Journal articles

Severe chronic allergic (and related) diseases: a uniform approach--a MeDALL--GA2LEN--ARIA position paper.

Jean Bousquet ^{1, 2, *} Josep M. Anto ^{3, 4, 5, 6} Pascal Demoly ^{7, 8} Holger J. Schünemann ⁹ Alkis Togias ¹⁰ Mübeccel Akdis ¹¹ Charles Auffray ¹² Claus Bachert ¹³ Thomas Bieber ¹⁴ Philippe J. Bousquet ¹ Kai-Håkon Carlsen ¹⁵ Thomas B. Casale ¹⁶ Alavaro A. Cruz ¹⁷ Thomas Keil ¹⁸ Karin C. Lodrup Carlsen ¹⁵ Marcus Maurer ¹⁹ K. Ohta ²⁰ N. G. Papadopoulos ²¹ M. Roman Rodriguez ²² B. Samolinski ²³ I. Agache ²⁴ A. Andrianarisoa ²⁵ Isabella Annesi-Maesano ²⁶ F. Ballester ²⁷ C. E. Baena-Cagnani ^{28, 29} X. Basagaña ^{3, 4, 5} E. D. Bateman ³⁰ E. H. Bel ³¹ A. Bedbrook ⁷ B. Beghé ³² M. Beji ³³ Ali Ben Kheder ³⁴ M. Benet ^{3, 4, 5} Kazi Saifuddin Bennoor ³⁵ K. C. Bergmann ¹⁹ Fouad Berrissoul ³⁶ Carsten Bindslev Jensen ³⁷ Eugene R. Bleecker ³⁸ S. Bonini ³⁹ A. L. Boner ⁴⁰ L. P. Boulet ⁴¹ Christopher E. Brightling ⁴² Jan L. Brozek ⁹ Andrew Bush ⁴³ W. W. Busse ⁴⁴ Paulo Augusto Moreira Camargos ⁴⁵ Giorgio Walter Canonica ⁴⁶ Warner Carr ⁴⁷ Alfredo Cesario ^{48, 49} y. Z. Chen ⁵⁰ A. M. Chiriac ¹ David J. Costa ⁵¹ Latonia Cox ⁵² Adnan Custovic ⁵³ Ronald Dahl ⁵⁴ Ulf Darsow ⁵⁵ Toufik Didi ⁵⁶ Habib Douagui ⁵⁷ Ruta Dubakiene ⁵⁸ Abdellah El-Meziane ⁵⁹ Joao A. Fonseca ⁶⁰ W. J. Fokkens ⁶¹ E. Fthenou ⁶² Amiran Gamkrelidze ⁶³ J. Garcia-Aymerich ^{3, 4, 5, 6} Roy Gerth van Wijk ⁶⁴ E. Gimeno-Santos ³ Stefano Guerra ^{3, 4, 5, 65} Tari Haahtela ⁶⁶ H. Haddad ⁶⁷ Peter W. Hellings ⁶⁸ B. Hellquist-Dahl ⁵⁴ C. Hohmann ¹⁸ Peter Howarth ⁶⁹ J. O. Hourihane ⁷⁰ Marc Humbert ⁷¹ Bénédicte Jacquemin ² Jocelyne Just ⁷² Omer Kalayci ⁷³ Michael A. Kaliner ⁷⁴ Francine Kauffmann ² Marjan Kerkhof ⁷⁵ G. Khayat ⁷⁶ Bernard Koffi N'Goran ⁷⁷ M. Kogevinas ^{3, 4, 5} Gerard