Whole Exome Sequencing Identifies Epithelial and Immune Dysfunction-Related Biomarkers in Food Protein-Induced Enterocolitis Syndrome.

ATG16L1 DGKZ RBM8A FPIES NGS exomes food allergy

Journal

Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
ISSN: 1365-2222
Titre abrégé: Clin Exp Allergy
Pays: England
ID NLM: 8906443

Informations de publication

Date de publication:
30 Sep 2024
Historique:
received: 09 07 2024
accepted: 01 09 2024
medline: 1 10 2024
pubmed: 1 10 2024
entrez: 30 9 2024
Statut: aheadofprint

Résumé

Food protein-induced enterocolitis syndrome (FPIES) is a food allergy primarily affecting infants, often leading to vomiting and shock. Due to its poorly understood pathophysiology and lack of specific biomarkers, diagnosis is frequently delayed. Understanding FPIES genetics can shed light on disease susceptibility and pathophysiology-key to developing diagnostic, prognostic, preventive and therapeutic strategies. Using a well-characterised cohort of patients we explored the potential genome-wide susceptibility factors underlying FPIES. Blood samples from 41 patients with oral food challenge-proven FPIES were collected for a comprehensive whole exome sequencing association study. Notable genetic variants, including rs872786 (RBM8A), rs2241880 (ATG16L1) and rs2289477 (ATG16L1), were identified as significant findings in FPIES. A weighted SKAT model identified six other associated genes including DGKZ and SIRPA. DGKZ induces TGF-β signalling, crucial for epithelial barrier integrity and IgA production; RBM8A is associated with thrombocytopenia absent radius syndrome, frequently associated with cow's milk allergy; SIRPA is associated with increased neutrophils/monocytes in inflamed tissues as often observed in FPIES; ATG16L1 is associated with inflammatory bowel disease. Coexpression correlation analysis revealed a functional correlation between RBM8A and filaggrin gene (FLG) in stomach and intestine tissue, with filaggrin being a known key pathogenic and risk factor for IgE-mediated food allergy. A transcriptome-wide association study suggested genetic variability in patients impacted gene expression of RBM8A (stomach and pancreas) and ATG16L1 (transverse colon). This study represents the first case-control exome association study of FPIES patients and marks a crucial step towards unravelling genetic susceptibility factors underpinning the syndrome. Our findings highlight potential factors and pathways contributing to FPIES, including epithelial barrier dysfunction and immune dysregulation. While these results are novel, they are preliminary and need further validation in a second cohort of patients.

Sections du résumé

BACKGROUND BACKGROUND
Food protein-induced enterocolitis syndrome (FPIES) is a food allergy primarily affecting infants, often leading to vomiting and shock. Due to its poorly understood pathophysiology and lack of specific biomarkers, diagnosis is frequently delayed. Understanding FPIES genetics can shed light on disease susceptibility and pathophysiology-key to developing diagnostic, prognostic, preventive and therapeutic strategies. Using a well-characterised cohort of patients we explored the potential genome-wide susceptibility factors underlying FPIES.
METHODS METHODS
Blood samples from 41 patients with oral food challenge-proven FPIES were collected for a comprehensive whole exome sequencing association study.
RESULTS RESULTS
Notable genetic variants, including rs872786 (RBM8A), rs2241880 (ATG16L1) and rs2289477 (ATG16L1), were identified as significant findings in FPIES. A weighted SKAT model identified six other associated genes including DGKZ and SIRPA. DGKZ induces TGF-β signalling, crucial for epithelial barrier integrity and IgA production; RBM8A is associated with thrombocytopenia absent radius syndrome, frequently associated with cow's milk allergy; SIRPA is associated with increased neutrophils/monocytes in inflamed tissues as often observed in FPIES; ATG16L1 is associated with inflammatory bowel disease. Coexpression correlation analysis revealed a functional correlation between RBM8A and filaggrin gene (FLG) in stomach and intestine tissue, with filaggrin being a known key pathogenic and risk factor for IgE-mediated food allergy. A transcriptome-wide association study suggested genetic variability in patients impacted gene expression of RBM8A (stomach and pancreas) and ATG16L1 (transverse colon).
CONCLUSIONS CONCLUSIONS
This study represents the first case-control exome association study of FPIES patients and marks a crucial step towards unravelling genetic susceptibility factors underpinning the syndrome. Our findings highlight potential factors and pathways contributing to FPIES, including epithelial barrier dysfunction and immune dysregulation. While these results are novel, they are preliminary and need further validation in a second cohort of patients.

