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1. Multi-Disciplinary Expert Perspective on the Management of Type 2 Inflammation-Driven Severe CRSwNP: A Brief Overview of Pathophysiology and Recent Clinical Insights

Author: Toppila-Salmi S, Bjermer L, Cardell LO, Cervin A, Heinikari T, Lehtimäki L, Lundberg M, Richter JC, and Sillanpää S
Subjects: chronic rhinosinusitis, type 2 immunity, surgery, biological therapy, nordic countries, collaboration, Immunologic diseases. Allergy, RC581-607
Abstract: Sanna Toppila-Salmi,1,2 Leif Bjermer,3 Lars-Olaf Cardell,4,5 Anders Cervin,6,7 Tuuli Heinikari,2 Lauri Lehtimäki,8,9 Marie Lundberg,10 Jens C Richter,11 Saara Sillanpää9,12 1Department of Otorhinolaryngology, Kuopio University Hospital and School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland; 2Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; 3Department of Clinical Sciences, Respiratory Medicine and Allergology, Lund University, Lund, Sweden; 4Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; 5Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden; 6Centre for Clinical Research, University of Queensland, Brisbane, Australia; 7Faculty of Medicine, Lund University, Lund, Sweden; 8Allergy Centre, Tampere University Hospital, Tampere, Finland; 9Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; 10Department of Otorhinolaryngology – Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; 11Department of Asthma and Allergology, Clinic of Lung Medicine, Skåne University Hospital and Lund University, Lund, Sweden; 12Department of Otorhinolaryngology and Head and Neck Surgery, Tampere University Hospital, Tampere, FinlandCorrespondence: Sanna Toppila-Salmi, Haartmaninkatu 3, Haartman Institute, University of Helsinki, Helsinki, 00014, Finland, Email sanna.salmi@helsinki.fiAbstract: Severe chronic rhinosinusitis with nasal polyposis (CRSwNP) is a disabling airway disease that significantly impacts patients’ lives through the severity of symptoms, the need for long-term medical treatment and the high risk of recurrence post-surgery. Biological agents targeting type 2 immune responses underlying the pathogenesis of CRSwNP have shown effectiveness in reducing polyp size and eosinophilic infiltrate, and in decreasing the need for additional sinus surgeries. However, despite recent progress in understanding and treating the disease, type 2 inflammation-driven severe CRSwNP continues to pose challenges to clinical management due to several factors such as persistent inflammation, polyp recurrence, heterogeneity of disease, and comorbidities. This article presents the findings of a scientific discussion involving a panel of ear, nose and throat (ENT) specialists and pulmonologists across Sweden and Finland. The discussion aimed to explore current management practices for type 2 inflammation-driven severe CRSwNP in the Nordic region. The main topics examined encompassed screening and referral, measurements of disease control, treatment goals, and future perspectives. The experts emphasized the importance of a collaborative approach in the management of this challenging patient population. The discussion also revealed a need to broaden treatment options for patients with type 2 inflammation-driven CRSwNP and comorbid conditions with shared type 2 pathophysiology. In light of the supporting evidence, a shift in the disease model from the presence of polyps to that of type 2 inflammation may be warranted. Overall, this discussion provides valuable insights for the scientific community and can potentially guide the future management of CRSwNP.Keywords: chronic rhinosinusitis, type 2 immunity, surgery, biological therapy, Nordic countries, collaboration
Published: 2024

2. Lung Fibroblasts from Chronic Obstructive Pulmonary Disease Subjects Have a Deficient Gene Expression Response to Cigarette Smoke Extract Compared to Healthy

Author: Garcia-Ryde M, van der Burg NMD, Larsson CE, Larsson-Callerfelt AK, Westergren-Thorsson G, Bjermer L, and Tufvesson E
Subjects: copd, lung fibroblast, gene expression, cigarette smoke extract, go term, signaling pathways, Diseases of the respiratory system, RC705-779
Abstract: Martin Garcia-Ryde,1 Nicole MD van der Burg,1 Carin E Larsson,1 Anna-Karin Larsson-Callerfelt,2 Gunilla Westergren-Thorsson,2 Leif Bjermer,1 Ellen Tufvesson1 1Department of Clinical Sciences Lund, Respiratory Medicine, Allergology and Palliative Medicine, Lund University, Lund, Sweden; 2Department of Experimental Medical Science, Lung Biology, Lund University, Lund, SwedenCorrespondence: Ellen Tufvesson, Department of Clinical Sciences Lund, Respiratory Medicine, Allergology and Palliative Medicine, Lund University, BMC, D12, 221 84, Lund, Sweden, Email Ellen.Tufvesson@med.lu.seBackground and aim: Cigarette smoking is the most common cause of chronic obstructive pulmonary disease (COPD) but more mechanistic studies are needed. Cigarette smoke extract (CSE) can elicit a strong response in many COPD-related cell types, but no studies have been performed in lung fibroblasts. Therefore, we aimed to investigate the effect of CSE on gene expression in lung fibroblasts from healthy and COPD subjects.Patients and methods: Primary lung fibroblasts, derived from six healthy and six COPD subjects (all current or ex-smokers), were either unstimulated (baseline) or stimulated with 30% CSE for 4 h prior to RNA isolation. The mRNA expression levels were measured using the NanoString nCounter Human Fibrosis V2 panel (760 genes). Pathway enrichment was assessed for unique gene ontology terms of healthy and COPD.Results: At baseline, a difference in the expression of 17 genes was found in healthy and COPD subjects. Differential expression of genes after CSE stimulation resulted in significantly less changes in COPD lung fibroblasts (70 genes) than in healthy (207 genes), with 51 genes changed in both. COPD maintained low NOTCH signaling throughout and upregulated JUN > 80%, indicating an increase in apoptosis. Healthy downregulated the Mitogen-activated protein kinase (MAPK) signaling cascade, including a ≥ 50% reduction in FGF2, CRK, TGFBR1 and MEF2A. Healthy also downregulated KAT6A and genes related to cell proliferation, all together indicating possible cell senescence signaling.Conclusion: Overall, COPD lung fibroblasts responded to CSE stimulation with a very different and deficient expression profile compared to healthy. Highlighting that stimulated healthy cells are not an appropriate substitute for COPD cells which is important when investigating the mechanisms of COPD.Plain Language Summary: We investigated, for the first time, the effect of cigarette smoke extract (CSE) on gene expression in lung fibroblasts from healthy subjects and subjects with COPD. We found that fibroblasts from subjects with COPD respond very differently than from healthy subjects by changing fewer gene expressions after CSE. Pathway enrichment suggested that fibroblasts from subjects with COPD respond to CSE by affecting genes involved in apoptosis pathways, while fibroblasts from healthy subjects respond by affecting genes involved in cell senescence. This study highlights the importance of assessing stimulated COPD cells in mechanistic studies.Keywords: COPD, lung fibroblast, gene expression, cigarette smoke extract, GO term, signaling pathways
Published: 2023

3. Adult Severe Asthma Registries: A Global and Growing Inventory

Author: Cushen B, Koh MS, Tran TN, Martin N, Murray R, Uthaman T, Goh CYY, Vella R, Eleangovan N, Bulathsinhala L, Maspero JF, Peters MJ, Schleich F, Pitrez P, Christoff G, Sadatsafavi M, Torres-Duque CA, Porsbjerg C, Altraja A, Lehtimäki L, Bourdin A, Taube C, Papadopoulos NG, Zsuzsanna C, Björnsdóttir U, Salvi S, Heffler E, Iwanaga T, al-Ahmad M, Larenas-Linnemann D, van Boven JF, Aarli BB, Kuna P, Loureiro CC, Al-lehebi R, Lee JH, Marina N, Bjermer L, Sheu CC, Mahboub B, Busby J, Menzies-Gow A, Wang E, and Price DB
Subjects: asia-pacific, biologics, covid-19, europe, isar, international severe asthma registry, oral corticosteroids, registry, middle east, severe asthma, latin america, usa, Medicine
Abstract: Breda Cushen,1,&ast; Mariko Siyue Koh,2,&ast; Trung N Tran,3 Neil Martin,3,4 Ruth Murray,5 Thendral Uthaman,6 Celine Yun Yi Goh,5,6 Rebecca Vella,7 Neva Eleangovan,5,6 Lakmini Bulathsinhala,5,6 Jorge F Maspero,8,9 Matthew J Peters,10 Florence Schleich,11 Paulo Pitrez,12 George Christoff,13 Mohsen Sadatsafavi,14 Carlos A Torres-Duque,15,16 Celeste Porsbjerg,17 Alan Altraja,18 Lauri Lehtimäki,19 Arnaud Bourdin,20 Christian Taube,21 Nikolaos G Papadopoulos,22,23 Csoma Zsuzsanna,24 Unnur Björnsdóttir,25 Sundeep Salvi,26 Enrico Heffler,27 Takashi Iwanaga,28 Mona al-Ahmad,29 Désirée Larenas-Linnemann,30 Job FM van Boven,31 Bernt Bøgvald Aarli,32,33 Piotr Kuna,34 Cláudia Chaves Loureiro,35,36 Riyad Al-lehebi,37 Jae Ha Lee,38 Nuria Marina,39 Leif Bjermer,40 Chau-Chyun Sheu,41,42 Bassam Mahboub,43 John Busby,44 Andrew Menzies-Gow,45 Eileen Wang,46 David B Price5,6,47 On behalf of ISAR Inventory Study Group1Department of Respiratory Medicine, Beaumont Hospital, Dublin, Ireland; 2Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore, Singapore; 3AstraZeneca, Gaithersburg, MD, USA; 4Department of Respiratory Medicine, University of Leicester, Leicester, UK; 5Optimum Patient Care Global, Cambridge, UK; 6Observational Pragmatic Research Institute, Singapore, Singapore; 7Optimum Patient Care, Brisbane, Queensland, Australia; 8Clinical Research for Allergy and Respiratory Medicine, CIDEA Foundation, Buenos Aires, Argentina; 9University Career of Specialists in Allergy and Clinical Immunology at the Buenos Aires University School of Medicine, Buenos Aires, Argentina; 10Department of Thoracic Medicine, Concord Hospital, Sydney, Australia; 11CHU Sart-Tilman, GIGA I3, University of Liege, Liège, Wallonia, Belgium; 12Pulmonology Division, Hospital Santa Casa de Porto Alegre, Porto Alegre, Brazil; 13Faculty of Public Health, Medical University, Sofia, Bulgaria; 14Respiratory Evaluation Sciences Program, Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, Canada; 15CINEUMO, Respiratory Research Center, Fundación Neumológica Colombiana, Bogotá, Colombia; 16Universidad de La Sabana, Chia, Colombia; 17Department of Respiratory Medicine and Infectious Diseases, Research Unit, Bispebjerg Hospital, Copenhagen, Denmark; 18Department of Pulmonology, University of Tartu and Lung Clinic, Tartu University Hospital, Tartu, Estonia; 19Allergy Centre, Tampere University Hospital, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; 20PhyMedExp, Univ Montpellier, CNRS, INSERM, CHU Montpellier, Montpellier, France; 21Department of Pulmonary Medicine, University Medical Center Essen-Ruhrlandklinik, Essen, Germany; 22Division of Infection, Immunity & Respiratory Medicine, University of Manchester, Manchester, UK; 23Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece; 24Asthma Outpatient Clinic, National Koranyi Institute for Pulmonology, Budapest, Hungary; 25Department of Allergy and Respiratory Medicine, University Hospital, Reykjavik, Iceland; 26Pulmocare Research and Education Foundation, Pune, India; 27Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; 28Kindai University Hospital, Osakasayama, Japan; 29Microbiology Department, College of Medicine, Kuwait University, Kuwait, Al-Rashed Allergy Center, Ministry of Health, Kuwait City, Kuwait; 30Centro de Excelencia en Asma y Alergia, Hospital Médica Sur, Ciudad de México, Mexico; 31University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Department of Clinical Pharmacy & Pharmacology, Groningen, the Netherlands; 32Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway; 33Department of Clinical Science, University of Bergen, Bergen, Norway; 34Division of Internal Medicine Asthma and Allergy, Medical University of Lodz, Lodz, Poland; 35Pneumology Unit, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; 36Centre of Pneumology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; 37Department of Pulmonology, King Fahad Medical City, Riyadh, Saudi Arabia, Alfaisal University, Riyadh, Saudi Arabia; 38Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea; 39Pneumology Service, Biocruces, Cruces University Hospital, Barakaldo, Spain; 40Respiratory Medicine and Allergology, Department of Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden; 41Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; 42Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; 43Rashid Hospital, Dubai Health Authority (DHA), Dubai, United Arab Emirates; 44Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, Northern Ireland, UK; 45Lung Division, Royal Brompton & Harefield Hospital, London, UK; 46Division of Allergy and Clinical Immunology, Department of Medicine, National Jewish Health and University of Colorado School of Medicine, Denver and Aurora, CO, USA; 47Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK&ast;These authors contributed equally to this workCorrespondence: David B Price, Observational and Pragmatic Research Institute (OPRI) Pte Ltd, 22 Sin Ming Lane, &num;06-76, Midview City, 573969, Singapore, Tel +65 3105 1489, Email dprice@opri.sgAim: The International Severe Asthma Registry (ISAR; http://isaregistries.org/) uses standardised variables to enable multi-country and adequately powered research in severe asthma. This study aims to look at the data countries within ISAR and non-ISAR countries reported collecting that enable global research that support individual country interests.Methods: Registries were identified by online searches and approaching severe asthma experts. Participating registries provided data collection specifications or confirmed variables collected. Core variables (results from ISAR’s Delphi study), steroid-related comorbidity variables, biologic safety variables (serious infection, anaphylaxis, and cancer), COVID-19 variables and additional variables (not belonging to the aforementioned categories) that registries reported collecting were summarised.Results: Of the 37 registries identified, 26 were ISAR affiliates and 11 non-ISAR affiliates. Twenty-five ISAR-registries and 4 non-ISAR registries reported collecting > 90% of the 65 core variables. Twenty-three registries reported collecting all optional steroid-related comorbidity variables. Twenty-nine registries reported collecting all optional safety variables. Ten registries reported collecting COVID-19 variables. Twenty-four registries reported collecting additional variables including data from asthma questionnaires (10 Asthma Control Questionnaire, 20 Asthma Control Test, 11 Asthma Quality of Life Questionnaire, and 4 EuroQol 5-dimension 5-level Questionnaire). Eight registries are linked to databases such as electronic medical records and national claims or disease databases.Conclusion: Standardised data collection has enabled individual severe asthma registries to collect unified data and increase statistical power for severe asthma research irrespective of ISAR affiliations.Keywords: Asia-Pacific, biologics, COVID-19, Europe, ISAR, International Severe Asthma Registry, oral corticosteroids, Registry, Middle East, Severe Asthma, Latin America, USA
Published: 2023

4. Characterization of Patients in the International Severe Asthma Registry with High Steroid Exposure Who Did or Did Not Initiate Biologic Therapy

Author: Chen W, Sadatsafavi M, Tran TN, Murray RB, Wong CBN, Ali N, Ariti C, Garcia Gil E, Newell A, Alacqua M, Al-Ahmad M, Altraja A, Al-Lehebi R, Bhutani M, Bjermer L, Bjerrum AS, Bourdin A, Bulathsinhala L, von Bülow A, Busby J, Canonica GW, Carter V, Christoff GC, Cosio BG, Costello RW, FitzGerald JM, Fonseca JA, Yoo KH, Heaney LG, Heffler E, Hew M, Hilberg O, Hoyte F, Iwanaga T, Jackson DJ, Jones RC, Koh MS, Kuna P, Larenas-Linnemann D, Lehmann S, Lehtimäki LA, Lyu J, Mahboub B, Maspero J, Menzies-Gow AN, Sirena C, Papadopoulos N, Papaioannou AI, Pérez de Llano L, Perng DW, Peters M, Pfeffer PE, Porsbjerg CM, Popov TA, Rhee CK, Salvi S, Taillé C, Taube C, Torres-Duque CA, Ulrik CS, Ra SW, Wang E, Wechsler ME, and Price DB
Subjects: severe asthma, biologics, real-world, treatment pattern, patient characteristics, Immunologic diseases. Allergy, RC581-607
Abstract: Wenjia Chen,1 Mohsen Sadatsafavi,2 Trung N Tran,3 Ruth B Murray,4 Chong Boon Nigel Wong,1 Nasloon Ali,4,5 Cono Ariti,4,5 Esther Garcia Gil,6 Anthony Newell,5,7 Marianna Alacqua,8 Mona Al-Ahmad,9 Alan Altraja,10 Riyad Al-Lehebi,11,12 Mohit Bhutani,13 Leif Bjermer,14 Anne Sofie Bjerrum,15 Arnaud Bourdin,16 Lakmini Bulathsinhala,4,5 Anna von Bülow,17 John Busby,18 Giorgio Walter Canonica,19,20 Victoria Carter,4,5 George C Christoff,21 Borja G Cosio,22 Richard W Costello,23 J Mark FitzGerald,24 João A Fonseca,25 Kwang Ha Yoo,26 Liam G Heaney,27 Enrico Heffler,19,20 Mark Hew,28,29 Ole Hilberg,30 Flavia Hoyte,31,32 Takashi Iwanaga,33 David J Jackson,34,35 Rupert C Jones,36 Mariko Siyue Koh,37,38 Piotr Kuna,39 Désirée Larenas-Linnemann,40 Sverre Lehmann,41 Lauri A Lehtimäki,42,43 Juntao Lyu,5,7 Bassam Mahboub,44,45 Jorge Maspero,46,47 Andrew N Menzies-Gow,48 Concetta Sirena,49 Nikolaos Papadopoulos,50,51 Andriana I Papaioannou,52 Luis Pérez de Llano,53,54 Diahn-Warng Perng,55,56 Matthew Peters,57 Paul E Pfeffer,58,59 Celeste M Porsbjerg,17 Todor A Popov,60 Chin Kook Rhee,61 Sundeep Salvi,62 Camille Taillé,63 Christian Taube,64 Carlos A Torres-Duque,65 Charlotte S Ulrik,66 Seung Won Ra,67 Eileen Wang,31,32 Michael E Wechsler,68 David B Price4,5,69 1Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore; 2Respiratory Evaluation Sciences Program, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada; 3AstraZeneca, Gaithersburg, MD, USA; 4Optimum Patient Care, Cambridge, UK; 5Observational and Pragmatic Research Institute, Singapore, Singapore; 6AstraZeneca, Barcelona, Spain; 7Optimum Patient Care, Queensland, VIC, Australia; 8AstraZeneca, Cambridge, UK; 9Microbiology Department, Faculty of Medicine, Kuwait University, Al-Rashed Allergy Center, Ministry of Health, Kuwait City, Kuwait; 10Department of Pulmonology, University of Tartu and Lung Clinic, Tartu University Hospital, Tartu, Estonia; 11Department of Pulmonology, King Fahad Medical City, Riyadh, Saudi Arabia; 12College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; 13Department of Medicine, Division of Pulmonary Medicine, University of Alberta, Western Canada, AB, Canada; 14Department of Clinical Sciences, Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Lund, Sweden; 15Department of Respiratory Medicine and Allergy, Aarhus University Hospital, Jutland, Aarhus, Denmark; 16PhyMedExp, Univ Montpellier, CNRS, INSERM, CHU Montpellier, Montpellier, France; 17Respiratory Research Unit, Bispebjerg University Hospital, Copenhagen, Denmark; 18Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland; 19Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Milan, Italy; 20Department of Biomedical Sciences, Humanitas University, Milan, Italy; 21Medical University-Sofia, Faculty of Public Health, Sofia, Bulgaria; 22Son Espases University Hospital-IdISBa-Ciberes, Mallorca, Spain; 23Department of Respiratory Medicine, Clinical Research Centre, Smurfit Building Beaumont Hospital, RCSI, Dublin, Ireland; 24Department of Medicine, the University of British Columbia, Vancouver, BC, Canada; 25Comunity Health, Information and Decision Sciences Department (MEDCIDS) & Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine of University of Porto, Porto, Portugal; 26KonKuk University School of Medicine in Seoul, Seoul, Korea; 27Wellcome-Wolfson Centre for Experimental Medicine, Queen’s University Belfast, Belfast, Northern Ireland; 28Allergy, Asthma & Clinical Immunology Service, Alfred Health, Melbourne, VIC, Australia; 29Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; 30Medical Department, Vejle University Hospital, Jutland, Vejle, Denmark; 31Department of Medicine, Division of Allergy and Clinical Immunology, National Jewish Health, Denver, CO, USA; 32Department of Internal Medicine, Division of Allergy & Clinical Immunology, University of Colorado School of Medicine, Aurora, CO, USA; 33Center for General Medical Education and Clinical Training, Kindai University Hospital, Osakasayama, Japan; 34UK Severe Asthma Network and National Registry, Guy’s and St Thomas’ NHS Trust, London, UK; 35School of Immunology & Microbial Sciences, King’s College London, London, UK; 36Research and Knowledge Exchange, Plymouth Marjon University, Plymouth, UK; 37Respiratory & Critical Care Medicine, Singapore General Hospital, Singapore, Singapore; 38SingHealth Duke-NUS Lung Centre, Singapore, Singapore; 39Division of Internal Medicine, Asthma and Allergy Medical University of &Lstrok;ód&zacute;, &Lstrok;ód&zacute;, Poland; 40Directora Centro de Excelencia en Asma y Alergia, Hospital Médica Sur, Ciudad de México, Mexico; 41Section of Thoracic Medicine, Department of Clinical Science, University of Bergen, Bergen, Norway; 42Allergy Centre, Tampere University Hospital, Tampere, Finland; 43Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; 44College of Medicine, University of Sharjah, Sharjah, United Arab Emirates; 45Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates; 46Clinical Research for Allergy and Respiratory Medicine, CIDEA Foundation, Buenos Aires, Argentina; 47University Career of Specialists in Allergy and Clinical Immunology at the Buenos Aires University School of Medicine, Buenos Aires, Argentina; 48Royal Brompton & Harefield Hospitals, London, UK; 49Severe Asthma Network in Italy (SANI), Milano, Italy; 50Division of Infection, Immunity & Respiratory Medicine, University of Manchester, Manchester, UK; 51Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece; 52 2nd Respiratory Medicine Department, National and Kapodistrian University of Athens Medical School, Attikon University Hospital, Athens, Greece; 53Pneumology Service, Lucus Augusti University Hospital, EOXI Lugo, Lugo, Spain; 54Biodiscovery Research Group, Health Research Institute of Santiago de Compostela, Santiago de Compostela, Spain; 55Division of Clinical Respiratory Physiology Chest Department, Taipei Veterans General Hospital, Taipei, Taiwan; 56COPD Assembly of the Asian Pacific Society of Respirology Hongo, Bunkyo-ku, Tokyo, Japan; 57Department of Thoracic Medicine, Concord Hospital, Sydney, NSW, Australia; 58Department of Respiratory Medicine, Barts Health NHS Trust, London, UK; 59Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK; 60University Hospital ”sv. Ivan Rilski”, Sofia, Bulgaria; 61Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Seoul St. Mary’s Hospital, College of Medicine, the Catholic University of Korea, Seoul, South Korea; 62Pulmocare Research and Education Foundation, Pune, India; 63Department of Respiratory Diseases, Bichat Hospital, AP-HP Nord-Université de Paris, Paris, France; 64Department of Pulmonary Medicine, University Medical Center Essen-Ruhrlandklinik, Essen, Germany; 65CINEUMO, Respiratory Research Center, Fundación Neumológica Colombiana, Bogotá, Colombia; 66Department of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, Hvidovre, Denmark; 67Department of Internal Medicine, Division of Pulmonology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea; 68Department of Medicine, NJH Cohen Family Asthma Institute, National Jewish Health, Denver, CO, USA; 69Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UKCorrespondence: David B Price, Observational and Pragmatic Research Institute, 22 Sin Ming Lane, &num;06 Midview City, Singapore, Singapore, 573969, Tel +65 3105 1489, Email dprice@opri.sgBackground: Many severe asthma patients with high oral corticosteroid exposure (HOCS) often do not initiate biologics despite being eligible. This study aimed to compare the characteristics of severe asthma patients with HOCS who did and did not initiate biologics.Methods: Baseline characteristics of patients with HOCS (long-term maintenance OCS therapy for at least 1 year, or ≥ 4 courses of steroid bursts in a year) from the International Severe Asthma Registry (ISAR; https://isaregistries.org/), who initiated or did not initiate biologics (anti-lgE, anti-IL5/5R or anti-IL4R), were described at the time of biologic initiation or registry enrolment. Statistical relationships were tested using Pearson’s chi-squared tests for categorical variables, and t-tests for continuous variables, adjusting for potential errors in multiple comparisons.Results: Between January 2015 and February 2021, we identified 1412 adult patients with severe asthma from 19 countries that met our inclusion criteria of HOCS, of whom 996 (70.5%) initiated a biologic and 416 (29.5%) did not. The frequency of biologic initiation varied across geographical regions. Those who initiated a biologic were more likely to have higher blood eosinophil count (483 vs 399 cells/μL, p=0.003), serious infections (49.0% vs 13.3%, p< 0.001), nasal polyps (35.2% vs 23.6%, p< 0.001), airflow limitation (56.8% vs 51.8%, p=0.013), and uncontrolled asthma (80.8% vs 73.2%, p=0.004) despite greater conventional treatment adherence than those who did not start a biologic. Both groups had similar annual asthma exacerbation rates in the previous 12 months (5.7 vs 5.3, p=0.147).Conclusion: Around one third of severe HOCS asthma patients did not receive biologics despite a similar high burden of asthma exacerbations as those who initiated a biologic therapy. Other disease characteristics such as eosinophilic phenotype, serious infectious events, nasal polyps, airflow limitation and lack of asthma control appear to dictate biologic use.Keywords: severe asthma, biologics, real-world, treatment pattern, patient characteristics
Published: 2022

