Position Paper
Allergen immunotherapy in the current COVID-19 pandemic: A position paper of AeDA, ARIA, EAACI, DGAKI and GPA
Ludger Klimek, Oliver Pfaar, Margitta Worm, Karl-Christian Bergmann, Thomas Bieber, Roland Buhl, Jeroen Buters, Ulf Darsow, Thomas Keil, Jörg Kleine-Tebbe, Susanne Lau, Marcus Maurer, Hans Merk, Ralph Mösges, Joachim Saloga, Petra Staubach, Petra Stute, Klaus Rabe, Uta Rabe, Claus Vogelmeier, Tilo Biedermann, Kirsten Jung, Wolfgang Schlenter, Johannes Ring, Adam Chaker, Wolfgang Wehrmann, Sven Becker, Norbert Mülleneisen, Katja Nemat, Wofgang Czech, Holger Wrede, Randolf Brehler, Thomas Fuchs, Peter-Valentin Tomazic, Werner Aberer, Antje Fink-Wagner, Friedrich Horak, Stefan Wöhrl, Verena Niederberger-Leppin, Isabella Pali-Schöll, Wolfgang Pohl, Regina Roller-Wirnsberger, Otto Spranger, Rudolf Valenta, Mübecell Akdis, Cezmi Akdis, Karin Hoffmann-Sommergruber, Marek Jutel, Paolo Matricardi, FranÇois Spertini, Nikolai Khaltaev, Jean-Pierre Michel, Laurent Nicod, Peter Schmid-Grendelmeier, Eckard Hamelmann, Thilo Jakob, Thomas Werfel, Martin Wagenmann, Christian Taube, Michael Gerstlauer, Christian Vogelberg, Jean Bousquet, and Torsten Zuberbier
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Volume 4 (2020) p. 44 - 52
Abstract
Allergologie select, Volume 4/2020 (44-52)
Allergen immunotherapy in the current COVID-19 pandemic: A position paper of AeDA, ARIA, EAACI, DGAKI and GPA
Ludger Klimek1, Oliver Pfaar2, Margitta Worm3, Karl-Christian Bergmann3, Thomas Bieber4, Roland Buhl5, Jeroen Buters6, Ulf Darsow7, Thomas Keil8, Jörg Kleine-Tebbe9, Susanne Lau10, Marcus Maurer69, Hans Merk11, Ralph Mösges12,13,14, Joachim Saloga15, Petra Staubach15, Petra Stute16, Klaus Rabe17, Uta Rabe18, Claus Vogelmeier19, Tilo Biedermann7,20, Kirsten Jung21, Wolfgang Schlenter22, Johannes Ring23,24, Adam Chaker25,26, Wolfgang Wehrmann27, Sven Becker28, Norbert Mülleneisen29, Katja Nemat30,31, Wofgang Czech32, Holger Wrede33, Randolf Brehler34, Thomas Fuchs35, Peter-Valentin Tomazic36, Werner Aberer37, Antje Fink-Wagner38, Friedrich Horak39, Stefan Wöhrl40, Verena Niederberger-Leppin41, Isabella Pali-Schöll42,43, Wolfgang Pohl44, Regina Roller-Wirnsberger45, Otto Spranger38, Rudolf Valenta46, Mübecell Akdis47, Cezmi Akdis47, Karin Hoffmann-Sommergruber43, Marek Jutel48, Paolo Matricardi49, FranÇois Spertini50, Nikolai Khaltaev51, Jean-Pierre Michel52, Laurent Nicod53,54, Peter Schmid-Grendelmeier55, Eckard Hamelmann56, Thilo Jakob57, Thomas Werfel58, Martin Wagenmann59, Christian Taube60, Michael Gerstlauer67, Christian Vogelberg68, Jean Bousquet61,62,63,64,65,66, and Torsten Zuberbier3
1Zentrum für Rhinologie und Allergologie, Wiesbaden, 2Sektion Rhinologie und Allergologie, Klinik für Hals-, Nasen-und Ohrenheilkunde, Universitätsklinikum Gießen und Marburg, Philipps-Universität Marburg, 3Comprehensive Allergy Centre Charité, Klinik für Dermatologie, Venerologie und Allergologie, Charité – Universitätsmedizin Berlin, 4Klinik und Poliklinik für Dermatologie und Allergologie, Universitätsklinikum Bonn, 5III. Medizinische Klinik und Poliklinik Hämatologie, Internistische Onkologie und Pneumologie, Universitätsmedizin Mainz, 6Zentrum Allergie und Umwelt (ZAUM) Technische Universität und Helmholtz Zentrum München, 7Klinik und Poliklinik für Dermatologie und Allergologie der Technischen Universität München, 8Institut für klinische Epidemiologie und Biometrie, Julius-Maximilian-Universität, Würzburg, 9Allergie- und Asthma-Zentrum Westend, Berlin, 10Klinik für Pädiatrie m.S. Pneumologie, Immunologie und Intensivmedizin, Charité – Universitätsmedizin Berlin, 11Abteilung Dermatologie & Allergologie, RWTH Aachen Universität, 12Medizinische Fakultät der Universität zu Köln, 13CRI – Clinical Research International Ltd., Hamburg, 14ClinCompetence Cologne GmbH, Köln, 15Hautklinik, Universitätsmedizin, Johannes Gutenberg-Universität, Mainz, 16Europäische Vereinigung für Vitalität und Aktives Altern, Leipzig, 17Abteilung für Pneumologie, LungenClinic Grosshansdorf, 18Klinik für Allergologie, Johanniter-Krankenhaus im Fläming Treuenbrietzen GmbH, Treuenbrietzen, 19Klinik für Innere Medizin Schwerpunkt Pneumologie, Philipps-Universität Marburg, 20Einheit für Klinische Allergologie (EKA), Helmholtz Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH), Neuherberg, 21Praxis für Dermatologie, Immunologie und Allergologie, Erfurt, 22Ärzteverband Deutscher Allergologen, Dreieich, 23Haut- und Laserzentrum an der Oper, München, 24Academia: München, 25HNO-Klinik des Klinikums rechts der Isar, Technische Universität München, 26Zentrum Allergie und Umwelt München (ZAUM); Helmholtz Zentrum München, 27Praxis für Dermatologie und Allergologie, Münster, 28Klinik für Hals-, Nasen- und Ohrenheilkunde, Universität Tübingen, 29Asthma und Allergiezentrum Leverkusen, 30Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, Dresden, 31Praxis für Kinderpenumologie/Allergologie