-Thi, F.S. Regateiro, S. Reitsma, P.W. Rouadi, B. Samolinski, F. Sarquis-Serpa, J. Sastre, N. Scichilone, R. Stelmach, C. Suppli-Ulrik, A. Todo-Bom, P.V. Tomazic, S. Toppila-Salmi, I. Tsigiliani, A. Valero, A. Valiulis, E. Valovirta, M. van Eerd, M.T. Ventura, S. Waserman, A. Yorgancioglu, M. Zidarn, Sousa-Pinto B., Sa-Sousa A., Amaral R., Czarlewski W., Bedbrook A., Anto J.M., Bousquet J., Fonseca J.A., Agache I., Basagana X., Bedard A., Bergmann K.C., Bindslev-Jensen C., Blain H., Bosnic-Anticevich S., Bosse I., Boulet L.P., Brussino L., Camargos P., Canonica G.W., Carreiro-Martins P., Cardona V., Cecchi L., Chu D., Costa E., Cruz A.A., da Silva J., De Vries G., Devillier P., Fokkens W.J., Fontaine J.F., Fuentes-Perez J.-M., Gemicioglu B., Haahtela T., Huerta-Villalobos Y.R., Ivancevich J.C., Jutel M., Kaidashev I., Khaitov M., Klimek L., Kraxner H., Kuna P., Kvedariene V., Larenas-Linnemann D.E.S., Laune D., Lipworth B., Manning P., Makris M., Melen E., Morais-Almeida M., Mosges R., Mullol J., Nekam K., Niedoszytko M., O'Hehir R.E., Okamoto Y., Papadopoulos N.G., Patella V., Pfaar O., Pham-Thi N., Regateiro F.S., Reitsma S., Rouadi P.W., Samolinski B., Sarquis-Serpa F., Sastre J., Scichilone N., Stelmach R., Suppli-Ulrik C., Todo-Bom A., Tomazic P.V., Toppila-Salmi S., Tsigiliani I., Valero A., Valiulis A., Valovirta E., van Eerd M., Ventura M.T., Waserman S., Yorgancioglu A., Zidarn M., Ear, Nose and Throat, and AII - Inflammatory diseases

Subjects
Carat, medicine.medical_specialty, business.industry, MEDLINE, Settore MED/10 - Malattie Dell'Apparato Respiratorio, medicine.disease, Rhinitis, Allergic, Asthma, Test (assessment), Internal medicine, Humans, Immunology and Allergy, Medicine, business, Rhinitis
Abstract

n/a

Published
2022
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34. The Allergic Rhinitis and its Impact on Asthma (ARIA) score of allergic rhinitis using mobile technology correlates with quality of life: The MASK study

Author

Thomas Keil, Aziz Sheikh, G. De Vries, Pascal Demoly, Piotr Kuna, A. A. Cruz, A Valero, A. Todo Bom, P. Devillier, K. C. Bergmann, A. Bedbrook, Torsten Zuberbier, Erkka Valovirta, M. van Eerd, Ralph Mösges, Valérie Siroux, Cristiana Stellato, J. da Silva, Ludger Klimek, Sinthia Bosnic-Anticevich, A. Yorgancioglu, Magnus Wickman, M. Rodriguez Gonzalez, Jean Bousquet, F. Sarquis Serpa, Sylvie Arnavielhe, Esben Eller, David Price, Tari Haahtela, Carsten Bindslev-Jensen, Inger Kull, G. Passalacqua, Davide Caimmi, W. J. Fokkens, D. Larenas-Linnemann, Dermot Ryan, S. Shamai, M. Bewick, Bilun Gemicioglu, M. T. Ventura, Claus Bachert, Robyn E O'Hehir, J Mullol, Enrica Menditto, P. V. Tomazic, M. T. Burguete Cabañas, Erik Melén, Josep M. Antó, João Fonseca, P W Hellings, M. Morais Almeida, I. Annesi-Maesano, B. Samolinski, Bousquet, J., Arnavielhe, S., Bedbrook, A., Fonseca, J., Morais Almeida, M., Todo Bom, A., Annesi-Maesano, I., Caimmi, D., Demoly, P., Devillier, P., Siroux, V., Menditto, E., Passalacqua, G., Stellato, C., Ventura, M. T., Cruz, A. A., Sarquis Serpa, F., da Silva, J., Larenas-Linnemann, D., Rodriguez Gonzalez, M., Burguete Cabañas, M. T., Bergmann, K. C., Keil, T., Klimek, L., Mösges, R., Shamai, S., Zuberbier, T., Bewick, M., Price, D., Ryan, D., Sheikh, A., Anto, J. M., Mullol, J., Valero, A., Haahtela, T., Valovirta, E., Fokkens, W. J., Kuna, P., Samolinski, B., Bindslev-Jensen, C., Eller, E., Bosnic-Anticevich, S., O'Hehir, R. E., Tomazic, P. V., Yorgancioglu, A., Gemicioglu, B., Bachert, C., Hellings, P. W., Kull, I., Melén, E., Wickman, M., van Eerd, M., De Vries, G., Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), ESIM - Déterminants Sociaux de la Santé et du Recours aux Soins (DS3), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Laboratoire de recherche sur les mécanismes moléculaires et pharmacologiques de l’obstruction bronchique (LOBIP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Foch [Suresnes], Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) (IAB), Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), 'Federico II' University of Naples Medical School, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], University Hospital of Cologne [Cologne], University of Edinburgh, University of Helsinki, The University of Sydney, Karl-Franzens-Universität [Graz, Autriche], Ghent University Hospital, University Hospitals Leuven [Leuven], Karolinska Institutet [Stockholm], AII - Inflammatory diseases, Ear, Nose and Throat, AII - Amsterdam institute for Infection and Immunity, Other departments, MACVIA-France, Contre les MAladies Chroniques Pour un VIeillissement Actif en France European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France, INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, France, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, Montigny le Bretonneux, France, Kyomed, Montpellier, France, Faculdade de Medicina, Center for Health Technology and Services Research- CINTESIS, Universidade do Porto, Porto, Portugal, Allergy Unit, CUF Porto Instituto & Hospital, Porto, Portugal, Allergy Center, CUF-Descobertas Hospital, Lisboa, Portugal, Faculty of Medicine, Imunoalergologia, Centro Hospitalar Universitário de Coimbra, University of Coimbra, Coimbra, Portugal, EPAR U707 INSERM, Paris and EPAR UMR-S UPMC, Paris VI, Paris, France, UPMC Paris 06, UMR-S 1136, IPLESP, Equipe EPAR, CHRU de Montpellier, Sorbonne Universités, Paris, France, Laboratoire de Pharmacologie Respiratoire UPRES EA220, Pôle des Maladies Respiratoires, Hôpital Foch, Université Versailles Saint-Quentin, Suresnes, France, INSERM, IAB, U 1209, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Université Joseph Fourier, Université Grenoble Alpes, Grenoble, France, CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, Naples, Italy, Personalized Medicine Clinic Asthma & Allergy, Humanitas Research Hospital, Humanitas University, Milan, Italy, Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', University of Salerno, Salerno, Italy, Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy, ProAR – Nucleo de Excelencia em Asma, Brasil and GARD Executive Committee, Federal University of Bahia, Salvador, Brazil, Asthma Reference Center, Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria, Vitória, Brazil, Allergy Service, University Hospital of Federal University of Santa Catarina (HU-UFSC), Florianopolis, Brazil, Center of Excellence in Asthma and Allergy, Hospital Médica Sur, México, Mexico, Pediatric Allergy and Clinical Immunology, Hospital Angeles Pedregal, Mexico City, Mexico, Centro Médico Zambrano Hellion, Monterrey, Mexico, Comprehensive Allergy-Centre-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany, Global Allergy and Asthma European Network (GA 2 LEN) , Berlin, Germany, Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany, Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany, Center for Rhinology and Allergology, Wiesbaden, Germany, Medical Faculty, Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany, iQ4U Consultants Ltd, London, United Kingdom, Observational and Pragmatic Research Institute, Singapore, Singapore, Optimum Patient Care, Cambridge, United Kingdom, Academic Centre of Primary Care, University of Aberdeen, Aberdeen, United Kingdom, Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom, Asthma UK Centre for Applied Research, Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, United Kingdom, Centre for Research in Environmental Epidemiology (CREAL), ISGLoBAL, Barcelona, Spain, IMIM (Hospital del Mar Research Institute), Barcelona, Spain, CIBER Epidemiología y Salud Pública (CIBERESP) & Universitat Pompeu Fabra (UPF), Barcelona, Spain, Pneumology and Allergy Department Hospital Clínic, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain, Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland, Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, Netherlands, Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland, Department of Dermatology and Allergy Centre, Odense University Hospital, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark, Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW, Australia, Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, VIC, Australia, Department of Immunology, Monash University, Melbourne, VIC, Australia, Department of ENT, Medical University of Graz, Graz, Austria, Department of Pulmonology, Celal Bayar University, Manisa, Turkey, GARD Executive Committee, Manisa, Turkey, Cerrahpasa Faculty of Medicine, Department of Pulmonary Diseases, Istanbul University, Istanbul, Turkey, Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium, Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium, Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden, Sachs’ Children and Youth Hospital, Södersjukhuset, Stockholm and Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden, Peercode DV, Gerdermalsen, Netherlands, and Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Poland

Subjects
Male, 0301 basic medicine, Allergy, Cross-sectional study, Pilot Projects, Audiology, EuroQuol, 0302 clinical medicine, Quality of life, Work Productivity and Activity Impairment in allergy, Surveys and Questionnaires, Immunology and Allergy, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, Work productivity, Asthma/complications, Rhinitis, Allergic/complications, Mobile Applications, humanities, 3. Good health, Europe, rhiniti, MACVIA-ARIA Sentinel NetworK, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, Adult, medicine.medical_specialty, Visual analogue scale, Immunology, Allergic Rhinitis and its Impact on Asthma, EuroQuol, MACVIA-ARIA Sentinel NetworK, rhinitis, Work Productivity and Activity Impairment in allergy, Immunology and Allergy, Immunology, 03 medical and health sciences, rhinitis, EQ-5D, Internal medicine, Journal Article, medicine, Humans, Mobile technology, Work Performance, Asthma, business.industry, ta3121, medicine.disease, Rhinitis, Allergic, Allergic Rhinitis and its Impact on Asthma, Cross-Sectional Studies, 030104 developmental biology, 030228 respiratory system, Quality of Life, business
Abstract

Mobile technology has been used to appraise allergic rhinitis control, but more data are needed. To better assess the importance of mobile technologies in rhinitis control, the ARIA (Allergic Rhinitis and its Impact on Asthma) score ranging from 0 to 4 of the Allergy Diary was compared with EQ-5D (EuroQuol) and WPAI-AS (Work Productivity and Activity Impairment in allergy) in 1288 users in 18 countries. This study showed that quality-of-life data (EQ-5D visual analogue scale and WPA-IS Question 9) are similar in users without rhinitis and in those with mild rhinitis (scores 0-2). Users with a score of 3 or 4 had a significant impairment in quality-of-life questionnaires. © 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

Published
2017
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35. Transfer of innovation on allergic rhinitis and asthma multimorbidity in the elderly ( <scp>MACVIA</scp> ‐ <scp>ARIA</scp> ) ‐ <scp>EIP</scp> on <scp>AHA</scp> Twinning Reference Site ( <scp>GARD</scp> research demonstration project)

