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
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
Biologics for atopic diseases: Indication, side effect management, and new developments
Uta Jappe, Hendrik Beckert, Karl-Christian Bergmann, Askin Gülsen, Ludger Klimek, Sandra Philipp, Julia Pickert, Michèle M. Rauber-Ellinghaus, Harald Renz, Christian Taube, Regina Treudler, Martin Wagenmann, Thomas Werfel, Margita Worm, and Torsten Zuberbier
Volume 5 (2021) p. 1 - 25
Abstract
Allergologie select, Vol. 5/2021 (1-25)
Biologics for atopic diseases: Indication, side effect management, and new developments
Uta Jappe1,2, Hendrik Beckert3, Karl-Christian Bergmann4, Askin Gülsen2, Ludger Klimek5, Sandra Philipp6, Julia Pickert7, Michèle M. Rauber-Ellinghaus8, Harald Renz9, Christian Taube3, Regina Treudler10, Martin Wagenmann11, Thomas Werfel12, Margita Worm13, and Torsten Zuberbier14
1Research Group Clinical and Molecular Allergology of the Research Center Borstel, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), 2Interdisciplinary Allergy Outpatient Clinic, Medical Clinic III, University of Lübeck, 3Department of Pulmonary Medicine, University Hospital Essen – Ruhrlandklinik, Essen, 4Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 5Center for Rhinology and Allergology, Wiesbaden, 6Dermatology practice Dr. Markus Friedrich/Dr. Sandra Philipp, Oranienburg, 7Department of Dermatology and Allergology, University Hospital Gießen and Marburg, Marburg site, 8Experimental Dermatology and Allergology, Justus Liebig University Giessen, 9Department of Medicine, Institute of Laboratory Medicine and Pathobiochemistry – Molecular Diagnostics, Member of the German Centre for Lung Research (DZL), Philipps-University, Marburg, 10Leipzig Comprehensive Allergy Center LICA-CAC, Department of Dermatology, Venereology and Allergology, University of Leipzig, 11Department of Otorhinolaryngology, HNO-Klinik, Universitätsklinikum Düsseldorf, Düsseldorf, 12Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, 13Dermatology, Venerology and Allergology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, 14Department of Dermatology and Allergy, Charité Universitätsmedizin, Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Comprehensive Allergy Center, Berlin, Germany
With the advent of biologicals, more and more therapeutics are available that specifically address specific switch points in the pathomechanism of immunologically dominated diseases. Thus, the focus of diagnostics and therapy (precision medicine) is more on the individual disease characteristics of the individual patient. Regarding the different phenotypes of atopic diseases, severe asthma was the first entity for which biologicals were approved, followed by urticaria, and finally atopic dermatitis and chronic rhinosinusitis with nasal polyps. Experience in the treatment of severe bronchial asthma has shown that the intensity of the response to biological therapy depends on the quality of clinical and immunological phenotyping of the patients. This also applies to different diseases of the atopic form, as patients can suffer from several atopic diseases at the same time, each with different characteristics. Biologics are already emerging that may represent a suitable therapy for allergic bronchial asthma, which often occurs together with severe neurodermatitis, and chronic rhinosinusitis with nasal polyps. In practice, however, the question of possible combinations of biologicals for the therapy of complex clinical pictures of individual patients is increasingly arising. In doing so, the side effect profile must be taken into account, including hypersensitivity reactions, whose diagnostic and logistical management must aim at a safe and efficient therapy of the underlying disease. Increased attention must also be paid to biological therapy in pregnancy and planned (predictable) vaccinations as well as existing infections, such as SARS-CoV-2 infection. Before starting a biological therapy, the immune status should be checked with regard to chronic viral and bacterial infections and, if necessary, the vaccination status should be refreshed or missing vaccinations should be made up for before starting therapy. Currently, reliable data on the effect of biologicals on the immunological situation of SARS-CoV-2 infection and COVID-19 are not available. Therefore, research and development of suitable diagnostic methods for detection of immunologically caused side effects as well as detection of potential therapy responders and non-responders is of great importance.Correspondence to:
Prof. Dr. med. Uta Jappe, Research Center Borstel, Leibniz Lung Center, Parkallee 35, 23845 Borstel
Email: [email protected]
Review
Nonpharmacological measures to prevent allergic symptoms in pollen allergy: A critical review
Karl-Christian Bergmann, Markus Berger, Ludger Klimek, Oliver Pfaar, Barbora Werchan, Matthias Werchan, and Torsten Zuberbier
Volume 5 (2021) p. 349 - 360
Abstract
Allergologie select, Vol. 5/2021 (349-360)
Nonpharmacological measures to prevent allergic symptoms in pollen allergy: A critical review
Karl-Christian Bergmann1, Markus Berger2, Ludger Klimek3, Oliver Pfaar4, Barbora Werchan5, Matthias Werchan5, and Torsten Zuberbier1
1Charité, Universitätsmedizin Berlin, Clinic for Dermatology, Venereology and Allergy, Berlin, Germany, 2Institut für Pathophysiologie und Allergieforschung, Zentrum für Pathophysiologie, Infektiologie und Immunologie, Medizinische Universität Wien, Vienna, Austria, 3Center for Rhinology and Allergology, Wiesbaden, 4Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, 5German Pollen Information Service Foundation (PID), Berlin, Germany
Allergic rhinoconjunctivitis (hay fever) is the most common chronic disease in all industrialized nations. Therapy consists essentially in the use of anti-allergic and anti-inflammatory drugs, which mostly show a good and quick effect. With allergenspecific immunotherapy, there is also a causal possibility of tolerance induction. There is currently a considerable undersupply, as those affected trivialize the symptoms and often have concerns about long-term drug therapy. There is also great interest in using non-medicinal measures to prevent and/or relieve allergic symptoms on the assumption that these are free from side effects. In this publication, we present non-drug methods for which clinical studies are available in the literature. The methods have varying degrees of effectiveness. An evidence-based comparative assessment between the methods is not possible. There are also hardly any studies in comparison to standard drug therapy. A large number of the interventions consist of allergen reduction, e.g., with air filters, or cleaning of the mucous membranes with nasal irrigation, etc., none of which should be seen as a substitute but as a supplement to drug therapy.Correspondence to:
Prof. Dr. Karl-Christian Bergmann, Charité, Universitätsmedizin Berlin, Klinik für Dermatologie, Venerologie und Allergie, Luisenstraße 2, 10117 Berlin, Germany
Email: [email protected]
Case Report
Oral mite anaphylaxis (pancake syndrome) caused by storage mite Acarus siro and its treatment with allergen immunotherapy
Tanjana Preiser-Funke and Karl-Christian Bergmann
Volume 7 (2023) p. 113 - 115
Abstract
Allergologie select, Vol. 7/2023 (113-115)
Oral mite anaphylaxis (pancake syndrome) caused by storage mite Acarus siro and its treatment with allergen immunotherapy
Tanjana Preiser-Funke1 and Karl-Christian Bergmann2
1Nuss-Anaphylaxie Netzwerk e.V., Wiesbaden, and 2Institute of Allergology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany, and Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
A 10-year-old atopic patient with asthma, peanut, and house dust mite allergy developed frequent episodes with symptoms including abdominal pain, nausea, vomiting, dizziness, drop of blood pressure, and occasionally shortness of breath and wheezing. After detailed diagnostics including an ISAC test and several other specific IgE blood tests, which could not explain the symptoms, the patient tested positive for specific IgE to Acarus siro (flour mites) (9.2 kU/L). As no oral food challenge with Acarus siro was available, the patient’s family implemented avoidance measures by storing food containing flour in the refrigerator, and the patient started subcutaneous immunotherapy (SCIT) with Depigoid Acarus siro. The implementation of avoidance measures led to an immediate improvement of symptoms, and after 3 years of treatment, products containing flour, stored at room temperature, are tolerated again.Correspondence to:
Prof. Karl-Christian Bergmann, Charité – Universitätsmedizin Berlin, Ambulanz: Campus