Identifiants

pubmed: 39348862
doi: 10.1111/cea.14564
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Strategic Health Action, "Instituto de Salud Carlos III" (ISCIII) cofinanciados FEDER
ID : TRINEO-PI22/00162
Organisme : Strategic Health Action, "Instituto de Salud Carlos III" (ISCIII) cofinanciados FEDER
ID : DIAVIR-DTS19/00049
Organisme : Strategic Health Action, "Instituto de Salud Carlos III" (ISCIII) cofinanciados FEDER
ID : Resvi-Omics-PI19/01039
Organisme : Strategic Health Action, "Instituto de Salud Carlos III" (ISCIII) cofinanciados FEDER
ID : ReSVinext-PI16/01569
Organisme : Strategic Health Action, "Instituto de Salud Carlos III" (ISCIII) cofinanciados FEDER
ID : Enterogen-PI19/01090
Organisme : Strategic Health Action, "Instituto de Salud Carlos III" (ISCIII) cofinanciados FEDER
ID : OMI-COVI-VAC-PI22/00406
Organisme : Strategic Health Action, "Instituto de Salud Carlos III" (ISCIII) cofinanciados FEDER
ID : BIO-FPIES-PI19/00497
Organisme : Axencia Galega de Innovación (GAIN)
ID : IN607B2020/08
Organisme : Axencia Galega de Innovación (GAIN)
ID : IN607A2023/02
Organisme : Axencia Galega de Innovación (GAIN)
ID : IN607D2024/06
Organisme : Axencia Galega de Innovación (GAIN)
ID : GENCOVID-IN845D2020/23
Organisme : Axencia Galega de Innovación (GAIN)
ID : IIN607A2021/05
Organisme : Agencia Gallega de Conocimiento en Salud (ACIS)
ID : BI-BACVIR
Organisme : Agencia Gallega de Conocimiento en Salud (ACIS)
ID : CovidPhy-SA304C
Organisme : Spanish Ministry of Science and Innovation (MCIN)/Spanish Research Agency (AEI)
ID : PID2022-142156OB-I00
Organisme : Instituto de Salud Carlos III (ISCIII) and co-funded by the European Union
ID : CP23/00080
Organisme : Consorcio Centro de Investigación Biomédica en Red de Enfermedades Respiratorias
ID : CB21/06/00103

Informations de copyright

© 2024 The Author(s). Clinical & Experimental Allergy published by John Wiley & Sons Ltd.