Author

Alan Estrada-Cardona, Désirée Larenas-Linnemann, A. A. Cruz, A. Bedbrook, Torsten Zuberbier, B. De Martino, Esben Eller, K. C. Bergmann, A. Farsi, Ana Maria Carriazo, João Fonseca, Manuel Teixeira Veríssimo, Carsten Bindslev-Jensen, S. La Grutta, G. De Feo, Rimantas Stukas, M Doulapsi, Jean-Louis Pépin, Adnan Custovic, Gabrielle L. Onorato, Oliver Pfaar, U. Trama, Timo E. Strandberg, Ana Margarida Pereira, M. Bochenska Marciniak, V. Tibaldi, M. H. Garcia Cruz, Juan Carlos Ivancevich, Alessandro Vatrella, Denis Caillaud, Tuula Vasankari, J. A. Rizzo, Robyn E O'Hehir, Anne Lise Courbis, D. Lauri, Benoit Pugin, José Luis Gálvez-Romero, Juan José Matta-Campos, Jean Bousquet, G. De Vries, Johanna Salimäki, A. Yorgancioglu, A. Ciceran, C. Dario, Luc Colas, W. J. Fokkens, J. Millot-Keurinck, Josep M. Antó, I. Annesi-Maesano, F. Corti, Nick A. Guldemond, Renzo Angles, Arūnas Valiulis, Vicky Kritikos, Martin Wagenmann, J Mullol, G. Canfora, Peter Hellings, M. T. Ventura, Bilun Gemicioglu, Martín Bedolla-Barajas, Elísio Costa, M. Guidacci, Milan Sova, Isabelle Bosse, Jesús Guillermo Espinoza-Contreras, D. Conforti, J. Correia de Sousa, M. Sorlini, Massimo Triggiani, Jorge Maspero, Maciej Kupczyk, Rachel Tan, Jean-François Ferrero, D Caiazza, N. Di Carluccio, O. Kalayci, L. Lewis, Javier Gómez-Vera, Antoine Magnan, J. Farrell, T. Dedeu, I. Bogus-Buczynska, J. Just, Erkka Valovirta, Frederic Viart, Daniel Laune, Marco Nalin, Regina Roller-Wirnsberger, A. Szylling, Caterina Bucca, G. Castellano, Davide Caimmi, V. Stroetmann, Filip Raciborski, Rafael Stelmach, Luiana Hernández-Velázquez, Violeta Kvedariene, E. Bacci, Maurizio Romano, Cemal Cingi, A. C. Pozzi, Marit Westman, I. Young, S. Forti, M. T. Burguete Cabañas, Bolesław Samoliński, Ruta Dubakiene, E. Zernotti, A. Blua, Ioana Agache, B. A. Barreto, João O. Malva, J. Lavrut, Thomas Keil, Miguel Alejandro Medina-Ávalos, C. I. García-Cobas, Jorge A. Luna-Pech, J. F. Fontaine, R. Emuzyte, Biljana Cvetkovski, Ruth Murray, Giovanni Rolla, Antonella Muraro, Jussi Karjalainen, H. Neffen, E Cousein, Claus Bachert, V. Kolek, Magnus Wickman, Elaine Colgan, Mario R. Romano, Miguel A. Sierra, Erik Melén, A. Senn, Paulo Augusto Moreira Camargos, C. Cartier, Jawad Hajjam, Ali Fuat Kalyoncu, S. Shamai, Sinthia Bosnic-Anticevich, L. Cecci, Renaud Louis, Ana Todo-Bom, Rodolphe Bourret, Enrica Menditto, Nikolaos G. Papadopoulos, M. M. Ciaravolo, Emmanuel P. Prokopakis, G. Passalacqua, P. V. Tomazic, Edgardo Jares, C. Robalo-Cordeiro, L. Bertorello, M. Bewick, Roland Buonaiuto, A. Romano, Sîan A Williams, Anabela Mota-Pinto, Marcello Persico, Luigi Napoli, M. Lessa, Ralph Mösges, G. Levato, M. Nogues, Tari Haahtela, Edyta Krzych-Fałta, Janet Rimmer, F. de Blay, A. Zurkuhlen, Ludger Klimek, I. Baroni, Niels H. Chavannes, Faradiba Sarquis Serpa, T. Bieber, E. Asayag, Yves Dauvilliers, Piotr Lacwik, R. M. Cortés-Grimaldo, Piotr Kuna, Cristiana Stellato, A Valero, J. da Silva, M. Illario, S Birov, R. Gerth van Wijk, M. R. Aliberti, Inger Kull, Z. Gutter, Sanna Toppila-Salmi, Gérard Dray, Sylvie Arnavielhe, Victoria Cardona, M. Morais-Almeida, Guy Joos, S. Di Capua Ercolano, J. Coll, M. van Eerd, C. Wanscher, N. Khaltaev, Agnieszka Lipiec, Mónica Rodríguez-González, Oscar Mayora, Pascal Demoly, G. Moda, S. Palkonen, I. Lieten, and B. De Oliviera

Subjects
Gerontology, Allergy, Carat, medicine.medical_specialty, Visual analogue scale, business.industry, Immunology, Alternative medicine, medicine.disease, Comorbidity, 03 medical and health sciences, 0302 clinical medicine, Quality of life (healthcare), 030228 respiratory system, medicine, Physical therapy, Immunology and Allergy, Multimorbidity, 030212 general & internal medicine, business, health care economics and organizations, Asthma
Abstract

The overarching goals of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) are to enable European citizens to lead healthy, active and independent lives whilst ageing. The EIP on AHA includes 74 Reference Sites. The aim of this study was to transfer innovation from an app developed by the MACVIA-France EIP on AHA reference site (Allergy Diary) to other reference sites. The phenotypic characteristics of rhinitis and asthma multimorbidity in adults and the elderly will be compared using validated information and communication technology (ICT) tools (i.e. the Allergy Diary and CARAT: Control of Allergic Rhinitis and Asthma Test) in 22 Reference Sites or regions across Europe. This will improve the understanding, assessment of burden, diagnosis and management of rhinitis in the elderly by comparison with an adult population. Specific objectives will be: (i) to assess the percentage of adults and elderly who are able to use the Allergy Diary, (ii) to study the phenotypic characteristics and treatment over a 1-year period of rhinitis and asthma multimorbidity at baseline (cross-sectional study) and (iii) to follow-up using visual analogue scale (VAS). This part of the study may provide some insight into the differences between the elderly and adults in terms of response to treatment and practice. Finally (iv) work productivity will be examined in adults.

Published
2017
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36. Baseline characteristics of patients with chronic rhinosinusitis with nasal polyps and comorbid asthma from the pooled populations of the SINUS-24 and SINUS-52 Dupilumab phase 3 trials

Author

Martin Desrosiers, J Mullol, Xuezhou Mao, Leda Mannent, Jorge Maspero, K. Forwith, Nikhil Amin, M. Zhang, and Philippe Gevaert

Subjects
medicine.medical_specialty, business.industry, Chronic rhinosinusitis, medicine.disease, Gastroenterology, Dupilumab, medicine.anatomical_structure, Baseline characteristics, Internal medicine, Medicine and Health Sciences, Medicine, Nasal polyps, business, Sinus (anatomy), Asthma
Published
2020

37. Assessment of craniofacial hyperhidrosis and flushing by sphenopalatine blockade - a randomized trial

Author

A Nogues, Eduardo Lehrer, Isam Alobid, F Jaume, and J Mullol

Subjects
Sphenopalatine Ganglion Block, Lidocaine, Visual analogue scale, law.invention, Acoustic rhinometry, Randomized controlled trial, law, medicine, Humans, Hyperhidrosis, medicine.diagnostic_test, business.industry, Endoscopy, General Medicine, eye diseases, Blockade, Ganglion, medicine.anatomical_structure, Otorhinolaryngology, Face, Anesthesia, Quality of Life, business, medicine.drug
Abstract

Background Craniofacial hyperhidrosis (CFH) and flushing express nervous system autonomic dysfunction. Available reference treatments lack good compliance. The study objective was to investigate variations of CFH/flushing after two methods of sphenopalatine ganglion (SPG) blockade. Methodology CFH patients (n=25) were randomized in a ratio of 1:3 in two groups; 1) endoscopic application of topical lidocaine over SPG (TL; n=7); 2) endoscopic injection of lidocaine in the SPG (IL; n=18). CFH, flushing, rhinorrhoea, nasal obstruction, and smell detection were scored by Visual Analogue Scale (VAS). Nasal endoscopy, acoustic rhinometry, mucociliary transport test, smell/taste test, Schirmer test, Short Form-12, Chronic Skin Diseases Questionnaire, and Skin Satisfaction Questionnaire were also performed at visit 0, 1, 3 and 6 months. Results At baseline, groups reported similar CFH VAS (TL: 89.3 plus or minus 17.5mm; IL: 85.7 plus or minus 22.1mm) or flushing VAS (TL: 52.7 plus or minus 30mm; IL: 59 plus or minus 33.8mm). After 6 months, the least squares mean of CFH VAS in IL was -38.1 (-47.3 to -28.9) compared to TL 1.9 (-12.2 to 15.9). However, flushing VAS did not improve. Any rhinological measure nor quality of life test showed significant changes. One patient presented controlled epistaxis intraoperatively during IL. Conclusions This preliminary study shows the sphenopalatine blockade injection as a safe procedure. Patients with CFH or flushing had significant improvement after lidocaine injection which lasted 6 months. Due to the small sample and the lack of objective measures more studies are needed.

Published
2019
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38. The GALEN rhinosinusitis cohort: chronic rhinosinusitis with nasal polyps affects health-related quality of life

Author

T. Van Zele, G Scadding, Marek L. Kowalski, Valérie Hox, C. M. van Drunen, Valerie J. Lund, Asif Khan, Heidi Olze, Julia Arebro, Peter Tomassen, J Mullol, Isam Alobid, U Förster-Ruhrmann, Elina Toskala, Claus Bachert, Leda Mannent, W. J. Fokkens, G. Vandeplas, Lars-Olaf Cardell, Vijay N. Joish, A. Olszewska-Ziaber, Peter Hellings, T. M. T. Huynh, Ear, Nose and Throat, and AII - Inflammatory diseases

Subjects
medicine.medical_specialty, SYMPTOMS, SF-36, IMPACT, sinusitis, Population, QUESTIONNAIRE, Disease, 03 medical and health sciences, 0302 clinical medicine, rhinitis, Nasal Polyps, Quality of life, Internal medicine, Medicine, Humans, Sinusitis, 030223 otorhinolaryngology, education, POPULATION, Asthma, Rhinitis, education.field_of_study, Science & Technology, nasal polyps, business.industry, COST, General Medicine, medicine.disease, Comorbidity, humanities, PREVALENCE, Otorhinolaryngology, quality of life, Cohort, Chronic Disease, Quality of Life, GLOBAL ALLERGY, ASTHMA, business, Life Sciences & Biomedicine
Abstract

BACKGROUND: Chronic rhinosinusitis (CRS) significantly affects health-related quality of life (HRQoL). Few multinational observational studies have evaluated the impact of CRS with nasal polyps (CRSwNP) on patients’ HRQoL. This study aimed to assess HRQoL outcomes (including analyses by disease severity and impact of comorbidities and refractory disease) in CRSwNP patients from a large European database. METHODOLOGY: Data were analysed from the Global Allergy and Asthma European Network (GALEN) Rhinosinusitis Cohort, including sociodemographic data, patient-reported disease severity (visual analogue scale), and scores on the 36-Item ShortForm Health Survey (SF-36) questionnaire. Differences in mean SF-36 scores were evaluated between patients with CRSwNP and population norms and between subgroups of interest (disease severity, comorbidity, and refractory disease, defined by a history of sinonasal surgery). RESULTS: Patients with CRSwNP (N = 445) had significantly lower mean SF-36 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores vs population norms, demonstrating that CRSwNP negatively affects HRQoL. The presence of comorbidities affected HRQoL, as shown by significant differences in PCS scores in patients with asthma or non-steroidal antiinflammatory drug-exacerbated respiratory disease, compared with patients without asthma. Patients with moderate-to-severe disease had significantly lower PCS scores than patients with mild disease. Severe disease had a significant impact on MCS score. History of surgery had a clinically meaningful negative effect on HRQoL compared with no history of surgery. CONCLUSIONS: CRSwNP patients have significantly lower HRQoL compared with population norms. The impact is greater in patients with greater disease severity, comorbidities, or refractory disease. ispartof: RHINOLOGY vol:57 issue:5 pages:343-351 ispartof: location:Netherlands status: published