Benjamin Franklin, Haus 2, Hindenburgdamm 30, 12200 Berlin, Germany, and Tanjana Preiser-Funke, Nuss-Anaphylaxie Netzwerk e.V., Philipp-Holl Str. 4, 65195 Wiesbaden
Email: [email protected]; [email protected]
Original
Individual wearable air purifier protects against pollen, house dust mite, and cat allergens: Report from an allergen exposure chamber
Karl-Christian Bergmann, Teresa Hartung, and Torsten Zuberbier
Volume 8 (2024) p. 70 - 77
Abstract
Allergologie select, Vol. 8/2024 (70-77)
Individual wearable air purifier protects against pollen, house dust mite, and cat allergens: Report from an allergen exposure chamber
Karl-Christian Bergmann1,2, Teresa Hartung2, and Torsten Zuberbier1
1Institute of Allergology, Charité-Universitätsmedizin Berlin, and 2European Center Allergy Research Foundation, Berlin, Germany
Purpose: Evaluation of a new individual wearable air purifier (Respiray Wear A+) for birch pollen, house dust mite (HDM), and cat-allergic rhinoconjunctivitis (ARC) patients in a standardized allergen exposure chamber (AEC). Materials and methods: Eligible allergic patients were exposed to birch pollen, HDM raw material, and cat allergen in an AEC for 60 minutes without (V1) and with (V3) the use of the Respiray device. Nasal, ocular, bronchial, and other symptoms were rated by the patients every 10 minutes, and their wellbeing, peak nasal inspiratory flow (PNIF), and lung function parameters were assessed every 30 minutes. The primary endpoint was the change in the median of the total symptom score (TSS) at V3 compared to V1 at 60 minutes of exposure. The secondary endpoints consisted of the total nasal symptom score (TNSS) and total eye symptom score (TESS). Results: 23 patients with birch pollen allergy, 37 patients with HDM allergy, and 41 patients with cat allergy were included in the analysis. Significant reduced symptom scores of ~ 49% were observed when using Respiray Wea A+ under birch pollen exposure (p < 0.05) in the primary endpoint TSS (V3 2.43 compared to V1 4.78). An 48% reduction of symptoms was seen in TSS in case of HDM exposure (V3 3.59; V1 6.92, (t-test: p < 0.01)) and the highest reduction of TSS (60%) under Respiray A+ using cat allergens (V3 2.95, V1 7.44, (t-test p < 0.01) after 60 minutes of exposure. The personal wellbeing revealed clinically meaningful improvements over time in all three studies which manifested in a lower symptom increase during the final allergen exposures. Conclusion: The individual wearable air purifier Respiray Wear A+ protects significantly against airborne pollen, HDM, and cat allergens and may be a very useful device for avoiding indoor allergens in a new way.Correspondence to:
Prof. Karl-Christian Bergmann, Institute of Allergology, Charité-Universitätsmedizin Berlin, or European Centre For Allergy Research Foundation, Berlin, Germany
Email: [email protected]
Guideline
AWMF mold guideline “Medical clinical diagnostics for indoor mold exposure” – Update 2023 AWMF Register No. 161/001
Julia Hurraß, Birger Heinzow, Sandra Walser-Reichenbach, Ute Aurbach, Sven Becker, Romuald Bellmann, Karl-Christian Bergmann, Oliver A. Cornely, Steffen Engelhart, Guido Fischer, Thomas Gabrio, Caroline E.W. Herr, Marcus Joest, Christian Karagiannidis, Ludger Klimek, Martin Köberle, Annette Kolk, Herbert Lichtnecker, Thomas Lob-Corzilius, Norbert Mülleneisen, Dennis Nowak, Uta Rabe, Monika Raulf, Jörg Steinmann, Jens-Oliver Steiß, Jannik Stemler, Ulli Umpfenbach, Kerttu Valtanen, Barbora Werchan, Birgit Willinger, and Gerhard A. Wiesmüller
Volume 8 (2024) p. 90 - 198
Abstract
Allergologie select, Vol. 8/2024 (90-198)
AWMF mold guideline “Medical clinical diagnostics for indoor mold exposure” – Update 2023 AWMF Register No. 161/001
Julia Hurraß1,a,b, Birger Heinzow2,a, Sandra Walser-Reichenbach3,a,b, Ute Aurbach4,5,a, Sven Becker6,a, Romuald Bellmann7,a, Karl-Christian Bergmann8,a,b, Oliver A. Cornely9,a, Steffen Engelhart10,a,b, Guido Fischer11,a, Thomas Gabrio12,a, Caroline E.W. Herr3,13,a,b, Marcus Joest14,a, Christian Karagiannidis15,16,a, Ludger Klimek17,a,b, Martin Köberle18,a,b, Annette Kolk19,a, Herbert Lichtnecker20,a, Thomas Lob-Corzilius21,a,b, Norbert Mülleneisen22,a,b, Dennis Nowak23,a,b, Uta Rabe24,a,b, Monika Raulf25,a,b, Jörg Steinmann26,a, Jens-Oliver Steiß27,28,a,b, Jannik Stemler9,a, Ulli Umpfenbach29,a, Kerttu Valtanen30,a, Barbora Werchan31,a, Birgit Willinger32,a,b, and Gerhard A. Wiesmüller4,5,33,a,b