5. Temperature-controlled Laminar Airflow (TLA) in symptomatic severe asthma – a post hoc analysis of severe exacerbations, quality of life and health economics

Author: Chauhan, A. J., Eriksson, G., Storrar, W., Brown, T., Peterson, S., Radner, F., D’Cruz, L. G., Miller, P., and Bjermer, L.
Published: 2022
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6. Economic Evaluation of Umeclidinium/Vilanterol versus Umeclidinium or Salmeterol in Symptomatic Non-Exacerbating Patients with COPD from a UK Perspective Using the GALAXY Model

Author: Shukla S, Shah D, Martin A, Risebrough NA, Kendall R, Vogelmeier CF, Boucot I, Tombs L, Bjermer L, Jones PW, Kerwin E, Compton C, Maltais F, Lipson DA, and Ismaila AS
Subjects: copd treatment, cost-effectiveness, umeclidinium, salmeterol, umeclidinium/vilanterol, Diseases of the respiratory system, RC705-779
Abstract: Soham Shukla,1 Dhvani Shah,2 Alan Martin,3 Nancy A Risebrough,4 Robyn Kendall,5 Claus F Vogelmeier,6 Isabelle Boucot,3 Lee Tombs,7 Leif Bjermer,8 Paul W Jones,3 Edward Kerwin,9 Chris Compton,3 François Maltais,10 David A Lipson,11,12 Afisi S Ismaila1,13 1Value Evidence and Outcomes, GSK, Collegeville, PA, USA; 2ICON, New York, NY, USA; 3Value Evidence and Outcomes, GSK, Brentford, Middlesex, UK; 4Global Health Economics, and Outcomes Research and Epidemiology, ICON, Toronto, ON, Canada; 5Global Health Economics, and Outcomes Research and Epidemiology, ICON, Vancouver, BC, Canada; 6Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-Universität Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany; 7Precise Approach Ltd, Contingent Worker on Assignment at GSK, Brentford, Middlesex, UK; 8Respiratory Medicine and Allergology, Lund University, Lund, Sweden; 9Altitude Clinical Consulting and Clinical Research Institute of Southern Oregon, Medford, OR, USA; 10Centre de Pneumologie, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec, QC, Canada; 11Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 12Respiratory Clinical Sciences, GSK, Collegeville, PA, USA; 13Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, CanadaCorrespondence: Afisi S IsmailaValue Evidence and Outcomes, GlaxoSmithKline 1250 South Collegeville Road, Collegeville, PA, 19426-0989, USATel +1 919 315 8229Email afisi.s.ismaila@gsk.comIntroduction: Dual bronchodilators are recommended as maintenance treatment for patients with symptomatic COPD in the UK; further evidence is needed to evaluate cost-effectiveness versus monotherapy. Cost-effectiveness of umeclidinium/vilanterol versus umeclidinium and salmeterol from a UK healthcare perspective in patients without exacerbations in the previous year was assessed using post hoc EMAX trial data.Methods: The validated GALAXY model was populated with baseline characteristics and treatment effects from the non-exacerbating subgroup of the symptomatic EMAX population (COPD assessment test score ≥ 10) and 2020 UK healthcare and drug costs. Outputs included estimated exacerbation rates, costs, life-years (LYs), and quality-adjusted LYs (QALYs); incremental cost-effectiveness ratio (ICER) was calculated as incremental cost/QALY gained. The base case (probabilistic model) used a 10-year time horizon, assumed no treatment discontinuation, and discounted future costs and QALYs by 3.5% annually. Sensitivity and scenario analyses assessed robustness of model results.Results: Umeclidinium/vilanterol treatment was dominant versus umeclidinium and salmeterol, providing an additional 0.090 LYs (95% range: 0.035, 0.158) and 0.055 QALYs (− 0.059, 0.168) with total cost savings of £ 690 (£ 231, £ 1306) versus umeclidinium, and 0.174 LYs (0.076, 0.286) and 0.204 QALYs (0.079, 0.326) with savings of £ 1336 (£ 1006, £ 2032) versus salmeterol. In scenario and sensitivity analyses, umeclidinium/vilanterol was dominant versus umeclidinium except over a 5-year time horizon (more QALYs at higher total cost; ICER=£ 4/QALY gained) and at the lowest estimate of the St George’s Respiratory Questionnaire treatment effect (fewer QALYs at lower total cost; ICER=£ 12,284/QALY gained); umeclidinium/vilanterol was consistently dominant versus salmeterol. At willingness-to-pay threshold of £ 20,000/QALY, probability that umeclidinium/vilanterol was cost-effective in this non-exacerbating subgroup was 95% versus umeclidinium and 100% versus salmeterol.Conclusion: Based on model predictions from a UK perspective, symptomatic patients with COPD and no exacerbations in the prior year receiving umeclidinium/vilanterol are expected to have better outcomes at lower costs versus umeclidinium and salmeterol.Keywords: COPD treatment, cost-effectiveness, umeclidinium, salmeterol, umeclidinium/vilanterol
Published: 2021

7. Treatment of COPD with Long-Acting Bronchodilators: Association Between Early and Longer-Term Clinically Important Improvement

Author: Vogelmeier CF, Naya IP, Maltais F, Bjermer L, Kerwin EM, Tombs L, Jones PW, Compton C, Lipson DA, and Boucot IH
Subjects: bronchodilator, clinically important improvement, clinically important deterioration, copd symptoms, early improvement, patient-reported outcomes, Diseases of the respiratory system, RC705-779
Abstract: Claus F Vogelmeier,1 Ian P Naya,2,3 François Maltais,4 Leif Bjermer,5 Edward M Kerwin,6 Lee Tombs,7 Paul W Jones,2 Chris Compton,2 David A Lipson,8,9 Isabelle H Boucot2,10 1Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-Universität Marburg, Member of the German Center for Lung Research (DZL), Marburg, Germany; 2Global Specialty & Primary Care, GSK, Brentford, Middlesex, UK; 3RAMAX Ltd, Bramhall, Cheshire, UK; 4Centre De Pneumologie, Institut Universitaire De Cardiologie Et De Pneumologie De Québec, Université Laval, Québec, Canada; 5Respiratory Medicine and Allergology, Lund University, Lund, Sweden; 6Altitude Clinical Consulting and Clinical Research Institute of Southern Oregon, Medford, OR, USA; 7Precise Approach Ltd, Contingent Worker on Assignment at GSK, Brentford, Middlesex, UK; 8Respiratory Clinical Sciences, GSK, Collegeville, PA, USA; 9Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 10Medical Emerging Markets, GSK, Brentford, Middlesex, UKCorrespondence: Claus F VogelmeierUniversity Medical Center Giessen and Marburg, Philipps-Universität Marburg, Member of the German Center for Lung Research (DZL), Baldingerstraße, Marburg, 35043, GermanyTel +49 6421/58-66451Email claus.vogelmeier@med.uni-marburg.deIntroduction: This post hoc analysis of the “Early MAXimization of bronchodilation for improving COPD stability” (EMAX) trial investigated whether patients achieving early clinically important improvement (CII) sustained longer-term improvements and lower risk of clinically important deterioration (CID).Methods: Patients were randomized to umeclidinium/vilanterol, umeclidinium, or salmeterol for 24 weeks. The patient-reported outcomes (PROs) Transition Dyspnea Index (TDI), Evaluating Respiratory Symptoms, St George’s Respiratory Questionnaire (SGRQ) and COPD Assessment Test (CAT) were assessed. CII, defined as attaining minimum clinically important differences (MCID) in ≥ 2 PROs, was assessed at Weeks 4, 12 and 24. CID was defined as a deterioration in CAT, SGRQ, TDI by the MCID and/or a moderate/severe exacerbation from Day 30.Results: Of 2425 patients, 50%, 53% and 51% achieved a CII at Weeks 4, 12 and 24, respectively. Patients with a CII at Week 4 versus those without had significantly greater odds of achieving a CII at Weeks 12 and 24 (odds ratio: 5.57 [95% CI: 4.66, 6.66]; 4.09 [95% CI: 3.44, 4.86]). The risk of a CID was higher in patients who did not achieve a CII at Week 4 compared with patients who did (hazard ratio [95% CI]: 2.09 [1.86, 2.34]). Patients treated with umeclidinium/vilanterol versus either monotherapy had significantly greater odds of achieving CII at Weeks 4, 12 and 24.Conclusion: Achieving a CII at Week 4 was associated with longer-term improvement in PROs and a reduced risk of deterioration. Further research is required to investigate the importance of an early response to treatment on the long-term disease course.Keywords: bronchodilator, clinically important improvement, clinically important deterioration, COPD symptoms, early improvement, patient-reported outcomes
Published: 2021

8. Metabolic pathways in immune senescence and inflammaging: Novel therapeutic strategy for chronic inflammatory lung diseases. An EAACI position paper from the Task Force for Immunopharmacology

Author: Roth‐Walter, F; https://orcid.org/0000-0001-5005-9228, Adcock, I M; https://orcid.org/0000-0003-2101-8843, Benito‐Villalvilla, C; https://orcid.org/0000-0002-5544-0199, Bianchini, R; https://orcid.org/0000-0003-0351-6937, Bjermer, L; https://orcid.org/0000-0002-3441-8099, Caramori, G; https://orcid.org/0000-0002-9807-327X, Cari, L; https://orcid.org/0000-0003-0698-3872, Chung, K F; https://orcid.org/0000-0001-7101-1426, Diamant, Z; https://orcid.org/0000-0003-0133-0100, Eguiluz‐Gracia, I; https://orcid.org/0000-0002-3774-931X, Knol, E F; https://orcid.org/0000-0001-7368-9820, Jesenak, M; https://orcid.org/0000-0001-7976-2523, Levi‐Schaffer, F; https://orcid.org/0000-0003-0620-2810, Nocentini, G; https://orcid.org/0000-0002-5209-0488, O'Mahony, L; https://orcid.org/0000-0003-4705-3583, Palomares, O; https://orcid.org/0000-0003-4516-0369, Redegeld, F; https://orcid.org/0000-0001-8830-7960, Sokolowska, M; https://orcid.org/0000-0001-9710-6685, Van Esch, B C A M; https://orcid.org/0000-0001-9961-750X, Stellato, C; https://orcid.org/0000-0002-1294-8355, Roth‐Walter, F; https://orcid.org/0000-0001-5005-9228, Adcock, I M; https://orcid.org/0000-0003-2101-8843, Benito‐Villalvilla, C; https://orcid.org/0000-0002-5544-0199, Bianchini, R; https://orcid.org/0000-0003-0351-6937, Bjermer, L; https://orcid.org/0000-0002-3441-8099, Caramori, G; https://orcid.org/0000-0002-9807-327X, Cari, L; https://orcid.org/0000-0003-0698-3872, Chung, K F; https://orcid.org/0000-0001-7101-1426, Diamant, Z; https://orcid.org/0000-0003-0133-0100, Eguiluz‐Gracia, I; https://orcid.org/0000-0002-3774-931X, Knol, E F; https://orcid.org/0000-0001-7368-9820, Jesenak, M; https://orcid.org/0000-0001-7976-2523, Levi‐Schaffer, F; https://orcid.org/0000-0003-0620-2810, Nocentini, G; https://orcid.org/0000-0002-5209-0488, O'Mahony, L; https://orcid.org/0000-0003-4705-3583, Palomares, O; https://orcid.org/0000-0003-4516-0369, Redegeld, F; https://orcid.org/0000-0001-8830-7960, Sokolowska, M; https://orcid.org/0000-0001-9710-6685, Van Esch, B C A M; https://orcid.org/0000-0001-9961-750X, and Stellato, C; https://orcid.org/0000-0002-1294-8355
Abstract: The accumulation of senescent cells drives inflammaging and increases morbidity of chronic inflammatory lung diseases. Immune responses are built upon dynamic changes in cell metabolism that supply energy and substrates for cell proliferation, differentiation, and activation. Metabolic changes imposed by environmental stress and inflammation on immune cells and tissue microenvironment are thus chiefly involved in the pathophysiology of allergic and other immune‐driven diseases. Altered cell metabolism is also a hallmark of cell senescence, a condition characterized by loss of proliferative activity in cells that remain metabolically active. Accelerated senescence can be triggered by acute or chronic stress and inflammatory responses. In contrast, replicative senescence occurs as part of the physiological aging process and has protective roles in cancer surveillance and wound healing. Importantly, cell senescence can also change or hamper response to diverse therapeutic treatments. Understanding the metabolic pathways of senescence in immune and structural cells is therefore critical to detect, prevent, or revert detrimental aspects of senescence‐related immunopathology, by developing specific diagnostics and targeted therapies. In this paper, we review the main changes and metabolic alterations occurring in senescent immune cells (macrophages, B cells, T cells). Subsequently, we present the metabolic footprints described in translational studies in patients with chronic asthma and chronic obstructive pulmonary disease (COPD), and review the ongoing preclinical studies and clinical trials of therapeutic approaches aiming at targeting metabolic pathways to antagonize pathological senescence. Because this is a recently emerging field in allergy and clinical immunology, a better understanding of the metabolic profile of the complex landscape of cell senescence is needed. The progress achieved so far is already providing opportunities for new therapies, as well as for st
Published: 2024

9. Metabolic pathways in immune senescence and inflammaging: Novel therapeutic strategy for chronic inflammatory lung diseases. An EAACI position paper from the Task Force for Immunopharmacology

Author: Afd Pharmacology, Pharmacology, Roth-Walter, F., Adcock, I. M., Benito-Villalvilla, C., Bianchini, R., Bjermer, L., Caramori, G., Cari, L., Chung, K. F., Diamant, Z., Eguiluz-Gracia, I., Knol, E. F., Jesenak, M., Levi-Schaffer, F., Nocentini, G., O'Mahony, L., Palomares, O., Redegeld, F., Sokolowska, M., Van Esch, B. C.A.M., Stellato, C., Afd Pharmacology, Pharmacology, Roth-Walter, F., Adcock, I. M., Benito-Villalvilla, C., Bianchini, R., Bjermer, L., Caramori, G., Cari, L., Chung, K. F., Diamant, Z., Eguiluz-Gracia, I., Knol, E. F., Jesenak, M., Levi-Schaffer, F., Nocentini, G., O'Mahony, L., Palomares, O., Redegeld, F., Sokolowska, M., Van Esch, B. C.A.M., and Stellato, C.
Published: 2024

10. EPOS2020/EUFOREA expert opinion on defining disease states and therapeutic goals in CRSwNP.

Author: Fokkens, W. J., De Corso, E., Backer, V., Bernal-Sprekelsen, M., Bjermer, L., von Buchwald, C., Chaker, A., Diamant, Z., Gevaert, P., Han, J., Hopkins, C., Hox, V., Klimek, L., Lund, V. J., Lee, S., Luong, A., Mullol, J., Peters, A., Pfaar, O., and Reitsma, S.
Published: 2024
Full Text: View/download PDF

11. Metabolic pathways in immune senescence and inflammaging: Novel therapeutic strategy for chronic inflammatory lung diseases. An EAACI position paper from the Task Force for Immunopharmacology.

Author: Roth‐Walter, F., Adcock, I. M., Benito‐Villalvilla, C., Bianchini, R., Bjermer, L., Caramori, G., Cari, L., Chung, K. F., Diamant, Z., Eguiluz‐Gracia, I., Knol, E. F., Jesenak, M., Levi‐Schaffer, F., Nocentini, G., O'Mahony, L., Palomares, O., Redegeld, F., Sokolowska, M., Van Esch, B. C. A. M., and Stellato, C.
Subjects: LUNG diseases, CELLULAR aging, AGING, TASK forces, CHRONIC obstructive pulmonary disease
Abstract: The accumulation of senescent cells drives inflammaging and increases morbidity of chronic inflammatory lung diseases. Immune responses are built upon dynamic changes in cell metabolism that supply energy and substrates for cell proliferation, differentiation, and activation. Metabolic changes imposed by environmental stress and inflammation on immune cells and tissue microenvironment are thus chiefly involved in the pathophysiology of allergic and other immune‐driven diseases. Altered cell metabolism is also a hallmark of cell senescence, a condition characterized by loss of proliferative activity in cells that remain metabolically active. Accelerated senescence can be triggered by acute or chronic stress and inflammatory responses. In contrast, replicative senescence occurs as part of the physiological aging process and has protective roles in cancer surveillance and wound healing. Importantly, cell senescence can also change or hamper response to diverse therapeutic treatments. Understanding the metabolic pathways of senescence in immune and structural cells is therefore critical to detect, prevent, or revert detrimental aspects of senescence‐related immunopathology, by developing specific diagnostics and targeted therapies. In this paper, we review the main changes and metabolic alterations occurring in senescent immune cells (macrophages, B cells, T cells). Subsequently, we present the metabolic footprints described in translational studies in patients with chronic asthma and chronic obstructive pulmonary disease (COPD), and review the ongoing preclinical studies and clinical trials of therapeutic approaches aiming at targeting metabolic pathways to antagonize pathological senescence. Because this is a recently emerging field in allergy and clinical immunology, a better understanding of the metabolic profile of the complex landscape of cell senescence is needed. The progress achieved so far is already providing opportunities for new therapies, as well as for strategies aimed at disease prevention and supporting healthy aging. [ABSTRACT FROM AUTHOR]
Published: 2024
Full Text: View/download PDF

12. Reduced Variability of Endurance Time in New Protocols for Exercise Tests in COPD

Author: Tufvesson E, Radner F, Papapostolou G, Jarenbäck L, Jönsson S, Nihlén U, Ankerst J, Tunsäter A, Peterson S, Bjermer L, and Eriksson G
Subjects: copd, exercise testing, constant endurance test, endurance time, Diseases of the respiratory system, RC705-779
Abstract: Ellen Tufvesson,1 Finn Radner,1 Georgia Papapostolou,1 Linnea Jarenbäck,1 Saga Jönsson,1 Ulf Nihlén,1 Jaro Ankerst,1 Alf Tunsäter,1 Stefan Peterson,2 Leif Bjermer,1 Göran Eriksson1 1Department of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund University, Skane University Hospital, Lund, Sweden; 2Regional Cancer Centre South, Region Skane, Lund, SwedenCorrespondence: Ellen TufvessonDepartment of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund University, Skane University Hospital, Lund 22185, SwedenTel +46 73 640 19 16Email ellen.tufvesson@med.lu.sePurpose: For exercise testing of COPD patients, a standard endurance test (ET) with constant workload is recommended. The test suffers from large inter-individual variability and need for large sample sizes in order to evaluate treatment effects.Methods: A new protocol for ET in COPD was designed. In contrast to the standard ET, the new ET involved an increasing workload in order to reduce the standard deviation of endurance time. Two new ETs were compared with the standard ET. In Study A, the new ET started at 75% of the patient’s maximum workload (WMAX) and increased stepwise with 3%/2 min until exhaustion. Study B started at 70% of WMAX and increased linearly with 1%/min.Results: In Study A, that included 15 patients, the standard deviation and range for endurance time and work capacity were narrower for the new versus the standard ET. However, the higher mean workload at end and the low mean work capacity relative to the standard ET indicated that the stepwise increase was too aggressive. In Study B, that included 18 patients, with a modified protocol, the averages for endurance time, workload at end and work capacity were similar for new and standard ET, while the standard deviations and ranges for endurance time and work capacity were kept more narrow in the new ET. The variances for endurance time were not equal between the standard ET and the two new ETs (p< 0.05 for both according to Levene’s test).Conclusion: The new ET reduced the number of patients with extreme endurance times (short and long) compared to the standard test. The new test showed a significant lower variance for endurance time, which potentially can lead to fewer patients needed in comparative studies. The overall best results were observed with a low linear increase during endurance.Keywords: COPD, exercise testing, constant endurance test, endurance time
Published: 2020