am Kinderzentrum Dresden (Kid), Dresden, 32Klinik für Dermatologie, Universität Freiburg, 33Hals-, Nasenund Ohrenarzt, Nordrhein-Westfalen, 34Klinik für Allergologie, Berufsdermatologie und Umweltmedizin, Universitätsklinikum Münster, 35Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum, Georg-August-Universität, Göttingen, 36Klinische Abteilung für Allgemeine HNO, Medizinische Universität Graz, Österreich, 37Universitätsklinik für Dermatologie und Venerologie, Medizinische Universität Graz, Österreich, 38Global Allergy and Airways Patient Platform GAAPP, Wien, Österreich, 39Praxis für Hals-, Nasen- und Ohrenkrankheiten, Wien, Österreich, 40Floridsdorfer Allergiezentrum, Wien, Österreich, 41Universitätsklinik für Hals-, Nasen- und Ohrenkrankheiten, Medizinische Universität Wien, Österreich, 42Institut für Komparative Medizin, Interdisziplinäres Messerli Forschungsinstitut, Veterinärmedizinische Universität Wien und Medizinische Universität Wien, Österreich, 43Institut für Pathophysiologie und Allergieforschung, Medizinische Universität Wien, Österreich, 44Abteilung für Atmungs- und Lungenkrankheiten, Krankenhaus Hietzing, Wien, Österreich, 45Universitätsklinik für Innere Medizin, Medizinische Universität Graz, Österreich, 46Institut für Pathophysiologie, Medizinische Universität Wien, Österreich, 47Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Schweiz, 48Department of Clinical Immunology, Medizinische Universität Breslau, Polen, 49Charité – Universitätsmedizin Berlin, 50Division of Allergy and Immunology, Centre Hospitalier Universitaire Vaudois, Lausanne, Schweiz, 51GARD Chairman, Genf, Schweiz, 52Department of Rehabilitation and Geriatrics, University of Geneva, Genf, Schweiz, 53Clinique Cecil, Hirslanden Gruppe, Lausanne, Schweiz, 54Abteilung Pneumologie, Centre hospitalier universitaire vaudois, Lausanne, Schweiz, 55Allergiestation, Dermatologische Klinik, Universitätsspital Zürich, Schweiz, 56Kinderzentrum Bethel, Evangelisches Klinikum Bethel, Universitätsmedizin OWL der Universität Bielefeld, 57Klinik für Dermatologie, Allergologie, Universitätsklinikum Gießen, UKGM, Justus-Liebig-Universität Gießen, 58Klinik fürDermatologie, Allergologie und Venerologie Medizinische Hochschule Hannover, 59HNO-Klinik, Universitätsklinikum Düsseldorf, 60Klinik für Pneumologie, Ruhrlandklinik, Universitätsmedizin Essen, 61MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, Frankreich, 62INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, 63Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, Frankreich, 64Euforea, Brussels, Belgien, 65Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, 66Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin, 67Abteilung für Kinderpneumologie und Allergologie, Medizinische Universität Augsburg, 68Klinik für Kinderpneumologie und Allergologie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, 69Dermatologische Allergologie, Allergie-Centrum-Charité, Klinik für Dermatologie, Venerologie und Allergologie, Charité – Universitätsmedizin Berlin
Correspondence to:
Prof. Dr. Ludger Klimek, Zentrum für Rhinologie und Allergologie, An den Quellen 10, 65183 Wiesbaden
Email: [email protected]
Position Paper
Use of biologicals in allergic and type-2 inflammatory diseases during the current COVID-19 pandemic
Ludger Klimek, Oliver Pfaar, Margitta Worm, Thomas Eiwegger, Jan Hagemann, Markus Ollert, Eva Untersmayr, Karin Hoffmann-Sommergruber, Alessandra Vultaggio, Ioana Agache, Sevim Bavbek, Apostolos Bossios, Ingrid Casper, Susan Chan, Alexia Chatzipetrou, Christian Vogelberg, Davide Firinu, Paula Kauppi, Antonios Kolios, Akash Kothari, Andrea Matucci, Oscar Palomares, Zsolt Szépfalusi, Wolfgang Pohl, Wolfram Hötzenecker, Alexander R. Rosenkranz, Karl-Christian Bergmann, Thomas Bieber, Roland Buhl, Jeroen Buters, Ulf Darsow, Thomas Keil, Jörg Kleine-Tebbe, Susanne Lau, Marcus Maurer, Hans Merk, Ralph Mösges, Joachim Saloga, Petra Staubach, Uta Jappe, Klaus F. Rabe, Uta Rabe, Claus Vogelmeier, Tilo Biedermann, Kirsten Jung, Wolfgang Schlenter, Johannes Ring, Adam Chaker, Wolfgang Wehrmann, Sven Becker, Laura Freudelsperger, Norbert Mülleneisen, Katja Nemat, Wolfgang Czech, Holger Wrede, Randolf Brehler, Thomas Fuchs, Peter-Valentin Tomazic, Werner Aberer, Antje-Henriette Fink-Wagner, Fritz Horak, Stefan Wöhrl, Verena Niederberger-Leppin, Isabella Pali-Schöll, Wolfgang Pohl, Regina Roller-Wirnsberger, Otto Spranger, Rudolf Valenta, Mübecell Akdis, Paolo M. Matricardi, François Spertini, Nicolai Khaltaev, Jean-Pierre Michel, Larent Nicod, Peter Schmid-Grendelmeier, Marco Idzko, Eckard Hamelmann, Thilo Jakob, Thomas Werfel, Martin Wagenmann, Christian Taube, Erika Jensen-Jarolim, Stephanie Korn, Francois Hentges, Jürgen Schwarze, Liam O´Mahony, Edward F. Knol, Stefano del Giacco, Tomás Chivato Pérez, Jean Bousquet, Anna Bedbrook, Torsten Zuberbier, Cezmi Akdis, and Marek Jutel