Références

A. Nowak‐Wegrzyn, M. Chehade, M. E. Groetch, et al., “International Consensus Guidelines for the Diagnosis and Management of Food Protein‐Induced Enterocolitis Syndrome: Executive Summary‐Workgroup Report of the Adverse Reactions to Foods Committee, American Academy of Allergy, Asthma & Immunology,” Journal of Allergy and Clinical Immunology 139, no. 4 (2017): 1111–1126.e4.
S. Mehr, E. Lee, P. Hsu, et al., “Innate Immune Activation Occurs in Acute Food Protein‐Induced Enterocolitis Syndrome Reactions,” Journal of Allergy and Clinical Immunology 144, no. 2 (2019): 600–602.e2.
S. H. Sicherer, T. J. Furlong, H. H. Maes, R. J. Desnick, H. A. Sampson, and B. D. Gelb, “Genetics of Peanut Allergy: A Twin Study,” Journal of Allergy and Clinical Immunology 106, no. 1 Pt 1 (2000): 53–56.
I. Marenholz, S. Grosche, B. Kalb, et al., “Genome‐Wide Association Study Identifies the SERPINB Gene Cluster as a Susceptibility Locus for Food Allergy,” Nature Communications 8, no. 1 (2017): 1056.
S. B. Sindher, A. Fiocchi, T. Zuberbier, S. Arasi, R. A. Wood, and R. S. Chinthrajah, “The Role of Biologics in the Treatment of Food Allergy,” Journal of Allergy and Clinical Immunology: In Practice 151 (2023): 595–606.
G. Du Toit, G. Roberts, P. H. Sayre, et al., “Randomized Trial of Peanut Consumption in Infants at Risk for Peanut Allergy,” New England Journal of Medicine 372, no. 9 (2015): 803–813.
M. Vaseghi‐Shanjani, K. L. Smith, R. J. Sara, et al., “Inborn Errors of Immunity Manifesting as Atopic Disorders,” Journal of Allergy and Clinical Immunology 148, no. 5 (2021): 1130–1139.
L. Argiz, S. Infante, A. Machinena, et al., “Reactions on Re‐Exposure Following Negative and Inconclusive Follow‐Up Food Challenges in Children With Acute FPIES,” Journal of Allergy and Clinical Immunology. In Practice 8, no. 9 (2020): 3228–3231.e3.
1000 Genomes Project Consortium, A. Auton, L. D. Brooks, et al., “A Global Reference for Human Genetic Variation,” Nature 526, no. 7571 (2015): 68–74.
J. Brown, M. Pirrung, and L. A. McCue, “FQC Dashboard: Integrates FastQC Results Into a Web‐Based, Interactive, and Extensible FASTQ Quality Control Tool,” Bioinformatics 33 (2017): 3137–3139.
H. Li, “Aligning Sequence Reads, Clone Sequences and Assembly Contigs With BWA‐MEM,” arXiv:13033997v2 [q‐bioGN] 2013.
B. S. Pedersen and A. R. Quinlan, “Mosdepth: Quick Coverage Calculation for Genomes and Exomes,” Bioinformatics 34, no. 5 (2018): 867–868.
D. W. Barnett, E. K. Garrison, A. R. Quinlan, M. P. Stromberg, and G. T. Marth, “BamTools: A C++ API and Toolkit for Analyzing and Managing BAM Files,” Bioinformatics 27, no. 12 (2011): 1691–1692.
H. Li, B. Handsaker, A. Wysoker, et al., “The Sequence Alignment/Map Format and SAMtools,” Bioinformatics 25, no. 16 (2009): 2078–2079.
P. Ewels, M. Magnusson, S. Lundin, and M. Kaller, “MultiQC: Summarize Analysis Results for Multiple Tools and Samples in a Single Report,” Bioinformatics 32, no. 19 (2016): 3047–3048.
A. McKenna, M. Hanna, E. Banks, et al., “The Genome Analysis Toolkit: A MapReduce Framework for Analyzing Next‐Generation DNA Sequencing Data,” Genome Research 20, no. 9 (2010): 1297–1303.
J. Pardo‐Seco, J. Amigo, W. González‐Manteiga, and A. Salas, “A Generalized Model to Estimate the Statistical Power in Mitochondrial Disease Studies Involving 2 × k Tables,” PLoS One 8, no. 9 (2013): e73567.