13. Type 2 Inflammatory Biomarker Response After Exercise Challenge Testing

Author: Tufvesson E, Stenberg H, Ankerst J, and Bjermer L
Subjects: asthma, biomarkers, exercise, inflammation, Immunologic diseases. Allergy, RC581-607
Abstract: Ellen Tufvesson, Henning Stenberg, Jaro Ankerst, Leif Bjermer Respiratory Medicine and Allergology, Department of Clinical Sciences Lund, Lund University, Lund, SwedenCorrespondence: Ellen Tufvesson Respiratory Medicine and Allergology, Department of Clinical Sciences LundLund University, Lund 221 84, SwedenTel +46 736 401916Email Ellen.Tufvesson@med.lu.seIntroduction: Exercise-induced bronchoconstriction is due to osmotic stimulus of the airway epithelium and leads to a cascade of biomarker release from several inflammatory cells. Several type 2 (T2) mediators have been linked to exercise-induced bronchoconstriction, but the T2 response per se has not been described during exercise. The aim of this study was therefore to investigate T2 biomarkers in plasma and urine from subjects with asthma and healthy controls before and after an exercise challenge.Methods: Twenty-two subjects with mild asthma and 18 healthy controls performed an exercise challenge test on a treadmill, and fractional exhaled NO (FeNO) was measured at baseline. Blood and urine samples were collected repeatedly during 60 min after the test and Interleukin-13 (IL-13), thymus and activation-related chemokine (TARC), periostin and leukotrienes were measured.Results: Asthmatics and controls showed similar levels of IL-13, TARC, periostin and Cys-LT in plasma at baseline, and there were no differences in baseline levels between subjects with a negative and positive exercise challenge. After exercise, there was an overall increase in interleukin-13 (IL-13) in plasma in all subjects (p< 0.001), with a peak at 10 min after the exercise challenge in both the asthmatic and control group. An increase in TARC in plasma was also seen (p< 0.001), but only in the control subjects. In contrast, Cys-LT in plasma showed an overall decrease in all subjects (p< 0.001), while periostin in plasma did not change. In conjunction with plasma, the level of IL-13 was increased in urine 30 min after the exercise challenge (p=0.002) and decreased again at 60 min (p=0.004). Similarly, leukotriene E4 (LTE4) was increased in urine samples, with a peak at 60 min and most pronounced in asthmatic subjects (p< 0.001) but was seen also in controls (p=0.008).Discussion: In conclusion, circulating levels of IL-13 are increased after exercise to the same extent in asthmatics and healthy control subjects, which indicates a physiological rather than a pathophysiological response. Also, the levels of TARC and leukotrienes were affected after exercise.Keywords: asthma, biomarkers, exercise, inflammation
Published: 2020

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

Author: 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., Jr., 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., Bousquet, Jean, Hellings, Peter W., Agache, Ioana, Amat, Flore, Annesi-Maesano, Isabella, Ansotegui, Ignacio J., Anto, Josep M., Bachert, Claus, 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, Thomas, 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-François, Fokkens, Wytske J., Guzmán, Maria-Antonieta, Haahtela, Tari, Illario, Maddalena, Ivancevich, Juan-Carlos, Just, Jocelyne, Kaidashev, Igor, Khaitov, Musa, Kalayci, Omer, Keil, Thomas, 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-Carlos, Rajabian-Söderlund, Rojin, Sooronbaev, Talant, Stellato, Cristiana, To, Teresa, Todo-Bom, Ana-Maria, Tomazic, Peter-Valentin, Toppila-Salmi, Sanna, Valero, Antonio, Valiulis, Arunas, Valovirta, Erkka, Ventura, Maria-Teresa, Wagenmann, Martin, Wang, De Yun, Wallace, Dana, Waserman, Susan, Wickman, Magnus, Yorgancioglu, Arzu, Zhang, Luo, Zhong, Nanshan, Zidarn, Mihaela, and Zuberbier, Torsten
Published: 2019
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15. Time to onset of improvements in Quality of Life from Temperature-controlled Laminar Airflow (TLA) in severe allergic asthma

Author: Bjermer, L., Eriksson, G., Radner, F., Peterson, Stefan, and Warner, J.O.
Published: 2019
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16. Effects of baseline symptom burden on treatment response in COPD

Author: Martinez FJ, Abrahams RA, Ferguson GT, Bjermer L, Grönke L, Voß F, and Singh D
Subjects: tiotropium, olodaterol, COPD, Diseases of the respiratory system, RC705-779
Abstract: Fernando J Martinez,1 Roger A Abrahams,2,3 Gary T Ferguson,4 Leif Bjermer,5 Lars Grönke,6 Florian Voß,7 Dave Singh8 1Division of Pulmonary and Critical Care Medicine, Weill Cornell Medical College, New York, NY, USA; 2Morgantown Pulmonary Clinical Research, Morgantown, WV, USA; 3Department of Pulmonary & Critical Care, Mon Health Care, Morgantown, WV, USA; 4Pulmonary Research Institute of Southeast Michigan, Farmington Hills, MI, USA; 5Department of Respiratory Medicine and Allergology, Lund University, Lund, Sweden; 6Biotechnology, CSL Behring, Wiesbaden, Germany; 7Biostatistics + Data Sciences Corp., Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany; 8Medicines Evaluation Unit, University of Manchester, Manchester, UK Rationale: In symptomatic patients with COPD, the decision whether to initiate maintenance treatment with a single agent or a combination of long-acting bronchodilators remains unclear. Objective: To investigate whether baseline symptomatic status influences response to tiotropium/olodaterol treatment. Materials and methods: Post hoc analysis of the randomized OTEMTO® studies (NCT01964352; NCT02006732), in which patients with moderate-to-severe COPD received placebo, tiotropium 5 µg, tiotropium/olodaterol 2.5/5 µg, or tiotropium/olodaterol 5/5 µg once daily for 12 weeks via the Respimat® inhaler (Boehringer Ingelheim, Ingelheim am Rhein, Germany). Impact of baseline symptomatic status (modified Medical Research Council [mMRC] score) on response to treatment with tiotropium/olodaterol 5/5 µg, tiotropium 5 µg, or placebo at Week 12 was assessed by St George’s Respiratory Questionnaire (SGRQ) total score and response rate, transition dyspnea index (TDI) focal score and response rate, and trough forced expiratory volume in 1 second response. Results: Tiotropium/olodaterol improved SGRQ total scores and response rates compared with placebo and tiotropium for patients with baseline mMRC scores 0–1 and ≥2. For tiotropium/olodaterol vs tiotropium, greater improvements were observed for patients with mMRC ≥2 (SGRQ score adjusted mean treatment difference -3.44 [95% CI: -5.43, -1.46]; P=0.0007; SGRQ response rate ORs 2.09 [95% CI: 1.41, 3.10]; P=0.0002). Dyspnea, measured by TDI score, was consistently improved with tiotropium/olodaterol vs placebo for patients with mMRC scores 0–1 and ≥2 (adjusted mean treatment difference 1.63 [95% CI: 1.06, 2.20]; P
Published: 2019

17. Reduced Variability of Endurance Time in New Protocols for Exercise Tests in COPD [Corrigendum]

Author: Tufvesson E, Radner F, Papapostolou G, Jarenbäck L, Jönsson S, Nihlén U, Ankerst J, Tunsäter A, Peterson S, Bjermer L, and Eriksson G
Subjects: copd, exercise testing, constant endurance test, endurance time, Diseases of the respiratory system, RC705-779
Abstract: Tufvesson E, Radner F, Papapostolou G, et al. Int J Chron Obstruct Pulmon Dis. 2020;15:3003–3012. Page 3004, left column, line 2 from the bottom, the sentence “The study also included a new WMAX test where the participants started biking with a 3-min warm-up at 40% of their predicted WMAX, followed by an instant increase to 70% and then a linear increase in workload to achieve the predicted WMAX within 8 min” should read “The study also included a new WMAX test where the participants started biking with a 3-min warm-up at 40% of their predicted WMAX, followed by a linear increase in workload to achieve the predicted WMAX within 8 min”. Page 3005, left column, line 4 from the bottom, the sentence “The new maximum test included an initial phase of pedalling for 3 min at 40% (Study A) or 30% (Study B) of the predicted WMAX, followed by an instant increase to 75% (Study A) or 70% (Study B), followed by a stepwise (Study A) or linear (Study B) increase in workload until exhaustion” should read “The new maximum test included an initial phase of pedalling for 3 min at 40% (Study A) or 30% (Study B) of the predicted WMAX, followed by a linear increase in workload to achieve the predicted WMAX within 8 min”. The authors apologize for these errors. Read the original article
Published: 2021

18. The Efficiency Index (EFFi), based on volumetric capnography, may allow for simple diagnosis and grading of COPD

Author: Jarenbäck L, Tufvesson E, Ankerst J, Bjermer L, and Jonson B
Subjects: Chronic obstructive pulmonary disease, Volumetric capnography, carbon dioxide, single breath, Diseases of the respiratory system, RC705-779
Abstract: Linnea Jarenbäck,1 Ellen Tufvesson,1 Jaro Ankerst,1 Leif Bjermer,1 Björn Jonson2 1Respiratory Medicine and Allergology, Department of Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden; 2Clinical Physiology, Department of Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden Background: Spirometry, the main tool for diagnosis and follow-up of COPD, incompletely describes the disease. Based on volumetric capnography (VCap), an index was developed for the diagnosis and grading of COPD, aimed as a complement or alternative to spirometry.Methods: Nine non-smokers, 10 smokers/former smokers without COPD and 54 smokers/former smokers with COPD were included in the study. Multiple breath washout of N2 and VCap were studied with Exhalyzer D during tidal breathing. VCap was based on signals for flow rate and CO2 and was recorded during one breath preceding N2 washout. Efficiency Index (EFFi) is the quotient between exhaled CO2 volume and the hypothetical CO2 volume exhaled from a completely homogeneous lung over a volume interval equal to 15% of predicted total lung capacity.Results: EFFi increased with increased Global initiative for chronic Obstructive Lung Disease (GOLD) stage and the majority of subjects in GOLD 2 and all subjects in GOLD 3 and 4 could be diagnosed as having COPD using the lower 95% confidence interval of the healthy group. EFFi also correlated with N2 washout (r=–0.73; p
Published: 2018

19. Inflammation and chronic colonization of Haemophilus influenzae in sputum in COPD patients related to the degree of emphysema and bronchiectasis in high-resolution computed tomography

Author: Tufvesson E, Markstad H, Bozovic G, Ekberg M, and Bjermer L
Subjects: bronchiectasis, emphysema, COPD, chronic colonisation, inflammation, pathogenic bacteria, Diseases of the respiratory system, RC705-779
Abstract: Ellen Tufvesson,1 Hanna Markstad,2 Gracijela Bozovic,2 Marie Ekberg,1 Leif Bjermer1 1Respiratory Medicine and Allergology, 2Radiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden Abstract: The presence of bacteria in the lower airways in COPD results in inflammation, further airway structural damage, and might lead to repeated exacerbations. We have previously shown that chronic colonization of Haemophilus influenzae during stable disease is related to increased inflammation, and we now aimed to relate previous findings of bacterial colonization and inflammation to the degree of radiological findings of bronchiectasis and emphysema. Thirty-nine patients with COPD were included in their stable state, and a high-resolution computed tomography of the lung was performed. They were followed-up monthly for up to a maximum of 6 months or until exacerbation, and they answered questionnaires, performed spirometry, and induced sputum at every visit. Thirty-five patients had emphysema with an emphysema degree of median 20% (interquartile range 10–50), and five patients had bronchiectasis, of which only four could expectorate sputum. The degree of emphysema correlated with several inflammatory mediators in sputum, such as interleukin-8 concentration, myeloperoxidase activity, and Leukotriene B4 concentration. Ten patients were chronically colonized with H. influenzae (ie, had a positive culture for H. influenzae at all visits). The four sputum patients with bronchiectasis were chronically colonized with H. influenzae and showed higher degree of H. influenzae growth compared to patients without bronchiectasis. During exacerbation, there was no longer any correlation between emphysema degree and inflammation, but patients with bronchiectasis showed higher sputum purulence score than patients without bronchiectasis. Emphysema and bronchiectasis in COPD patients show different clinical features. The presence of emphysema is more related to inflammation, while bronchiectasis is associated with bacterial colonization. We believe that both emphysema and bronchiectasis are therefore COPD phenotypes of highest impact and need evaluation to prevent further disease progression. Keywords: bronchiectasis, emphysema, COPD, chronic colonization, inflammation, pathogenic bacteria
Published: 2017

20. EUFOREA summit in Brussels 2023: inspiring the future of allergy & respiratory care

Author: Hellings, P. W., primary, Lau, S., additional, Scadding, G. K., additional, Bjermer, L., additional, Backer, V., additional, Chaker, A. M., additional, Conti, D. M., additional, De Corso, E., additional, Diamant, Z., additional, Djukanovic, R., additional, Fokkens, W., additional, Gevaert, P., additional, Gray, C. L., additional, Han, J. K., additional, Heaney, L. G., additional, Hoffmann, H. J., additional, Jesenak, M., additional, Johansen, P., additional, Kumaran, M. S., additional, McDonald, M., additional, Melén, E., additional, Mullol, J., additional, Reitsma, S., additional, Ryan, D., additional, Scadding, G., additional, Schmid-Grendelmeier, P., additional, Teeling, T., additional, Odemyr, M., additional, and Wahn, U., additional
Published: 2023
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21. Salbutamol use in relation to maintenance bronchodilator efficacy in COPD: a prospective subgroup analysis of the EMAX trial

Author: Maltais, F., Naya, I. P., Vogelmeier, C. F., Boucot, I. H., Jones, P. W., Bjermer, L., Tombs, L., Compton, C., Lipson, D. A., and Kerwin, E. M.
Published: 2020
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22. Eosinophils and tissue remodeling: relevance to airway disease

Author: Siddiqui, S, Bachert, C, Bjermer, L, Buchheit, KM, Castro, M, Qin, Y, Rupani, H, Sagara, H, Howarth, P, and Taillé, C
Abstract: The ability of human tissue to reorganize and restore its existing structure underlies tissue homeostasis in the healthy airways, but in disease can persist without normal resolution, leading to an altered airway structure. Eosinophils play a cardinal role in airway remodeling both in health and disease, driving epithelial homeostasis and extracellular matrix turnover. Physiological consequences associated with eosinophil-driven remodeling include impaired lung function and reduced bronchodilator reversibility in asthma, and obstructed airflow in chronic rhinosinusitis with nasal polyps (CRSwNP). Given the contribution of airway remodeling to the development and persistence of symptoms in airways disease, targeting remodeling is an important therapeutic consideration. Indeed, there is early evidence that eosinophil attenuation may reduce remodeling and disease progression in asthma. This review provides an overview of tissue remodeling in both health and airway disease with a particular focus on eosinophilic asthma and CRSwNP, as well as the role of eosinophils in these processes and the implications for therapeutic interventions. Areas for future research are also noted, to help improve our understanding of the homeostatic and pathological roles of eosinophils in tissue remodeling, which should aid the development of targeted and effective treatments for eosinophilic diseases of the airways.
Published: 2023

23. Asthma symptoms, mannitol reactivity and exercise-induced bronchoconstriction in adolescent swimmers versus tennis players

Author: Romberg K, Tufvesson E, and Bjermer L
Subjects: Asthma, sport, swimming, tennis, mannitol, exercise, CC16, Immunologic diseases. Allergy, RC581-607
Abstract: Kerstin Romberg,1,2 Ellen Tufvesson,1 Leif Bjermer1 1Respiratory Medicine and Allergology, Department of Clinical Sciences, Lund, Lund University, Lund, 2Health Care Center, Näsets Läkargrupp, Höllviken, Sweden Background: Strenuous physical activity at an elite level is associated with an increased risk for asthma and, in some sports, also prevalence of allergies. The aim of this study was to investigate the prevalence of asthma and allergy among elite swimmers and tennis players and compare airway hyperreactivity to mannitol and exercise.Materials and methods: One hundred and one adolescent swimmers and 86 tennis players answered a questionnaire about respiratory symptoms and allergy and performed mannitol challenge and sport-specific exercise challenge. Atopy was assessed and fractional exhaled nitric oxide was measured. Mannitol positivity was defined as drop in FEV1 ≥15% (ordinary criteria) and/or β2-reversibility (≥15%) after provocation (extended criteria). A positive exercise test was defined as a drop in FEV1 ≥10% (ordinary criteria) and/or β2-reversibility (≥15%) after provocation (extended criteria). Club cell protein (CC16) was measured in urine before and after the challenges.Results: Asthma symptoms were common in both groups. More swimmers had exercise-induced symptoms (77% versus 50%) and current asthma symptoms (56% versus 38%), compared to the tennis players. More swimmers also had a positive mannitol challenge test both using ordinary (26% versus 6%) and extended criteria (43% versus 17%), while the number of positive exercise tests did not differ. After exercise (but not mannitol) challenge, CC16 level was increased in both groups, but to a higher extent in tennis players. There were no differences in atopy, rhinitis or fractional exhaled nitric oxide.Conclusion: We found a high prevalence of asthma among elite swimmers and tennis players and a higher frequency of current asthma and positive mannitol challenge tests among the swimmers. This indicates an unfavorable exercise environment. Keywords: asthma, sport, swimming, tennis, mannitol, exercise, CC16 bronchial hyperreactivity, bronchial hyperreactivity test
Published: 2017

24. Asthma referrals: a key component of asthma management that needs to be addressed

Author: Price D, Bjermer L, Bergin DA, and Martinez R
Subjects: Asthma, Disease management, Specialization, Primary care physicians, Referral, Immunologic diseases. Allergy, RC581-607
Abstract: David Price,1,2 Leif Bjermer,3 David A Bergin,4 Rafael Martinez5 1Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK; 2Observational and Pragmatic Research Institute, Singapore; 3Department of Respiratory Medicine and Allergology, Lund University, Lund, Sweden; 4Novartis Ireland Limited, Dublin, Ireland; 5Novartis Pharma AG, Basel, Switzerland Abstract: Heterogeneity of asthma and difficulty in achieving optimal control are the major challenges in the management of asthma. To help attain the best possible clinical outcomes in patients with asthma, several guidelines provide recommendations for patients who will require a referral to a specialist. Such referrals can help in clearing the uncertainty from the initial diagnosis, provide tailored treatment options to patients with persistent symptoms and offer the patients access to health care providers with expertise in the management of the asthma; thus, specialist referrals have a substantial impact on disease prognosis and the patient’s health status. Hurdles in implementing these recommendations include lack of their dissemination among health care providers and nonadherence to these guidelines; these hurdles considerably limit the implementation of specialist referrals, eventually affecting the rate of referrals. In this review, recommendations for specialist referrals from several key international and national asthma guidelines and other relevant published literature are evaluated. Furthermore, we highlight why referrals are not happening, how this can be improved, and ultimately, what should be done in the specialist setting, based on existing evidence in published literature. Keywords: asthma, disease management, specialization, primary care physicians, referral
Published: 2017

25. Bronchodilator response of advanced lung function parameters depending on COPD severity

Author: Jarenbäck L, Eriksson G, Peterson S, Ankerst J, Bjermer L, and Tufvesson E
Subjects: COPD, IOS, Body plethysmography, bronchodilation, lung function, reversibility, Diseases of the respiratory system, RC705-779
Abstract: Linnea Jarenbäck,1 Göran Eriksson,1 Stefan Peterson,2 Jaro Ankerst,1 Leif Bjermer,1 Ellen Tufvesson1 1Respiratory Medicine and Allergology, Department of Clinical Sciences Lund, Lund University, 2Regional Cancer Center South, Skåne University Hospital, Lund, Sweden Background: COPD is defined as partly irreversible airflow obstruction. The response pattern of bronchodilators has not been followed in advanced lung function parameters. Purpose: The aim of this study was to investigate bronchodilator response pattern in advanced lung function parameters in a continuous fashion along forced expiratory volume in 1 second (FEV1) percent predicted (%p) in COPD patients and controls. Patients and methods: Eighty-one smokers/ex-smokers (41 controls and 40 COPD) performed spirometry, body plethysmography, impulse oscillometry and single-breath helium dilution carbon monoxide diffusion at baseline, after salbutamol inhalation and then after an additional inhalation of ipratropium. Results: Most pulmonary function parameters showed a linear increase in response to decreased FEV1%p. The subjects were divided into groups of FEV1%p 65, and the findings from continuous analysis were verified. The exceptions to this linear response were inspiratory capacity (IC), forced vital capacity (FVC), FEV1/FVC and expiratory resistance (Rex), which showed a segmented response relationship to FEV1%p. IC and FVC, with break points (BP) of 57 and 58 FEV1%p respectively, showed no response above, but an incresed slope below the BP. In addition, in patients with FEV1%p 65, response of FEV1%p did not correlate to response of volume parameters. Conclusion: Response of several advanced lung function parameters differs depending on patients’ baseline FEV1%p, and specifically response of volume parameters is most pronounced in COPD patients with FEV1%p
Published: 2016