Volume 4 (2020) p. 53 - 68
Abstract
Allergologie select, Volume 4/2020 (53-68)
Use of biologicals in allergic and type-2 inflammatory diseases during the current COVID-19 pandemic
Ludger Klimek1, Oliver Pfaar2, Margitta Worm3, Thomas Eiwegger4,5,6, Jan Hagemann7, Markus Ollert8,9, Eva Untersmayr10, Karin Hoffmann-Sommergruber10, Alessandra Vultaggio11, Ioana Agache12, Sevim Bavbek13, Apostolos Bossios14,15, Ingrid Casper1,16,17, Susan Chan18, Alexia Chatzipetrou19, Christian Vogelberg20, Davide Firinu21, Paula Kauppi22, Antonios Kolios16,23, Akash Kothari4, Andrea Matucci11, Oscar Palomares24, Zsolt Szépfalusi25, Wolfgang Pohl26, Wolfram Hötzenecker27, Alexander R. Rosenkranz28, Karl-Christian Bergmann3, Thomas Bieber29, Roland Buhl30, Jeroen Buters31, Ulf Darsow32, Thomas Keil33, Jörg Kleine-Tebbe34, Susanne Lau35, Marcus Maurer98, Hans Merk36, Ralph Mösges37,38,39, Joachim Saloga40, Petra Staubach40, Uta Jappe41, Klaus F. Rabe42, Uta Rabe42, Claus Vogelmeier44, Tilo Biedermann32,45, Kirsten Jung46, Wolfgang Schlenter47, Johannes Ring48,49, Adam Chaker50,51, Wolfgang Wehrmann52, Sven Becker53, Laura Freudelsperger7, Norbert Mülleneisen54, Katja Nemat55, Wolfgang Czech56, Holger Wrede57, Randolf Brehler58, Thomas Fuchs59, Peter-Valentin Tomazic60, Werner Aberer61, Antje-Henriette Fink-Wagner62, Fritz Horak63, Stefan Wöhrl64, Verena Niederberger-Leppin65, Isabella Pali-Schöll10,66,67, Wolfgang Pohl68, Regina Roller-Wirnsberger69, Otto Spranger70, Rudolf Valenta71,94,95,96, Mübecell Akdis72, Paolo M. Matricardi73, François Spertini74, Nicolai Khaltaev75, Jean-Pierre Michel76, Larent Nicod77, Peter Schmid-Grendelmeier78, Marco Idzko79, Eckard Hamelmann80, Thilo Jakob81, Thomas Werfel82, Martin Wagenmann83, Christian Taube84, Erika Jensen-Jarolim10,66, Stephanie Korn30, Francois Hentges85, Jürgen Schwarze86, Liam O´Mahony87, Edward F. Knol88, Stefano del Giacco89, Tomás Chivato Pérez90, Jean Bousquet91,92,93,94,95, Anna Bedbrook91, Torsten Zuberbier3, Cezmi Akdis72, and Marek Jutel96,97
1Zentrum für Rhinologie und Allergologie, Wiesbaden, 2HNO-Universitätsklinik Marburg, Sektion Rhinologie und Allergologie, Medizinische Fakultät Marburg, Philipps-Universität Marburg, 3Comprehensive Allergy Centre Charité, Klinik für Dermatologie, Venerologie und Allergologie, Charité – Universitätsmedizin Berlin, Germany, 4Translational Medicine Program, Peter Gilgan Centre for Research and Learning, Hospital for Sick Children, Toronto, Ontario, Canada, 5Division of Immunology and Allergy, Food Allergy and Anaphylaxis Program, The Hospital for Sick Children, Toronto, Ontario, Canada, 6Department of Immunology, University of Toronto, Toronto, Ontario, Canada, 7Hals-, Nasen-, Ohrenklinik und Poliklinik, Universitätsmedizin Mainz, Germany 8Department of Infection and Immunity, Luxembourg Institute of Health (LIH), Esch-sur-Alzette, Luxemburg, 9Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis, University of Southern Denmark, Odense, Denmark, 10Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medizinische Fakultät der Universität Wien, Vienna, Austria, 11Immunoallergology Unit, Careggi University Hospital, Florence, Italy, 12Transylvania University, Brasov, Romania, 13Ankara University, School of Medicine, Department of Chest Disease, Division of, Immunology and Allergy, Ankara, Turkey, 14Abteilung für Atemwegsmedizin und Allergie, Karolinska University Hospital, Huddinge und Abteilung für Medizin, Huddinge, Karolinska Institutet, Stockholm, Sweden, 15Zentrum für Allergieforschung, Karolinska Institutet, Stockholm, Sweden, 16Department of Immunology, University Hospital Zürich, Zürich, Switzerland, 17Faculty of Medicine, University of Zürich, Zürich, Switzerland, 18Guy’s and St. Thomas’ NHS Foundation Trust, Westminster Bridge Road, London, United Kingdom, King’s College London School of Life Course Sciences & School of Immunology & Microbial Sciences, King’s Health Partners, United Kingdom, 19Allergy Unit 2nd Department of Dermatology and Venereology, National University of Athens, Medical School, University General Hospital „ATTIKON“, Athen, Greece, 20Universitätsklinikum Carl Gustav Carus, Klinik und Poliklinik für Kinder- und Jugendmedizin, Fachbereich Kinderpneumologie/Allergologie, Dresden, Germany 21Department of Medical Sciences and Public Health, University of Cagliari, Monserrato, Italy, 22Abteilung für Allergie, Entzündungszentrum, Universitätsklinikum Helsinki, Helsinki, Finland, 23Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA, 24Department of Biochemistry and Molecular Biology, Chemistry School, Complutense University of Madrid, Spain, 25Abteilung für Pädiatrische Pulmologie, Allergologie und Endokrinologie, Universitätsklinik für Kinder- und Jugendheilkunde, Comprehensive Center for Pediatrics, Medizinische Universität Wien, Vienna, Austria, 26Abteilung für Atmungs- und Lungenerkrankungen, Krankenhaus Hietzing, Vienna, Austria, 27Abteilung für Dermatologie und Venerologie, Kepler Universitätsklinikum, Linz, Austria, 28Klinische Abteilung für Nephrologie, Universitätsklinik für Innere Medizin, Medizinische Universität Graz, Graz, Austria, 29Klinik für Dermatologie und Allergologie, Universität Bonn, Bonn, 30Schwerpunkt Pneumologie, III. Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz, Mainz, 31Zentrum Allergie und Umwelt (ZAUM) Technische Universität und Helmholtz Zentrum München, 32Klinik und Poliklinik für Dermatologie und Allergologie der Technischen Universität München, 33Institut für Klinische Epidemiologie und Biometrie, Universität Würzburg, 34Allergie- und Asthma-Zentrum Westend, Berlin, 35Klinik für Pädiatrie m.S. Pneumologie, Immunologie und Intensivmedizin, Charité – Universitätsmedizin Berlin, 36Abteilung Dermatologie und Allergologie, RWTH Universität, Aachen, 37Medizinische Fakultät der Universität zu Köln, Cologne 38CRI – Clinical Research International Ltd., Hamburg, 39ClinCompetence Cologne GmbH, Köln, Cologne 40Hautklinik und Poliklinik, Universitätsmedizin Mainz, 41Forschungsgruppe Klinische und Molekulare Allergologie des Forschungszentrums Borstel, Airway Research Center North (ARCN), Mitglied des Deutschen Zentrums für Lungenforschung (DZL); Interdisziplinäre Allergie-Ambulanz, Medizinische Klinik III, Universität zu Lübeck, 42LungenClinic Grosshansdorf, Großhansdorf, 43Klinik für Allergologie, Johanniter-Krankenhaus im Fläming Treuenbrietzen GmbH, Treuenbrietzen, 44Klinik für Innere Medizin Schwerpunkt Pneumologie, Philipps-Universität Marburg, 45Einheit für Klinische Allergologie (EKA), Helmholtz Zentrum München, German Research Center for Environmental Health GmbH, Neuherberg, 46Praxis für Dermatologie, Immunologie und Allergologie, Erfurt, 47Ärzteverband Deutscher Allergologen, Dreieich, 48Haut- und Laserzentrum an der Oper, München, Munich, 49Academia München, 50HNO-Klinik, Universitätsklinik TUM, München, 51ZAUM, Helmholtz Zentrum München, Munich 52Praxis für Dermatologie und Allergologie, Münster, 53Klinik für Hals-, Nasen- und Ohrenheilkunde, Universität Tübingen, 54Asthma und Allergiezentrum Leverkusen, 55Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus, Dresden; Praxis für Kinderpenumologie/Allergologie am Kinderzentrum Dresden (Kid), Dresden, 56Praxis und Klinik für Dermatologie/Allergologie am Schwarzwald-Baar Klinikum, Villingen-Schwenningen, 57Hals-, Nasen- und Ohrenarzt, Nordrhein-Westfalen, 58Universitätsklinikum Münster, Klinik für Hautkrankheiten, Ambulanz für Allergologie, Berufsdermatologie und Umweltmedizin, Münster, 59Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum, Georg-August-Universität, Göttingen, Germany 60Klinische Abteilung für allgemeine HNO, Medizinische Universität Graz, Austria, 61Universitätsklinik für Dermatologie und Venerologie, Medizinische Universität Graz, Austria, 62Global Allergy and Airways Patient Platform GAAPP, Vienna, Austria, 63Allergiezentrum Wien West, Vienna, Austria, 64Floridsdorfer Allergiezentrum, Vienna, Austria, 65Universitätsklinik für Hals-, Nasen- und Ohrenkrankheiten, Medizinische Universität Vienna, Austria, 66Komperative Medizin, Interdisziplinäres Messerli Forschungsinstitut, Veterinärmedizinische Universität Wien, Medizinische Universität Wien, 67Institut für Pathophysiologie und Allergieforschung, Medizinische Universität Wien, 68Abteilung für Atmungs- und Lungenerkrankungen, Krankenhaus Hietzing, Vienna, Austria, 69Universitätsklinik für Innere Medizin, Medizinische Universität Graz, Austria, 70Österreichische Lungenunion, Vienna, Austria, 71Immunopathologie, Abteilung für Pathophysiologie und Allergieforschung, Zentrum für Pathophysiologie, Infektiologie und Immunologie, Medizinische Universität Wien, Austria, 72Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland, 73Charité – Universitätsmedizin Berlin, 74Division of Allergy and Immunology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland, 75GARD Chairman, Genf, Switzerland, 76Department of Rehabilitation and Geriatrics, University of Geneva, Genf, Switzerland, 77Clinic Cecil of Hirslanden Group of Lausanne; Centre Hôpitalier Universitaire du canton de Vaud Lausanne, Switzerland, 78Allergiestation, Dermatologische Klinik, Universitätsspital Zürich, Switzerland, 79Klinische Abteilung für Pneumologie, Universitätsklinik für Innere Medizin II, Medizinische Universität Wien, Austria, 80Kinderzentrum Bethel, Evangelisches Klinikum Bethel, Universitätsmedizin OWL der Universität Bielefeld, 81Klinik für Dermatologie und Allergologie, Universitätsklinikum Gießen, UKGM, Justus-Liebig-Universität, Gießen, 82Klinik für Dermatologie, Allergologie und Venerologie Medizinische Hochschule Hannover, 83HNO-Klinik, Universitätsklinikum Düsseldorf, 84Universitätsklinikum Essen (AöR), Germany 85Service Immunologie-Allergologie Centre Hospitalier de Luxembourg, Luxemburg, 86Kinderleben und Gesundheit, Universität