1Section for Hygiene in Healthcare Facilities, Division of Infection Control and Environmental Hygiene, Cologne Health Department, Cologne, 2Formerly: State Agency for Social Services (LAsD) Schleswig-Holstein, Kiel, 3Bavarian Health and Food Safety Authority, Munich, 4Laboratory Dr. Wisplinghoff, 5ZfMK – Center for Environment, Hygiene and Mycology Cologne, Cologne, 6Department for Otorhinolaryngology, Head and Neck Surgery, University Medical Center Tübingen, Tübingen, Germany, 7Department of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria, 8Institute of Allergology Charité, Charité – University Medicine Berlin, Berlin, 9Institute for Translational Research, CECAD Cluster of Excellence, University of Cologne, Cologne, Germany and Department I for Internal Medicine, Cologne University Hospital, Cologne, 10Institute for Hygiene and Public Health, University Hospital Bonn, Bonn, 11Baden-Württemberg State Health Office in the Stuttgart Regional Council, Stuttgart, 12Formerly: Baden-Württemberg State Health Office in the Stuttgart Regional Council, Stuttgart, 13Environmental Health and Prevention, Institute and Polyclinic for Occupational, Social and Environmental Medicine, University of Munich Hospital Ludwig-Maximilians-University, Munich, 14Allergological-Immunological Laboratory, Helios Lung and Allergy Center Bonn, Bonn, 15Faculty of Health, Professorship for Extracorporeal Lung Replacement Procedures, University of Witten/Herdecke, Witten/Herdecke, 16Lung Clinic Cologne Merheim, Clinics of the City of Cologne, Cologne, 17Center for Rhinology and Allergology, Wiesbaden, 18Department of Dermatology and Allergy Biederstein, School of Medicine, Technical University of Munich, Munich, 19Institute for Occupational Safety and Health (IFA) of the German Social Accident Insurance (DGUV), Unit Biological Agents, Sankt Augustin, 20Medical Institute for Environmental and Occupational Medicine MIU GmbH Erkrath, Erkrath, 21Scientific working group of environmental medicine of the German Society of Pediatric Allergology (GPAU), 22Asthma and Allergy Center Leverkusen, Leverkusen, 23Institute and Polyclinic for Occupational, Social and Environmental Medicine, member of the German Center for Lung Research, Hospital of the University of Munich, Munich, 24Center for Allergology and Asthma, Johanniter Hospital Treuenbrietzen, Treuenbrietzen, 25Institute for Prevention and Occupational Medicine of the German Statutory Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, 26Center for Pediatrics and Adolescent Medicine, University Hospital Giessen and Marburg GmbH, Giessen, 27Specialized Practice in Allergology and Pediatric Pulmonology in Fulda, Fulda, 28Institute for Clinical Hygiene, Medical Microbiology and Clinical Infectiology, Paracelsus Private Medical University Nuremberg Clinic, Nuremberg, 29Doctor for Pediatrics and Adolescent Medicine, Pediatric Pulmonology, Environmental Medicine, Classical Homeopathy, Asthma Trainer, Neurodermatitis Trainer, Viersen, 30FG II 1.4 Microbiological Risks, German Environment Agency, Berlin, 31German Pollen Information Service Foundation (PID), Berlin, Germany, 32Department of Laboratory Medicine, Division of Clinical Microbiology – Medical University of Vienna, Vienna, Austria, and 33Institute for Occupational, Social and Environmental Medicine, Uniclinic RWTH Aachen, Aachen, Germany, aCo-author, bMember of a scientific medical society, a society or a medical association with voting rights
Correspondence to:
Dr. rer. nat. Julia Hurraß, Hygiene in Health Care Facilities, Department of Infection and Environmental Hygiene, Cologne City Health Department, Neumarkt 15 – 21, 50667 Cologne, Germany
Email: [email protected]
Review
Biologics in allergology and clinical immunology: Update on therapies for atopic diseases, urticaria, and angioedema and on safety aspects focusing on hypersensitivity reactions
Uta Jappe, Karl-Christian Bergmann, Folke Brinkmann, Valentina Faihs, Askin Gülsen, Ludger Klimek, Harald Renz, Sebastian Seurig, Christian Taube, Stephan Traidl, Regina Treudler, Martin Wagenmann, Thomas Werfel, Margitta Worm, and Torsten Zuberbier
Volume 8 (2024) p. 365 - 406
Abstract
Allergologie select, Vol. 8/2024 (365-406)
Biologics in allergology and clinical immunology: Update on therapies for atopic diseases, urticaria, and angioedema and on safety aspects focusing on hypersensitivity reactions