26. EUFOREA summit in Brussels 2023: inspiring the future of allergy & respiratory care

Author: Hellings, P W, Lau, S, Scadding, G K, Bjermer, L, Backer, V, Chaker, A M, Conti, D M, De Corso, E, Diamant, Z, Djukanovic, R, Fokkens, W, Gevaert, P, Gray, C L, Han, J K, Heaney, L G, Hoffmann, H J, Jesenak, M, Johansen, Pål; https://orcid.org/0000-0002-5055-6299, Kumaran, M S, McDonald, M, Melén, E, Mullol, J, Reitsma, S, Ryan, D, Scadding, G, Schmid-Grendelmeier, Peter; https://orcid.org/0000-0003-3215-3370, Teeling, T, Odemyr, M, Wahn, U, Hellings, P W, Lau, S, Scadding, G K, Bjermer, L, Backer, V, Chaker, A M, Conti, D M, De Corso, E, Diamant, Z, Djukanovic, R, Fokkens, W, Gevaert, P, Gray, C L, Han, J K, Heaney, L G, Hoffmann, H J, Jesenak, M, Johansen, Pål; https://orcid.org/0000-0002-5055-6299, Kumaran, M S, McDonald, M, Melén, E, Mullol, J, Reitsma, S, Ryan, D, Scadding, G, Schmid-Grendelmeier, Peter; https://orcid.org/0000-0003-3215-3370, Teeling, T, Odemyr, M, and Wahn, U
Abstract: In March 2023, the European Forum for Research and Education in Allergy and Airways diseases (EUFOREA) organized its bi-annual Summit in Brussels with expert panel members of EUFOREA, representatives of the EUFOREA patient advisory board, and the EUFOREA board and management teams. Its aim was to define the research, educational and advocacy initiatives to be developed by EUFOREA over the next 2 years until the 10th anniversary in 2025. EUFOREA is an international non-for-profit organization forming an alliance of all stakeholders dedicated to reducing the prevalence and burden of chronic allergic and respiratory diseases via research, education, and advocacy. Based on its medical scientific core competency, EUFOREA offers an evidence-supported platform to introduce innovation and education in healthcare leading to optimal patient care, bridging the gap between latest scientific evidence and daily practice. Aligned with the mission of improving health care, the expert panels of asthma, allergic rhinitis (AR), chronic rhinosinusitis (CRS) & European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS), allergen immunotherapy (AIT) and paediatrics have proposed and elaborated a variety of activities that correspond to major unmet needs in the allergy and respiratory field. The current report provides a concise overview of the achievements, ambitions, and action plan of EUFOREA for the future, allowing all stakeholders in the allergy and respiratory field to be up-dated and inspired to join forces in Europe and beyond.
Published: 2023

27. Two Phase II randomized trials on the CRTh2 antagonist AZD1981 in adults with asthma

Author: Kuna P, Bjermer L, and Tornling G
Subjects: CRTh2 receptor, efficacy, phase II, respiratory, Th2 cells, prostaglandin D2, Therapeutics. Pharmacology, RM1-950
Abstract: Piotr Kuna,1 Leif Bjermer,2 Göran Tornling3,4 1Department of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Łódz, Łódz, Poland; 2Department of Respiratory Medicine and Allergology, Skane University Hospital, Lund University, 3AstraZeneca Research and Development, Molndal, 4Respiratory Medicine Unit, Department of Medicine Solna and CMM, Karolinska Institute and Karolinska University Hospital, Solna, Sweden Background: Chemoattractant receptor-homologous molecule expressed on T helper type 2 (Th2) cell (CRTh2) receptor antagonists is being investigated for asthma.Objectives: The aim of this study was to assess the effects of the CRTh2 receptor antagonist, AZD1981 (with/without inhaled corticosteroids [ICSs]), on lung function and asthma control.Patients and methods: Adults aged 18–60 years were enrolled in two randomized, placebo-controlled, parallel-group trials (protocol number: D9830C00003 [study 1, n=209] and protocol number: D9830C00004 [study 2, n=510]). In study 1, patients with stable asthma (forced expiratory volume in 1 second [FEV1]: 65%-110%) were withdrawn from ICS (
Published: 2016

28. The lung function profile of once-daily tiotropium and olodaterol via Respimat® is superior to that of twice-daily salmeterol and fluticasone propionate via Accuhaler® (ENERGITO® study)

Author: Beeh KM, Derom E, Echave-Sustaeta J, Grönke L, Hamilton A, Zhai D, and Bjermer L
Subjects: COPD, maintenance treatment, lung function, tiotropium, olodaterol, inhaled corticosteroid, Diseases of the respiratory system, RC705-779
Abstract: Kai-Michael Beeh,1 Eric Derom,2 José Echave-Sustaeta,3 Lars Grönke,4 Alan Hamilton,5 Dongmei Zhai,6 Leif Bjermer71Insaf GmbH Institut für Atemwegsforschung, Wiesbaden, Germany; 2Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium; 3Servicio de Neumología, Hospital Universitario Quirón, Madrid, Spain; 4Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany; 5Boehringer Ingelheim, Burlington, ON, Canada; 6InVentiv Health Clinical, Wilmington, DE, USA; 7Department of Respiratory Medicine and Allergology, Lund University, Lund, SwedenBackground: Tiotropium + olodaterol has demonstrated improvements beyond lung function benefits in a large Phase III clinical program as a once-daily maintenance treatment for COPD and may be a potential option for the initiation of maintenance treatment in COPD. Despite guideline recommendations that combined long-acting β2-agonists and inhaled corticosteroids should only be used in individuals at high risk of exacerbation, there is substantial use in individuals at lower risk. This raises the question of the comparative effectiveness of this combination as maintenance treatment in this group compared to other combination regimens.Objective: The study aimed to assess the effect on lung function of once-daily tiotropium + olodaterol versus twice-daily salmeterol + fluticasone propionate in all participants with Global initiative for chronic Obstructive Lung Disease 2 or 3 (moderate to severe) COPD.Methods: This was a randomized, double-blind, double-dummy, four-treatment, complete crossover study in which participants received once-daily tiotropium + olodaterol (5/5 µg and 2.5/5 µg) via Respimat® and twice-daily salmeterol + fluticasone propionate (50/500 µg and 50/250 µg) via Accuhaler® for 6 weeks. The primary end point was change in forced expiratory volume in 1 second (FEV1) area under the curve from 0 hour to 12 hours (AUC0–12) relative to the baseline after 6 weeks.Results: Tiotropium + olodaterol 5/5 µg and 2.5/5 µg demonstrated statistically significant improvements in FEV1 AUC0–12 compared to salmeterol + fluticasone propionate (improvements from baseline were 317 mL and 295 mL with tiotropium + olodaterol 5/5 µg and 2.5/5 µg, and 188 mL and 192 mL with salmeterol + fluticasone propionate 50/500 µg and 50/250 µg, respectively). Tiotropium + olodaterol was superior to salmeterol + fluticasone propionate in lung function secondary end points, including FEV1 area under the curve from 0 hour to 24 hours (AUC0–24).Conclusion: Once-daily tiotropium + olodaterol in participants with moderate-to-severe COPD provided superior lung function improvements to twice-daily salmeterol + fluticasone propionate. Dual bronchodilation can be considered to optimize lung function in individuals requiring maintenance treatment for COPD. Keywords: COPD, maintenance treatment, lung function, tiotropium, FEV1, inhaled corticosteroid
Published: 2016

29. The EUFOREA pocket guide for chronic rhinosinusitis

Author: Hellings, P.W., primary, Fokkens, W.J., additional, Orlandi, R., additional, Adriaensen, G.F., additional, Alobid, I., additional, Baroody, F.M., additional, Bjermer, L., additional, Senior, B.A., additional, Cervin, A., additional, Cohen, N.A., additional, Constantinidis, J., additional, De Corso, E., additional, Desrosiers, M., additional, Diamant, Z., additional, Douglas, R.G., additional, Gane, S., additional, Gevaert, P., additional, Han, J.K., additional, Harvey, R.J., additional, Hopkins, C., additional, Kern, R.C., additional, Landis, B.N., additional, Lee, J.T., additional, Lee, S.E., additional, Leunig, A., additional, Lund, V.J., additional, Manuel-Sprekelsen, B., additional, Mullol, J., additional, Philpott, C., additional, Prokopakis, E., additional, Reitsma, S., additional, Ryan, D., additional, Salmi, S., additional, Scadding, G., additional, Schlosser, R.J., additional, Steinsvik, A., additional, Tomazic, P.V., additional, Van Staeyen, E., additional, Van Zele, T., additional, Vanderveken, O., additional, Viskens, A-S., additional, Conti, D., additional, and Wagenmann, M., additional
Published: 2022
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30. Adrenal function recovery after durable oral corticosteroid sparing with benralizumab in the PONENTE study

Author: Menzies-Gow, A., Gurnell, M., Heaney, L. G., Corren, J., Bel, E. H., Maspero, J., Harrison, T., Jackson, D. J., Price, D., Lugogo, N., Kreindler, J., Burden, A., de Giorgio-Miller, A., Faison, S., Padilla, K., Martin, U. J., Gil, E. G., Ardusso, L., Bazerque, R. F., Doreski, P. A. C., Elias, P. C., Gattolin, G., Medina, A. C., Ruiz, X. B., Salvado, A., Del Olmo Sansone, R. A., Wehbe, L., Verra, F. J. B., Brusselle, G., Pilette, C., Martinot, J. -B., Antila, M. A., Blanco, D. C., Cerci, A., Cunha, T. M., Fiss, E., Franza, L., Machado, A. S., De Mattos, W. L. L. D., Grava, S., Minamoto, S. E. T., De Oliveira, C. A., Cheema, A. S., Dorscheid, D., Fera, T. A. E., Gagnon, R., Philteos, G., Sussman, G., Yang, W. H. -C., Aguilar, C. D., Jaller, R., Jazime, M. L., Serrano, F. O., Vanegas, A. C., Vargas, L. K., Villegas, M. F., Hilberg, O., Nielsen, H. B., Nielsen, J., Weinreich, U. M., Ulrik, C. S., Adam, S. M., Deslee, G., Pegliasco, H., Pradelli, J., Roux, P. -M., Russier, M., Deckelmann, R., Eich, A., Forster, A., Herth, F., Kirschner, J., Kirsten, A. -M., Schuhmann, M., Schultz, T. K., Ludwig-Sengpiel, A., Teber, I., Zimmermann, G. S., Almerigogna, F., Celi, A., Paggiaro, P., D'Amato, M., Palange, P., Pirina, P., Spanevello, A., Colin, D. D. H., Hernandez, A. R., Garcia, E. A. R., Gonzalez, E. M., Terrones, R. A. R., Javier, R. C., Suarez, J. F. R., Cheimihska, M., Cudzik, K., Olech-Cudzik, A., Filipek, K., Golinski, L., Kwasniewski, A., Madra-Rogacka, D., Mroz, R., Nittner-Marszalska, M., Pawlukiewicz, M., Lekarska, P. P., Pioszczuk, A., Springer, E., Swiderska, A., Zurowska-Gebala, M., Emelyanov, A. V., Kurbacheva, O., Odegova, A., Peskov, A., Petrov, D. V., Rubanik, T. V., Vasilev, M., Vershinina, M., Barcala, F. J. G., Blanco, V. R., Fernandez, A. M. P., Fernandez, C. G., Garcia, J. M. I., Munoz, A. V. A., Ramos, C. C., Sanz, C. C., Bjermer, L., Chen, C. -Y., Fang, W. -F., Hang, L. -W., Hsu, J. -Y., Kuo, H. -P., Lee, K. -Y., Shen, S. -Y., Sheu, C. -C., Gore, R., Saralaya, D., Alpizar, S. A., Bansal, S., Ismail, H., Kaelin, T. D., Koura, F., Lee, M. D., Maddipati, V., Malur, A., Mcevoy, C. E., Mehta, H., Mohan, A., Moore, W. C., Krings, J., Pippins, A., Deaton, I., Hmieleski, B., Field, P., Reibman, J., Siri, D. D., Sumino, K., Swenson, C., Tilley, S. L., Villareal, M., Pulmonology, and Pulmonary medicine
Subjects: Pulmonary and Respiratory Medicine, Adrenal Cortex Hormones, Humans, Anti-Asthmatic Agents, Recovery of Function, Asthma, Adrenal Insufficiency
Abstract: BackgroundOral corticosteroid (OCS) dependence among patients with severe eosinophilic asthma can cause adverse outcomes, including adrenal insufficiency. PONENTE's OCS reduction phase showed that, following benralizumab initiation, 91.5% of patients eliminated corticosteroids or achieved a final dosage ≤5 mg·day−1(median (range) 0.0 (0.0–40.0) mg).MethodsThe maintenance phase assessed the durability of corticosteroid reduction and further adrenal function recovery. For ∼6 months, patients continued benralizumab 30 mg every 8 weeks without corticosteroids or with the final dosage achieved during the reduction phase. Investigators could prescribe corticosteroids for asthma exacerbations or increase daily dosages for asthma control deteriorations. Outcomes included changes in daily OCS dosage, Asthma Control Questionnaire (ACQ)-6 and St George's Respiratory Questionnaire (SGRQ), as well as adrenal status, asthma exacerbations and adverse events.Results598 patients entered PONENTE; 563 (94.1%) completed the reduction phase and entered the maintenance phase. From the end of reduction to the end of maintenance, the median (range) OCS dosage was unchanged (0.0 (0.0–40.0) mg), 3.2% (n=18/563) of patients experienced daily dosage increases, the mean ACQ-6 score decreased from 1.26 to 1.18 and 84.5% (n=476/563) of patients were exacerbation free. The mean SGRQ improvement (–19.65 points) from baseline to the end of maintenance indicated substantial quality-of-life improvements. Of patients entering the maintenance phase with adrenal insufficiency, 32.4% (n=104/321) demonstrated an improvement in adrenal function. Adverse events were consistent with previous reports.ConclusionsMost patients successfully maintained maximal OCS reduction while achieving improved asthma control with few exacerbations and maintaining or recovering adrenal function.
Published: 2022

31. A new approach to assess COPD by identifying lung function break-points

Author: Eriksson G, Jarenbäck L, Peterson S, Ankerst J, Bjermer L, and Tufvesson E
Subjects: Diseases of the respiratory system, RC705-779
Abstract: Göran Eriksson,1,* Linnea Jarenbäck,1,* Stefan Peterson,2 Jaro Ankerst,1 Leif Bjermer,1 Ellen Tufvesson11Respiratory Medicine and Allergology, Department of Clinical Sciences, Lund University, 2Regional Cancer Center South, Skåne University Hospital, Lund, Sweden*These authors contributed equally to this workPurpose: COPD is a progressive disease, which can take different routes, leading to great heterogeneity. The aim of the post-hoc analysis reported here was to perform continuous analyses of advanced lung function measurements, using linear and nonlinear regressions.Patients and methods: Fifty-one COPD patients with mild to very severe disease (Global Initiative for Chronic Obstructive Lung Disease [GOLD] Stages I–IV) and 41 healthy smokers were investigated post-bronchodilation by flow-volume spirometry, body plethysmography, diffusion capacity testing, and impulse oscillometry. The relationship between COPD severity, based on forced expiratory volume in 1 second (FEV1), and different lung function parameters was analyzed by flexible nonparametric method, linear regression, and segmented linear regression with break-points.Results: Most lung function parameters were nonlinear in relation to spirometric severity. Parameters related to volume (residual volume, functional residual capacity, total lung capacity, diffusion capacity [diffusion capacity of the lung for carbon monoxide], diffusion capacity of the lung for carbon monoxide/alveolar volume) and reactance (reactance area and reactance at 5Hz) were segmented with break-points at 60%–70% of FEV1. FEV1/forced vital capacity (FVC) and resonance frequency had break-points around 80% of FEV1, while many resistance parameters had break-points below 40%. The slopes in percent predicted differed; resistance at 5 Hz minus resistance at 20 Hz had a linear slope change of -5.3 per unit FEV1, while residual volume had no slope change above and -3.3 change per unit FEV1 below its break-point of 61%.Conclusion: Continuous analyses of different lung function parameters over the spirometric COPD severity range gave valuable information additional to categorical analyses. Parameters related to volume, diffusion capacity, and reactance showed break-points around 65% of FEV1, indicating that air trapping starts to dominate in moderate COPD (FEV1 =50%–80%). This may have an impact on the patient’s management plan and selection of patients and/or outcomes in clinical research.Keywords: spirometry, severity, body plethysmography, single-breath carbon-monoxide diffusion test, impulse oscillometry, break-point
Published: 2015

32. Patients with chronic obstructive pulmonary disease and chronically colonized with Haemophilus influenzae during stable disease phase have increased airway inflammation

Author: Tufvesson E, Bjermer L, and Ekberg M
Subjects: Diseases of the respiratory system, RC705-779
Abstract: Ellen Tufvesson, Leif Bjermer, Marie Ekberg Respiratory Medicine and Allergology, Department of Clinical Sciences, Lund University, Lund, Sweden Background: Some patients with chronic obstructive pulmonary disease (COPD) show increased airway inflammation and bacterial colonization during stable phase. The aim of this study was to follow COPD patients and investigate chronic colonization with pathogenic bacteria during stable disease phase, and relate these findings to clinical parameters, inflammatory pattern, lung function, and exacerbations. Methods: Forty-three patients with COPD were included while in a stable state and followed up monthly until exacerbation or for a maximum of 6 months. The patients completed the Clinical COPD Questionnaire and Medical Research Council dyspnea scale questionnaires, and exhaled breath condensate was collected, followed by spirometry, impulse oscillometry, and sputum induction. Results: Ten patients were chronically colonized (ie, colonized at all visits) with Haemophilus influenzae during stable phase. These patients had higher sputum levels of leukotriene B4 (P
Published: 2015

33. Clinical pharmacokinetics of AZD3199, an inhaled ultra-long-acting β2-adrenoreceptor agonist (uLABA)

Author: Bjermer L, Kuna P, Jorup C, Bengtsson T, and Rosenborg J
Subjects: Therapeutics. Pharmacology, RM1-950
Abstract: Leif Bjermer,1 Piotr Kuna,2 Carin Jorup,3 Thomas Bengtsson,4 Johan Rosenborg4 1Department of Respiratory Medicine and Allergology, University Hospital, Lund, Sweden; 2Department of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland; 3AstraZeneca R&D, Mölndal, Sweden; 4StatMind, Lund, Sweden Objective: The clinical pharmacokinetics of AZD3199, an ultra-long-acting β2-agonist, were investigated in healthy volunteers and patients with asthma or chronic obstructive pulmonary disease (COPD). Materials and methods: Five studies are presented: one single ascending dose study in healthy Caucasian males; two multiple ascending dose studies in healthy males, one in Caucasians and one in Japanese; a Phase IIA asthma study; and a Phase IIB COPD study. Subjects received AZD3199 via a Spira nebulizer (Turbuhaler; equivalent delivered doses 5–3200 µg) or Turbuhaler (single delivered doses of 120–1920 µg or repeated delivered once-daily doses 240–1,680 µg). AZD3199 pharmacokinetics were assessed using total plasma concentration and urinary excretion, and tolerability using adverse events, clinical laboratory tests, and physical examinations. Results: AZD3199 appeared rapidly in the systemic circulation following single and multiple dosing in healthy volunteers and patients (maximum plasma concentration within 30 minutes), with dose-proportional time-independent pharmacokinetics. Plasma exposure to unmetabolized drug was similar in healthy volunteers and patients with asthma, but relatively lower in patients with COPD. Estimated terminal half-life was up to 142 hours in healthy Caucasian males. AZD3199 was well tolerated and showed no or at most mild systemic effects. Conclusion: AZD3199 plasma exposure in healthy volunteers and patients suggested linear pharmacokinetics and a long half-life. Systemic availability was similar in healthy subjects and patients with asthma, but was lower in patients with COPD. These clinical trials suggest that AZD3199 is well-tolerated in healthy male volunteers and patients, with no safety concerns identified to preclude further evaluation. Keywords: AZD3199, uLABA, COPD, asthma, pharmacokinetics, tolerability
Published: 2015

34. Using NanoString to investigate effects of cigarette smoke extract on gene expression in lung fibroblasts from healthy and COPD subjects

Author: Ryde, M, primary, Van Der Burg, N, additional, Westergren-Thorsson, G, additional, Bjermer, L, additional, and Tufvesson, E, additional
Published: 2022
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35. Expiratory flow limitation in association to symptoms and quality of life in asthma, COPD and healthy subjects

Author: Nasr, A, primary, Papapostolou, G, additional, Romberg, K, additional, Jarenbäck, L, additional, Ankerst, J, additional, Tunsäter, A, additional, Bjermer, L, additional, and Tufvesson, E, additional
Published: 2022
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36. scRNA sequencing on human airway epithelium reveals metabolic changes during healthy aging

Author: Prabhala, P, primary, Wijk, S, additional, Lang, S, additional, Tufvesson, E, additional, Bjermer, L, additional, Soneji, S, additional, Westergren-Thorsson, G, additional, and Magnusson, M, additional
Published: 2022
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37. Prevalence and predictors of airway hyperresponsiveness in asthma, COPD, and overlap-findings from a large real-life population

Author: Felby, M L, primary, Klein, D, additional, Frøssing, L, additional, Hvidtfeldt, M, additional, Bodtger, U, additional, Romberg, K, additional, Bjermer, L, additional, Tufvesson, E, additional, and Porsbjerg, C, additional
Published: 2022
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38. ADAM17 and CD62L in BAL fluid as a measure of leukocyte transmigration in COPD, asthma, and healthy individuals

Author: Larsson, C, primary, Van Der Burg, N, additional, Ankerst, J, additional, Bjermer, L, additional, and Tufvesson, E, additional
Published: 2022
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39. The added value of hybrid ventilation/perfusion SPECT/CT in patients with stable COPD or apparently healthy smokers. Cancer-suspected CT findings in the lungs are common when hybrid imaging is used