von Edinburgh, United Kingdom, 87Medicine and Microbiology, APC Microbiome Ireland, National University of Ireland, Cork, Irland, 88Departments of Immunology, Dermatology and Allergology, University Medical Center Utrecht, the Netherlands, 89Università degli Studi di Cagliari, Cagliari, Italy, 90University Foundation San Pablo CEU, Madrid, Spain, 91MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France, 92INSERM U 1168, VIMA: Ageing and chronic diseases Epidemiological and public health approaches, Villejuif, France, 93Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France, 94Euforea, Brussels, Belgium, 95Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Germany 96Department of Clinical Immunology, Wrocław Medical University, Wrocław, Poland, 97ALL-MED Medical Research Institute, Wrocław, Poland, and 98Dermatologische Allergologie, Allergie-Centrum-Charité, Klinik für Dermatologie, Venerologie und Allergologie, Charité – Universitätsmedizin Berlin, Germany
Background: Since the beginning of the COVID-19 pandemic, the treatment of patients with allergic and atopy-associated diseases has faced major challenges. Recommendations for “social distancing” and the fear of patients becoming infected during a visit to a medical facility have led to a drastic decrease in personal doctor-patient contacts. This affects both acute care and treatment of the chronically ill. The immune response after SARS-CoV-2 infection is so far only insufficiently understood and could be altered in a favorable or unfavorable way by therapy with monoclonal antibodies. There is currently no evidence for an increased risk of a severe COVID-19 course in allergic patients. Many patients are under ongoing therapy with biologicals that inhibit type 2 immune responses via various mechanisms. There is uncertainty about possible immunological interactions and potential risks of these biologicals in the case of an infection with SARS-CoV-2. Materials and methods: A selective literature search was carried out in PubMed, Livivo, and the internet to cover the past 10 years (May 2010 – April 2020). Additionally, the current German-language publications were analyzed. Based on these data, the present position paper provides recommendations for the biological treatment of patients with allergic and atopy-associated diseases during the COVID-19 pandemic. Results: In order to maintain in-office consultation services, a safe treatment environment must be created that is adapted to the pandemic situation. To date, there is a lack of reliable study data on the care for patients with complex respiratory, atopic, and allergic diseases in times of an imminent infection risk from SARS-CoV-2. Type-2-dominant immune reactions, as they are frequently seen in allergic patients, could influence various phases of COVID-19, e.g., by slowing down the immune reactions. Theoretically, this could have an unfavorable effect in the early phase of a SARS-Cov-2 infection, but also a positive effect during a cytokine storm in the later phase of severe courses. However, since there is currently no evidence for this, all data from patients treated with a biological directed against type 2 immune reactions who develop COVID-19 should be collected in registries, and their disease courses documented in order to be able to provide experience-based instructions in the future. Conclusion: The use of biologicals for the treatment of bronchial asthma, atopic dermatitis, chronic rhinosinusitis with nasal polyps, and spontaneous urticaria should be continued as usual in patients without suspected infection or proven SARS-CoV-2 infection. If available, it is recommended to prefer a formulation for self-application and to offer telemedical monitoring. Treatment should aim at the best possible control of difficult-to-control allergic and atopic diseases using adequate rescue and add-on therapy and should avoid the need for systemic glucocorticosteroids. If SARS-CoV-2 infection is proven or reasonably suspected, the therapy should be determined by weighing the benefits and risks individually for the patient in question, and the patient should be involved in the decision-making. It should be kept in mind that the potential effects of biologicals on the immune response in COVID-19 are currently not known. Telemedical offers are particularly desirable for the acute consultation needs of suitable patients.Correspondence to:
Prof. Dr. Ludger Klimek, Zentrum für Rhinologie und Allergologie, An den Quellen 10, 65183 Wiesbaden
Email: [email protected]
Review
SARS-CoV-2 and allergy – what have we learned after two and a half years?
Knut Brockow, Rosi Wang, Sonja Mathes, Rebekka Bent, Valentina Faihs, Bernadette Eberlein, Ulf Darsow, and Tilo Biedermann
Volume 7 (2023) p. 101 - 112
Abstract
Allergologie select, Vol. 7/2023 (101-112)
SARS-CoV-2 and allergy – what have we learned after two and a half years?