Published
2019

39. Baseline Characteristics of Patients With Chronic Rhinosinusitis With Nasal Polyps (With and Without Asthma) Enrolled in SINUS-52, a Randomized, Double-Blind, Phase 3 Study of Dupilumab

Author

I Niemann, Martin Wagenmann, Jorge Maspero, Martin Desrosiers, Asif Khan, J Mullol, L.P. Mannent, Nikhil Amin, Siddhesh Kamat, and Claus Bachert

Subjects
medicine.medical_specialty, Chronic rhinosinusitis, business.industry, Phases of clinical research, medicine.disease, Gastroenterology, Dupilumab, Double blind, medicine.anatomical_structure, Baseline characteristics, Internal medicine, medicine, Nasal polyps, business, Sinus (anatomy), Asthma
Published
2019
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41. Altered expression and signalling of EP2 receptor in nasal polyps of AERD patients: role in inflammation and remodelling

Author

César Picado, Laura Pujols, J. Roca-Ferrer, Maria Perez-Gonzalez, J Mullol, R Torres, L Machado-Carvalho, and Isam Alobid

Subjects
Male, 0301 basic medicine, medicine.medical_specialty, Prostaglandin E2 receptor, Respiratory Tract Diseases, Down-Regulation, Prostaglandin, Mucous membrane of nose, Inflammation, Stimulation, Dinoprostone, 03 medical and health sciences, chemistry.chemical_compound, Nasal Polyps, 0302 clinical medicine, Internal medicine, Cyclic AMP, Humans, Receptors, Prostaglandin E, Medicine, Nasal polyps, Alprostadil, Receptor, Cell Proliferation, Aspirin, business.industry, Anti-Inflammatory Agents, Non-Steroidal, Granulocyte-Macrophage Colony-Stimulating Factor, General Medicine, Fibroblasts, Middle Aged, medicine.disease, Nasal Mucosa, 030104 developmental biology, Endocrinology, 030228 respiratory system, Otorhinolaryngology, chemistry, Disease Progression, Female, lipids (amino acids, peptides, and proteins), Signal transduction, medicine.symptom, business, Signal Transduction
Abstract

Background: Down-regulation of the E-prostanoid (EP)2 receptor has been reported in aspirin exacerbated respiratory disease (AERD). We aimed to evaluate the expression and activation of EP receptors in AERD and their role in prostaglandin (PG) E2 signalling. Methods: Samples were obtained from nasal mucosa of control subjects (NM-C, n=7) and from nasal polyps of AERD patients (NP-AERD, n=7). Expression of EP1-4 was assessed at baseline. Fibroblasts were stimulated with receptor agonists to measure cAMP levels, cell proliferation and granulocyte-macrophage colony-stimulating factor (GM-CSF) release. Results: NM-C and NP-AERD samples and fibroblasts expressed EP2, EP3 and EP4 at baseline. Lower expression of EP2 and higher expression of EP4 was observed in NP-AERD compared with NM-C. Stimulation with PGE2 and butaprost caused a higher increase in cAMP in NM-C than in NP-AERD. On the contrary, CAY10598 produced a higher production of cAMP in NP-AERD compared with NM-C. The anti-proliferative effect of PGE2 and butaprost was lower in NP-AERD than in NM-C fibroblasts. Similarly, the capacity of PGE2 and butaprost to inhibit GM-CSF release was lower in NP-AERD than in NM-C. Conclusions: The altered expression of EP2 in AERD may contribute to reduce the capacity of PGE2 to mediate anti-proliferative and anti-inflammatory effects.

Published
2017
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42. A possible role of stem cells in nasal polyposis

Author

Ludger Klimek, P W Hellings, Barbara Wollenberg, W. J. Fokkens, D. Y. Wang, M. Koennecke, J Mullol, and Philippe Gevaert

Subjects
0301 basic medicine, Respiratory Mucosa, Cellular differentiation, Immunology, 03 medical and health sciences, Nasal Polyps, Immunology and Allergy, Medicine, Animals, Humans, Nasal polyps, Progenitor cell, business.industry, Stem Cells, Treatment options, Cell Differentiation, medicine.disease, Disease Models, Animal, 030104 developmental biology, Gene Expression Regulation, Treatment strategy, Signal transduction, Stem cell, business, Signal Transduction
Abstract

Since its discovery, the understanding of stem/progenitor cells raised dramatically in the last decade. Their regenerative potential is important to develop new therapeutic applications, but the identification advanced much faster than our understanding of stem/progenitor cells. In nasal polyposis, little is known about stem cells/progenitor cells and their ability. However, the further characterization of stem cells/progenitor cells may provide new treatment options for combating nasal polyposis. This review highlights the knowledge of the current literature about stem cells/progenitor cells in nasal polyposis and how this may be exploited in the development of novel treatment strategies.

Published
2017
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43. The Global Allergy and Asthma European Network (GALEN) rhinosinusitis cohort: a large European cross-sectional study of chronic rhinosinusitis patients with and without nasal polyps

Author

P W Hellings, W. J. Fokkens, Julia Arebro, Lars-Olaf Cardell, Vijay N. Joish, Valerie J. Lund, G Scadding, Marek L. Kowalski, Heidi Olze, Asif Khan, Valérie Hox, N. De Ruyck, T. Van Zele, Leda Mannent, Peter Tomassen, C. M. van Drunen, T. M. T. Huynh, Gabriele Holtappels, Griet Vandeplas, Elina Toskala, Claus Bachert, J Mullol, A. Olszewska-Ziaber, U. Foerster-Ruhrmann, University Hospitals Leuven - Department of Ear, Nose and Throat Disease, Head and Neck surgery, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, Ear, Nose and Throat, and AII - Inflammatory diseases

Subjects
Adult, medicine.medical_specialty, SYMPTOMS, IMPACT, SURGERY, sinusitis, Population, cross-sectional studies, NATIONAL COMPARATIVE AUDIT, 03 medical and health sciences, 0302 clinical medicine, rhinitis, Nasal Polyps, cohort studies, QUALITY-OF-LIFE, SF-36, Internal medicine, medicine, Medicine and Health Sciences, otorhinolaryngologic diseases, Humans, Nasal polyps, Sinusitis, 030223 otorhinolaryngology, education, Nose, Asthma, Rhinitis, education.field_of_study, nasal polyps, business.industry, General Medicine, medicine.disease, Comorbidity, PREVALENCE, ASPIRIN, medicine.anatomical_structure, Cross-Sectional Studies, Otorhinolaryngology, Case-Control Studies, Cohort, Chronic Disease, Quality of Life, business, Cohort study
Abstract

BACKGROUND: Chronic rhinosinusitis (CRS) is a common yet under-recognised chronic inflammatory disease of the nose and paranasal sinuses that is classified according to the presence (CRSwNP) or absence (CRSsNP) of nasal polyps. METHODS: This paper reports the methodology and descriptive results of the Global Allergy and Asthma European Network (GALEN) rhinosinusitis cohort. We established a large CRS cohort within the GALEN consortium (European FP6 research initiative) to identify inflammatory endotypes, the natural disease course, and its impact on health-related quality of life (HRQoL). Detailed information on the impact of CRS on HRQoL, comorbidity incidence, objective disease measures, and medical and surgical treatments were collected. RESULTS: This multicentre cross-sectional case-control study recruited 935 adults (869 eligible for analysis: 237 CRSsNP; 445 CRSwNP; 187 controls [reference group]). Comorbidities such as asthma, allergy, eczema, food allergy, urticaria, and chronic obstructive pulmonary disease were significantly more frequent in CRS patients. Nasal corticosteroids, antibiotics, and oral corticosteroids were the most common treatments. Significantly more CRSwNP patients reported previous sinonasal surgery. CONCLUSIONS: This study provides detailed information that facilitates studying CRS and its main phenotypes. However, patient distribution of this study does not necessarily reflect disease distribution in the general population. ispartof: RHINOLOGY vol:57 issue:1 pages:32-42 ispartof: location:Netherlands status: published

Published
2019

44. Patient advisory board for chronic rhinosinusitis : a EUFOREA initiative

Author

J Mullol, C Pereira-Perez, G. De Carlo, Evelijn Lourijsen, Claus Bachert, P. V. Tomazic, Jean Bousquet, Claire Hopkins, Simon B. Gane, Gert Marien, Sven Seys, C Holzmeister, Olivier M. Vanderveken, Benoit Pugin, Isam Alobid, L Deneyer, M Mavris, W. J. Fokkens, Valerie J Lund, Peter Hellings, Cristobal Langdon, Ear, Nose and Throat, AII - Inflammatory diseases, and Graduate School

Subjects
medicine.medical_specialty, High prevalence, business.industry, Chronic rhinosinusitis, MEDLINE, General Medicine, Patient Advocacy, medicine.disease, Patient advocacy, Quality of life (healthcare), Otorhinolaryngology, Health care, Chronic Disease, medicine, Prevalence, Quality of Life, Humans, Medical emergency, Human medicine, Sinusitis, business, Rhinitis
Abstract

Despite the high prevalence of chronic rhinosinusitis (CRS) and its impact on patients'quality of life, no European patient organization that advocates for patients with CRS currently exists.To fill this gap and give a voice to CRS patients, EUFOREA has created a patient advisory board, whose goal is to better understand the real-life needs of patients, to raise awareness at political level and to involve patients in the development of novel integrated solutions to accelerate access to accurate diagnosis and treatments. This report summarizes the key discussion points from the kick-off meeting of the board on the 8th June 2018 and provides an outline of the key objectives for the future.