Author: Jögi J, Markstad H, Tufvesson E, Bjermer L, and Bajc M
Subjects: Diseases of the respiratory system, RC705-779
Abstract: Jonas Jögi,1 Hanna Markstad,2 Ellen Tufvesson,3 Leif Bjermer,3 Marika Bajc1 1Department of Clinical Physiology and Nuclear Medicine, 2Department of Radiology, 3Department of Respiratory Medicine and Allergology, Skåne University Hospital and Lund University, Lund, Sweden Abstract: Ventilation/perfusion (V/P) single-photon emission computed tomography (SPECT) is recognized as a diagnostic method with potential beyond the diagnosis of pulmonary embolism. V/P SPECT identifies functional impairment in diseases such as heart failure (HF), pneumonia, and chronic obstructive pulmonary disease (COPD). The development of hybrid SPECT/computed tomography (CT) systems, combining functional with morphological imaging through the addition of low-dose CT (LDCT), may be useful in COPD, as these patients are prone to lung cancer and other comorbidities. The aim of this study was to investigate the added value of LDCT among healthy smokers and patients with stable COPD, when examined with V/P SPECT/CT hybrid imaging. Sixty-nine subjects, 55 with COPD (GOLD I–IV) and 14 apparently healthy smokers, were examined with V/P SPECT and LDCT hybrid imaging. Spirometry was used to verify COPD grade. Only one apparently healthy smoker and three COPD patients had a normal or nearly normal V/P SPECT. All other patients showed various degrees of airway obstruction, even when spirometry was normal. The same interpretation was reached on both modalities in 39% of the patients. LDCT made V/P SPECT interpretation more certain in 9% of the patients and, in 52%, LDCT provided additional diagnoses. LDCT better characterized the type of emphysema in 12 patients. In 19 cases, tumor-suspected changes were reported. Three of these 19 patients (ie, 4.3% of all subjects) were in the end confirmed to have lung cancer. The majority of LDCT findings were not regarded as clinically significant. V/P SPECT identified perfusion patterns consistent with decompensated left ventricular HF in 14 COPD patients. In 16 patients (23%), perfusion defects were observed. HF and perfusion defects were not recognized with LDCT. In COPD patients and long-time smokers, hybrid imaging had added value compared to V/P SPECT alone, by identifying patients with lung malignancy and more clearly identifying emphysema. V/P SPECT visualizes comorbidities to COPD not seen with LDCT, such as pulmonary embolism and left ventricular HF. Keywords: lung, lung cancer, V/P SPECT, ventilation/perfusion, single-photon emission computed tomography, computed tomography
Published: 2014

40. Uncontrolled asthmatics have increased FceRI+ and TGF‐β–positive MCTC mast cells and collagen VI in the alveolar parenchyma

Author: Andersson, C. K., Weitoft, M., Rydell‐Törmänen, K., Bjermer, L., Westergren‐Thorsson, G., and Erjefält, J. S.
Published: 2018
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41. Allergens produce serine proteases‐dependent distinct release of metabolite DAMPs in human bronchial epithelial cells

Author: Ramu, S., Menzel, M., Bjermer, L., Andersson, C., Akbarshahi, H., and Uller, L.
Published: 2018
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42. Feno and blood eosinophils as biomarkers in predicting asthma exacerbations: P198

Author: Rastogi, S, Bosnic-Antievich, S, Pavord, I, Roche, N, Halpin, D, Bjermer, L, Usmani, O S, Brusselle, G, Yau Ming, Wan S, Halim, S, Gopalan, G, and Price, D
Published: 2017
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43. Small airway involvement in the late allergic response in asthma

Author: Stenberg, H., Diamant, Z., Ankerst, J., Bjermer, L., and Tufvesson, E.
Published: 2017
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44. Correlation between work impairment, scores of rhinitis severity and asthma using the MASK-air ® App

Author: Bédard, Annabelle, Antó, Josep, Fonseca, Joao, Arnavielhe, Sylvie, Bachert, Claus, Bedbrook, Anna, Bindslev-Jensen, Carsten, Bosnic-Anticevich, Sinthia, Cardona, Victoria, Cruz, Alvaro, Fokkens, Wytske, Garcia-Aymerich, Judith, Hellings, Peter, Ivancevich, Juan, Klimek, Ludger, Kuna, Piotr, Kvedariene, Violeta, Larenas-Linnemann, Désirée, Melen, Erik, Monti, Ricardo, Mösges, Ralf, Mullol, Joaquim, Papadopoulos, Nikos, Pham-Thi, Nhan, Samolinski, Boleslaw, V Tomazic, Peter, Toppila-Salmi, Sanna, Ventura, Maria Teresa, Yorgancioglu, Arzu, Bousquet, Jean, Pfaar, Oliver, Basagana, Xavier, Bosnic‐Anticevich, Sinthia, Pham‐Thi, Nhân, Hellings, PW, Aberer, W., Agache, I., Akdis, Ca, Akdis, M., Aliberti, MR, Almeida, R., Amat, F., Angles, R, Annesi‐Maesano, I, Ansotegui, IJ, Anto, JM, Arnavielle, S, Asayag, E, Asarnoj, A, Arshad, H, Avolio, F, Bacci, E, Baiardini, I, Barbara, C, Barbagallo, M., Baroni, I, Barreto, BA, Basagaña, X., Bateman, ED, Bedolla‐Barajas, M, Bewick, M., Beghé, B., Bel, EH, Bergmann, KC, Bennoor, KS, Benson, M, Bertorello, L, Białoszewski, AZ, Bieber, T., Bialek, S, Bindslev‐Jensen, Carsten, Bjermer, L., Blain, H., Blasi, F., Blua, A, Bochenska Marciniak, M, Bogus‐Buczynska, I, Boner, AL, Bonini, M., Bonini, S., Bosnic‐Anticevich, CS, Bosse, I., Bouchard, J., Boulet, LP, Bourret, R., Bousquet, Pj, Braido, F, Briedis, V, Brightling, CE, Brozek, J, Bucca, C, Buhl, R, Buonaiuto, R, Panaitescu, C, Burguete Cabañas, MT, Burte, E., Bush, A, Caballero‐Fonseca, F, Caillaud, D., Caimmi, D., Calderon, MA, Camargos, PAM, Camuzat, T., Canfora, G, Canonica, Gw, Carlsen, KH, Carreiro‐Martins, P, Carriazo, AM, Carr, W, Cartier, C., Casale, T., Castellano, G, Cecchi, L, Cepeda, AM, Chavannes, NH, Chen, Y., Chiron, R., Chivato, T, Chkhartishvili, E, Chuchalin, AG, Chung, KF, Ciaravolo, MM, Ciceran, A, Cingi, C, Ciprandi, G, Carvalho Coehlo, AC, Colas, L, Colgan, E, Coll, J, Conforti, D, Constantinidis, J, de Sousa, J Correia, Cortés‐Grimaldo, RM, Corti, F, Costa, E, Costa‐Dominguez, MC, Courbis, AL, Cox, L, Crescenzo, M, Cruz, AA, Custovic, A., Czarlewski, W., Dahlen, Se, D’Amato, G, 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, Motta Rubini, NP, Deleanu, D, Denburg, JA, devillier, P., Di Capua Ercolano, S, Di Carluccio, N, Didier, A., Dokic, D, Dominguez‐Silva, MG, Douagui, H, Dray, G., Dubakiene, R, Durham, Sr, Du Toit, G, Dykewicz, MS, El‐Gamal, Y, Eklund, P, Eller, E, Emuzyte, R., Farrell, J, Farsi, A, de Mello, J Ferreira, Ferrero, J, Fink‐Wagner, A, Fiocchi, A, Fokkens, WJ, Fonseca, JA, Fontaine, Jf, Forti, S, Fuentes‐Perez, JM, Gálvez‐Romero, JL, Gamkrelidze, A, Garcia‐Aymerich, Judith, García‐Cobas, CY, Garcia‐Cruz, MH, Gemicioğlu, B, Genova, S, Christoff, G, Gereda, JE, Van Wijk, R Gerth, Gomez, RM, Gómez‐Vera, J, González Diaz, S, Gotua, M., Grisle, I, Guidacci, M, Guldemond, NA, Gutter, Z, Guzmán, MA, Haahtela, T., Hajjam, J, Hernández, L, Hourihane, JO’B, Huerta‐Villalobos, YR, Humbert, M., Iaccarino, G., Illario, M, Ispayeva, Z, Ivancevich, JC, Jares, EJ, Jassem, E, Johnston, Sl, Joos, G, Jung, KS, Just, J., Jutel, M, Kaidashev, I, Kalayci, O, Kalyoncu, AF, Karjalainen, J, Kardas, P, Keil, T, Keith, PK, Khaitov, M, Khaltaev, N, Kleine‐Tebbe, J, Kowalski, Ml, Kuitunen, M, Kull, I., Kupczyk, M, Krzych‐Fałta, E, Lacwik, P, Larenas‐Linnemann, Désirée, Laune, D., Lauri, D, Lavrut, J, Le, LTT, Lessa, M, Levato, G, Li, J., Lieberman, P, Lipiec, A, Lipworth, B, Lodrup Carlsen, KC, Louis, R, Lourenço, O, Luna‐Pech, JA, Magnan, A., Mahboub, B, Maier, D., Mair, A, Majer, I, Malva, J, Mandajieva, E, Manning, P, De Manuel Keenoy, E, Marshall, GD, Masjedi, MR, Maspero, JF, Mathieu‐Dupas, E, Matta Campos, JJ, Matos, AL, Maurer, M, Mavale‐Manuel, S, Mayora, O, Meco, C, Medina‐Avalos, MA, Melo‐Gomes, E, Meltzer, EO, Menditto, E., Miculinic, N, Mihaltan, F., Milenkovic, B, Moda, G, Mogica‐Martinez, MD, Mohammad, Y, Momas, I., Montefort, S, Mora Bogado, D, Morais‐Almeida, M, Morato‐Castro, FF, Mota‐Pinto, A, Moura Santo, P, 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, TD, O’Hehir, RE, Odzhakova, C, Ohta, K., Okamoto, Y., Okubo, K, Onorato, GL, Ortega Cisneros, M, Ouédraogo, S., Pali‐Schöll, I, Palkonen, S, Panzner, P, Papadopoulos, NG, Park, HS, Papi, A., Passalacqua, G, Paulino, E, Pawankar, R, Pedersen, S, Pépin, JL, Pereira, AM, Persico, M, PHILLIPS, J, Picard, R., Pigearias, B, Pin, I., Pitsios, C., Plavec, D, Pohl, W, Popov, TA, Portejoie, F., Potter, P, Pozzi, AC, Price, D, Prokopakis, EP, Puy, R, Pugin, B, Pulido Ross, RE, Przemecka, M, Rabe, KF, Raciborski, F, Rajabian‐Soderlund, R, Reitsma, S, Ribeirinho, I, Rimmer, J, Rivero‐Yeverino, D, Rizzo, JA, Rizzo, MC, 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, RE, Romano, M, Rosado‐Pinto, J, Rosario, N., Rottem, M, Ryan, D, Sagara, H, Salimäki, J, Sanchez‐Borges, M, Sastre‐Dominguez, J, Scadding, GK, Schunemann, HJ, Scichilone, N, Schmid‐Grendelmeier, P, Sarquis Serpa, F, Shamai, S., Sheikh, A., Sierra, M, Simons, FER, Siroux, V., Sisul, JC, 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, JN, Thibaudon, M., To, T., Todo‐Bom, A, Tomazic, PV, Toppila‐Salmi, Sanna, 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 Hage, M, Vandenplas, O, Ventura, MT, Vezzani, G, Vasankari, T, Vatrella, A., Verissimo, MT, Viart, F., Viegi, G., Vicheva, D, Vontetsianos, T, Wagenmann, M, Walker, S, Wallace, D, Wang, DY, Waserman, S., Werfel, T, Westman, M, Wickman, M., Williams, DM, Williams, S, Wilson, N, Wright, J, Wroczynski, P, Yakovliev, P, Yawn, BP, Yiallouros, PK, Yusuf, OM, Zar, HJ, Zhang, L., Zhong, N, Zernotti, ME, Zhanat, I, Zidarn, M, Zuberbier, T., Zubrinich, C, Zurkuhlen, A, Mercier, Jacques, Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), Universitat Pompeu Fabra [Barcelona] (UPF), CIBER de Epidemiología y Salud Pública (CIBERESP), IMIM-Hospital del Mar, Generalitat de Catalunya, Center of Research in Health Technologies and Information Systems (CINTESIS), Universidade do Porto = University of Porto, KYomed INNOV, Ghent University Hospital, 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), Odense University Hospital [Odense, Denmark], Woolcock Institute of Medical Research [Sydney], The University of Sydney, Vall d'Hebron University Hospital [Barcelona], ProAR - FMB, Federal University of Bahia School of Medicine, European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), University Hospitals Leuven [Leuven], Zentrum für Rhinologie und Allergologie [Wiesbaden, Germany], Division of Internal Medicine, Asthma and Allergy, Medical University of Łódź (MUL)-Barlicki University Hospital, Vilnius University [Vilnius], Clínica de Alergia- Asma y Pediatría, Hospital Medica Sur, Institute of Environmental Medicine, Karolinska Institutet [Stockholm]-Karolinska University Hospital [Stockholm]-Astrid Lindgren Children's Hospital, Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Service de Pneumologie Allergologie [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Pasteur [Paris] (IP), Medical University of Warsaw - Poland, Department of Pulmonology, Manisa Celal Bayar University, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), 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), Center for Rhinology and Allergology Wiesbaden, University Hospital Mannheim, Center for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra [Barcelona] (UPF)-Catalunya ministerio de salud, Department of Allergy and Clinical Immunology, Faculty of Medicine-Transylvania University, Swiss Institute of Allergy and Asthma Research (SIAF), Universität Zürich [Zürich] = University of Zurich (UZH), Department Engineering Quimica (ICEMS), Aix Marseille Université (AMU), Istituto Nazionale di Fisica Nucleare, sezione di Bari (INFN, sezione di Bari), Istituto Nazionale di Fisica Nucleare (INFN), iQ4U consultants Ltd, Divisions of Human Genetics Infection, Inflammation and Repair, University of Southampton-School of Medicine, Department of Respiratory Medicine and Allergy, 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, CHU Montpellier, Laboratoire National Henri Becquerel (LNHB), Département Métrologie Instrumentation & Information (DM2I), Laboratoire d'Intégration des Systèmes et des Technologies (LIST (CEA)), Direction de Recherche Technologique (CEA) (DRT (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Direction de Recherche Technologique (CEA) (DRT (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Laboratoire d'Intégration des Systèmes et des Technologies (LIST (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Département d'instrumentation Numérique (DIN (CEA-LIST)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Unité de Nutrition Humaine (UNH), Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Laboratoire de recherche sur les mécanismes moléculaires et pharmacologiques de l’obstruction bronchique (LOBIP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Région Languedoc-Roussillon-Midi-Pyrénées, University of South Florida [Tampa] (USF), Chinese academy of sciences Sanya, 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, Laboratoire de Génie Informatique et d'Ingénierie de Production (LGI2P), IMT - MINES ALES (IMT - MINES ALES), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), Department of Paediatrics, UCB Pharma, Colombes, CHU Strasbourg, Università degli Studi di Salerno = University of Salerno (UNISA), Hôpital Foch [Suresnes], Service de pneumologie [Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Informatique, Image, Intelligence Artificielle (I3A), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-IMT - MINES ALES (IMT - MINES ALES), Laboratoire Electronique, Informatique et Image [UMR6306] (Le2i), Université de Bourgogne (UB)-École Nationale Supérieure d'Arts et Métiers (ENSAM), Arts et Métiers Sciences et Technologies, HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Arts et Métiers Sciences et Technologies, HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique (CNRS), Center for Allergy and Immunology Research [Tbilisi], Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Center for Turbulence Research [Stanford] (CTR), Stanford University, CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), The Institute of Environmental Medicine [Stockholm] (IMM), Karolinska Institutet [Stockholm], Sysdiag-Modélisation et Ingénierie des Systèmes Complexes Biologiques pour le Diagnostic (SysDiag ), BIO-RAD-Centre National de la Recherche Scientifique (CNRS), Équipe de Recherche en Textes, Informatique, Multilinguisme (ERTIM), Institut National des Langues et Civilisations Orientales (Inalco), 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), Biomax Informatics AG, 'Federico II' University of Naples Medical School, Pneumology Department, Marius Nasta Institute of Pneumology, Epidémiologie Environnementale : Impact Sanitaire des Pollutions (EA 4064), Université Paris Descartes - Paris 5 (UPD5), Johns Hopkins University School of Medicine [Baltimore], CARSAT-LR, Montpellier, Dept. of Electronic Engineering, Chubu University, Institute for Solid State Physics, The University of Tokyo (UTokyo), Respiratory Medicine, 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, University of Cyprus [Nicosia] (UCY), Son Pisa Primary Care Centre, IB-Salut Balearic Health Service, Department of Computer Science [Haifa], University of Haifa [Haifa], University of Edinburgh, 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 (UGA), Réseau National de Surveillance Aérobiologique (RNSA), CIRCE, Ctr Res Energy Resources & Consumpt, Zaragoza 50018, Spain, University of Turku, Evaluation et modélisation des effets thérapeutiques, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), ASA (Advanced Solution Accelerator) (Data management : Développement Back-Office, hébergement…), 34830 Jacou, Consiglio nazionale delle ricerche, Instituto di fisiologia clinica, McMaster University [Hamilton, Ontario], Department of Molecular Medicine and Surgery, UMR CNRS 8179, Université de Lille, Sciences et Technologies-Centre National de la Recherche Scientifique (CNRS), University Hospital of Cologne [Cologne], 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), ISGlobal, Barcelona, Spain, Universitat Pompeu Fabra (UPF), Barcelona, Spain, CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain, IMIM (Hospital del Mar Research Institute), Barcelona, Spain, CINTESIS, Center for Research in Health Technology and Information Systems, Faculdade de Medicina da Universidade do Porto, Porto, Portugal, Medida, Lda Porto, Porto, Portugal, KYomed INNOV, Montpellier, France, Upper Airways Research Laboratory, ENT Dept, Ghent University Hospital, Ghent, Belgium, MACVIA-France, Montpellier, France, 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 Woolcock Emphysema Centre and Sydney Local Health District, Glebe, NSW, Australia, Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron & ARADyAL Research Network, Barcelona, Spain, ProAR – Nucleo de Excelencia em Asma, Federal University of Bahia, Brasil and WHO GARD Planning Group, Salvador, Brazil, Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, Netherlands, Euforea, Brussels, Belgium, Department of Otorhinolaryngology, University Hospitals Leuven, Leuven, Belgium, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands, Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina, Center for Rhinology and Allergology, Wiesbaden, Germany, Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland, Department of Pathology, Faculty of Medicine, Institute of Biomedical Sciences, Vilnius University, Vilnius, Lithuania, Clinic of Chest diseases and Allergology, Faculty of Medicine, Institute of Clinical Medicine, Vilnius, Lithuania, Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico, Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden, Allergy and Clinical Immunology Unit, Department of Medical Sciences, University of Torino & Mauriziano Hospital, Torino, Italy, Institute of Medical Statistics, and Computational Biology, Medical Faculty, University of Cologne, Cologne, Germany, CRI-Clinical Research International-Ltd, Hamburg, Germany, Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, University of Barcelona, Barcelona, Spain, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain, Division of Infection, Immunity & Respiratory Medicine, Royal Manchester Children's Hospital, University of Manchester, Manchester, United Kingdom, Allergy Department, Pasteur Institute, Paris, France, Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland, Department of General ORL, H&NS, Medical University of Graz, Graz, Austria, Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland, Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy, Department of Pulmonary Diseases, Faculty of Medicine, Celal Bayar University, Manisa, Turkey, University Hospital, 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, Versailles, France, Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany, Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin Institute of Health, Berlin, Germany, Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Phillipps-Universität, Marburg, Germany, Universidade do Porto, 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), Institut Pasteur [Paris], University of Milan, University of Naples Federico II-CNR, Rome, Italy and Department of Medicine, Laboratoire d'Intégration des Systèmes et des Technologies (LIST), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Laboratoire d'Intégration des Systèmes et des Technologies (LIST), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay, Università degli Studi di Salerno (UNISA), CHU Toulouse [Toulouse]-Hôpital Larrey [Toulouse], CHU Toulouse [Toulouse], Université de Bourgogne (UB)-Centre National de la Recherche Scientifique (CNRS)-École Nationale Supérieure d'Arts et Métiers (ENSAM), HESAM Université (HESAM)-HESAM Université (HESAM)-Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, University of Helsinki, Service d'Allergologie pédiatrique [CHU Trousseau], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), 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), 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 Cyprus [Nicosia], Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Bedard, A., Anto, J. M., Fonseca, J. A., Arnavielhe, S., Bachert, C., Bedbrook, A., Bindslev-Jensen, C., Bosnic-Anticevich, S., Cardona, V., Cruz, A. A., Fokkens, W. J., Garcia-Aymerich, J., Hellings, P. W., Ivancevich, J. C., Klimek, L., Kuna, P., Kvedariene, V., Larenas-Linnemann, D., Melen, E., Monti, R., Mosges, R., Mullol, J., Papadopoulos, N. G., Pham-Thi, N., Samolinski, B., Tomazic, P. V., Toppila-Salmi, S., Ventura, M. T., Yorgancioglu, A., Bousquet, J., Pfaar, O., Basagana, X., Aberer, W., Agache, I., Akdis, C. A., Akdis, M., Aliberti, M. R., Almeida, R., Amat, F., Angles, R., Annesi-Maesano, I., Ansotegui, I. J., Arnavielle, S., Asayag, E., Asarnoj, A., Arshad, H., Avolio, F., Bacci, E., Baiardini, I., Barbara, C., Barbagallo, M., Baroni, I., Barreto, B. A., Bateman, E. D., Bedolla-Barajas, M., Bewick, M., Beghe, B., Bel, E. H., Bergmann, K. C., Bennoor, K. S., 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., 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 Cabanas, M. T., Burte, E., Bush, A., Caballero-Fonseca, F., Caillaud, D., Caimmi, D., Calderon, M. A., Camargos, P. A. M., Camuzat, T., Canfora, G., Canonica, G. W., Carlsen, K. H., Carreiro-Martins, P., Carriazo, A. M., Carr, W., Cartier, C., Casale, T., Castellano, G., Cecchi, L., Cepeda, 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., Constantinidis, J., Correia de Sousa, J., Cortes-Grimaldo, R. M., Corti, F., Costa, E., Costa-Dominguez, M. C., Courbis, A. L., Cox, L., Crescenzo, M., Custovic, A., Czarlewski, W., Dahlen, S. E., D'Amato, G., Dario, C., da Silva, J., Dauvilliers, Y., Darsow, U., De Blay, F., De Carlo, G., Dedeu, T., de Fatima Emerson, M., De Feo, G., De Vries, G., De Martino, B., Motta Rubini, N. P., Deleanu, D., 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., Fontaine, J. F., Forti, S., Fuentes-Perez, J. M., Galvez-Romero, J. L., Gamkrelidze, A., Garcia-Cobas, C. Y., Garcia-Cruz, M. H., Gemicioglu, B., Genova, S., Christoff, G., 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., Guzman, M. A., Haahtela, T., Hajjam, J., Hernandez, L., Hourihane, J. O. '. B., Huerta-Villalobos, Y. R., Humbert, M., Iaccarino, G., Illario, M., Ispayeva, Z., Jares, E. J., Jassem, E., Johnston, S. L., Joos, G., Jung, K. S., Just, J., 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., Kowalski, M. L., Kuitunen, M., Kull, I., Kupczyk, M., Krzych-Falta, E., Lacwik, P., 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., Lourenco, O., Luna-Pech, J. A., 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., Meco, C., Medina-Avalos, M. A., 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., Mora Bogado, D., Morais-Almeida, M., Morato-Castro, F. F., Mota-Pinto, A., Moura Santo, P., Munter, 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-Scholl, I., Palkonen, S., Panzner, P., Park, H. S., Papi, A., Passalacqua, G., Paulino, E., Pawankar, R., Pedersen, S., Pepin, J. L., Pereira, A. M., Persico, M., 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-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., Rottem, M., Ryan, D., Sagara, H., Salimaki, J., Sanchez-Borges, M., Sastre-Dominguez, J., Scadding, G. K., Schunemann, H. J., Scichilone, N., Schmid-Grendelmeier, P., Sarquis Serpa, F., Shamai, S., Sheikh, A., Sierra, M., Simons, F. E. R., Siroux, V., Sisul, J. C., Skrindo, I., Sole, 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., Tebyrica, J. N., Thibaudon, M., To, T., Todo-Bom, A., 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 Hage, M., Vandenplas, O., Vezzani, G., Vasankari, T., Vatrella, A., Verissimo, M. T., Viart, F., Viegi, G., 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., Yusuf, O. M., Zar, H. J., Zhang, L., Zhong, N., Zernotti, M. E., Zhanat, I., Zidarn, M., Zuberbier, T., Zubrinich, C., Zurkuhlen, A., HESAM Université (HESAM)-HESAM Université (HESAM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-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)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Universitat Pompeu Fabra [Barcelona]-Catalunya ministerio de salud, Universidade do Porto [Porto], Kyomed, 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), Universitat Pompeu Fabra [Barcelona], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Necker - Enfants Malades [AP-HP], Service des Maladies Respiratoires, Hôpital Arnaud de Villeneuve-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Dermatology [Graz, Austria], Medical University Graz, University of Zürich [Zürich] (UZH), National Institute for Nuclear Physics (INFN), Institut Jean Lamour (IJL), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Université Paris-Saclay-Direction de Recherche Technologique (CEA) (DRT (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Direction de Recherche Technologique (CEA) (DRT (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Laboratoire d'Intégration des Systèmes et des Technologies (LIST), Clermont Université-Université d'Auvergne - Clermont-Ferrand I (UdA)-Institut National de la Recherche Agronomique (INRA), University of South Florida (USF), University of Salerno (UNISA), CHU Toulouse [Toulouse]-Hôpital Larrey, Institut Mines-Télécom [Paris] (IMT), Center for Turbulence Research (CTR), Stanford University [Stanford], Service d'allergologie [CHU Trousseau], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Trousseau [APHP], 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), The University of Tokyo, Sondra, CentraleSupélec, Université Paris-Saclay (SONDRA), ONERA-CentraleSupélec-Université Paris-Saclay, Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-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), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Centre National de la Recherche Scientifique (CNRS), RNSA, Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Ear, Nose and Throat, AII - Inflammatory diseases, Pulmonology, CNR, Rome, Italy and Department of Medicine-University of Naples Federico II, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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), HUS Inflammation Center, Department of Dermatology, Allergology and Venereology, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (MGD) Service de pneumologie, Bedard A., Anto J.M., Fonseca J.A., Arnavielhe S., Bachert C., Bedbrook A., Bindslev-Jensen C., Bosnic-Anticevich S., Cardona V., Cruz A.A., Fokkens W.J., Garcia-Aymerich J., Hellings P.W., Ivancevich J.C., Klimek L., Kuna P., Kvedariene V., Larenas-Linnemann D., Melen E., Monti R., Mosges R., Mullol J., Papadopoulos N.G., Pham-Thi N., Samolinski B., Tomazic P.V., Toppila-Salmi S., Ventura M.T., Yorgancioglu A., Bousquet J., Pfaar O., Basagana X., Aberer W., Agache I., Akdis C.A., Akdis M., Aliberti M.R., Almeida R., Amat F., Angles R., Annesi-Maesano I., Ansotegui I.J., Arnavielle S., Asayag E., Asarnoj A., Arshad H., Avolio F., Bacci E., Baiardini I., Barbara C., Barbagallo M., Baroni I., Barreto B.A., Bateman E.D., Bedolla-Barajas M., Bewick M., Beghe B., Bel E.H., Bergmann K.C., Bennoor K.S., 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., 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 Cabanas M.T., Burte E., Bush A., Caballero-Fonseca F., Caillaud D., Caimmi D., Calderon M.A., Camargos P.A.M., Camuzat T., Canfora G., Canonica G.W., Carlsen K.H., Carreiro-Martins P., Carriazo A.M., Carr W., Cartier C., Casale T., Castellano G., Cecchi L., Cepeda 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., Constantinidis J., Correia de Sousa J., Cortes-Grimaldo R.M., Corti F., Costa E., Costa-Dominguez M.C., Courbis A.L., Cox L., Crescenzo M., Custovic A., Czarlewski W., Dahlen S.E., D'Amato G., Dario C., da Silva J., Dauvilliers Y., Darsow U., De Blay F., De Carlo G., Dedeu T., de Fatima Emerson M., De Feo G., De Vries G., De Martino B., Motta Rubini N.P., Deleanu D., 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., Fontaine J.F., Forti S., Fuentes-Perez J.M., Galvez-Romero J.L., Gamkrelidze A., Garcia-Cobas C.Y., Garcia-Cruz M.H., Gemicioglu B., Genova S., Christoff G., 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., Guzman M.A., Haahtela T., Hajjam J., Hernandez L., Hourihane J.O.'.B., Huerta-Villalobos Y.R., Humbert M., Iaccarino G., Illario M., Ispayeva Z., Jares E.J., Jassem E., Johnston S.L., Joos G., Jung K.S., Just J., 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., Kowalski M.L., Kuitunen M., Kull I., Kupczyk M., Krzych-Falta E., Lacwik P., 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., Lourenco O., Luna-Pech J.A., 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., Meco C., Medina-Avalos M.A., 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., Mora Bogado D., Morais-Almeida M., Morato-Castro F.F., Mota-Pinto A., Moura Santo P., Munter 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-Scholl I., Palkonen S., Panzner P., Park H.S., Papi A., Passalacqua G., Paulino E., Pawankar R., Pedersen S., Pepin J.L., Pereira A.M., Persico M., 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-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., Rottem M., Ryan D., Sagara H., Salimaki J., Sanchez-Borges M., Sastre-Dominguez J., Scadding G.K., Schunemann H.J., Scichilone N., Schmid-Grendelmeier P., Sarquis Serpa F., Shamai S., Sheikh A., Sierra M., Simons F.E.R., Siroux V., Sisul J.C., Skrindo I., Sole 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., Tebyrica J.N., Thibaudon M., To T., Todo-Bom A., 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 Hage M., Vandenplas O., Vezzani G., Vasankari T., Vatrella A., Verissimo M.T., Viart F., Viegi G., 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., Yusuf O.M., Zar H.J., Zhang L., Zhong N., Zernotti M.E., Zhanat I., Zidarn M., Zuberbier T., Zubrinich C., and Zurkuhlen A.
Subjects: 0301 basic medicine, SYMPTOMS, Smart phone, Allergy, Escala visual analógica, INNOVATION, [SDV]Life Sciences [q-bio], Medical and Health Sciences, Correlation, visual analogue scale, 0302 clinical medicine, Quality of life, Visual analogue scale, QUALITY-OF-LIFE, Màscares, Immunology and Allergy, score, Nose, Rinitis, Rhinitis, PRODUCTIVITY COSTS, asthma, MASK, rhinitis, Score, Explained variation, Response Variability, Mobile Applications, ALLERGIC RHINITIS, rhiniti, medicine.anatomical_structure, TRIALS, Rinite, 1107 Immunology, [SDV.IMM]Life Sciences [q-bio]/Immunology, Smartphone, medicine.medical_specialty, MASK study group, Immunology, MACVIA-ARIA, 03 medical and health sciences, Allergic, medicine, Humans, TECHNOLOGY, IMMUNOTHERAPY, Asma, Asthma, business.industry, Rhinitis, Allergic, medicine.disease, RHINOCONJUNCTIVITIS, 030104 developmental biology, 030228 respiratory system, 3121 General medicine, internal medicine and other clinical medicine, Physical therapy, Clinical Medicine, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Background: In allergic rhinitis, a relevant outcome providing information on the effectiveness of interventions is needed. In MASK-air (Mobile Airways Sentinel Network), a visual analogue scale (VAS) for work is used as a relevant outcome. This study aimed to assess the performance of the work VAS work by comparing VAS work with other VAS measurements and symptom-medication scores obtained concurrently. Methods: All consecutive MASK-air users in 23 countries from 1 June 2016 to 31 October 2018 were included (14 189 users; 205 904 days). Geolocalized users self-assessed daily symptom control using the touchscreen functionality on their smart phone to click on VAS scores (ranging from 0 to 100) for overall symptoms (global), nose, eyes, asthma and work. Two symptom-medication scores were used: the modified EAACI CSMS score and the MASK control score for rhinitis. To assess data quality, the intra-individual response variability (IRV) index was calculated. Results: A strong correlation was observed between VAS work and other VAS. The highest levels for correlation with VAS work and variance explained in VAS work were found with VAS global, followed by VAS nose, eye and asthma. In comparison with VAS global, the mCSMS and MASK control score showed a lower correlation with VAS work. Results are unlikely to be explained by a low quality of data arising from repeated VAS measures. Conclusions: VAS work correlates with other outcomes (VAS global, nose, eye and asthma) but less well with a symptom-medication score. VAS work should be considered as a potentially useful AR outcome in intervention studies. © 2020 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.
Published: 2020