D. H. Alexander, J. Novembre, and K. Lange, “Fast Model‐Based Estimation of Ancestry in Unrelated Individuals,” Genome Research 19, no. 9 (2009): 1655–1664.
M. C. Wu, S. Lee, T. Cai, Y. Li, M. Boehnke, and X. Lin, “Rare‐Variant Association Testing for Sequencing Data With the Sequence Kernel Association Test,” American Journal of Human Genetics 89, no. 1 (2011): 82–93.
P. Rentzsch, M. Schubach, J. Shendure, and M. Kircher, “CADD‐Splice‐Improving Genome‐Wide Variant Effect Prediction Using Deep Learning‐Derived Splice Scores,” Genome Medicine 13, no. 1 (2021): 31.
C. C. Chang, C. C. Chow, L. C. Tellier, S. Vattikuti, S. M. Purcell, and J. J. Lee, “Second‐Generation PLINK: Rising to the Challenge of Larger and Richer Datasets,” GigaScience 4 (2015): 7.
S. Purcell, B. Neale, K. Todd‐Brown, et al., “PLINK: A Tool Set for Whole‐Genome Association and Population‐Based Linkage Analyses,” American Journal of Human Genetics 81, no. 3 (2007): 559–575.
R Core Team, R: A Language and Enviroment for Statistical Computing (Vienna, Austria: R Foundation for Statistical Computing, 2019).
S. Zhao, “SKAT: SNP‐Set (Sequence) Kernel Association Test 2023,” https://cran.r‐project.org/web/packages/SKAT/index.html.
T. Wu, E. Hu, S. Xu, et al., “clusterProfiler 4.0: A Universal Enrichment Tool for Interpreting Omics Data,” Innovation (N Y) 2, no. 3 (2021): 100141.
A. N. Barbeira, R. Bonazzola, E. R. Gamazon, et al., “Exploiting the GTEx Resources to Decipher the Mechanisms at GWAS Loci,” Genome Biology 22, no. 1 (2021): 49.
S. Zhu, T. Qian, Y. Hoshida, Y. Shen, J. Yu, and K. Hao, “GIGSEA: Genotype Imputed Gene Set Enrichment Analysis Using GWAS Summary Level Data,” Bioinformatics 35, no. 1 (2019): 160–163.
J. Du, Z. Yuan, Z. Ma, J. Song, X. Xie, and Y. Chen, “KEGG‐PATH: Kyoto Encyclopedia of Genes and Genomes‐Based Pathway Analysis Using a PATH Analysis Model,” Molecular BioSystems 10, no. 9 (2014): 2441–2447.
J. Wixon and D. Kell, “The Kyoto Encyclopedia of Genes and Genomes—KEGG,” Yeast 17, no. 1 (2000): 48–55.
N. Stefanovic and A. D. Irvine, “Filaggrin and Beyond: New Insights Into the Skin Barrier in Atopic Dermatitis and Allergic Diseases, From Genetics to Therapeutic Perspectives,” Annals of Allergy, Asthma & Immunology 132, no. 2 (2023): 187–195.
R. A. Harris, A. H. Bush, T. N. Eagar, et al., “Exome Sequencing Implicates DGKZ, ESRRA, and GXYLT1 for Modulating Granuloma Formation in Crohn Disease,” Journal of Pediatric Gastroenterology and Nutrition 77, no. 3 (2023): 354–357.
P. Suenaert, P. Maerten, G. Van Assche, et al., “Effects of T Cell‐Induced Colonic Inflammation on Epithelial Barrier Function,” Inflammatory Bowel Diseases 16, no. 8 (2010): 1322–1331.
M. H. Shamji and S. R. Durham, “Mechanisms of Allergen Immunotherapy for Inhaled Allergens and Predictive Biomarkers,” Journal of Allergy and Clinical Immunology 140, no. 6 (2017): 1485–1498.
G. N. Konstantinou, R. Bencharitiwong, A. Grishin, et al., “The Role of Casein‐Specific IgA and TGF‐Beta in Children With Food Protein‐Induced Enterocolitis Syndrome to Milk,” Pediatric Allergy and Immunology 25, no. 7 (2014): 651–656.