Published
2019

45. P452 DUPILUMAB IMPROVES PATIENT-REPORTED OUTCOMES IN CHRONIC RHINOSINUSITIS WITH NASAL POLYPS AND COMORBID ASTHMA: SINUS-24/SINUS-52 TRIALS

Author

J Mullol, Xuezhou Mao, Philippe Gevaert, Jorge Maspero, Heribert Staudinger, Nikhil Amin, Claus Bachert, Siddhesh Kamat, Asif Khan, Martin Desrosiers, M. Zhang, and Leda Mannent

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, business.industry, Chronic rhinosinusitis, Immunology, medicine.disease, Dermatology, Dupilumab, medicine.anatomical_structure, medicine, Immunology and Allergy, Nasal polyps, business, Sinus (anatomy), Asthma
Published
2019
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46. Churg-Strauss Syndrome or Eosinophilic Granulomatosis with Polyangiitis

Author

Isam Alobid, J. Mullol, Arturo Cordero Castillo, and Adriana Izquierdo-Domínguez

Subjects
Pathology, medicine.medical_specialty, business.industry, Azathioprine, respiratory system, Eosinophil, medicine.disease, medicine.anatomical_structure, Necrotizing Vasculitis, Eosinophilic, Immunology, Medicine, Eosinophilia, medicine.symptom, business, Granulomatosis with polyangiitis, Vasculitis, Mepolizumab, medicine.drug
Abstract

Eosinophilic granulomatosis with polyangiitis (Churg-Strauss, EGPA) is a systemic small-to-medium-sized vasculitis associated with asthma and eosinophilia. Histologically EGPA presents tissue eosinophilia, necrotizing vasculitis, and granulomatous inflammation with eosinophil tissue infiltration. EGPA commonly involves the upper airway and lung parenchyma, peripheral neuropathy, cardiac disorders, and skin lesions. The anti-neutrophil cytoplasmic antibodies (ANCA) are positive in 40% of cases, especially in those patients with clinical signs of vasculitis. The pathogenesis of EGPA is multifactorial. The disease can be triggered by exposure to a variety of allergens and drugs, but a genetic background has also been described, particularly an association with HLA-DRB4. Th2 response is of special importance in the upregulation of different interleukins such as IL-4, IL-13, and IL-5. Th1 and Th17 responses are also of significance. Activated eosinophils have a prolonged survival and probably cause tissue damage by releasing eosinophil granule proteins, while their tissue recruitment can be regulated by chemokines such as eotaxin-3 and CCL17. Humoral immunity is also abnormally regulated, as demonstrated by excessive responses of IgG4 and IgE. EGPA has a good respond to glucocorticoids, although the combination of glucocorticoids and immunosuppressants (e.g., cyclophosphamide, azathioprine) is needed in most of cases. Newer treatment options include anti-IL-5 antibodies (mepolizumab), whose efficacy has been described in clinical trials, and anti-CD-20, a B cell-depleting agent (rituximab), reported in several case series.

Published
2015
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47. Late Breaking Poster Discussion Session LB PDS 1

Author

Thibaut Van Zele, Elina Toskala, Julia Arebro, Ulrike Foerster, Griet Vandeplas, Claus Bachert, Lars-Olaf Cardell, W. J. Fokkens, Isam Alobid, Marek L. Kowalski, Heidi Olze, J Mullol, Peter Hellings, Leda Mannent, T. M. T. Huynh, A. Olszewska-Ziaber, Glenis Scadding, C. M. van Drunen, Valerie J. Lund, Asif Khan, Valérie Hox, and Peter Tomassen

Subjects
Pediatrics, medicine.medical_specialty, business.industry, Chronic rhinosinusitis, Immunology, medicine.disease, Quality of life, Internal medicine, Cohort, Immunology and Allergy, Medicine, In patient, Nasal polyps, business, Sinusitis
Published
2015
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48. The work productivity and activity impairment allergic specific (WPAI-AS) questionnaire using mobile technology: The mask study

Author

P. V. Tomazic, A. Todo Bom, B. Samolinski, A. Bedbrook, Torsten Zuberbier, Cristiana Stellato, J. da Silva, Daniel Laune, Davide Caimmi, Thomas Keil, Josep M. Antó, Pascal Demoly, A. A. Cruz, R E O Hehir, M. T. Ventura, K. C. Bergmann, Enrica Menditto, M. T. Burguete Cabañas, Aziz Sheikh, G. De Vries, J Mullol, Jean Bousquet, Olivier Vandenplas, Ludger Klimek, Ruth Murray, G. Passalacqua, D. Larenas-Linnemann, João Fonseca, M. Morais-Almeida, M. van Eerd, Ralph Mösges, M. Rodriguez Gonzalez, Dermot Ryan, S. Shamai, F. Sarquis Serpa, M. Bewick, Sinthia Bosnic-Anticevich, Piotr Kuna, A Valero, Marek L. Kowalski, Sylvie Arnavielhe, Bousquet, Jean, Vandenplas, O., Bewick, M., Arnavielhe, S., Bedbrook, A., Murray, R., van Eerd, M., Fonseca, J., Morais-Almeida, M., Todo Bom, A., Cruz, A. A., Sarquis Serpa, F., da Silva, J., Menditto, E., Passalacqua, G., Stellato, C., Ventura, M. T., Caimmi, D., Demoly, P., Bergmann, K. C., Keil, T., Klimek, L., Mösges, R., Shamai, S., Zuberbier, T., Larenas-Linnemann, D., Rodriguez Gonzalez, M., Burguete Cabañas, M. T., Ryan, D., Sheikh, A., Anto, J. M., Mullol, J., Valero, A., Kowalski, M. L., Kuna, P., Samolinski, B., Tomazic, P. V., Bosnic-Anticevich, S., O'Hehir, R. E., De Vries, G., Laune, D., Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), GoLP/Centro de Física dos Plasmas and Fusão Nuclear, Instituto Superior Técnico, Universidade Técnica de Lisboa (IST), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)

Subjects
Gerontology, Adult, Male, Work productivity, MASK, Cross-sectional study, Immunology, MEDLINE, Efficiency, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Quality of life (healthcare), Surveys and Questionnaires, Journal Article, Hypersensitivity, Medicine, Humans, Immunology and Allergy, Mobile technology, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, WPAI-AS, ComputingMilieux_MISCELLANEOUS, Rhiniti, Rhinitis, ARIA, business.industry, Activity, Cross-Sectional Studies, 030228 respiratory system, Quality of Life, Activity, ARIA, MASK, Rhinitis, Work productivity, WPAI-AS, Immunology and Allergy, Immunology, Female, business
Abstract

International audience

Published
2018
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49. Allergic Rhinitis and its Impact on Asthma (ARIA) Phase 4 (2018): Change management in allergic rhinitis and asthma multimorbidity using mobile technology