H. Koppelman ⁷⁸ Marek L. Kowalski ⁷⁹ Inger Kull ^{80, 81} Piotr Kuna ⁸² Désirée Larenas ⁸³ I. Lavi ³ Lan Thi Tuyet Le ⁸⁴ Phil Lieberman ⁸⁵ Brian J. Lipworth ⁸⁶ Bassam H. Mahboub ⁸⁷ M. J. Makela ⁶⁶ Francis Martin ⁸⁸ Fernando D. Martinez ⁸⁹ Gailen D. Marshall ⁹⁰ A. Mazon ²⁷ Erik Melen ⁹¹ Eli O. Meltzer ⁹² F. Mihaltan ⁹³ yousser Mohammad ⁹⁴ Azzeddine Mohammadi ⁹⁵ Isabelle Momas ⁹⁶ Mario Morais-Almeida ⁹⁷ Joaquim Mullol ⁹⁸ Antonella Muraro ⁹⁹ Robert Naclerio ¹⁰⁰ Salim Nafti ¹⁰¹ Leyla Namazova-Baranova ¹⁰² Martijn C. Nawijn ¹⁰³ Tshipukane Dieudonné Nyembue ¹⁰⁴ Sam Oddie ¹⁰⁵ Robyn E. O'Hehir ¹⁰⁶ yoshitaka Okamoto ¹⁰⁷ M. P. Orru ¹⁰⁸ Cevdet Ozdemir ¹⁰⁹ G. S. Ouedraogo ¹¹⁰ Susanna Palkonen ¹¹¹ Petr Panzner ¹¹² G. Passalacqua ⁴⁶ Ruby Pawankar ¹¹³ Bernard Pigearias ¹¹⁴ Isabelle Pin ¹¹⁵ M. Pinart ³ Christophe Pison ¹¹⁶ Ted A. Popov ¹¹⁷ Daniela Porta ¹¹⁸ Dirkje S. Postma ⁷⁸ David Price ¹¹⁹ Klaus F. Rabe ¹²⁰ Julia Ratomaharo ¹²¹ S. Reitamo ⁶⁵ Djamel Rezagui ¹²² Johannes Ring ¹²³ R. Roberts ¹²⁴ Joseph Roca ¹²⁵ B. Rogala ¹²⁶ Antonino Romano ¹²⁷ José Rosado-Pinto ¹²⁸ Dermot Ryan ^{129, 130} Mario Sanchez-Borges ¹³¹ Glenis K. Scadding ¹³² Aziz Sheikh ¹³³ Frances Estelle Reed Simons ¹³⁴ Valérie Siroux ¹¹⁵ Peter D. Schmid-Grendelmeier ¹³⁵ H. A. Smit ¹³⁶ Talant M. Sooronbaev ¹³⁷ Renato Tetelbom Stein ^{3, 138} P. J. Sterk ^{31, 121} J. Sunyer ^{3, 4, 5, 6} Ingrid Terreehorst ¹³⁹ Elina Toskala ¹⁴⁰ yves Tremblay ¹⁴¹ Rudolf Valenta ¹⁴² Dominique Valeyre ¹⁴³ Olivier Vandenplas ¹⁴⁴ Chris van Weel ¹⁴⁵ M. Vassilaki ⁶² R. Varraso ^{71, 2} Giovanni Viegi ^{146, 147} de yun Wang ¹⁴⁸ Magnus Wickman ¹⁴⁹ Dennis Williams ¹⁵⁰ Stefan Wöhrl ¹⁵¹ J. Wright ¹⁰⁵ Arzu yorgancioglu ¹⁵² Osman M. yusuf ¹⁵³ H. J. Zar ¹⁵⁴ M. E. Zernotti ²⁸ Mihaela Zidarn ¹⁵⁵ N. Zhong ¹⁵⁶ Torsten Zuberbier ^{19, 157}