H. L. Chung, J. B. Hwang, J. J. Park, and S. G. Kim, “Expression of Transforming Growth Factor Beta1, Transforming Growth Factor Type I and II Receptors, and TNF‐Alpha in the Mucosa of the Small Intestine in Infants With Food Protein‐Induced Enterocolitis Syndrome,” Journal of Allergy and Clinical Immunology 109, no. 1 (2002): 150–154.
L. P. Shek, L. Bardina, R. Castro, H. A. Sampson, and K. Beyer, “Humoral and Cellular Responses to Cow Milk Proteins in Patients With Milk‐Induced IgE‐Mediated and Non‐IgE‐Mediated Disorders,” Allergy 60, no. 7 (2005): 912–919.
J. Hampe, A. Franke, P. Rosenstiel, et al., “A Genome‐Wide Association Scan of Nonsynonymous SNPs Identifies a Susceptibility Variant for Crohn Disease in ATG16L1,” Nature Genetics 39, no. 2 (2007): 207–211.
A. M. Kabat, O. J. Harrison, T. Riffelmacher, et al., “The Autophagy Gene Atg16l1 Differentially Regulates Treg and TH2 Cells to Control Intestinal Inflammation,” eLife 5 (2016): e12444.
P. Gonzalez‐Delgado, J. Muriel, T. Jimenez, J. I. Cameo, A. Palazon‐Bru, and J. Fernandez, “Food Protein‐Induced Enterocolitis Syndrome in Adulthood: Clinical Characteristics, Prognosis, and Risk Factors,” Journal of Allergy and Clinical Immunology. In Practice 10, no. 9 (2022): 2397–2403.
M. C. Berin, D. Lozano‐Ojalvo, C. Agashe, M. G. Baker, J. A. Bird, and A. Nowak‐Wegrzyn, “Acute FPIES Reactions Are Associated With an IL‐17 Inflammatory Signature,” Journal of Allergy and Clinical Immunology 148, no. 3 (2021): 895–901.e6.
D. Aschenbrenner, M. Quaranta, S. Banerjee, et al., “Deconvolution of Monocyte Responses in Inflammatory Bowel Disease Reveals an IL‐1 Cytokine Network That Regulates IL‐23 in Genetic and Acquired IL‐10 Resistance,” Gut 70, no. 6 (2021): 1023–1036.
M. M. Xie, B. Dai, J. A. Hackney, et al., “An Agonistic Anti‐Signal Regulatory Protein Alpha Antibody for Chronic Inflammatory Diseases,” Cell Reports Medicine 4, no. 8 (2023): 101130.
R. Goswami, A. B. Blazquez, R. Kosoy, A. Rahman, A. Nowak‐Wegrzyn, and M. C. Berin, “Systemic Innate Immune Activation in Food Protein‐Induced Enterocolitis Syndrome,” Journal of Allergy and Clinical Immunology 139, no. 6 (2017): 1885–1896.e9.
R. A. van den Oord and A. Sheikh, “Filaggrin Gene Defects and Risk of Developing Allergic Sensitisation and Allergic Disorders: Systematic Review and Meta‐Analysis,” BMJ 339 (2009): b2433.
C. A. Albers, R. Newbury‐Ecob, W. H. Ouwehand, and C. Ghevaert, “New Insights Into the Genetic Basis of TAR (Thrombocytopenia‐Absent Radii) Syndrome,” Current Opinion in Genetics & Development 23, no. 3 (2013): 316–323.
K. L. Greenhalgh, R. T. Howell, A. Bottani, et al., “Thrombocytopenia‐Absent Radius Syndrome: A Clinical Genetic Study,” Journal of Medical Genetics 39, no. 12 (2002): 876–881.
M. F. Whitfield and D. G. Barr, “Cows' Milk Allergy in the Syndrome of Thrombocytopenia With Absent Radius,” Archives of Disease in Childhood 51, no. 5 (1976): 337–343.
E. G. Foerster, T. Mukherjee, L. Cabral‐Fernandes, J. D. B. Rocha, S. E. Girardin, and D. J. Philpott, “How Autophagy Controls the Intestinal Epithelial Barrier,” Autophagy 18, no. 1 (2022): 86–103.
T. Shoda, A. Isozaki, and Y. Kawano, “Food Protein‐Induced Gastrointestinal Syndromes in Identical and Fraternal Twins,” Allergology International 60, no. 1 (2011): 103–108.