Author

Karin C. Lødrup Carlsen, L. Cecchi, F. Portejoie, T. Vontetsianos, Olivier Vandenplas, M. van Hague, D. Mora Bogado, M. Illario, Dana Wallace, L. Namazova-Baranova, E. Asayag, I. Ribeirinho, E. Costa, Shona Pedersen, Inger Kull, Davor Plavec, M. Morais-Almeida, Mickael Bewick, N.H. Chavannes, I. J. Ansotegui, G. De Carlo, K. S. Bennoor, Faradiba Sarquis Serpa, S. Arnavielle, F. Corti, Moises A. Calderon, Martín Bedolla-Barajas, Mette Sørensen, Isabella Annesi-Maesano, Elaine Colgan, Przemyslaw Kardas, M. van Eerd, Jorge Maspero, Valérie Siroux, Isabelle Momas, Ralph Mösges, Yves Dauvilliers, T. Keil, T. Bieber, Marit Westman, Rachel Nadif, O. Pfaar, A.C. Carvalho Coehlo, R. M. Cortés-Grimaldo, I. Skrindo, Piotr Kuna, Nicola Scichilone, Antonella Muraro, Kimihiro Okubo, Paulo Augusto Moreira Camargos, C. Cartier, Oliver Pfaar, K. Ohta, Barbara P. Yawn, Igor Kaidashev, Michel Thibaudon, X. Basagana, I. Kaidashev, Bilun Gemicioglu, S. Genova, Hae-Sim Park, J.J. Matta Campos, Simon Walker, Ulf Darsow, Fulvio Braido, J. Salimäki, T. Zuberbier, Raphaël Chiron, Mohammad Reza Masjedi, G.D. Marshall, Branislava Milenkovic, W. J. Fokkens, Eric D. Bateman, Robert M. Naclerio, Steve Montefort, M. de Fátima Emerson, T. Werfel, Cemal Cingi, A. Szylling, Martin Wagenmann, I. Baiardini, L. T. T. Le, N. Khaltaev, Ki-Suck Jung, Agnieszka Lipiec, Panayiotis K. Yiallouros, A Valero, R. Gerth van Wijk, L. Hernández, Marek L. Kowalski, C. Zubrinich, Sinthia Bosnic-Anticevich, Miguel A. Sierra, Erik Melén, T. Haahtela, Rute Almeida, Violeta Kvedariene, R. Pawankar, T.A. Popov, Flore Amat, Sanna Toppila-Salmi, M. Gotua, A. Sheikh, A. Bedbrook, Torsten Zuberbier, B. De Martino, Gérard Dray, Francesca Avolio, E. Mandajieva, B. Samolinski, Petr Panzner, P. Kuna, Philippe-Jean Bousquet, T. D. Nyembue, Luo Zhang, Leyla Namazova-Baranova, Ana Maria Carriazo, João Fonseca, E. Van Ganse, Roland Buhl, M. Bochenska Marciniak, Cristiana Stellato, J. da Silva, J. E. Gereda, Han-Jung Park, M.C. Costa-Dominguez, W. Carr, Dirceu Solé, S. Forti, Nanshan Zhong, Jordi Sunyer, Alain Didier, Y. Z. Chen, Thomas B. Casale, Jim Phillips, Isabelle Bosse, Manuel Teixeira Veríssimo, D. Y. Wang, U. Trama, Cristina Bárbara, David Somekh, T. Camuzat, R. N. Naclerio, Enrico Novellino, Leszek Klimek, M. Rodriguez Gonzalez, Holger J. Schünemann, Mario Barbagallo, D. Larenas-Linnemann, Mario Sánchez-Borges, Massimo Triggiani, Y. Okamoto, E. Mathieu-Dupas, N. Di Carluccio, S. Toppila-Salmi, Omer Kalayci, Rudolf Valenta, J. Coll, F. de Blay, Wienczyslawa Czarlewski, W. Pohl, Piotr Wroczyński, Kian Fan Chung, Nikolaos G. Papadopoulos, Pascal Demoly, Hubert Blain, M. Crescenzo, O. Kalayci, Leocadio Rodríguez-Mañas, G. Moda, L. Cox, Z. Gutter, A. Mair, Andrew Bush, Maria-Dolores Mogica-Martinez, Giorgio Walter Canonica, Antonio Valero, Daniel Laune, A. Zurkuhlen, Paul C. Potter, D. Wallace, Gabrielle L. Onorato, Mihaela Zidarn, E.P. Prokopakis, Anne Lise Courbis, Sergio Bonini, Ruta Dubakiene, A. Papi, Y. El-Gamal, Jacques Mercier, Wytske Fokkens, Rodolphe Bourret, S. Palkonen, A. Yorgancioglu, G. Vezzani, J. A. Rizzo, D. Plavec, D. Caillot, G. De Feo, E. Menditto, Caterina Bucca, A. C. Pozzi, Hironori Sagara, I. Grisle, I. Pin, Christopher E. Brightling, Ludger Klimek, F.F. Morato-Castro, Désirée Larenas-Linnemann, Alessandro Vatrella, A. A. Cruz, Guy Joos, E.D. Bateman, Erendira Rodriguez-Zagal, H. Douagui, T. To, Edgardo Jares, C. Bindslev-Jensen, G. Levato, J. O. B. Hourihane, R. Rajabian-Soderlund, C. Odzhakova, J. Bousquet, M. T. Ventura, Arzu Yorgancioglu, Osman M. Yusuf, H. J. Zar, Giovanni Rolla, Sebastian L. Johnston, M.S. Dykewicz, Esben Eller, A. Gamkrelidze, Filip Raciborski, Renzo Angles, Rafael Stelmach, M. Nogues, David Price, Mário Morais-Almeida, Tari Haahtela, Teresa To, D. Conforti, Stephen R. Durham, S. Gonzalez Diaz, V. Cardona, Werner Aberer, B. Milenkovic, Luigi Napoli, K. C. Bergmann, P W Hellings, M. Lessa, P. Panzner, Alfonso M. Cepeda Sarabia, M. Guidacci, A.L. Matos, Todor A. Popov, C. Suppli Ulrik, Diana Deleanu, N. de Paula Motta Rubini, Carsten Bindslev-Jensen, I. Majer, Ioana Agache, B. A. Barreto, R. Picard, Erkka Valovirta, A. Fink-Wagner, L. Colas, João O. Malva, Thomas Keil, M. T. Burguete Cabañas, Bolesław Samoliński, M.H. Garcia-Cruz, L.P. Boulet, K. Nekam, Edyta Krzych-Fałta, P. Devillier, J. Ferreira de Mello, Jussi Karjalainen, I. Bogus-Buczynska, Susan Waserman, Marcus Maurer, Tomas Chivato, Elena Bacci, M. Przemecka, Olga Lourenço, José Miguel Fuentes-Pérez, M. Zidarn, Talant Sooronbaev, J.M. Anto, W. Czarlewski, R. Murray, Luís Nogueira-Silva, G. Passalacqua, E. Chkhartishvili, Oscar Mayora, Victoria Cardona, M. Sondermann, Piotr Lacwik, S. Ouedraogo, I. Baroni, Artur Z. Białoszewski, G Scadding, J. Strozek, R. Emuzyte, Neven Miculinic, Ruby Pawankar, Ken Ohta, I. Agache, J.L. Gálvez-Romero, Nikos G. Papadopoulos, E. O. Meltzer, I. Annesi-Maesano, E. De Manuel Keenoy, Jorge A. Luna-Pech, Ana Margarida Pereira, Paul Potter, M. Ortega Cisneros, J. Li, K. F. Rabe, M. Rottem, Mikael Benson, Ali Fuat Kalyoncu, Dermot Ryan, Dieter Maier, C.Y. García-Cobas, S. Bialek, G. Du Toit, S. Shamai, S. Mavale-Manuel, Rojin Rajabian-Soderlund, Maddalena Illario, Philippe Devillier, F. Rodenas, Emmanuel P. Prokopakis, De Yun Wang, Niels H. Chavannes, E.H.D. Bel, Bianca Beghe, Sietze Reitsma, John Wright, O. Lourenço, L.T.T. Le, Josep M. Antó, T. Casale, Paul K. Keith, K. C. Lødrup Carlsen, P. Demoly, Mikael Kuitunen, Marc Humbert, A. M. Cepeda Sarabia, Ignacio J. Ansotegui, M.C. Rizzo, Davide Caimmi, Milan Sova, Nick A. Guldemond, P. Yakovliev, Judah A. Denburg, Jaime Correia de Sousa, Elisabete Melo-Gomes, Aziz Sheikh, I. Bosse, M. M. Ciaravolo, S. Di Capua Ercolano, Alpana Mair, P. Lieberman, Isabella Pali-Schöll, Leif Bjermer, G. De Vries, M. Roman Rodriguez, Johanna Salimäki, Carmen Panaitescu, F. Mihaltan, Giulia De Feo, F. E. R. Simons, A. Blua, B. Mahboub, D. Ryan, M. Bewick, Anabela Mota-Pinto, J.A. Fonseca, Neil Wilson, Marek Jutel, Dennis M. Williams, M. Akdis, Menachem Rottem, Marcello Persico, J. C. Ivancevich, Nelson Rosario, A. Farsi, Alvaro A. Cruz, Liguo Zhang, Anna Bedbrook, L. Bertorello, Magnus Wickman, Marilyn Urrutia-Pereira, O. Spranger, René Maximiliano Gómez, C. Bachert, Renaud Louis, Musa Khaitov, C. Stellato, Constantinos Pitsios, Roland Buonaiuto, A. Romano, Sîan A Williams, R. Puy, Daniela Rivero-Yeverino, Y. Mohammad, J. Farrell, Jan Brozek, Ricardo Pio Monti, E. Paulino, J. Correia de Sousa, Miguel Alejandro Medina-Ávalos, Jocelyne Just, Peter Valentin Tomazic, Jean-François Ferrero, Antoine Magnan, S. Waserman, J Rosado-Pinto, Maciek Kupczyk, C.S. Bosnic-Anticevich, T. Dedeu, Tommi Vasankari, R. Mösges, Robin O'Hehir, Ema Paulino, Peter Hellings, A. Neou, M. Wickman, D. Lauri, Jean Bousquet, A. Ciceran, Jacques Bouchard, Yehia El-Gamal, M.G. Dominguez-Silva, M.R. Alberti, Jean-Louis Pépin, Kimi Okubo, Juan Carlos Ivancevich, Patrik Eklund, Benoit Pugin, C. Dario, Mussa Khaitov, Luisa Brussino, A.G. Chuchalin, Elísio Costa, Susanna Palkonen, Lars Münter, Pedro Carreiro-Martins, R.E. Pulido Ross, Ettore Novellino, Kai-Håkon Carlsen, María Antonieta Guzmán, G.W. Canonica, Gabriel Onorato, Giuseppe De Carlo, R.E. Roller-Wirnsberger, Brian J. Lipworth, M. A. Guzman, J.N. Tebyriçá, Adnan Custovic, Yoshitaka Okamoto, Rimantas Stukas, P. Manning, J. Sastre-Dominguez, Caroline L.S. George, Robyn E O'Hehir, K. Maciej, Bassam Mahboub, J. F. Fontaine, Arũnas Valiulis, Xavier Rodó, D. Vicheva, G. Canfora, Vitalis Briedis, S. Rodrigues Valle, Mark S. Dykewicz, Joanne Rimmer, G. Castellano, B. Pigearias, A. L. Boner, Yunuen Rocío Huerta-Villalobos, Christine Rolland, H. Neffen, H. Arshad, Javier Gómez-Vera, P. Moura Santo, Frederic Viart, F. Blasi, J. Garcia-Aymerich, Lorenzo Cecchi, V. Niedeberger, Giorgio Ciprandi, F. Caballero-Fonseca, Jean-François Fontaine, J Mullol, Maurizio Romano, M. Viegi, Mario E. Zernotti, Arunas Valiulis, Anna Asarnoj, Antonio Nieto, J. Lavrut, D. Dokic, V. Kvedariene, Ewa Jassem, Cezmi A. Akdis, Ruth Murray, Claus Bachert, Peter Schmid-Grendelmeier, Emilie Burte, Joaquim Mullol, Guido Iaccarino, J. Kleine-Tebbe, P. V. Tomazic, E. Eller, Alessandro Fiocchi, H.J. Schunemann, M. Sorlini, C. Robalo-Cordeiro, Ana-Maria Todo-Bom, J. Brozek, Marco Nalin, Matteo Bonini, J. C. Sisul, S.E. Dahlen, F. Amat, Juan Carlos Sisul, Jawad Hajjam, Ana Todo-Bom, Enrica Menditto, Bousquet J., Hellings P.W., Agache I., Amat F., Annesi-Maesano I., Ansotegui I.J., Anto J.M., Bachert C., Bateman E.D., Bedbrook A., Bennoor K., Bewick M., Bindslev-Jensen C., Bosnic-Anticevich S., Bosse I., Brozek J., Brussino L., Canonica G.W., Cardona V., Casale T., Cepeda Sarabia A.M., Chavannes N.H., Cecchi L., Correia de Sousa J., Costa E., Cruz A.A., Czarlewski W., De Carlo G., De Feo G., Demoly P., Devillier P., Dykewicz M.S., El-Gamal Y., Eller E.E., Fonseca J.A., Fontaine J.-F., Fokkens W.J., Guzman M.-A., Haahtela T., Illario M., Ivancevich J.-C., Just J., Kaidashev I., Khaitov M., Kalayci O., Keil T., Klimek L., Kowalski M.L., Kuna P., Kvedariene V., Larenas-Linnemann D., Laune D., Le L.T.T., Carlsen K.L., Lourenco O., Mahboub B., Mair A., Menditto E., Milenkovic B., Morais-Almeida M., Mosges R., Mullol J., Murray R., Naclerio R., Namazova-Baranova L., Novellino E., O'Hehir R.E., Ohta K., Okamoto Y., Okubo K., Onorato G.L., Palkonen S., Panzner P., Papadopoulos N.G., Park H.-S., Paulino E., Pawankar R., Pfaar O., Plavec D., Popov T.A., Potter P., Prokopakis E.P., Rottem M., Ryan D., Salimaki J., Samolinski B., Sanchez-Borges M., Schunemann H.J., Sheikh A., Sisul J.-C., Rajabian-Soderlund R., Sooronbaev T., Stellato C., To T., Todo-Bom A.-M., Tomazic P.-V., Toppila-Salmi S., Valero A., Valiulis A., Valovirta E., Ventura M.-T., Wagenmann M., Wang D.Y., Wallace D., Waserman S., Wickman M., Yorgancioglu A., Zhang L., Zhong N., Zidarn M., Zuberbier T., Aberer W., Akdis C.A., Akdis M., Alberti M.R., Almeida R., Angles R., Arnavielle S., Asayag E., Asarnoj A., Arshad H., Avolio F., Bacci E., Baiardini I., Barbara C., Barbagallo M., Baroni I., Barreto B.A., Basagana X., Bedolla-Barajas M., Beghe B., Bel E.H., Bergmann K.C., Benson M., Bertorello L., Bialoszewski A.Z., Bieber T., Bialek S., Bjermer L., Blain H., Blasi F., Blua A., Bochenska Marciniak M., Bogus-Buczynska I., Boner A.L., Bonini M., Bonini S., Bouchard J., Boulet L.P., Bourret R., Braido F., Briedis V., Brightling C.E., Bucca C., Buhl R., Buonaiuto R., Panaitescu C., Burguete Cabanas M.T., Burte E., Bush A., Caballero-Fonseca F., Caillot D., Caimmi D., Calderon M.A., Camargos P.A.M., Camuzat T., Canfora G., Carreiro-Martins P., Carriazo A.M., Carr W., Cartier C., Castellano G., Chen Y., Chiron R., Chivato T., Chkhartishvili E., Chuchalin A.G., Chung K.F., Ciaravolo M.M., Ciceran A., Cingi C., Ciprandi G., Carvalho Coehlo A.C., Colas L., Colgan E., Coll J., Conforti D., Cortes-Grimaldo R.M., Corti F., Costa-Dominguez M.C., Courbis A.L., Cox L., Crescenzo M., Custovic A., Dahlen S.E., Dario C., da Silva J., Dauvilliers Y., Darsow U., De Blay F., Dedeu T., de Fatima Emerson M., De Vries G., De Martino B., de Paula Motta Rubini N., Deleanu D., Denburg J.A., Di Capua Ercolano S., Di Carluccio N., Didier A., Dokic D., Dominguez-Silva M.G., Douagui H., Dray G., Dubakiene R., Durham S.R., Du Toit G., Eklund P., Emuzyte R., Farrell J., Farsi A., Ferreira de Mello J., Ferrero J., Fink-Wagner A., Fiocchi A., Forti S., Fuentes-Perez J.M., Galvez-Romero J.L., Gamkrelidze A., Garcia-Aymerich J., Garcia-Cobas C.Y., Garcia-Cruz M.H., Gemicioglu B., Genova S., George C., Gereda J.E., Gerth van Wijk R., Gomez R.M., Gomez-Vera J., Gonzalez Diaz S., Gotua M., Grisle I., Guidacci M., Guldemond N.A., Gutter Z., Hajjam J., Hernandez L., Hourihane J.O., Huerta-Villalobos Y.R., Humbert M., Iaccarino G., Jares E.J., Jassem E., Johnston S.L., Joos G., Jung K.S., Jutel M., Kalyoncu A.F., Karjalainen J., Kardas P., Keith P.K., Khaltaev N., Kleine-Tebbe J., Kuitunen M., Kull I., Kupczyk M., Krzych-Falta E., Lacwik P., Lauri D., Lavrut J., Lessa M., Levato G., Li J., Lieberman P., Lipiec A., Lipworth B., Lodrup Carlsen K.C., Louis R., Luna-Pech J.A., Maciej K., Magnan A., Maier D., Majer I., Malva J., Mandajieva E., Manning P., De Manuel Keenoy E., Marshall G.D., Masjedi M.R., Maspero J.F., Mathieu-Dupas E., Matta Campos J.J., Matos A.L., Maurer M., Mavale-Manuel S., Mayora O., Medina-Avalos M.A., Melen E., Melo-Gomes E., Meltzer E.O., Mercier J., Miculinic N., Mihaltan F., Moda G., Mogica-Martinez M.D., Mohammad Y., Momas I., Montefort S., Monti R., Mora Bogado D., Morato-Castro F.F., Mota-Pinto A., Moura Santo P., Munter L., Muraro A., Nadif R., Nalin M., Napoli L., Neffen H., Niedeberger V., Nekam K., Neou A., Nieto A., Nogueira-Silva L., Nogues M., Nyembue T.D., Odzhakova C., Ortega Cisneros M., Ouedraogo S., Pali-Scholl I., Papi A., Passalacqua G., Pedersen S., Pepin J.L., Pereira A.M., Persico M., Phillips J., Picard R., Pigearias B., Pin I., Pitsios C., Pohl W., Portejoie F., Pozzi A.C., Price D., Puy R., Pugin B., Pulido Ross R.E., Przemecka M., Rabe K.F., Raciborski F., Reitsma S., Ribeirinho I., Rimmer J., Rivero-Yeverino D., Rizzo J.A., Rizzo M.C., Robalo-Cordeiro C., Rodenas F., Rodo X., Rodriguez Gonzalez M., Rodriguez-Manas L., Rolland C., Rodrigues Valle S., Roman Rodriguez M., Romano A., Rodriguez-Zagal E., Rolla G., Roller-Wirnsberger R.E., Romano M., Rosado-Pinto J., Rosario N., Sagara H., Sastre-Dominguez J., Scadding G.K., Scichilone N., Schmid-Grendelmeier P., Serpa F.S., Shamai S., Sierra M., Simons F.E.R., Siroux V., Skrindo I., Sole D., Somekh D., Sondermann M., Sova M., Sorensen M., Sorlini M., Spranger O., Stelmach R., Stukas R., Sunyer J., Strozek J., Szylling A., Tebyrica J.N., Thibaudon M., Trama U., Triggiani M., Suppli Ulrik C., Urrutia-Pereira M., Valenta R., van Eerd M., van Ganse E., van Hague M., Vandenplas O., Vezzani G., Vasankari T., Vatrella A., Verissimo M.T., Viart F., Viegi M., Vicheva D., Vontetsianos T., Walker S., Werfel T., Westman M., Williams D.M., Williams S., Wilson N., Wright J., Wroczynski P., Yakovliev P., Yawn B.P., Yiallouros P.K., Yusuf O.M., Zar H.J., Zernotti M.E., Zubrinich C., Zurkuhlen A., Bousquet, Jean, Hellings, Peter W., Agache, Ioana, Amat, Flore, Annesi-Maesano, Isabella, Ansotegui, Ignacio J., Anto, Josep M., Bachert, Clau, Bateman, Eric D., Bedbrook, Anna, Bennoor, Kazi, Bewick, Mickael, Bindslev-Jensen, Carsten, Bosnic-Anticevich, Sinthia, Bosse, Isabelle, Brozek, Jan, Brussino, Luisa, Canonica, Giorgio W., Cardona, Victoria, Casale, Thoma, Cepeda Sarabia, Alfonso M., Chavannes, Niels H., Cecchi, Lorenzo, Correia de Sousa, Jaime, Costa, Elisio, Cruz, Alvaro A., Czarlewski, Wienczyslawa, De Carlo, Giuseppe, De Feo, Giulia, Demoly, Pascal, Devillier, Philippe, Dykewicz, Mark S., El-Gamal, Yehia, Eller, Esben E., Fonseca, Joao A., Fontaine, Jean-Françoi, Fokkens, Wytske J., Guzmán, Maria-Antonieta, Haahtela, Tari, Illario, Maddalena, Ivancevich, Juan-Carlo, Just, Jocelyne, Kaidashev, Igor, Khaitov, Musa, Kalayci, Omer, Keil, Thoma, Klimek, Ludger, Kowalski, Marek L., Kuna, Piotr, Kvedariene, Violeta, Larenas-Linnemann, Desiree, Laune, Daniel, Le, Lan T. T., Carlsen, Karin Lodrup, Lourenço, Olga, Mahboub, Bassam, Mair, Alpana, Menditto, Enrica, Milenkovic, Branislava, Morais-Almeida, Mario, Mösges, Ralph, Mullol, Joaquim, Murray, Ruth, Naclerio, Robert, Namazova-Baranova, Leyla, Novellino, Ettore, O'Hehir, Robyn E., Ohta, Ken, Okamoto, Yoshitaka, Okubo, Kimi, Onorato, Gabrielle L., Palkonen, Susanna, Panzner, Petr, Papadopoulos, Nikos G., Park, Hae-Sim, Paulino, Ema, Pawankar, Ruby, Pfaar, Oliver, Plavec, Davor, Popov, Ted A., Potter, Paul, Prokopakis, Emmanuel P., Rottem, Menachem, Ryan, Dermot, Salimäki, Johanna, Samolinski, Boleslaw, Sanchez-Borges, Mario, Schunemann, Holger J., Sheikh, Aziz, Sisul, Juan-Carlo, Rajabian-Söderlund, Rojin, Sooronbaev, Talant, Stellato, Cristiana, To, Teresa, Todo-Bom, Ana-Maria, Tomazic, Peter-Valentin, Toppila-Salmi, Sanna, Valero, Antonio, Valiulis, Aruna, Valovirta, Erkka, Ventura, Maria-Teresa, Wagenmann, Martin, Wang, De Yun, Wallace, Dana, Waserman, Susan, Wickman, Magnu, Yorgancioglu, Arzu, Zhang, Luo, Zhong, Nanshan, Zidarn, Mihaela, Zuberbier, Torsten, Bousquet, J., Hellings, P. W., Aberer, W., Agache, I., Akdis, C. A., Akdis, M., Alberti, M. R., Almeida, R., Amat, F., Angles, R., Annesi-Maesano, I., Ansotegui, I. J., Anto, J. M., Arnavielle, S., Asayag, E., Asarnoj, A., Arshad, H., Avolio, F., Bacci, E., Bachert, C., Baiardini, I., Barbara, C., Barbagallo, M., Baroni, I., Barreto, B. A., Basagana, X., Bateman, E. D., Bedolla-Barajas, M., Bedbrook, A., Bewick, M., Beghé, B., Bel, E. H., Bergmann, K. C., Bennoor, K. S., Benson, M., Bertorello, L., Białoszewski, A. Z., Bieber, T., Bialek, S., Bindslev-Jensen, C., Bjermer, L., Blain, H., Blasi, F., Blua, A., Bochenska Marciniak, M., Bogus-Buczynska, I., Boner, A. L., Bonini, M., Bonini, S., Bosnic-Anticevich, C. S., Bosse, I., Bouchard, J., Boulet, L. P., Bourret, R., Bousquet, P. J., Braido, F., Briedis, V., Brightling, C. E., Brozek, J., Bucca, C., Buhl, R., Buonaiuto, R., Panaitescu, C., Burguete Cabañas, M. T., Burte, E., Bush, A., Caballero-Fonseca, F., Caillot, D., Caimmi, D., Calderon, M. A., Camargos, P. A. M., Camuzat, T., Canfora, G., Canonica, G. W., Cardona, V., Carlsen, K. H., Carreiro-Martins, P., Carriazo, A. M., Carr, W., Cartier, C., Casale, T., Castellano, G., Cecchi, L., Cepeda Sarabia, A. M., Chavannes, N. H., Chen, Y., Chiron, R., Chivato, T., Chkhartishvili, E., Chuchalin, A. G., Chung, K. F., Ciaravolo, M. M., Ciceran, A., Cingi, C., Ciprandi, G., Carvalho Coehlo, A. C., Colas, L., Colgan, E., Coll, J., Conforti, D., Correia de Sousa, J., Cortés-Grimaldo, R. M., Corti, F., Costa, E., Costa-Dominguez, M. C., Courbis, A. L., Cox, L., Crescenzo, M., Cruz, A. A., Custovic, A., Czarlewski, W., Dahlen, S. E., Dario, C., da Silva, J., Dauvilliers, Y., Darsow, U., De Blay, F., De Carlo, G., Dedeu, T., de Fátima Emerson, M., De Feo, G., De Vries, G., De Martino, B., de Paula Motta Rubini, N., Deleanu, D., Demoly, P., Denburg, J. A., Devillier, P., Di Capua Ercolano, S., Di Carluccio, N., Didier, A., Dokic, D., Dominguez-Silva, M. G., Douagui, H., Dray, G., Dubakiene, R., Durham, S. R., Du Toit, G., Dykewicz, M. S., El-Gamal, Y., Eklund, P., Eller, E., Emuzyte, R., Farrell, J., Farsi, A., Ferreira de Mello, J., Ferrero, J., Fink-Wagner, A., Fiocchi, A., Fokkens, W. J., Fonseca, J. A., Fontaine, J. F., Forti, S., Fuentes-Perez, J. M., Gálvez-Romero, J. L., Gamkrelidze, A., Garcia-Aymerich, J., García-Cobas, C. Y., Garcia-Cruz, M. H., Gemicioğlu, B., Genova, S., George, C., Gereda, J. E., Gerth van Wijk, R., Gomez, R. M., Gómez-Vera, J., González Diaz, S., Gotua, M., Grisle, I., Guidacci, M., Guldemond, N. A., Gutter, Z., Guzmán, M. A., Haahtela, T., Hajjam, J., Hernández, L., Hourihane, J. O. 