Uta Jappe1#2, Karl-Christian Bergmann3, Folke Brinkmann4, Valentina Faihs5, Askin Gülsen6, Ludger Klimek7, Harald Renz8, Sebastian Seurig9, Christian Taube10, Stephan Traidl11, Regina Treudler12, Martin Wagenmann13, Thomas Werfel11, Margitta Worm14, and Torsten Zuberbier3
1Division Clinical and Molecular Allergology, Research Center Borstel, Leibniz Lung Center, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Borstel, 2Interdisciplinary Allergy Outpatient Clinic, Department of Pneumology, University Medical Center Schleswig-Holstein, Campus Lübeck, University of Lübeck, 3Institute of Allergology, Charité Universitätsmedizin Berlin und Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, 4Division of Pediatric Pulmonology and Allergology, University Children’s Hospital, German Center for Lung Research (ARCN, DZL), Lübeck, 5Department of Dermatology and Allergy Biederstein, Klinikum rechts der Isar, Technical University of Munich, 6Division of Cardiology, Pulmonary Diseases, Vascular Medicine, University Hospital Duesseldorf, 7Center for Rhinology and Allergology, Wiesbaden, 8Institute of Laboratory Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Philipps Universität Marburg, Member of the German Center for Lung Research (DZL) Marburg, 9Interdisciplinary Allergy Center Nuremberg (NIZA), Department of Internal Medicine 3, Pneumology, Nuremberg Hospital, Nuremberg, 10Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Essen, 11Department of Dermatology and Allergy, Hannover Medical School, Hannover, 12Institute of Allergology IFA, Charité Universitätsmedizin corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Berlin, 13Department of Otorhinolaryngology, Düsseldorf University Hospital, Heinrich Heine University, Düsseldorf, 14Division of Allergy and Immunology, Department of Dermatology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany
The development of targeted therapies for atopic diseases, urticaria, and angioedema with biologics is progressing rapidly: New “targets” of clinical-therapeutic relevance have been identified, the corresponding targeted antibodies developed, tested in clinical trials, and approved for therapy. These include the anti-IgE antibody omalizumab (also effective and approved for the treatment of urticaria), the anti-IL-4/13 receptor-specific antibody dupilumab, the two anti-IL-13 antibodies lebrikizumab and tralokinumab, the anti-TSLP antibody tezepelumab, the two anti-IL-5 antibodies mepolizumab and reslizumab, and the anti-IL5 receptor-specific antibody benralizumab for the treatment of atopic diseases. For the treatment of hereditary angioedema, C1 inhibitor and the antibody lanadelumab (directed against kallikrein) have also long been approved as biologics in addition to low-molecular substances. Other therapeutic antibodies are in various stages of development. Furthermore, the range of indications for some very effective biologics has been successfully expanded to include additional diseases. In this context, the first results on biologic therapy of food allergy and eosinophilic esophagitis are interesting. Biologics that address different target structures are also increasingly being administered in combination, either simultaneously or sequentially, in order to achieve optimal efficacy. A developing area is the use of biologics in children and the observation of immunological and non-immunological side effects. In some cases, new unexpected side effects and hypersensitivity reactions have emerged, which in turn raise pathomechanistic questions, such as conjunctivitis with dupilumab therapy, which only appears to occur in the treatment of atopic dermatitis but not in the treatment of other atopic diseases. In dermatology, paradoxical reactions have been described under therapy with some biologics. And immune reactions of type alpha to epsilon to biologics (hypersensitivity reactions) continue to be a clinically relevant problem, whereby the selection of an alternative therapeutic agent is a challenge and the diagnostics that support this have not yet been sufficiently incorporated into routine work.Correspondence to:
Prof. Dr. med. Uta Jappe, Division Clinical and Molecular Allergology, Research Center Borstel, Leibniz Lung Center, Parkallee 35, 23845 Borstel, Germany
Email: [email protected]