Auteurs

Alba Camino-Mera (A)

Genetics, Vaccines and Infections Research Group (GenViP), Instituto de Investigación Sanitaria de Santiago, Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain.
Unidade de Xenética, Instituto de Ciencias Forenses, Facultade de Medicina, Universidade de Santiago de Compostela, and Genética de Poblaciones en Biomedicina (GenPoB) Research Group, Instituto de Investigación Sanitaria (IDIS), Hospital Clínico Universitario de Santiago (SERGAS), Galicia, Spain.
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBER-ES), Madrid, Spain.

Jacobo Pardo-Seco (J)

Genetics, Vaccines and Infections Research Group (GenViP), Instituto de Investigación Sanitaria de Santiago, Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain.
Unidade de Xenética, Instituto de Ciencias Forenses, Facultade de Medicina, Universidade de Santiago de Compostela, and Genética de Poblaciones en Biomedicina (GenPoB) Research Group, Instituto de Investigación Sanitaria (IDIS), Hospital Clínico Universitario de Santiago (SERGAS), Galicia, Spain.
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBER-ES), Madrid, Spain.

Xabier Bello (X)

Genetics, Vaccines and Infections Research Group (GenViP), Instituto de Investigación Sanitaria de Santiago, Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain.
Unidade de Xenética, Instituto de Ciencias Forenses, Facultade de Medicina, Universidade de Santiago de Compostela, and Genética de Poblaciones en Biomedicina (GenPoB) Research Group, Instituto de Investigación Sanitaria (IDIS), Hospital Clínico Universitario de Santiago (SERGAS), Galicia, Spain.
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBER-ES), Madrid, Spain.

Laura Argiz (L)

Allergy Section, Clinica Universidad de Navarra, Madrid, Spain.

Robert J Boyle (RJ)

Section of Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK.

Adnan Custovic (A)

Section of Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK.

Jethro Herberg (J)

Department of Infectious Disease, Imperial College London, London, UK.

Myrsini Kaforou (M)

Department of Infectious Disease, Imperial College London, London, UK.

Stefania Arasi (S)

Allergy Diseases Research Area, Pediatric Allergology Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.

Alessandro Fiocchi (A)

Allergy Diseases Research Area, Pediatric Allergology Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.

Valentina Pecora (V)

Allergy Diseases Research Area, Pediatric Allergology Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.

Simona Barni (S)

Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy.

Francesca Mori (F)

Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy.

Teresa Bracamonte (T)

Paediatric Allergy Section, Severo Ochoa University Hospital, Madrid, Spain.

Luis Echeverria (L)

Paediatric Allergy Section, Severo Ochoa University Hospital, Madrid, Spain.

Virginia O'Valle-Aísa (V)

Clinical Analysis and Clinical Biochemistry Service, Severo Ochoa University Hospital, Madrid, Spain.

Noelia Lara Hernández-Martínez (NL)

Clinical Analysis and Clinical Biochemistry Service, Severo Ochoa University Hospital, Madrid, Spain.

Iria Carballeira (I)

Paediatric Allergy Section, Arquitecto Marcide Hospital, Ferrol, A Coruña in Galicia, Spain.

Emilio García (E)

Paediatric Allergy Section, Arquitecto Marcide Hospital, Ferrol, A Coruña in Galicia, Spain.

Carlos Garcia-Magan (C)

Paediatrics Department, Hospital Clínico Universitario de Santiago de Compostela, Coruña, Galicia, Spain.

José Domingo Moure-González (JD)

Paediatrics Department, Hospital Clínico Universitario de Santiago de Compostela, Coruña, Galicia, Spain.

Purificación Gonzalez-Delgado (P)

Allergy Department, General University Hospital, Alicante, Spain.