'B., Huerta-Villalobos, Y. R., Humbert, M., Iaccarino, G., Illario, M., Ivancevich, J. C., Jares, E. J., Jassem, E., Johnston, S. L., Joos, G., Jung, K. S., Jutel, M., Kaidashev, I., Kalayci, O., Kalyoncu, A. F., Karjalainen, J., Kardas, P., Keil, T., Keith, P. K., Khaitov, M., Khaltaev, N., Kleine-Tebbe, J., Klimek, L., Kowalski, M. L., Kuitunen, M., Kull, I., Kuna, P., Kupczyk, M., Kvedariene, V., Krzych-Fałta, E., Lacwik, P., Larenas-Linnemann, D., Laune, D., Lauri, D., Lavrut, J., Le, L. T. T., Lessa, M., Levato, G., Li, J., Lieberman, P., Lipiec, A., Lipworth, B., Lodrup Carlsen, K. C., Louis, R., Lourenço, O., Luna-Pech, J. A., Maciej, K., Magnan, A., Mahboub, B., Maier, D., Mair, A., Majer, I., Malva, J., Mandajieva, E., Manning, P., De Manuel Keenoy, E., Marshall, G. D., Masjedi, M. R., Maspero, J. F., Mathieu-Dupas, E., Matta Campos, J. J., Matos, A. L., Maurer, M., Mavale-Manuel, S., Mayora, O., Medina-Avalos, M. A., Melén, E., Melo-Gomes, E., Meltzer, E. O., Menditto, E., Mercier, J., Miculinic, N., Mihaltan, F., Milenkovic, B., Moda, G., Mogica-Martinez, M. D., Mohammad, Y., Momas, I., Montefort, S., Monti, R., Mora Bogado, D., Morais-Almeida, M., Morato-Castro, F. F., Mösges, R., Mota-Pinto, A., Moura Santo, P., Mullol, J., Münter, L., Muraro, A., Murray, R., Naclerio, R., Nadif, R., Nalin, M., Napoli, L., Namazova-Baranova, L., Neffen, H., Niedeberger, V., Nekam, K., Neou, A., Nieto, A., Nogueira-Silva, L., Nogues, M., Novellino, E., Nyembue, T. D., O'Hehir, R. E., Odzhakova, C., Ohta, K., Okamoto, Y., Okubo, K., Onorato, G. L., Ortega Cisneros, M., Ouedraogo, S., Pali-Schöll, I., Palkonen, S., Panzner, P., Papadopoulos, N. G., Park, H. S., Papi, A., Passalacqua, G., Paulino, E., Pawankar, R., Pedersen, S., Pépin, J. L., Pereira, A. M., Persico, M., Pfaar, O., Phillips, J., Picard, R., Pigearias, B., Pin, I., Pitsios, C., Plavec, D., Pohl, W., Popov, T. A., Portejoie, F., Potter, P., Pozzi, A. C., Price, D., Prokopakis, E. P., Puy, R., Pugin, B., Pulido Ross, R. E., Przemecka, M., Rabe, K. F., Raciborski, F., Rajabian-Soderlund, R., Reitsma, S., Ribeirinho, I., Rimmer, J., Rivero-Yeverino, D., Rizzo, J. A., Rizzo, M. C., Robalo-Cordeiro, C., Rodenas, F., Rodo, X., Rodriguez Gonzalez, M., Rodriguez-Mañas, L., Rolland, C., Rodrigues Valle, S., Roman Rodriguez, M., Romano, A., Rodriguez-Zagal, E., Rolla, G., Roller-Wirnsberger, R. E., Romano, M., Rosado-Pinto, J., Rosario, N., Rottem, M., Ryan, D., Sagara, H., Salimäki, J., Samolinski, B., Sanchez-Borges, M., Sastre-Dominguez, J., Scadding, G. K., Schunemann, H. J., Scichilone, N., Schmid-Grendelmeier, P., Serpa, F. S., Shamai, S., Sheikh, A., Sierra, M., Simons, F. E. R., Siroux, V., Sisul, J. C., Skrindo, I., Solé, D., Somekh, D., Sondermann, M., Sooronbaev, T., Sova, M., Sorensen, M., Sorlini, M., Spranger, O., Stellato, C., Stelmach, R., Stukas, R., Sunyer, J., Strozek, J., Szylling, A., Tebyriçá, J. N., Thibaudon, M., To, T., Todo-Bom, A., Tomazic, P. V., Toppila-Salmi, S., Trama, U., Triggiani, M., Suppli Ulrik, C., Urrutia-Pereira, M., Valenta, R., Valero, A., Valiulis, A., Valovirta, E., van Eerd, M., van Ganse, E., van Hague, M., Vandenplas, O., Ventura, M. T., Vezzani, G., Vasankari, T., Vatrella, A., Verissimo, M. T., Viart, F., Viegi, M., Vicheva, D., Vontetsianos, T., Wagenmann, M., Walker, S., Wallace, D., Wang, D. Y., Waserman, S., Werfel, T., Westman, M., Wickman, M., Williams, D. M., Williams, S., Wilson, N., Wright, J., Wroczynski, P., Yakovliev, P., Yawn, B. P., Yiallouros, P. K., Yorgancioglu, A., Yusuf, O. M., Zar, H. J., Zhang, L., Zhong, N., Zernotti, M. E., Zidarn, M., Zuberbier, T., Zubrinich, C., Zurkuhlen, A., CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Laboratory of clinical immunology, Department of Allergy and Clinical Immunology, Transylvania University of Brasov, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Epidémiologie, Systèmes d'Information, Modélisation, Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Epidemiology of Allergic and Respiratory Diseases Department [iPlesp] (EPAR), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Department of Allergy and Immunology, Hospital Quirónsalud Bizkaia [Bilbao], Center for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra [Barcelona] (UPF)-Catalunya ministerio de salud, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hacettepe University = Hacettepe Üniversitesi, Mechanobiology Institute [Singapore] (MBI), National University of Singapore (NUS), Department of Clinical Epidemiology and Biostatistics and Medicine, McMaster University [Hamilton, Ontario], Department of Dermatology [Graz, Austria], Medical University Graz, Swiss Institute of Allergy and Asthma Research (SIAF), Universität Zürich [Zürich] = University of Zurich (UZH), Department Engineering Quimica (ICEMS), Ghent University Hospital, Istituto Nazionale di Fisica Nucleare, sezione di Bari (INFN, sezione di Bari), Istituto Nazionale di Fisica Nucleare (INFN), IMIM-Hospital del Mar, Generalitat de Catalunya, University of Cape Town, Divisions of Human Genetics Infection, Inflammation and Repair, University of Southampton-School of Medicine, Centre de gérontologie, Department of Pathophysiology and Transplantation, Università degli Studi di Milano = University of Milan (UNIMI), Istituto di Geoscienze e Georisorse, Pavia, Institute of Neurobiology and Molecular Medicine, CNR, Rome, Italy and Department of Medicine-University of Naples Federico II = Università degli studi di Napoli Federico II, Woolcock Institute of Medical Research [Sydney], The University of Sydney, Université Laval [Québec] (ULaval), Departments of Clinical Epidemiology and Biostatistics and Medicine [Ontario], Service greffe de moelle osseuse, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Royal Brompton Hospital, Région Languedoc-Roussillon-Midi-Pyrénées, Vall d'Hebron University Hospital [Barcelona], University of South Florida [Tampa] (USF), Università degli Studi di Firenze = University of Florence (UniFI), University of Michigan, Department of Atmospheric, Centres de Ressources et de Compétences de la Mucoviscidose [Montpellier] (CRCM [Montpellier]), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve-Service des Maladies Respiratoires, Russian State Medical University, Universidade do Porto, Instituto de Biologia Molecular e Celular (IBMC), UCB Pharma, Colombes, Hôpital Gui de Chauliac [CHU Montpellier], CHU Strasbourg, European Federation of Allergy (EFA), Airways Diseases Patients' Associations, Università degli Studi di Salerno = University of Salerno (UNISA), Laboratoire de recherche sur les mécanismes moléculaires et pharmacologiques de l’obstruction bronchique (LOBIP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Laboratoire de Génie Informatique et Ingénierie de Production (LGI2P), IMT - MINES ALES (IMT - MINES ALES), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), Linköping University (LIU), Department of Dermatology and Allergy Centre, Odense University Hospital, Vilnius University [Vilnius], Center of Research in Health Technologies and Information Systems (CINTESIS), Universidade do Porto = University of Porto, Institut d'Electronique du Solide et des Systèmes (InESS), Centre National de la Recherche Scientifique (CNRS), Son Pisa Primary Care Centre, IB-Salut Balearic Health Service, Center for Allergy and Immunology Research [Tbilisi], Department of Dermatology, Helsinki University Hospital-Skin and Allergy Hospital, Swedish Meteorological and Hydrological Institute (SMHI), CORYSS-TESS, Ukrainina Medical Stomatological Academy [Poltava, Ukraine], Institute of Social Medicine, Epidemiology and Health Economics-Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Biologie des organismes marins et écosystèmes (BOME), Muséum national d'Histoire naturelle (MNHN)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), NRC Institute of immunology FMBA, Moscow Russian federation, Allergy and Asthma Center Westend, German Society for Otorhinolaryngology HNS, Rheinische Friedrich-Wilhelms-Universität Bonn, The Institute of Environmental Medicine [Stockholm] (IMM), Karolinska Institutet [Stockholm], Medical University of Łódź (MUL), Hospital Medica Sur, Institut de Recherche en Infectiologie de Montpellier (IRIM), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Applied Physical Chemistry Laboratory (APCLab), Institute of Geophysics and Planetary Physics [Los Angeles] (IGPP), University of California [Los Angeles] (UCLA), University of California (UC)-University of California (UC), Équipe de Recherche en Textes, Informatique, Multilinguisme (ERTIM), Institut National des Langues et Civilisations Orientales (Inalco), Institute of Oceanology [China], University of Beira Interior [Portugal] (UBI), Unité de recherche de l'institut du thorax (ITX-lab), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Pulmonary and allergy unit, American University of Sharjah-Rashid Hospital-Dubai Health Authority (DHA), Astrophysique Interprétation Modélisation (AIM (UMR7158 / UMR_E_9005 / UM_112)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Sysdiag-Modélisation et Ingénierie des Systèmes Complexes Biologiques pour le Diagnostic (SysDiag ), BIO-RAD-Centre National de la Recherche Scientifique (CNRS), 'Federico II' University of Naples Medical School, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Pneumology Department, Marius Nasta Institute of Pneumology, Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw - Poland-Faculté de Pharmacie de Paris, Allergy and Clinical Immunology Department, Hospital CUF Descobertas, Universität zu Köln = University of Cologne, Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Section of Otolaryngology-Head & Neck Surgery (OHNS), University of Chicago, Department of Pharmacy Naples, Université de Naples, Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital-Monash University Building, AMREP, Dept. of Electronic Engineering, Chubu University, Department of Otorhinolaryngology, Chiba University Hospital, Department of Allergology and Clinical Immunology, Charles University [Prague] (CU)-Medical Faculty in Pilsen, Department of Earth and Planetary Sciences [Cambridge, USA] (EPS), Harvard University, Allergy and Respiratory Diseases, Università degli studi di Genova = University of Genoa (UniGe), Department of Pediatrics, Nippon Medical School, Centre Hospitalier Universitaire [Grenoble] (CHU), Department of Otorhinolaryngology, Head and Neck Surgery [Mannheim, Germany], University Hospital Mannheim, Laboratoire de physique et chimie des nano-objets (LPCNO), Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), Institut National des Sciences Appliquées (INSA)-Université de Toulouse (UT)-Institut National des Sciences Appliquées (INSA)-Université de Toulouse (UT)-Institut de Chimie de Toulouse (ICT), Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université de Toulouse (UT)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université de Toulouse (UT)-Institut de Recherche sur les Systèmes Atomiques et Moléculaires Complexes (IRSAMC), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Centre National de la Recherche Scientifique (CNRS)-Centre National de la Recherche Scientifique (CNRS), CHU Grenoble, Children’s Hospital Srebrnjak [Zagreb, Croatia], Department of Physics [UMIST Manchester], University of Manchester Institute of Science and Technology (UMIST), Laboratori Nazionali del Sud (LNS), Getafe University Hospital, Madrid, Karl-Franzens-Universität Graz, Ecologie comportementale (EC), École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Recherche Agronomique (INRA)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université Paris-Sud - Paris 11 (UP11)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université de Rennes (UR)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université de Bourgogne (UB)-Centre National de la Recherche Scientifique (CNRS), Allergy Asthma and Immunology [Haifa, Israel], Ha'Emek Medical Center, Afula-Rappaport Faculty of Medicine, University of Edinburgh, Medical University of Warsaw - Poland, Department of Allergy and Clinical Immunology [Caracas, Venezuela], Centro Médico Docente La Trinidad, Department of Computer Science [Haifa], University of Haifa [Haifa], Allergy and Respiratory Research Group, Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), National Centre of Cardiology and Internal Medicine, Ministry of Health Kyrgyz Republic, Réseau National de Surveillance Aérobiologique (RNSA), Berkeley Seismological Laboratory, Division of Clinical Immunology and Allergy, University of Naples Federico II = Università degli studi di Napoli Federico II, CIRCE, Ctr Res Energy Resources & Consumpt, Zaragoza 50018, Spain, Vilnius University Clinic of Children's Diseases, Suomen Terveystalo Allergy Clinic, Health Service and Performance Research (HESPER), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Centre d'EPistémologie et d'ERgologie Comparatives (CEPERC), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Institute for Climate and Atmospheric Science [Leeds] (ICAS), School of Earth and Environment [Leeds] (SEE), University of Leeds-University of Leeds, Nova Southeastern University (NSU), Department of Otolaryngology, National University of Singapore (NUS)-Yong Loo Lin School of Medicine, Sachs' Children's Hospital, IAES, Department of Pulmonology, Manisa Celal Bayar University, Center for Evolutionary and Theoretical Immunology [Albuquerque, New Mexico] (CETI), The University of New Mexico [Albuquerque], National Key State Laboratory for ThermoStructural Composites (TSCM), Northwestern Polytechnical University [Xi'an] (NPU), Respiratory and Allergic Diseases, University Clinic of Respiratory and Allergic Diseases Golnik, University Hospital of Cologne [Cologne], Supported by the European Innovation Partnership on Active and Healthy Ageing and POLLAR (EIT Health, European Union)., European Project: 643803,H2020,H2020-HCO-2014,PROEIPAHA(2015), UCL - (MGD) Service de pneumologie, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Epidemiology of Allergic and Respiratory Diseases Department [Paris] (EPAR), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospital Quiròn Bizkaia Erandio, Université Pierre et Marie Curie - Paris 6 (UPMC), University of Milan, University of Naples Federico II-CNR, Rome, Italy and Department of Medicine, Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Università degli Studi di Firenze = University of Florence [Firenze] (UNIFI), Hôpital Gui de Chauliac, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Università degli Studi di Salerno (UNISA), Institut de Physique du Globe de Paris (IPGP), Centre National de la Recherche Scientifique (CNRS)-Université de La Réunion (UR)-Université Paris Diderot - Paris 7 (UPD7)-IPG PARIS-Institut national des sciences de l'Univers (INSU - CNRS), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin]-Epidemiology and Health Economics, Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Muséum national d'Histoire naturelle (MNHN), University of California-University of California, unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Astrophysique Interprétation Modélisation (AIM (UMR_7158 / UMR_E_9005 / UM_112)), Centre National de la Recherche Scientifique (CNRS)-Institut national des sciences de l'Univers (INSU - CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris Diderot - Paris 7 (UPD7), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hospital CUF-Descobertas, Universität zu Köln, Medical Faculty in Pilsen-Charles University in Prague - the First Faculty of Medicine, Harvard University [Cambridge], University of Genoa (UNIGE), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut de Chimie de Toulouse (ICT-FR 2599), Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC)-Institut de Recherche sur les Systèmes Atomiques et Moléculaires Complexes (IRSAMC), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS), University of Graz, École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Recherche Agronomique (INRA)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université Paris-Sud - Paris 11 (UP11)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université Claude Bernard Lyon 1 (UCBL), Centro Medico-Docente La Trinidad, Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF), Università degli studi di Napoli Federico II, Center for Evolutionary and theoretical Immunology, Biology, National Institute for Health Research, CNR, Rome, Italy and Department of Medicine-University of Naples Federico II, Institut national des sciences de l'Univers (INSU - CNRS)-IPG PARIS-Université Paris Diderot - Paris 7 (UPD7)-Université de La Réunion (UR)-Centre National de la Recherche Scientifique (CNRS), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Institut de Recherche sur les Systèmes Atomiques et Moléculaires Complexes (IRSAMC), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Centre National de la Recherche Scientifique (CNRS), Karl-Franzens-Universität [Graz, Autriche], Department of Dermatology, Allergology and Venereology, Clinicum, University of Helsinki, Children's Hospital, Faculty of Law, HUS Children and Adolescents, HUS Inflammation Center, University Hospitals Leuven [Leuven], Universitat Pompeu Fabra [Barcelona]-Catalunya ministerio de salud, University of Zürich [Zürich] (UZH), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), University of South Florida (USF), Università degli Studi di Firenze = University of Florence [Firenze], Laboratoire Magmas et Volcans (LMV), Observatoire de Physique du Globe de Clermont-Ferrand (OPGC), Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS)-Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS)-Université Jean Monnet [Saint-Étienne] (UJM)-Centre National de la Recherche Scientifique (CNRS), Universidade do Porto [Porto], Charité - Universitätsmedizin Berlin / Charite - University Medicine Berlin -Epidemiology and Health Economics, Université Pierre et Marie Curie - Paris 6 (UPMC)-Muséum national d'Histoire naturelle (MNHN)-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre de Biologie pour la Gestion des Populations (UMR CBGP), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut National de la Recherche Agronomique (INRA)-Centre international d'études supérieures en sciences agronomiques (Montpellier SupAgro)-Université de Montpellier (UM)-Institut de Recherche pour le Développement (IRD [France-Sud])-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), Sondra, CentraleSupélec, Université Paris-Saclay (COmUE) (SONDRA), ONERA-CentraleSupélec-Université Paris Saclay (COmUE), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche sur les Systèmes Atomiques et Moléculaires Complexes (IRSAMC), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Toulouse III - Paul Sabatier (UT3), RNSA, Centre d'EPistémologie et d'ERgologie Comparatives - UMR 7304 (CEPERC), Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU), Ear, Nose and Throat, AII - Inflammatory diseases, Pulmonology, Institut de Recherche sur les Systèmes Atomiques et Moléculaires Complexes (IRSAMC), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie de Toulouse (ICT-FR 2599), Université Fédérale Toulouse Midi-Pyrénées-Institut de Recherche pour le Développement (IRD)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), National Institute for Nuclear Physics (INFN), Université Laval, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Università degli Studi di Firenze [Firenze], University of Salerno (UNISA), Centre National de la Recherche Scientifique (CNRS)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Observatoire de Physique du Globe de Clermont-Ferrand (OPGC), Centre National de la Recherche Scientifique (CNRS)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Centre National de la Recherche Scientifique (CNRS), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Sondra, CentraleSupélec, Université Paris-Saclay (SONDRA), ONERA-CentraleSupélec-Université Paris-Saclay, Centre National de la Recherche Scientifique (CNRS)-Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), École normale supérieure - Paris (ENS Paris)-Institut National de la Recherche Agronomique (INRA)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université Paris-Sud - Paris 11 (UP11)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université de Rennes 1 (UR1), Universidade do Minho, İÜC, Cerrahpaşa Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, uBibliorum, and Internal Medicine