* Corresponding author

1 Hôpital Arnaud de Villeneuve [CHRU Montpellier]

2 CESP - Centre de recherche en épidémiologie et santé des populations

3 IMIM-Hospital del Mar

4 CREAL - Center for Research in Environmental Epidemiology

5 CIBER Epidemiologia y Salud Publica

6 UPF - Universitat Pompeu Fabra [Barcelona]

7 WHO Collaborating Center for Asthma and Rhinitis

8 Pharmacoepidemiologie et évaluation de l'impact des produits de santé sur les populations

9 Department of Clinical Epidemiology and Biostatistics and Medicine

10 NIAID-NIH - National Institute of Allergy and Infectious Diseases [Bethesda]

11 SIAF - Swiss Institute of Allergy and Asthma Research

12 Génomique fonctionnelle et biologie systémique pour la santé

13 URL - Upper Airway Research Laboratory

14 Department of Dermatology and Allergy

15 Department of Paediatrics

16 Division of Allergy and Immunology, Department of Medicine

17 ProAR - FMB

18 Epidemiology and Health Economics

19 Department of Dermatology

20 Division of Respiratory Medicine and Allergology

21 Allergy Department

22 Son Pisa Primary Care Centre

23 Department of Prevention of Environmental Hazards and Allergology

24 Department of Allergy and Clinical Immunology

25 Public Hospital Medical Service

26 ESIM - Epidémiologie des maladies infectieuses et modélisation

27 CSISP - Center for Public Health Research

28 Respiratory Medicine

29 Faculty of Medicine

30 Health Sciences Faculty

31 Department of Pulmonology

32 Divisions of Human Genetics Infection, Inflammation and Repair

33 Service de Pneumologie Allergologie

34 Service de Pneumologie

35 National Asthma Centre

36 Pneumologie / Anesthésie - réanimation / Oxygénothérapie

37 Department of Dermatology and Allergy Center

38 Center for Genomics and Personalized Medicine

39 Institute of Neurobiology and Molecular Medicine

40 Department of Paediatrics

41 Institut de cardiologie et de pneumologie

42 Department of Respiratory Medicine and Thoracic Surgery

43 Department of Paediatric Respiratory Medicine

44 Department of Medicine

45 Department of Pediatrics

46 Allergy & Respiratory Diseases

47 Allergy & Asthma Associates

48 Deputy Scientific Director

49 Department of Thoracic Surgery

50 National Cooperative Group of Pediatric Research on Asthma

51 Service des Premiers Soins

52 Osteopathic College of Medicine

53 Respiratory Research Group

54 Department of Respiratory Diseases

55 Department of Dermatology and Allergy Biederstein

56 Service de pneumologie

57 Service de pneumo-allergologie

58 Allergy Centre

59 Société Marocaine des Maladies Respiratoires

60 Allergy Division

61 Department of Otorhinolaryngology

62 Department of Social Medicine

63 Health Care

64 Section of Allergology

65 Epidemiology and Biostatistics Division

66 Department of Dermatology

67 Service de pneumologie

68 Department of Otorhinolaryngology, Head, and Neck Surgery

69 Engineering and the Environment

70 Paediatrics and Child Health

71 Service de Pneumologie

72 Centre de l'Asthme et des Allergies [CHU Trousseau]

73 Pediatric Allergy and Asthma Unit

74 Institute for Asthma and Allergy

75 Department of Epidemiology

76 Service de Pneumologie

77 Service des Maladies Respiratoires

78 Pediatric Pulmonology, Allergology & Epidemiology

79 Department of Clinical Immunology and Allergy

80 Centre for Allergy Research

81 Department of Clinical Science and Education

82 Division of Internal Medicine, Asthma and Allergy

83 Allergy Department

84 Physiology Department

85 Division of Allergy Immunology

86 university of dundee asthma - allergic rhinitis - COPD - beta-2-adrenoceptor

87 Pulmonary and allergy unit

88 AFVP - Association Franco-Vietnamienne de Pneumologie

89 Arizona Respiratory Center

90 Department of Medicine, Clinical Immunology and Allergy

91 Institute of Environmental Medicine

92 Allergy & Asthma Medical Group & Research Center

93 Pneumology Department

94 Department of Internal Medicine

95 AFMAPATH - Association Franco-Marocaine de Pathologie Thoracique