45. Is diet partly responsible for differences in COVID-19 death rates between and within countries?

Author: Bousquet J., Anto J. M., Iaccarino G., Czarlewski W., Haahtela T., Anto A., Akdis C. A., Blain H., Canonica G. W., Cardona V., Cruz A. A., Illario M., Ivancevich J. C., Jutel M., Klimek L., Kuna P., Laune D., Larenas-Linnemann D., Mullol J., Papadopoulos N. G., Pfaar O., Samolinski B., Valiulis A., Yorgancioglu A., Zuberbier T., Abdul Latiff A. H., Abdullah B., Aberer W., Abusada N., Adcock I., Afani A., Agache I., Aggelidis X., Agustin J., Akdis C., Akdis M., Al-Ahmad M., Al-Zahab Bassam A., Aldrey-Palacios O., Alvarez Cuesta E., Alzaabi A., Amad S., Ambrocio G., Annesi-Maesano I., Ansotegui I., Anto J., Arshad H., Artesani M. C., Asayag E., Avolio F., Azhari K., Baiardini I., Bajrovic N., Bakakos P., Bakeyala Mongono S., Balotro-Torres C., Barba S., Barbara C., Barbosa E., Barreto B., Bartra J., Bateman E. D., Battur L., Bedbrook A., Bedolla Barajas M., Beghe B., Bel E., Ben Kheder A., Benson M., Berghea C., Bergmann K. -C., Bernstein D., Bewick M., Bialek S., Bialoszewski A., Bieber T., Billo N., Bilo M. B., Bindslev-Jensen C., Bjermer L., Bochenska Marciniak M., Bond C., Boner A., Bonini M., Bonini S., Bosnic-Anticevich S., Bosse I., Botskariova S., Bouchard J., Boulet L. -P., Bourret R., Bousquet P., Braido F., Briggs A., Brightling C., Brozek J., Buhl R., Bumbacea R., Burguete Cabanas M. T., Bush A., Busse W. W., Buters J., Caballero-Fonseca F., Calderon M. A., Calvo M., Camargos P., Camuzat T., Cano A., Capriles-Hulett A., Caraballo L., Carlsen K. -H., Caro J., Carr W., Carreon-Asuncion F., Carriazo A. M., Casale T., Castor M. A., Castro E., Cecchi L., Cepeda Sarabia A., Chandrasekharan R., Chang Y. -S., Chato-Andeza V., Chatzi L., Chatzidaki C., Chavannes N. H., Chen Y., Cheng L., Chivato T., Chkhartishvili E., Christoff G., Chrystyn H., Chu D. K., Chua A., Chuchalin A., Chung K. F., Ciceran A., Cingi C., Ciprandi G., Cirule I., Coelho A. C., Constantinidis J., Correia De Sousa J., Costa E., Costa D., Costa Dominguez M. D. C., Coste A., Cox L., Cullen J., Custovic A., Cvetkovski B., D'Amato G., Da Silva J., Dahl R., Dahlen S. -E., Daniilidis V., Darjazini Nahhas L., Darsow U., De Blay F., De Guia E., De Los Santos C., De Manuel Keenoy E., De Vries G., Deleanu D., Demoly P., Denburg J., Devillier P., Didier A., Dimou M., Dinh-Xuan A. T., Djukanovic R., Dokic D., Dominguez Silva M. G., Douagui H., Douladiris N., Doulaptsi M., Dray G., Dubakiene R., Durham S., Dykewicz M., Ebo D., Edelbaher N., Eklund P., El-Gamal Y., El-Sayed Z. A., El-Sayed S. S., El-Seify M., Emuzyte R., Enecilla L., Espinoza H., Espinoza Contreras J. G., Farrell J., Fernandez L., Fink Wagner A., Fiocchi A., Fokkens W. J., Fontaine J. -F., Forastiere F., Fuentes Perez J. M., Gaerlan-Resureccion E., Gaga M., Galvez Romero J. L., Gamkrelidze A., Garcia A., Garcia Cobas C. Y., Garcia Cruz M. D. L. L. H., Gayraud J., Gemicioglu B., Genova S., Gereda J., Gerth Van Wijk R., Gomez M., Gonzalez Diaz S., Gotua M., Grigoreas C., Grisle I., Guidacci M., Guldemond N., Gutter Z., Guzman A., Halloum R., Hamelmann E., Hammadi S., Harvey R., Heinrich J., Hejjaoui A., Hellquist-Dahl B., Hernandez Velazquez L., Hew M., Hossny E., Howarth P., Hrubisko M., Huerta Villalobos Y. R., Humbert M., Hyland M., Ibrahim M., Ilyina N., Irani C., Ispayeva Z., Jares E., Jarvis D., Jassem E., Jenko K., Jimeneracruz Uscanga R. D., Johnston S., Joos G., Jost M., Julge K., Jung K. -S., Just J., Kaidashev I., Kalayci O., Kalyoncu F., Kapsali J., Kardas P., Karjalainen J., Kasala C. A., Katotomichelakis M., Kazi B., Keil T., Keith P., Khaitov M., Khaltaev N., Kim Y. -Y., Kleine-Tebbe J., Koffi N'Goran B., Kompoti E., Kopac P., Koppelman G., Koren Jeverica A., Kosnik M., Kostov K. V., Kowalski M. L., Kralimarkova T., Kramer Vrscaj K., Kraxner H., Kreft S., Kritikos V., Kudlay D., Kull I., Kupczyk M., Kvedariene V., Kyriakakou M., Lalek N., Lane S., Latiff A., Lau S., Lavrut J., Le L., Lessa M., Levin M., Li J., Lieberman P., Liotta G., Lipworth B., Liu X., Lobo R., Lodrup Carlsen K. C., Lombardi C., Louis R., Loukidis S., Lourenco O., Luna Pech J. A., Madjar B., Magnan A., Mahboub B., Mair A., Mais Y., Maitland Van Der Zee A. -H., Makela M., Makris M., Malling H. -J., Mandajieva M., Manning P., Manousakis M., Maragoudakis P., Marshall G., Martinsmartins P., Masjedi M. R., Maspero J. F., Matta Campos J. J., Maurer M., Mavale-Manuel S., Meco C., Melen E., Melo-Gomes E., Meltzer E. O., Menditto E., Menzies-Gow A., Merk H., Michel J. -P., Miculinic N., Midao L., Mihaltan F., Mikael K., Mikos N., Milenkovic B., Mitsias D., Moalla B., Moda G., Mogica Martinez M. D., Mohammad Y., Moin M., Molimard M., Momas I., Monaco A., Montefort S., Mora D., Morais-Almeida M., Mosges R., Mostafa B. E., Munter L., Muraro A., Murray R., Mustakov T., Naclerio R., Nadif R., Nakonechna A., Namazova-Baranova L., Navarro-Locsin G., Neffen H., Nekam K., Neou A., Nicod L., Niederberger-Leppin V., Niedoszytko M., Nieto A., Novellino E., Nunes E., Nyembue D., O'Hehir R., Odjakova C., Ohta K., Okamoto Y., Okubo K., Oliver B., Onorato G. L., Orru M. P., Ouedraogo S., Ouoba K., Paggiaro P. L., Pagkalos A., Palaniappan S. P., Pali-Scholl I., Palkonen S., Palmer S., Panaitescu Bunu C., Panzner P., Papanikolaou V., Papi A., Paralchev B., Paraskevopoulos G., Park H. S., Passalacqua G., Patella V., Pavord I., Pawankar R., Pedersen S., Peleve S., Pereira A., Perez T., Pham-Thi N., Pigearias B., Pin I., Piskou K., Pitsios C., Pitsios K., Plavec D., Poethig D., Pohl W., Poplas Susic A., Popov T. A., Portejoie F., Potter P., Poulsen L., Prados-Torres A., Prarros F., Price D., Prokopakis E., Puy R., Rabe K., Raciborski F., Ramos J., Recto M. T., Reda S. M., Regateiro F., Reider N., Reitsma S., Repka-Ramirez S., Rimmer J., Rivero Yeverino D., Rizzo J. A., Robalo-Cordeiro C., Roberts G., Roche N., Rodriguez Gonzalez M., Rodriguez Zagal E., Rolland C., Roller-Wirnsberger R., Roman Rodriguez M., Romano A., Rombaux P., Romualdez J., Rosado-Pinto J., Rosario N., Rosenwasser L., Rottem M., Rouadi P., Rovina N., Rozman Sinur I., Ruiz M., Ruiz Segura L. T., Ryan D., Sagara H., Sakai D., Sakurai D., Saleh W., Salimaki J., Salina H., Samitas K., Sanchez Coronel M. G., Sanchez-Borges M., Sanchez-Lopez J., Sarafoleanu C., Sarquis Serpa F., Sastre-Dominguez J., Scadding G., Scheire S., Schmid-Grendelmeier P., Schuhl J. F., Schunemann H., Schvalbova M., Scichilone N., Sepulveda C., Serrano E., Sheikh A., Shields M., Shishkov V., Siafakas N., Simeonov A., Simons E. F., Sisul J. C., Sitkauskiene B., Skrindo I., Soklic Kosak T., Sole D., Sooronbaev T., Soto-Martinez M., Sova M., Spertini F., Spranger O., Stamataki S., Stefanaki L., Stellato C., Stelmach R., Sterk P., Strandberg T., Stute P., Subramaniam A., Suppli Ulrik C., Sutherland M., Sylvestre S., Syrigou A., Taborda Barata L., Takovska N., Tan R., Tan F., Tan V., Tang I. P., Taniguchi M., Tannert L., Tattersall J., Teixeira M. D. C., Thijs C., Thomas M., To T., Todo-Bom A. M., Togias A., Tomazic P. -V., Toppila-Salmi S., Toskala E., Triggiani M., Triller N., Triller K., Tsiligianni I., Ulmeanu R., Urbancic J., Urrutia Pereira M., Vachova M., Valdes F., Valenta R., Valentin Rostan M., Valero A., Vallianatou M., Valovirta E., Van Eerd M., Van Ganse E., Van Hage M., Vandenplas O., Vasankari T., Vassileva D., Ventura M. T., Vera-Munoz C., Vicheva D., Vichyanond P., Vidgren P., Viegi G., Vogelmeier C., Von Hertzen L., Vontetsianos T., Vourdas D., Wagenmann M., Walker S., Wallace D., Wang D. Y., Waserman S., Wickman M., Williams S., Williams D., Wilson N., Woo K., Wright J., Wroczynski P., Xepapadaki P., Yakovliev P., Yamaguchi M., Yan K., Yap Y. Y., Yawn B., Yiallouros P., Yoshihara S., Young I., Yusuf O. B., Zaidi A., Zaitoun F., Zar H., Zernotti M., Zhang L., Zhong N., Zidarn M., Zubrinich C., UCL - (MGD) Service de pneumologie, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, Bousquet J., Anto J.M., Iaccarino G., Czarlewski W., Haahtela T., Anto A., Akdis C.A., Blain H., Canonica G.W., Cardona V., Cruz A.A., Illario M., Ivancevich J.C., Jutel M., Klimek L., Kuna P., Laune D., Larenas-linnemann D., Mullol J., Papadopoulos N.G., Pfaar O., Samolinski B., Valiulis A., Yorgancioglu A., Zuberbier T., Abdul Latiff A.H., Abdullah B., Aberer W., Abusada N., Adcock I., Afani A., Agache I., Aggelidis X., Agustin J., Akdis C., Akdis M., Al-Ahmad M., Bassam A.A.-Z., Aldrey-Palacios O., Cuesta E.A., Alzaabi A., Amad S., Ambrocio G., Annesi-Maesano I., Ansotegui I., Anto J., Arshad H., Artesani M.C., Asayag E., Avolio F., Azhari K., Baiardini I., Bajrovic N., Bakakos P., Mongono S.B., Balotro-Torres C., Barba S., Barbara C., Barbosa E., Barreto B., Bartra J., Bateman E.D., Battur L., Bedbrook A., Barajas M.B., Beghe B., Bel E., Kheder A.B., Benson M., Berghea C., Bergmann K.-C., Bernstein D., Bewick M., Bialek S., Bialoszewski A., Bieber T., Billo N., Bilo M.B., Bindslev-Jensen C., Bjermer L., Marciniak M.B., Bond C., Boner A., Bonini M., Bonini S., Bosnic-Anticevich S., Bosse I., Botskariova S., Bouchard J., Boulet L.-P., Bourret R., Bousquet P., Braido F., Briggs A., Brightling C., Brozek J., Buhl R., Bumbacea R., Cabanas M.T.B., Bush A., Busse W.W., Buters J., Caballero-Fonseca F., Calderon M.A., Calvo M., Camargos P., Camuzat T., Cano A., Capriles-Hulett A., Caraballo L., Carlsen K.-H., Caro J., Carr W., Carreon-Asun-cion F., Carriazo A.M., Casale T., Castor M.A., Castro E., Cecchi L., Sarabia A.C., Chandrasekharan R., Chang Y.-S., Chato-Andeza V., Chatzi L., Chatzidaki C., Chavannes N.H., Chen Y., Cheng L., Chivato T., Chkhartishvili E., Christoff G., Chrystyn H., Chu D.K., Chua A., Chuchalin A., Chung K.F., Ciceran A., Cingi C., Ciprandi G., Cirule I., Coelho A.C., Constantinidis J., de Sousa J.C., Costa E., Costa D., Dominguez M.C.C., Coste A., Cox L., Cullen J., Custovic A., Cvetkovski B., D'amato G., Silva J.D., Dahl R., Dahlen S.-E., Daniilidis V., Nahhas L.D., Darsow U., Blay F., Guia E.D., Santos C., Keenoy E.D.M., Vries G.D., Deleanu D., Demoly P., Denburg J., Devillier P., Didier A., Dimou M., Dinh-Xuan A.T., Djukanovic R., Dokic D., Dominguez Silva M.G., Douagui H., Douladiris N., Doulaptsi M., Dray G., Dubakiene R., Durham S., Dykewicz M., Ebo D., Edelbaher N., Eklund P., El-Gamal Y., El-Sayed Z.A., El-Sayed S.S., El-Seify M., Emuzyte R., Enecilla L., Espinoza H., Guillermo J., Contreras E., Farrell J., Fernandez L., Wagner A.F., Fiocchi A., Fokkens W.J., Fontaine J.-F., Forastiere F., Perez J.M.F., Gaerlan-resureccion E., Gaga M., Romero J.L.G., Gamkrelidze A., Garcia A., Cobas C.Y.G., Garcia Cruz M.L.L.H., Gayraud J., Gemicioglu B., Genova S., Gereda J., Wijk R.G., Gomez M., Diaz S.G., Gotua M., Grigoreas C., Grisle I., Guidacci M., Guldemond N., Gutter Z., Guzman A., Halloum R., Hamelmann E., Hammadi S., Harvey R., Heinrich J., Hejjaoui A., Hellquist-Dahl B., Velazquez L.H., Hew M., Hossny E., Howarth P., Hrubisko M., Villalobos Y.R.H., Humbert M., Hyland M., Ibrahim M., Ilyina N., Irani C., Ispayeva Z., Jares E., Jarvis D., Jassem E., Jenko K., Uscanga R.D.J., Johnston S., Joos G., Jost M., Julge K., Jung K.-S., Just J., Kaidashev I., Kalayci O., Kalyoncu F., Kapsali J., Kardas P., Karjalainen J., Kasala C.A., Katotomichelakis M., Kazi B., Keil T., Keith P., Khaitov M., Khaltaev N., Kim Y.-Y., Kleine-Tebbe J., Koffi N'Goran B., Kompoti E., Kopac P., Koppelman G., Jeverica A.K., Kosnik M., Kostov K.V., Kowalski M.L., Kralimarkova T., Vrscaj K.K., Kraxner H., Kreft S., Kritikos V., Kudlay D., Kull I., Kupczyk M., Kvedariene V., Kyriakakou M., Lalek N., Lane S., Larenas-Linnemann D., Latiff A., Lau S., Lavrut J., Le L., Lessa M., Levin M., Li J., Lieberman P., Liotta G., Lipworth B., Liu X., Lobo R., Lodrup Carlsen K.C., Lombardi C., Louis R., Loukidis S., Lourenco O., Luna Pech J.A., Madjar B., Magnan A., Mahboub B., Mair A., Mais Y., van der Zee A.-H.M., Makela M., Makris M., Malling H.-J., Mandajieva M., Manning P., Manousakis M., Maragoudakis P., Marshall G., Martins P., Reza Masjedi M., Maspero J.F., Campos J.J.M., Maurer M., Mavale-Manuel S., Meco C., Melen E., Melo-Gomes E., Meltzer E.O., Menditto E., Menzies-Gow A., Merk H., Michel J.-P., Miculinic N., Midao L., Mihaltan F., Mikael K., Mikos N., Milenkovic B., Mitsias D., Moalla B., Moda G., Martinez M.D.M., Mohammad Y., Moin M., Molimard M., Momas I., Monaco A., Montefort S., Mora D., Morais-Almeida M., Mosges R., Mostafa B.E., Munter L., Muraro A., Murray R., Mustakov T., Naclerio R., Nadif R., Nakonechna A., Namazova-Baranova L., Navarro-Locsin G., Neffen H., Nekam K., Neou A., Nicod L., Niederberger-Leppin V., Niedoszytko M., Nieto A., Novellino E., Nunes E., Nyembue D., O'hehir R., Odjakova C., Ohta K., Okamoto Y., Okubo K., Oliver B., Onorato G.L., Orru M.P., Ouedraogo S., Ouoba K., Paggiaro P.L., Pagkalos A., Palaniappan S.P., Pali-Scholl I., Palkonen S., Palmer S., Bunu C.P., Panzner P., Papanikolaou V., Papi A., Paralchev B., Paraskevopoulos G., Park H.S., Passalacqua G., Patella V., Pavord I., Pawankar R., Pedersen S., Peleve S., Pereira A., Perez T., Pham-Thi N., Pigearias B., Pin I., Piskou K., Pitsios C., Pitsios K., Plavec D., Poethig D., Pohl W., Susic A.P., Popov T.A., Portejoie F., Potter P., Poulsen L., Prados-Torres A., Prarros F., Price D., Prokopakis E., Puy R., Rabe K., Raciborski F., Ramos J., Recto M.T., Reda S.M., Regateiro F., Reider N., Reitsma S., Repka-Ramirez S., Rimmer J., Yeverino D.R., Rizzo J.A., Robalo-Cordeiro C., Roberts G., Roche N., Gonzalez M.R., Zagal E.R., Rolland C., Roller-Wirns-berger R., Rodriguez M.R., Romano A., Rombaux P., Romualdez J., Rosado-Pinto J., Rosario N., Rosenwasser L., Rottem M., Rouadi P., Rovina N., Sinur I.R., Ruiz M., Segura L.T.R., Ryan D., Sagara H., Sakai D., Sakurai D., Saleh W., Salimaki J., Salina H., Samitas K.