Knut Brockow, Rosi Wang, Sonja Mathes, Rebekka Bent, Valentina Faihs, Bernadette Eberlein, Ulf Darsow, and Tilo Biedermann
Department of Dermatology and Allergy Biederstein, Technical University of Munich, Faculty of Medicine, Munich, Germany
Background: Coronavirus disease-2019 (COVID-19) has significantly hampered the regular workflow for allergists and allergy departments. Materials and methods: The purpose of this review is to highlight our own experiences on SARS-CoV-2 and allergy as well as to discuss findings from the literature. Results: Vaccination against SARS-CoV-2 is needed for protection against severe infection. Skin reactions may arise with SARS-CoV-2 infections. Short-term general immune reactions and skin reactions are also possible upon SARS-CoV-2 vaccination; however, they recur in only a proportion of patients during follow-up vaccinations. Initial reports of anaphylaxis after vaccination fueled public fear. On the other hand, more recent epidemiologic data do not show a substantially increased anaphylaxis risk compared with other vaccines. Fear-related reactions may be essential for many “anaphylaxis” reports. In Germany, the flow chart developed by Paul-Ehrlich-Institut (PEI) and Robert-Koch-Institut (RKI) together with the allergological societies helps to care for patients with suspected “allergy history” safely and effectively. Through this, patients with increased risk of anaphylaxis to SARS-CoV-2 vaccines and their ingredients (e.g., polyethylene glycol (PEG), polysorbate 80) are identified. However, since only small amounts of these excipients are contained in mRNA vaccines, even some PEG-allergic patients can tolerate the vaccination. In Germany, an allergy test-guided procedure is recommended for high-risk patients, including an allergy history, prick tests, intradermal and basophil activation tests, and, if necessary, provocation tests. This also appears effective for anxiety reduction in patients with vaccination skepticism. To date, all of our patients have been able to be vaccinated with SARS-CoV-2 vaccines without the occurrence of significant reactions. Conclusion: Many initial concerns about unexpected side effects of SARS-CoV-2 vaccination have not been confirmed. The flowchart and, in the case of suspicion of hypersensitivity, an allergy test-guided risk assessment helps to reduce patients’ fear of vaccination and enables safe vaccination.Correspondence to:
Knut Brockow, Department of Dermatology and Allergy Biederstein, Technical University of Munich, Faculty of Medicine, Biedersteiner Straße 29, 80802 Munich, Germany
Email: [email protected]
Original
High-risk groups for alpha-gal sensitization
Marie Benders-Guedj, Martin Köberle, Heidelore Hofmann, Tilo Biedermann, and Ulf Darsow
Volume 7 (2023) p. 140 - 148
Abstract
Allergologie select, Vol. 7/2023 (140-148)
High-risk groups for alpha-gal sensitization
Marie Benders-Guedj, Martin Köberle, Heidelore Hofmann, Tilo Biedermann, and Ulf Darsow
Department of Dermatology and Allergy Biederstein, Faculty of Medicine, Technical University of Munich, Munich, Germany
Background: Tick bite-induced IgE-mediated reactions to the oligosaccharide galactose α-1,3-galactose (alpha-gal) are increasingly recognized. This study investigated alpha-gal sensitization in three groups with different tick bite exposure. Materials and methods: Specific IgE antibodies to alpha-gal and total IgE were investigated in 485 patients with Lyme borreliosis with different disease manifestations and compared to a control group of 200 randomly selected patients without increased exposure to tick bites. A group of 232 hunters and forest workers served as a model for multiple tick bites. Results: Specific IgE (sIgE) antibodies to alpha-gal (> 0.1 kU/L) were found in 12.6% of all borreliosis samples compared to the control group with 9% (relative risk 1.4; 95% CI 0.85 – 2.3; not significant (n.s.). The highest prevalence of sIgE to alpha-gal was observed in hunters and forest service employees (22.8%, relative risk 2.5; 95% CI 1.5 – 4.2; p < 0.001). Higher age and elevated total IgE were also associated with alpha-gal sensitization. Conclusion: IgE sensitization to alpha-gal tends to be more frequent in tick-exposed patients with borreliosis than in controls (n.s.). Moreover, hunters and forest workers show an even higher rate of elevated IgE to alpha-gal. Thus, frequent tick contact may result in alpha-gal sensitization. In the area of Munich, the prevalence of alpha-gal sensitization appears lower than in the state of Baden-Württemberg and lower than in the USA, which may be due to the difference in tick species or the frequency of tick exposure. This study could show that alpha-gal sensitization and presumably alpha-gal syndrome does not seem to be a modern problem but existed already more than 30 years ago.Correspondence to:
Prof. Dr. U. Darsow, Department of Dermatology and Allergy Biederstein, School of Medicine, Technical University of Munich, Biedersteiner Str. 29, 80802 Munich, Germany
Email: [email protected]
Review
Basophil activation test in Hymenoptera venom allergy
Bernadette Eberlein, Knut Brockow, Ulf Darsow, Tilo Biedermann, and Simon Blank
Volume 8 (2024) p. 293 - 298
Abstract
Allergologie select, Vol. 8/2024 (293-298)
Basophil activation test in Hymenoptera venom allergy
Bernadette Eberlein1, Knut Brockow1, Ulf Darsow1, Tilo Biedermann1, and Simon Blank2
1Department of Dermatology and Allergy Biederstein, School of Medicine and Health, Technical University of Munich, and 2Center of Allergy and Environment (ZAUM), Technical University of Munich, School of Medicine and Helmholtz Center Munich, German Research Center for Environmental Health, Munich, Germany