96 EA 4064 - Epidémiologie Environnementale : Impact Sanitaire des Pollutions

97 Immunoallergy Department

98 Rhinology Unit & Smell Clinic

99 Allergy Unit

100 OHNS - Section of Otolaryngology-Head & Neck Surgery

101 Clinique des maladies respiratoires

102 Scientific Center for Children's Health

103 Laboratory of Allergology and Pulmonary Diseases

104 ENT Department

105 Bradford Neonatology

106 Department of Allergy, Immunology and Respiratory Medicine

107 Department of Otorhinolaryngology

108 Asthme Rhinite allergique

109 Division of Pediatric Allergy and Immunology

110 Pédiatrie

111 EFA - European Federation of Allergy

112 Department of Allergology and Clinical Immunology

113 Immunopharmacology

114 Laboratoire du Sommeil et de l'Effort

115 INSERM U823 - Institut d'oncologie/développement Albert Bonniot de Grenoble

116 LBFA - Laboratoire de bioénergétique fondamentale et appliquée

117 Clinic of Allergy and Asthma

118 Department of Epidemiology

119 Primary Care Respiratory Medicine

120 Department of Pulmonary Medicine

121 Pneumalgia

122 AFAP - Association Franco-Algérienne de Pneumologie

123 Department of Dermatology and Allergy

124 Allergy Department

125 Department of Pneumology

126 Allergology and Clinical Immunology

127 UCSC-Allergy Unit

128 Immunoallergy Department

129 Medical Centre

130 Research Fellow

131 Department of Allergy and Clinical Immunology

132 Department of Pharmacology

133 Primary Care Research & Development

134 Section of Allergy & Clinical Immunology

135 Allergy Unit - Department of Dermatology

136 Julius Center for Health Sciences and Primary Care

137 National Centre of Cardiology and Internal Medicine

138 School of Medicine

139 Department of ENT and Pediatrics

140 Department of Otorhinolaryngology

141 Department of Obstetrics and Gynaecology

142 Christian Doppler Laboratory for Allergy Research

143 Service de Pneumologie

144 Department of Chest Medicine

145 Department of Primary and Community Care

146 Epidemiology Unit

147 Pulmonary Environmental Epidemiology Unit

148 Department of Otolaryngology

149 Institute of Environmental Medicine

150 GLP Analytical Facility

151 DIAID - Department of Dermatology Division of Immunology, Allergy and Infectious Diseases

152 Department of Pulmonology

153 Allergy and Asthma Clinics

154 Department of Paediatrics and Child Health

155 Respiratory and Allergic Diseases

156 State Key Laboratory of Respiratory Diseases

157 GA2LEN - Secretary General of the Global Allergy and Asthma European Network

Abstract : Concepts of disease severity, activity, control and responsiveness to treatment are linked but different. Severity refers to the loss of function of the organs induced by the disease process or to the occurrence of severe acute exacerbations. Severity may vary over time and needs regular follow-up. Control is the degree to which therapy goals are currently met. These concepts have evolved over time for asthma in guidelines, task forces or consensus meetings. The aim of this paper is to generalize the approach of the uniform definition of severe asthma presented to WHO for chronic allergic and associated diseases (rhinitis, chronic rhinosinusitis, chronic urticaria and atopic dermatitis) in order to have a uniform definition of severity, control and risk, usable in most situations. It is based on the appropriate diagnosis, availability and accessibility of treatments, treatment responsiveness and associated factors such as comorbidities and risk factors. This uniform definition will allow a better definition of the phenotypes of severe allergic (and related) diseases for clinical practice, research (including epidemiology), public health purposes, education and the discovery of novel therapies.

Keywords : IgE allergy severity control risk asthma rhinitis rhinosinusitis urticaria atopic dermatitis

Document type :

Journal articles

Domain :

Life Sciences [q-bio] / Santé publique et épidémiologie

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