-N., Coronel M.G.S., Sanchez-Borges M., Sanchez-Lopez J., Sarafoleanu C., Serpa F.S., Sastre-Dominguez J., Scadding G., Scheire S., Schmid-Grendelmeier P., Schuhl J.F., Schunemann H., Schvalbova M., Scichilone N., Sepulveda C., Serrano E., Sheikh A., Shields M., Shishkov V., Siafakas N., Simeonov A., Simons E.F., Sisul J.C., Sitkauskiene B., Skrindo I., Kosak T.S., Sole D., Sooronbaev T., Soto-Martinez M., Sova M., Spertini F., Spranger O., Stamataki S., Stefanaki L., Stellato C., Stelmach R., Sterk P., Strandberg T., Stute P., Subramaniam A., Suppli Ulrik C., Sutherland M., Sylvestre S., Syrigou A., Barata L.T., Takovska N., Tan R., Tan F., Tan V., Tang I.P., Taniguchi M., Tannert L., Tattersall J., Teixeira M.D.C., Thijs C., Thomas M., To T., Todo-Bom A.M., Togias A., Tomazic P.-V., Toppila-Salmi S., Toskala E., Triggiani M., Triller N., Triller K., Tsiligianni I., Ulmeanu R., Urbancic J., Pereira M.U., Vachova M., Valdes F., Valenta R., Rostan M.V., Valero A., Vallianatou M., Valovirta E., Eerd M.V., Ganse E.V., Hage M., Vandenplas O., Vasankari T., Vassileva D., Ventura T., Vera-Munoz C., Vicheva D., Vichyanond P., Vidgren P., Viegi G., Vogelmeier C., Hertzen L.V., Vontetsianos T., Vourdas D., Wagenmann M., Walker S., Wallace D., Wang D.Y., Waserman S., Wickman M., Williams S., Williams D., Wilson N., Woo K., Wright J., Wroczynski P., Xepapadaki P., Yakovliev P., Yamaguchi M., Yan K., Yap Y.Y., Yawn B., Yiallouros P., Yoshihara S., Young I., Yusuf O.B., Zaidi A., Zaitoun F., Zar H., Zernotti M., Zhang L., Zhong N., Zidarn M., Zubrinich C., Dubakienė, Rūta, Ėmužytė, Regina, Kvedarienė, Violeta, Bousquet, J., Anto, J. M., Iaccarino, G., Czarlewski, W., Haahtela, T., Anto, A., Akdis, C. A., Blain, H., Canonica, G. W., Cardona, V., Cruz, A. A., Illario, M., Ivancevich, J. C., Jutel, M., Klimek, L., Kuna, P., Laune, D., Larenas-Linnemann, D., Mullol, J., Papadopoulos, N. G., Pfaar, O., Samolinski, B., Valiulis, A., Yorgancioglu, A., Zuberbier, T., Abdul Latiff, A. H., Abdullah, B., Aberer, W., Abusada, N., Adcock, I., Afani, A., Agache, I., Aggelidis, X., Agustin, J., Akdis, C., Akdis, M., Al-Ahmad, M., Al-Zahab Bassam, A., Aldrey-Palacios, O., Alvarez Cuesta, E., Alzaabi, A., Amad, S., Ambrocio, G., Annesi-Maesano, I., Ansotegui, I., Anto, J., Arshad, H., Artesani, M. C., Asayag, E., Avolio, F., Azhari, K., Baiardini, I., Bajrovic, N., Bakakos, P., Bakeyala Mongono, S., Balotro-Torres, C., Barba, S., Barbara, C., Barbosa, E., Barreto, B., Bartra, J., Bateman, E. D., Battur, L., Bedbrook, A., Bedolla Barajas, M., Beghe, B., Bel, E., Ben Kheder, A., Benson, M., Berghea, C., Bergmann, K. -C., Bernstein, D., Bewick, M., Bialek, S., Bialoszewski, A., Bieber, T., Billo, N., Bilo, M. B., Bindslev-Jensen, C., Bjermer, L., Bochenska Marciniak, M., Bond, C., Boner, A., Bonini, M., Bonini, S., Bosnic-Anticevich, S., Bosse, I., Botskariova, S., Bouchard, J., Boulet, L. -P., Bourret, R., Bousquet, P., Braido, F., Briggs, A., Brightling, C., Brozek, J., Buhl, R., Bumbacea, R., Burguete Cabanas, M. T., Bush, A., Busse, W. W., Buters, J., Caballero-Fonseca, F., Calderon, M. A., Calvo, M., Camargos, P., Camuzat, T., Cano, A., Capriles-Hulett, A., Caraballo, L., Carlsen, K. -H., Caro, J., Carr, W., Carreon-Asuncion, F., Carriazo, A. M., Casale, T., Castor, M. A., Castro, E., Cecchi, L., Cepeda Sarabia, A., Chandrasekharan, R., Chang, Y. -S., Chato-Andeza, V., Chatzi, L., Chatzidaki, C., Chavannes, N. H., Chen, Y., Cheng, L., Chivato, T., Chkhartishvili, E., Christoff, G., Chrystyn, H., Chu, D. K., Chua, A., Chuchalin, A., Chung, K. F., Ciceran, A., Cingi, C., Ciprandi, G., Cirule, I., Coelho, A. C., Constantinidis, J., Correia De Sousa, J., Costa, E., Costa, D., Costa Dominguez, M. D. C., Coste, A., Cox, L., Cullen, J., Custovic, A., Cvetkovski, B., D'Amato, G., Da Silva, J., Dahl, R., Dahlen, S. -E., Daniilidis, V., Darjazini Nahhas, L., Darsow, U., De Blay, F., De Guia, E., De Los Santos, C., De Manuel Keenoy, E., De Vries, G., Deleanu, D., Demoly, P., Denburg, J., Devillier, P., Didier, A., Dimou, M., Dinh-Xuan, A. T., Djukanovic, R., Dokic, D., Dominguez Silva, M. G., Douagui, H., Douladiris, N., Doulaptsi, M., Dray, G., Dubakiene, R., Durham, S., Dykewicz, M., Ebo, D., Edelbaher, N., Eklund, P., El-Gamal, Y., El-Sayed, Z. A., El-Sayed, S. S., El-Seify, M., Emuzyte, R., Enecilla, L., Espinoza, H., Espinoza Contreras, J. G., Farrell, J., Fernandez, L., Fink Wagner, A., Fiocchi, A., Fokkens, W. J., Fontaine, J. -F., Forastiere, F., Fuentes Perez, J. M., Gaerlan-Resureccion, E., Gaga, M., Galvez Romero, J. L., Gamkrelidze, A., Garcia, A., Garcia Cobas, C. Y., Garcia Cruz, M. D. L. L. H., Gayraud, J., Gemicioglu, B., Genova, S., Gereda, J., Gerth Van Wijk, R., Gomez, M., Gonzalez Diaz, S., Gotua, M., Grigoreas, C., Grisle, I., Guidacci, M., Guldemond, N., Gutter, Z., Guzman, A., Halloum, R., Hamelmann, E., Hammadi, S., Harvey, R., Heinrich, J., Hejjaoui, A., Hellquist-Dahl, B., Hernandez Velazquez, L., Hew, M., Hossny, E., Howarth, P., Hrubisko, M., Huerta Villalobos, Y. R., Humbert, M., Hyland, M., Ibrahim, M., Ilyina, N., Irani, C., Ispayeva, Z., Jares, E., Jarvis, D., Jassem, E., Jenko, K., Jimeneracruz Uscanga, R. D., Johnston, S., Joos, G., Jost, M., Julge, K., Jung, K. -S., Just, J., Kaidashev, I., Kalayci, O., Kalyoncu, F., Kapsali, J., Kardas, P., Karjalainen, J., Kasala, C. A., Katotomichelakis, M., Kazi, B., Keil, T., Keith, P., Khaitov, M., Khaltaev, N., Kim, Y. -Y., Kleine-Tebbe, J., Koffi N'Goran, B., Kompoti, E., Kopac, P., Koppelman, G., Koren Jeverica, A., Kosnik, M., Kostov, K. V., Kowalski, M. L., Kralimarkova, T., Kramer Vrscaj, K., Kraxner, H., Kreft, S., Kritikos, V., Kudlay, D., Kull, I., Kupczyk, M., Kvedariene, V., Kyriakakou, M., Lalek, N., Lane, S., Latiff, A., Lau, S., Lavrut, J., Le, L., Lessa, M., Levin, M., Li, J., Lieberman, P., Liotta, G., Lipworth, B., Liu, X., Lobo, R., Lodrup Carlsen, K. C., Lombardi, C., Louis, R., Loukidis, S., Lourenco, O., Luna Pech, J. A., Madjar, B., Magnan, A., Mahboub, B., Mair, A., Mais, Y., Maitland Van Der Zee, A. -H., Makela, M., Makris, M., Malling, H. -J., Mandajieva, M., Manning, P., Manousakis, M., Maragoudakis, P., Marshall, G., Martinsmartins, P., Masjedi, M. R., Maspero, J. F., Matta Campos, J. J., Maurer, M., Mavale-Manuel, S., Meco, C., Melen, E., Melo-Gomes, E., Meltzer, E. O., Menditto, E., Menzies-Gow, A., Merk, H., Michel, J. -P., Miculinic, N., Midao, L., Mihaltan, F., Mikael, K., Mikos, N., Milenkovic, B., Mitsias, D., Moalla, B., Moda, G., Mogica Martinez, M. D., Mohammad, Y., Moin, M., Molimard, M., Momas, I., Monaco, A., Montefort, S., Mora, D., Morais-Almeida, M., Mosges, R., Mostafa, B. E., Munter, L., Muraro, A., Murray, R., Mustakov, T., Naclerio, R., Nadif, R., Nakonechna, A., Namazova-Baranova, L., Navarro-Locsin, G., Neffen, H., Nekam, K., Neou, A., Nicod, L., Niederberger-Leppin, V., Niedoszytko, M., Nieto, A., Novellino, E., Nunes, E., Nyembue, D., O'Hehir, R., Odjakova, C., Ohta, K., Okamoto, Y., Okubo, K., Oliver, B., Onorato, G. L., Orru, M. P., Ouedraogo, S., Ouoba, K., Paggiaro, P. L., Pagkalos, A., Palaniappan, S. P., Pali-Scholl, I., Palkonen, S., Palmer, S., Panaitescu Bunu, C., Panzner, P., Papanikolaou, V., Papi, A., Paralchev, B., Paraskevopoulos, G., Park, H. S., Passalacqua, G., Patella, V., Pavord, I., Pawankar, R., Pedersen, S., Peleve, S., Pereira, A., Perez, T., Pham-Thi, N., Pigearias, B., Pin, I., Piskou, K., Pitsios, C., Pitsios, K., Plavec, D., Poethig, D., Pohl, W., Poplas Susic, A., Popov, T. A., Portejoie, F., Potter, P., Poulsen, L., Prados-Torres, A., Prarros, F., Price, D., Prokopakis, E., Puy, R., Rabe, K., Raciborski, F., Ramos, J., Recto, M. T., Reda, S. M., Regateiro, F., Reider, N., Reitsma, S., Repka-Ramirez, S., Rimmer, J., Rivero Yeverino, D., Rizzo, J. A., Robalo-Cordeiro, C., Roberts, G., Roche, N., Rodriguez Gonzalez, M., Rodriguez Zagal, E., Rolland, C., Roller-Wirnsberger, R., Roman Rodriguez, M., Romano, A., Rombaux, P., Romualdez, J., Rosado-Pinto, J., Rosario, N., Rosenwasser, L., Rottem, M., Rouadi, P., Rovina, N., Rozman Sinur, I., Ruiz, M., Ruiz Segura, L. T., Ryan, D., Sagara, H., Sakai, D., Sakurai, D., Saleh, W., Salimaki, J., Salina, H., Samitas, K., Sanchez Coronel, M. G., Sanchez-Borges, M., Sanchez-Lopez, J., Sarafoleanu, C., Sarquis Serpa, F., Sastre-Dominguez, J., Scadding, G., Scheire, S., Schmid-Grendelmeier, P., Schuhl, J. F., Schunemann, H., Schvalbova, M., Scichilone, N., Sepulveda, C., Serrano, E., Sheikh, A., Shields, M., Shishkov, V., Siafakas, N., Simeonov, A., Simons, E. F., Sisul, J. C., Sitkauskiene, B., Skrindo, I., Soklic Kosak, T., Sole, D., Sooronbaev, T., Soto-Martinez, M., Sova, M., Spertini, F., Spranger, O., Stamataki, S., Stefanaki, L., Stellato, C., Stelmach, R., Sterk, P., Strandberg, T., Stute, P., Subramaniam, A., Suppli Ulrik, C., Sutherland, M., Sylvestre, S., Syrigou, A., Taborda Barata, L., Takovska, N., Tan, R., Tan, F., Tan, V., Tang, I. P., Taniguchi, M., Tannert, L., Tattersall, J., Teixeira, M. D. C., Thijs, C., Thomas, M., To, T., Todo-Bom, A. M., Togias, A., Tomazic, P. -V., Toppila-Salmi, S., Toskala, E., Triggiani, M., Triller, N., Triller, K., Tsiligianni, I., Ulmeanu, R., Urbancic, J., Urrutia Pereira, M., Vachova, M., Valdes, F., Valenta, R., Valentin Rostan, M., Valero, A., Vallianatou, M., Valovirta, E., Van Eerd, M., Van Ganse, E., Van Hage, M., Vandenplas, O., Vasankari, T., Vassileva, D., Ventura, M. T., Vera-Munoz, C., Vicheva, D., Vichyanond, P., Vidgren, P., Viegi, G., Vogelmeier, C., Von Hertzen, L., Vontetsianos, T., Vourdas, D., Wagenmann, M., Walker, S., Wallace, D., Wang, D. Y., Waserman, S., Wickman, M., Williams, S., Williams, D., Wilson, N., Woo, K., Wright, J., Wroczynski, P., Xepapadaki, P., Yakovliev, P., Yamaguchi, M., Yan, K., Yap, Y. Y., Yawn, B., Yiallouros, P., Yoshihara, S., Young, I., Yusuf, O. B., Zaidi, A., Zaitoun, F., Zar, H., Zernotti, M., Zhang, L., Zhong, N., Zidarn, M., Zubrinich, C., University of Zurich, Bousquet, Jean, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Berlin Institute of Health (BIH), 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), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Center for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra [Barcelona] (UPF)-Catalunya ministerio de salud, IMIM-Hospital del Mar, Generalitat de Catalunya, Universitat Pompeu Fabra [Barcelona] (UPF), CIBER de Epidemiología y Salud Pública (CIBERESP), 'Federico II' University of Naples Medical School, Medical Consulting Czarlewski, Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Swiss Institute of Allergy and Asthma Research (SIAF), Universität Zürich [Zürich] = University of Zurich (UZH), Euromov (EuroMov), Université de Montpellier (UM), IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy., Vall d'Hebron University Hospital [Barcelona], ProAR – Nucleo de Excelencia em Asma, Universidade Federal da Bahia (UFBA), Global Alliance Against Chronic Respiratory Diseases (GARD-WHO), Division for Health Innovation, Servicio de Alergia e ImmunologiaBuenos Aires (Clinica Santa Isabel), Wrocław Medical University, Center for Rhinology and Allergology Wiesbaden, University Hospital Mannheim, Barlicki University Hospital, KYomed INNOV [Montpellier], Hospital Medica Sur [Mexico City, Mexico], Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona (UB), Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Royal Manchester Children's Hospital, University of Manchester [Manchester], General Children's Hospital of Athens P & A Kyriakou, Philipps Universität Marburg = Philipps University of Marburg, Medical University of Warsaw - Poland, Vilnius University [Vilnius], Manisa Celal Bayar University, and Salvy-Córdoba, Nathalie
Subjects: BLOOD-PRESSURE, Review, Angiotensin-converting enzyme, Antioxidant, Coronavirus, Diet, Food, law.invention, Dietary interventions, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, 10183 Swiss Institute of Allergy and Asthma Research, law, Medicine and Health Sciences, Immunology and Allergy, Medicine, 030212 general & internal medicine, [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, education.field_of_study, Mortality rate, 3. Good health, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, 2723 Immunology and Allergy, Angiotensin-converting enzyme, Antioxidant, Coronavirus, Diet, Food, Pulmonary and Respiratory Medicine, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Coronaviru, Immunology, Population, 610 Medicine & health, COVID-19, Settore MED/10 - Malattie Dell'Apparato Respiratorio, 03 medical and health sciences, Environmental health, population, angiotensin-converting enzyme, Quarantine, education, 2403 Immunology, ANTIHYPERTENSIVE PEPTIDES, business.industry, RC581-607, GENE, POLYMORPHISM, [SDV.AEN] Life Sciences [q-bio]/Food and Nutrition, 030228 respiratory system, 2740 Pulmonary and Respiratory Medicine, Immunologic diseases. Allergy, business, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, Regional differences, Coronavirus Infections
Abstract: Reported COVID-19 deaths in Germany are relatively low as compared to many European countries. Among the several explanations proposed, an early and large testing of the population was put forward. Most current debates on COVID-19 focus on the differences among countries, but little attention has been given to regional differences and diet. The low-death rate European countries (e.g. Austria, Baltic States, Czech Republic, Finland, Norway, Poland, Slovakia) have used different quarantine and/or confinement times and methods and none have performed as many early tests as Germany. Among other factors that may be significant are the dietary habits. It seems that some foods largely used in these countries may reduce angiotensin-converting enzyme activity or are anti-oxidants. Among the many possible areas of research, it might be important to understand diet and angiotensin-converting enzyme-2 (ACE2) levels in populations with different COVID-19 death rates since dietary interventions may be of great benefit.
Published: 2020