Before starting venom-specific immunotherapy (VIT), systemic sting reactions to Hymenoptera venoms require allergological workup in order to prove an IgEmediated reaction and to identify the culprit insect venom. In addition to skin tests and the determination of specific IgE antibodies, the basophil activation test (BAT) using flow cytometry has emerged as a powerful tool and sensitive marker for this purpose in recent years. BAT seems to have a better informative value in terms of clinical relevance compared to the other tests. In Hymenoptera venom allergies, BAT is particularly useful for the diagnosis of cases with unclear or contradictory history and sensitization profile. Its results are associated with adverse reactions during VIT and efficacy of VIT and therefore have a certain predictive value for side effects and treatment failure of VIT. In research, it is mainly used to characterize the allergenic components of Hymenoptera venoms. This review article focuses on these topics.Correspondence to:
Prof. Dr. Bernadette Eberlein, Department of Dermatology and Allergy Biederstein, School of Medicine and Health, Technical University of Munich, Biedersteiner Str. 29, 80802 Munich, Germany
Email: [email protected]
Case Report
Occupational buckwheat allergy in a health food store employee: From inhalative exposure to anaphylaxis
Julia Felicitas Pilz, Valentina Faihs, Claudia Kugler, Ulf Darsow, Tilo Biedermann, and Knut Brockow
Volume 9 (2025) p. 47 - 49
Abstract
Allergologie select, Vol. 9/2025 (47-49)
Occupational buckwheat allergy in a health food store employee: From inhalative exposure to anaphylaxis
Julia Felicitas Pilz, Valentina Faihs, Claudia Kugler, Ulf Darsow, Tilo Biedermann, and Knut Brockow
Department of Dermatology and Allergy Biederstein, School of Medicine and Health, Technical University of Munich (TUM), Munich, Germany
Background: Buckwheat allergy is common in East Asian countries with high buckwheat consumption. However, with increasing popularity of buckwheat as a gluten-free food, it is also expected to become more widespread in Europe. Case report: A health food store employee experienced anaphylaxis with urticaria, angioedema, and dyspnea after eating a slice of buckwheat bread. Prior to this reaction, the patient had repeatedly noticed rhinoconjunctival itching and sneezing when handling buckwheat. A positive skin prick test with buckwheat flour and elevated specific IgE levels to buckwheat confirmed the suspected diagnosis. Conclusion: Food industry employees may develop sensitization to buckwheat through inhalation of buckwheat flour. This sensitization can lead to rhinoconjunctival symptoms upon airborne exposure and to anaphylaxis after ingestion.Correspondence to:
Dr. med. Julia Felicitas Pilz, Department of Dermatology and Allergy Biederstein, Klinikum rechts der Isar, Technical University of Munich, Biedersteiner Str. 29, 80802 Munich, Germany
Email: [email protected]
Guideline
Update of the evidence- and consensus-based S3 guideline on atopic dermatitis: Systemic therapy with biologics or Janus kinase inhibitors and specific aspects of systemic therapy in pregnancy and lactation
Thomas Werfel, Annice Heratizadeh, Matthias Augustin, Christine Bangert, Andrea Bauer, Tilo Biedermann, Richard Brans, Nadine Domröse, Uwe Gieler, Oliver Gießler-Fichtner, Eckard Hamelmann, Selina Hampe, Ruben Heuer, Julia Kahle, Maria Kinberger, Markus Koch, Meike Köhler, Franz Legat, Katja Nemat, Irena Neustädter, Eva M. J. Peters, Susanne Radonjic-Hoesli, Imke Reese, Peter Schmid-Grendelmeier, Uta-Katharina Schmidt-Göhrich, Jochen Schmitt, Christina Schnopp, Thomas Schwennesen, Dagmar Simon, Kristina Stamos, Christian Termeer, Regina Treudler, Ralph von Kiedrowski, Iris Wagner, Anja Waßmann-Otto, Gesine Weckmann, Ricardo Niklas Werner, Andreas Wollenberg, Margitta Worm, and Hagen Ott
Volume 10 (2026) p. 120 - 144
Abstract
Allergologie select, Vol. 10/2026 (120-144)
Update of the evidence- and consensus-based S3 guideline on atopic dermatitis: Systemic therapy with biologics or Janus kinase inhibitors and specific aspects of systemic therapy in pregnancy and lactation
Thomas Werfel1, Annice Heratizadeh1, Matthias Augustin2, Christine Bangert3, Andrea Bauer4, Tilo Biedermann5, Richard Brans6, Nadine Domröse1, Uwe Gieler7, Oliver Gießler-Fichtner8, Eckard Hamelmann9, Selina Hampe10, Ruben Heuer11, Julia Kahle10, Maria Kinberger11, Markus Koch12, Meike Köhler13, Franz Legat14, Katja Nemat15,16, Irena Neustädter17, Eva M. J. Peters18, Susanne Radonjic-Hoesli19, Imke Reese20, Peter Schmid-Grendelmeier21, Uta-Katharina Schmidt-Göhrich22, Jochen Schmitt23, Christina Schnopp5, Thomas Schwennesen24, Dagmar Simon19, Kristina Stamos16, Christian Termeer25,26, Regina Treudler27, Ralph von Kiedrowski28, Iris Wagner24, Anja Waßmann-Otto29, Gesine Weckmann30, Ricardo Niklas Werner11, Andreas Wollenberg31,32, Margitta Worm33, and Hagen Ott13,34