Subjects
Allergy, Medicina Básica [Ciências Médicas], asthma -- guideline, Allergic asthma, DECISION-MAKING, Allergic Rhinitis and Its Impact on Asthma, GUIDELINES, Medical and Health Sciences, Medical Records, 0302 clinical medicine, Health care, Immunology and Allergy, 030212 general & internal medicine, asthma, Change management, rhinitis, Immunology, MASK-RHINITIS, ComputingMilieux_MISCELLANEOUS, Rinitis, mobilne aplikacije, upravljanje sprememb, Medical record, GLOBAL STRATEGY, WORK PRODUCTIVITY, Telemedicine, mobile applications, 3. Good health, Asma alérgica, rhiniti, 1107 Immunology, Ciências Médicas::Medicina Básica, klinične poti, allergic -- guideline, Life Sciences & Biomedicine, Human, PATIENT PARTICIPATION, Allergic Rhinitis, medicine.medical_specialty, animal structures, multimorbidity, EUROPEAN INNOVATION PARTNERSHIP, Change Management, [object Object], Settore MED/10 - Malattie Dell'Apparato Respiratorio, Asthma/diagnosis, CHRONIC DISEASES, MACVIA-ARIA, 03 medical and health sciences, medicine, multimorbidnost, QUALITY, Humans, critical pathways, astma -- smernica, Patient participation, Asma, udc:616.2, Asthma, Science & Technology, ARIA, business.industry, Multimorbidity, Rhinitis, Allergic, Settore MED/09 - MEDICINA INTERNA, change management, Mobile Airways Sentinel Network (MASK) Study Group, Guideline, ta3121, medicine.disease, Rinite alérgica, Rhinitis, Allergic/diagnosis, Integrated care, alergijski rinitis -- smernica, Allergic Rhinitis and Its Impact on Asthma, asthma, Change management, rhinitis, Immunology and Allergy, Immunology, 030228 respiratory system, Family medicine, 3121 General medicine, internal medicine and other clinical medicine, Medical Record, Clinical Medicine, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Impact on Asthma
Abstract

Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline by using the best approach to integrated care pathways using mobile technology in patients with allergic rhinitis (AR) and asthma multimorbidity. The proposed next phase of ARIA is change management, with the aim of providing an active and healthy life to patients with rhinitis and to those with asthma multimorbidity across the lifecycle irrespective of their sex or socioeconomic status to reduce health and social inequities incurred by the disease. ARIA has followed the 8-step model of Kotter to assess and implement the effect of rhinitis on asthma multimorbidity and to propose multimorbid guidelines. A second change management strategy is proposed by ARIA Phase 4 to increase self-medication and shared decision making in rhinitis and asthma multimorbidity. An innovation of ARIA has been the development and validation of information technology evidence-based tools (Mobile Airways Sentinel Network [MASK]) that can inform patient decisions on the basis of a self-care plan proposed by the health care professional., EAACI -European Academy of Allergy and Clinical Immunology(undefined), info:eu-repo/semantics/acceptedVersion

Published
2018
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50. Allergy rhinitis: similarities and differences between children and adults

Author

Marta Ferrer, Ignacio Jáuregui, J Mullol, Joaquín Sastre, Antonio Valero, Javier Montoro, A Izquierdo-Dominguez, Joan Bartra, Isam Alobid, A del Cuvillo, and Ignacio Dávila

Subjects
Adult, Male, Allergy, Pediatrics, medicine.medical_specialty, Visual Analog Scale, Visual analogue scale, Cross-sectional study, Disease, Comorbidity, Severity of Illness Index, Dermatitis, Atopic, 03 medical and health sciences, 0302 clinical medicine, Severity of illness, Medicine, Humans, 030212 general & internal medicine, Child, Asthma, business.industry, General Medicine, Atopic dermatitis, medicine.disease, Conjunctivitis, Rhinitis, Allergic, Cross-Sectional Studies, 030228 respiratory system, Otorhinolaryngology, Spain, Female, business
Abstract

Background: Allergic rhinitis (AR) is a highly prevalent disease worldwide. Although a number of studies have described AR, no studies compared children and adult AR populations. The objective was to compare the AR characteristics between two AR cohorts of children and adults. Methods: Two AR cohorts (children and adults) from Spain were studied through observational cross-sectional multicentre studies. AR was classified based on classical (allergen exposure), original (o-ARIA), and modified (m-ARIA) ARIA criteria. AR was evaluated by Total 4-Symptoms Score (T4SS), and disease severity by Visual Analogue Scale (VAS, 0-100 mm). AR comorbidities were also evaluated. Results: A total of 5,405 patients (1,275 children, 4,130 adults) were studied. According to symptoms duration, intermittent AR was more frequent in children than in adults. Using o-ARIA severity, more children than adults had moderate/severe AR while, using m-ARIA, more children than adults had severe AR. T4SS was higher in adults than in children. Moreover, VAS was also higher in adults than in children. In addition, asthma atopic dermatitis and conjunctivitis were more associated to children than adults with AR, the frequency of this comorbidities increasing according to higher severity. Conclusions: AR in children was more intermittent, severe, with less symptoms but with more comorbidities than in adults. These results suggest AR has similarities but also significant differences between children and adults.

Published
2017

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