46. EUFOREA treatment algorithm for allergic rhinitis.

Author: Hellings P.W., Bachert C., Bjermer L., Canonica G.W., Cardell L.O., Carney A.S., Constantinidis J., Deneyer L., Diamant Z., Durham S., Gevaert P., Harvey R., Hopkins C., Kjeldsen A., Klimek L., Lund V.J., Price D., Rimmer J., Ryan D., Roberts G., Sahlstrand-Johnson P., Salmi S., Samji M., Scadding G., Smith P., Steinsvik A., Wagenmann M., Seys S., Wahn U., Fokkens W.J., Hellings P.W., Bachert C., Bjermer L., Canonica G.W., Cardell L.O., Carney A.S., Constantinidis J., Deneyer L., Diamant Z., Durham S., Gevaert P., Harvey R., Hopkins C., Kjeldsen A., Klimek L., Lund V.J., Price D., Rimmer J., Ryan D., Roberts G., Sahlstrand-Johnson P., Salmi S., Samji M., Scadding G., Smith P., Steinsvik A., Wagenmann M., Seys S., Wahn U., and Fokkens W.J.
Published: 2022

47. Characterization of Patients in the International Severe Asthma Registry with High Steroid Exposure Who Did or Did Not Initiate Biologic Therapy.

Author: Chen, W, Sadatsafavi, M, Tran, TN, Murray, RB, Wong, CBN, Ali, N, Ariti, C, Garcia Gil, E, Newell, A, Alacqua, M, Al-Ahmad, M, Altraja, A, Al-Lehebi, R, Bhutani, M, Bjermer, L, Bjerrum, AS, Bourdin, A, Bulathsinhala, L, von Bülow, A, Busby, J, Canonica, GW, Carter, V, Christoff, GC, Cosio, BG, Costello, RW, FitzGerald, JM, Fonseca, JA, Yoo, KH, Heaney, LG, Heffler, E, Hew, M, Hilberg, O, Hoyte, F, Iwanaga, T, Jackson, DJ, Jones, RC, Koh, MS, Kuna, P, Larenas-Linnemann, D, Lehmann, S, Lehtimäki, LA, Lyu, J, Mahboub, B, Maspero, J, Menzies-Gow, AN, Sirena, C, Papadopoulos, N, Papaioannou, AI, Pérez de Llano, L, Perng, D-W, Peters, M, Pfeffer, PE, Porsbjerg, CM, Popov, TA, Rhee, CK, Salvi, S, Taillé, C, Taube, C, Torres-Duque, CA, Ulrik, CS, Ra, SW, Wang, E, Wechsler, ME, Price, DB, Chen, W, Sadatsafavi, M, Tran, TN, Murray, RB, Wong, CBN, Ali, N, Ariti, C, Garcia Gil, E, Newell, A, Alacqua, M, Al-Ahmad, M, Altraja, A, Al-Lehebi, R, Bhutani, M, Bjermer, L, Bjerrum, AS, Bourdin, A, Bulathsinhala, L, von Bülow, A, Busby, J, Canonica, GW, Carter, V, Christoff, GC, Cosio, BG, Costello, RW, FitzGerald, JM, Fonseca, JA, Yoo, KH, Heaney, LG, Heffler, E, Hew, M, Hilberg, O, Hoyte, F, Iwanaga, T, Jackson, DJ, Jones, RC, Koh, MS, Kuna, P, Larenas-Linnemann, D, Lehmann, S, Lehtimäki, LA, Lyu, J, Mahboub, B, Maspero, J, Menzies-Gow, AN, Sirena, C, Papadopoulos, N, Papaioannou, AI, Pérez de Llano, L, Perng, D-W, Peters, M, Pfeffer, PE, Porsbjerg, CM, Popov, TA, Rhee, CK, Salvi, S, Taillé, C, Taube, C, Torres-Duque, CA, Ulrik, CS, Ra, SW, Wang, E, Wechsler, ME, and Price, DB
Abstract: BACKGROUND: Many severe asthma patients with high oral corticosteroid exposure (HOCS) often do not initiate biologics despite being eligible. This study aimed to compare the characteristics of severe asthma patients with HOCS who did and did not initiate biologics. METHODS: Baseline characteristics of patients with HOCS (long-term maintenance OCS therapy for at least 1 year, or ≥4 courses of steroid bursts in a year) from the International Severe Asthma Registry (ISAR; https://isaregistries.org/), who initiated or did not initiate biologics (anti-lgE, anti-IL5/5R or anti-IL4R), were described at the time of biologic initiation or registry enrolment. Statistical relationships were tested using Pearson's chi-squared tests for categorical variables, and t-tests for continuous variables, adjusting for potential errors in multiple comparisons. RESULTS: Between January 2015 and February 2021, we identified 1412 adult patients with severe asthma from 19 countries that met our inclusion criteria of HOCS, of whom 996 (70.5%) initiated a biologic and 416 (29.5%) did not. The frequency of biologic initiation varied across geographical regions. Those who initiated a biologic were more likely to have higher blood eosinophil count (483 vs 399 cells/µL, p=0.003), serious infections (49.0% vs 13.3%, p<0.001), nasal polyps (35.2% vs 23.6%, p<0.001), airflow limitation (56.8% vs 51.8%, p=0.013), and uncontrolled asthma (80.8% vs 73.2%, p=0.004) despite greater conventional treatment adherence than those who did not start a biologic. Both groups had similar annual asthma exacerbation rates in the previous 12 months (5.7 vs 5.3, p=0.147). CONCLUSION: Around one third of severe HOCS asthma patients did not receive biologics despite a similar high burden of asthma exacerbations as those who initiated a biologic therapy. Other disease characteristics such as eosinophilic phenotype, serious infectious events, nasal polyps, airflow limitation and lack of asthma control appear to dictate bio
Published: 2022

48. Positioning the principles of precision medicine in care pathways for allergic rhinitis and chronic rhinosinusitis – A EUFOREA‐ARIA‐EPOS‐AIRWAYS ICP statement

Author: Hellings, P. W., Fokkens, W. J., Bachert, C., Akdis, C. A., Bieber, T., Agache, I., Bernal‐Sprekelsen, M., Canonica, G. W., Gevaert, P., Joos, G., Lund, V., Muraro, A., Onerci, M., Zuberbier, T., Pugin, B., Seys, S. F., Bousquet, J., Aberer, W, Agache, I, Akdis, CA, Akdis, M, Alobid, I, Ankri, J, Annesi‐Maesano, I, Ansotegui, IJ, Anto, JM, Arnavielhe, S, Arshad, H, Asarnoj, A, Avolio, F, Bachert, C, Bachert, C, Baiardini, I, Barbagallo, M, Barbara, C, Baroody, F, Bateman, ED, Bedbrook, A, Beghé, B, Bel, EH, Bennoor, KS, Benson, M, Bergmann, KC, Bewick, M, Bialoszewski, AZ, Bieber, T, Bindslev‐Jensen, C, Bjermer, L, Blain, H, Blasi, F, Boner, AL, Bonini, M, Bonini, S, Bosnic‐Anticevich, S, Bosse, I, Bouchard, J, Boulet, LP, Bourret, R, Bousquet, J, Bousquet, PJ, Braido, F, Briggs, AH, Brightling, CE, Brozek, J, Bucca, C, Buhl, R, Bunu, C, Burte, E, Bush, A, Caballero‐Fonseca, F, Caimmi, DP, Calderon, MA, Camargos, PA, Camuzat, T, Canonica, GW, Cardona, V, Carlsen, KH, Carr, W, Carreiro‐Martins, P, Carriazo, AM, Casale, T, Cepeda Sarabia, AM, Cervin, A, Cesari, M, Chatzi, L, Chavannes, NH, Chiron, R, Chivato, T, Chkhartishvili, E, Chuchalin, AG, Chung, KF, Ciprandi, G, Cohen, N, Conzález Diaz, S, Cox, L, Crooks, G, Cruz, AA, Custovic, A, Dahl, R, Dahlen, SE, Darsow, U, De Carlo, G, De Manuel Keenoy, E, de Sousa, JC, De Vries, G, Dedeu, T, Deleanu, D, Demoly, P, Denburg, JA, Devillier, P, Didier, A, Dinh‐Xuan, AT, Dokic, D, Douagui, H, Douglas, R, Dray, G, Du Toit, G, Dubakiene, R, Durham, SR, Dykewicz, MS, Eklund, P, El‐Gamal, Y, Ellers, E, Emuzyte, R, Farrell, J, Fink Wagner, A, Fiocchi, A, Fletcher, M, Fokkens, WJ, Fonseca, J, Forastiere, F, Gaga, M, Gamkrelidze, A, Gemicioğlu, B, Georgalas, C, Gereda, JE, Gevaert, P, Goossens, H, Grisle, I, Guldemond, NA, Gutter, Z, Guzmán, MA, Haahtela, T, Harvey, R, Heinrich, J, Hellings, PW, Hellings, PW, Hellquist‐Dahl, B, Hopkins, C, Horak, F, Hourihane, JO, Humbert, M, Hyland, M, Iaccarino, G, Illario, M, Jares, EJ, Jeandel, C, Johnston, SL, Jonquet, O, Joos, G, Joos, G, Jung, KS, Just, J, Jutel, M, Kaidashev, I, Kalayci, O, Kalogjera, L, Kalyoncu, AF, Kardas, P, Keil, T, Keith, PK, Kerkhof, M, Kern, B, Kerstjens, HA, Khaitov, M, Khaltaev, N, Klimek, L, Kogevinas, M, Kolek, V, Koppelman, GH, Kowalski, M, Kowalski, ML, Kuitunen, M, Kull, I, Kuna, P, Kvedariene, V, Lambrecht, B, Larenas‐Linnemann, D, Lau, S, Laune, D, Le, LT, Li, J, Lieberman, P, Lipworth, B, Lodrup Carlsen, KC, Louis, R, Lund, VJ, Lupinek, C, MacNee, W, Magar, Y, Magnan, A, Mahboub, B, Maier, D, Majer, I, Malva, J, Manning, P, Marshall, GD, Masjedi, MR, Mathieu‐Dupas, E, Maurer, M, Mavale‐Manuel, S, Melén, E, Melo‐Gomes, E, Meltzer, EO, Mercier, J, Merk, H, Miculinic, N, Mihaltan, F, Milenkovic, B, Millot‐Keurinck, J, Mohammad, Y, Momas, I, Morais‐Almeida, M, Mösges, R, Mullol, J, Mullol, J, Muraro, A, Murray, R, Naclerio, R, Nadif, R, Namazova‐Baranova, L, Neffen, H, Nekam, K, Nieto, A, Niggemann, B, Nogueira‐Silva, L, Nogues, M, Nyembue, TD, OʼHehir, RE, Ohta, K, Okamoto, Y, Okubo, K, Olive‐Elias, M, Ouedraogo, S, Paggiaro, P, Pali‐Schöll, I, Palkonen, S, Panzner, P, Papadopoulos, NG, Papi, A, Park, HS, Passalacqua, G, Pawankar, R, Pedersen, S, Pereira, AM, Pfaar, O, Picard, R, Pigearias, B, Pin, I, Plavec, D, Pohl, W, Popov, TA, Portejoie, F, Postma, D, Potter, P, Poulsen, LK, Price, D, Price, D, Rabe, KF, Raciborski, F, Riechelmann, H, Robalo‐Cordeiro, C, Roberts, G, Rodenas, F, Rodriguez‐Mañas, L, Rolland, C, Roman Rodriguez, M, Romano, A, Rosado‐Pinto, J, Rosario, N, Rottem, M, Ryan, D, Samolinski, B, Sanchez‐Borges, M, Sastre‐Dominguez, J, Scadding, GK, Schlosser, R, Schmid‐Grendelmeier, P, Schunemann, HJ, Scichilone, N, Senior, B, Serrano, E, Sheikh, A, Shields, M, Simons, FER, Siroux, V, Sisul, JC, Skrindo, I, Smit, HA, Solé, D, Sooronbaev, T, Spranger, O, Stellato, C, Stelmach, R, Sterk, PJ, Strandberg, T, Sunyer, J, Thijs, C, Thomas, M, Todo‐Bom, A, Tomazic, PV, Toskala, E, Triggiani, M, Valenta, R, Valero, A, Valiulis, A, Valovirta, E, van Eerd, M, van Ganse, E, van Hage, M, van Wick, RG, Vandenplas, O, Varona, LL, Vazankari, T, Vellas, B, Ventura, MT, Vezzani, G, Viegi, G, Voegels, R, Vontetsianos, T, Wagenmann, M, Wahn, U, Walker, S, Wang, DY, Wang, Y, Werfel, T, Whalley, B, Wickman, M, Williams, DM, Williams, S, Wilson, N, Wormald, PJ, Wright, J, Yawn, BP, Yiallouros, PK, Yorgancioglu, A, Young, I, Yusuf, OM, Zaidi, A, Zar, HJ, Zernotti, ME, Zhang, L, Zhong, N, Zidarn, M, and Zuberbier, T
Published: 2017
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49. Allergy in severe asthma

Author: Del Giacco, S. R., Bakirtas, A., Bel, E., Custovic, A., Diamant, Z., Hamelmann, E., Heffler, E., Kalayci, Ö., Saglani, S., Sergejeva, S., Seys, S., Simpson, A., and Bjermer, L.
Published: 2017
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50. ARIA 2016: Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle

Author: Bousquet, J., Hellings, P. W., Agache, I., Bedbrook, A., Bachert, C., Bergmann, K. C., Bewick, M., Bindslev-Jensen, C., Bosnic-Anticevitch, S., Bucca, C., Caimmi, D. P., Camargos, P. A. M., Canonica, G. W., Casale, T., Chavannes, N. H., Cruz, A. A., De Carlo, G., Dahl, R., Demoly, P., Devillier, P., Fonseca, J., Fokkens, W. J., Guldemond, N. A., Haahtela, T., Illario, M., Just, J., Keil, T., Klimek, L., Kuna, P., Larenas-Linnemann, D., Morais-Almeida, M., Mullol, J., Murray, R., Naclerio, R., O’Hehir, R. E., Papadopoulos, N. G., Pawankar, R., Potter, P., Ryan, D., Samolinski, B., Schunemann, H. J., Sheikh, A., Simons, F. E. R., Stellato, C., Todo-Bom, A., Tomazic, P. V., Valiulis, A., Valovirta, E., Ventura, M. T., Wickman, M., Young, I., Yorgancioglu, A., Zuberbier, T., Aberer, W., Akdis, C. A., Akdis, M., Annesi-Maesano, I., Ankri, J., Ansotegui, I. J., Anto, J. M., Arnavielhe, S., Asarnoj, A., Arshad, H., Avolio, F., Baiardini, I., Barbara, C., Barbagallo, M., Bateman, E. D., Beghé, B., Bel, E. H., Bennoor, K. S., Benson, M., Białoszewski, A. Z., Bieber, T., Bjermer, L., Blain, H., Blasi, F., Boner, A. L., Bonini, M., Bonini, S., Bosse, I., Bouchard, J., Boulet, L. P., Bourret, R., Bousquet, P. J., Braido, F., Briggs, A. H., Brightling, C. E., Brozek, J., Buhl, R., Bunu, C., Burte, E., Bush, A., Caballero-Fonseca, F., Calderon, M. A., Camuzat, T., Cardona, V., Carreiro-Martins, P., Carriazo, A. M., Carlsen, K. H., Carr, W., Cepeda Sarabia, A. M., Cesari, M., Chatzi, L., Chiron, R., Chivato, T., Chkhartishvili, E., Chuchalin, A. G., Chung, K. F., Ciprandi, G., de Sousa, J. Correia, Cox, L., Crooks, G., Custovic, A., Dahlen, S. E., Darsow, U., Dedeu, T., Deleanu, D., Denburg, J. A., De Vries, G., Didier, A., Dinh-Xuan, A. T., Dokic, D., Douagui, H., Dray, G., Dubakiene, R., Durham, S. R., Du Toit, G., Dykewicz, M. S., Eklund, P., El-Gamal, Y., Ellers, E., Emuzyte, R., Farrell, J., Fink Wagner, A., Fiocchi, A., Fletcher, M., Forastiere, F., Gaga, M., Gamkrelidze, A., Gemicioğlu, B., Gereda, J. E., van Wick, R. Gerth, González Diaz, S., Grisle, I., Grouse, L., Gutter, Z., Guzmán, M. A., Hellquist-Dahl, B., Heinrich, J., Horak, F., Hourihane, J. O’. B., Humbert, M., Hyland, M., Iaccarino, G., Jares, E. J., Jeandel, C., Johnston, S. L., Joos, G., Jonquet, O., Jung, K. S., Jutel, M., Kaidashev, I., Khaitov, M., Kalayci, O., Kalyoncu, A. F., Kardas, P., Keith, P. K., Kerkhof, M., Kerstjens, H. A. M., Khaltaev, N., Kogevinas, M., Kolek, V., Koppelman, G. H., Kowalski, M. L., Kuitunen, M., Kull, I., Kvedariene, V., Lambrecht, B., Lau, S., Laune, D., Le, L. T. T., Lieberman, P., Lipworth, B., Li, J., Lodrup Carlsen, K. C., Louis, R., Lupinek, C., MacNee, W., Magar, Y., Magnan, A., Mahboub, B., Maier, D., Majer, I., Malva, J., Manning, P., De Manuel Keenoy, E., Marshall, G. D., Masjedi, M. R., Mathieu-Dupas, E., Maurer, M., Mavale-Manuel, S., Melén, E., Melo-Gomes, E., Meltzer, E. O., Mercier, J., Merk, H., Miculinic, N., Mihaltan, F., Milenkovic, B., Millot-Keurinck, J., Mohammad, Y., Momas, I., Mösges, R., Muraro, A., Namazova-Baranova, L., Nadif, R., Neffen, H., Nekam, K., Nieto, A., Niggemann, B., Nogueira-Silva, L., Nogues, M., Nyembue, T. D., Ohta, K., Okamoto, Y., Okubo, K., Olive-Elias, M., Ouedraogo, S., Paggiaro, P., Pali-Schöll, I., Palkonen, S., Panzner, P., Papi, A., Park, H. S., Passalacqua, G., Pedersen, S., Pereira, A. M., Pfaar, O., Picard, R., Pigearias, B., Pin, I., Plavec, D., Pohl, W., Popov, T. A., Portejoie, F., Postma, D., Poulsen, L. K., Price, D., Rabe, K. F., Raciborski, F., Roberts, G., Robalo-Cordeiro, C., Rodenas, F., Rodriguez-Mañas, L., Rolland, C., Roman Rodriguez, M., Romano, A., Rosado-Pinto, J., Rosario, N., Rottem, M., Sanchez-Borges, M., Sastre-Dominguez, J., Scadding, G. K., Scichilone, N., Schmid-Grendelmeier, P., Serrano, E., Shields, M., Siroux, V., Sisul, J. C., Skrindo, I., Smit, H. A., Solé, D., Sooronbaev, T., Spranger, O., Stelmach, R., Sterk, P. J., Strandberg, T., Sunyer, J., Thijs, C., Triggiani, M., Valenta, R., Valero, A., van Eerd, M., van Ganse, E., van Hague, M., Vandenplas, O., Varona, L. L., Vellas, B., Vezzani, G., Vazankari, T., Viegi, G., Vontetsianos, T., Wagenmann, M., Walker, S., Wang, D. Y., Wahn, U., Werfel, T., Whalley, B., Williams, D. M., Williams, S., Wilson, N., Wright, J., Yawn, B. P., Yiallouros, P. K., Yusuf, O. M., Zaidi, A., Zar, H. J., Zernotti, M. E., Zhang, L., Zhong, N., and Zidarn, M.
Published: 2016
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