1Department of Dermatology and Allergy, Hannover Medical School, Hannover, 2Competence Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany, 3Department of Dermatology, Medical University of Vienna, Vienna, Austria, 4Department of Dermatology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, 5TUM University Hospital, Department of Dermatology and Allergy, Munich, 6Institute for Interdisciplinary Dermatological Prevention and Rehabilitation (iDerm) at the Osnabrück University, Osnabrück, 7Department of Psychosomatic Medicine and Psychotherapy, University Hospital Gießen, Gießen, 8Gaißach Specialist Clinic of DRV Bayern Süd, Gaißach, 9Children’s Center, Evangelical Hospital Bethel, University Hospital OWL, University of Bielefeld, Bielefeld, 10German Allergy and Asthma Association (DAAB), Mönchengladbach, 11Department of Dermatology, Venereology and Allergology, Division of Evidence Based Medicine in Dermatology (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, 12Alpenklinik Santa Maria, Bad Hindelang, 13Section for Integrated Pediatric Dermatology (iKinD), Munich Center for Children with Medical and Developmental Complexity, LMU University Hospital, Munich, Germany, 14Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria, 15Practice for pediatric pneumology and allergology, Children’s Center Dresden-Friedrichstadt (Kid), 16Department of Pediatrics, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, 17Hospital Hallerwiese, Cnopfsche Kinderklinik, Nuremberg, 18Psychoneuroimmunology Laboratory, Department of Psychosomatic Medicine and Psychotherapy, Justus-Liebig University Gießen, Gießen, Germany, 19Department of Dermatology, Inselspital Bern, Bern, Switzerland, 20Private Practice for Dietary Advice and Nutrition Therapy with Special Interest in Adverse Reactions to Food, Munich, Germany, 21Allergy Unit, Department of Dermatology, University Hospital Zurich and Christine Kuehne Center for Allergy Research and Education CK-CARE Davos, Switzerland, 22 Carus Family Practice at Dresden University Hospital, 23Center for Evidence-Based Healthcare (ZEGV), University Hospital Dresden and Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, 24German Eczema Association (DNB), Hamburg, 25Dermatology Practice at Löwenmarkt, Stuttgart-Weilimdorf, 26Department of Dermatology, University-Hospital Freiburg, Freiburg, 27Institute of Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, 28Selters Dermatology Practice, Selters, 29Mensing Derma MVZ, Hamburg, 30Weckmann Institute of Medical and Healthcare Education, Rostock, 31Department of Dermatology and Allergology, University Hospital Augsburg, Augsburg, 32Clinic and Polyclinic for Dermatology and Allergology, Ludwig Maximilian University, Munich, 33Department of Dermatology, Venereology, and Allergology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, and 34Department of Pediatric Surgery, Dr. Von Hauner Children’s Hospital, LMU University Hospital, Munich, Germany
This guideline is a partial update of the S3 guideline on atopic dermatitis (AWMF register no. 013-027) published in 2023. The chapters on systemic therapy with biologics and Janus kinase inhibitors as well as the chapter on pregnancy, breastfeeding and family planning in the context of systemic therapies for atopic dermatitis have been updated. This was prompted by new approvals (lebrikizumab, nemolizumab), approval extensions (abrocitinib from 12 years of age, baricitinib from 2 years of age) and new evidence on the use of biologics before and during pregnancy. In addition, a new chapter on treatment goals, treatment expectations and criteria for treatment adjustment (“treat-to-target”) in systemic therapies has been added to the guideline. This article only presents the updated and newly added chapters. The complete guideline is available on the AWMF website.Correspondence to:
PD Dr. Annice Heratizadeh, Department of Dermatology and Allergy, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany
Email: [email protected]
Case Report
Resolution of childhood wheat allergy through evolution into WALDA? A case report
Charlotte J. Kiani, Valentina Faihs, Claudia Kugler, Julia F. Pilz, Tilo Biedermann, and Knut Brockow
Volume 10 (2026) p. 114 - 119
Abstract
Allergologie select, Vol. 10/2026 (114-119)
Resolution of childhood wheat allergy through evolution into WALDA? A case report
Charlotte J. Kiani1, Valentina Faihs1, Claudia Kugler1, Julia F. Pilz1, Tilo Biedermann1, and Knut Brockow1,2
1Department of Dermatology and Allergy, Technical University of Munich, TUM School of Medicine and Health, Munich, Germany, and 2Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
Background: Wheat allergy may present with different phenotypes. Childhood-onset wheat allergy is characterized by immediate-type IgE-mediated reactions to wheat ingestion alone. It typically affects atopic individuals and often resolves spontaneously. The predominant adult-onset phenotype is WALDA (wheat allergy dependent on augmentation factors), triggered only when wheat is consumed in combination with augmentation factors. Phenotypic transition between these forms is rarely described. Case report: We present the case of a 30-year-old atopic female patient with a history of wheat-induced anaphylaxis, who presented with three distinct stages, compatible with a phenotypic transition. In infancy, the patient was diagnosed with classical IgE-mediated wheat allergy. In early adulthood, she developed augmentation factor-dependent reactions compatible with WALDA. At the age of 30, comprehensive oral food challenge testing and serological analysis revealed full clinical tolerance and loss of sensitization. Conclusion: This case illustrates a possible transient clinical course of wheat allergy with WALDA as an intermediate stage prior to resolution. Such cases may be underreported, as patients with declining wheat allergy may not be identified as having WALDA reactions, but rather as having inconstant reactivity. Allergy reassessment in adult patients with food allergy in childhood is essential to detect phenotypic shifts or to confirm resolution.Correspondence to:
Dr. med. Valentina Faihs, Department of Dermatology and Allergy, Technical University of Munich, TUM School of Medicine and Health, Biedersteiner Str. 29, 80802 Munich, Germany
Email: [email protected]