Teresa Garriga-Baraut (T)

Paediatric Allergy Section, Vall D'Hebron University Hospital, Growth and Development Research Group, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.

Sonsoles Infante (S)

Pediatric Allergy Unit, Hospital General Universitario Gregorio Marañón, Gregorio Marañón Health Research Institute (IiSGM), Madrid, Spain.

Gabriela Zambrano-Ibarra (G)

Pediatric Allergy Unit, Hospital General Universitario Gregorio Marañón, Gregorio Marañón Health Research Institute (IiSGM), Madrid, Spain.

Margarita Tomás-Pérez (M)

Pediatric Allergy Unit, Hospital General Universitario Gregorio Marañón, Gregorio Marañón Health Research Institute (IiSGM), Madrid, Spain.

Adrianna Machinena (A)

Allergy and Clinical Immunology Department, Hospital Sant Joan de Déu, Barcelona, Spain.

Mariona Pascal (M)

Immunology Department, CDB, Hospital Clínic de Barcelona, Barcelona, Spain.
IDIBAPS, Universitat de Barcelona, Barcelona, Spain.

Ana Prieto (A)

Paediatric Allergy Section, General University Hospital, Malaga, Spain.

Sonia Vázquez-Cortes (S)

Allergy Department, Hospital Clinico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain.

Montserrat Fernández-Rivas (M)

Allergy Department, Hospital Clinico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Universidad Complutense, Madrid, Spain.

Leticia Vila (L)

Paediatric Allergy Section, Teresa Herrera Hospital, Coruna, Spain.

Laia Alsina (L)

Clinical Immunology and Primary Immunodeficiencies Unit, Allergy and Clinical Immunology Department, Hospital Sant Joan de Déu, Institut de Recerca Sant Joan de Déu and Universitat de Barcelona, Barcelona, Spain.

María José Torres (MJ)

Allergy Department, General University Hospital, Málaga, Spain.
Allergy Research Group, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma Bionand, Málaga, Spain.
Universidad de Málaga (UMA), Málaga, Spain.
Allergy Clinical Unit, Hospital Regional Universitario de Málaga, Málaga, Spain.

Giusi Mangone (G)

Department of Health Sciences, University of Florence, Florence, Italy.

Santiago Quirce (S)

Department of Allergy, La Paz University Hospital, IdiPAZ, Madrid, Spain.

Federico Martinón-Torres (F)

Genetics, Vaccines and Infections Research Group (GenViP), Instituto de Investigación Sanitaria de Santiago, Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain.
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBER-ES), Madrid, Spain.
Translational Pediatrics and Infectious Diseases, Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Galicia, Spain.

Marta Vázquez-Ortiz (M)

Section of Inflammation, Repair and Development, National Heart and Lung Institute, Imperial College London, London, UK.

Alberto Gómez-Carballa (A)

Genetics, Vaccines and Infections Research Group (GenViP), Instituto de Investigación Sanitaria de Santiago, Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain.
Unidade de Xenética, Instituto de Ciencias Forenses, Facultade de Medicina, Universidade de Santiago de Compostela, and Genética de Poblaciones en Biomedicina (GenPoB) Research Group, Instituto de Investigación Sanitaria (IDIS), Hospital Clínico Universitario de Santiago (SERGAS), Galicia, Spain.
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBER-ES), Madrid, Spain.

Antonio Salas (A)

Genetics, Vaccines and Infections Research Group (GenViP), Instituto de Investigación Sanitaria de Santiago, Universidade de Santiago de Compostela, Santiago de Compostela, Galicia, Spain.
Unidade de Xenética, Instituto de Ciencias Forenses, Facultade de Medicina, Universidade de Santiago de Compostela, and Genética de Poblaciones en Biomedicina (GenPoB) Research Group, Instituto de Investigación Sanitaria (IDIS), Hospital Clínico Universitario de Santiago (SERGAS), Galicia, Spain.
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBER-ES), Madrid, Spain.

Classifications MeSH