Affiliated to research
I am specialist physician in Internal Medicine, Clinical Immunology and Allergology and currently serve as a senior consultant in the Respiratory Diseases and Allergy Clinic, Karolinska University Hospital, Huddinge. I received my PhD from the Karolinska Institutet in 2014 in allergy on a project dealing with Clonal Mast Cell Disorders (Mastocytosis) and Anaphylactic reactions.
Anaphylaxis, Mastocytosis and other mast cell disorders manifesting with mast cell activation
My current research focuses on clinical and experimental aspects of Mast Cell Activation Disorders, such as severe anaphylaxis and mastocytosis, in which perturbations in reactivity of mast cells, so called "hyperectivity", lead to severe, uncontrolled mast cell activation.
Anaphylaxis is a rapidly developing and serious hypersensitivity reaction that can concurrently affect multiple organ systems. It remains as a clinical entity and the diagnosis is based on constellation of different signs and symptoms according to the World Allergy Organization (WAO) diagnostic criteria, which involves two or more organs including skin/mucosal membranes, airways, cardiovascular, and/or gastrointestinal systems. These criteria enabled clinicians across the world to 'speak the same language' and facilitated tremendously patients and acute care physician to recognize and treat it promptly. It also made possible for scientist to report meaningful, comparable data. However, despite significant progresses in allergology and immunology during the last 2-3 decades, understanding of anaphylaxis for an allergist is fairly limited at present with respect to factors determining severity, underlying intracellular effector mechanisms within mast cells, co-factor influence, and immune mechanisms involving of mast cell activation disorders (MCAD). To achieve this, future studies should approach anaphylaxis in a concerted manner with detailed phenotyping/endotyping by exploring the role of mast cell activation biomarkers in plasma and urine. In this context, patients with MCAD, such as mastocytosis are of great relevance to study patients with severe anaphylaxis, as these patients usually develop recurrent, severe anaphylaxis. Therefore, the main focus of the current project will be exploring clinical and biological features of MCAD patients to better understand mechanisms of anaphylaxis by screening specific diagnostic and prognostic biomarkers in patients with mastocytosis. We also aim to identify novel biomarkers of severe anaphylaxis.
Ultimately, understanding these regulatory mechanisms might help to predict patients with severe anaphylaxis as well as to develop personalized treatment options for individual patients with mastocytosis and other mast cell disorders.
Gülen T, Akin C, Bonadonna P, Siebenhaar F, Broesby-Olsen S, Brockow K, Niedoszytko M, Nedoszytko B, Oude Elberink HNG, Butterfield JH, Sperr WR, Alvarez-Twose I, Horny HP, Sotlar K, Schwaab J, Jawhar M, Zanotti R, Nilsson G, Lyons JJ, Carter MC, George TI, Hermine O, Gotlib J, Orfao A, Triggiani M, Reiter A, Hartmann K, Castells M, Arock M, Schwartz LB, Metcalfe DD, Valent P.J Allergy Clin Immunol Pract. 2021 Jun 22:S2213-2198(21)00676-0. doi: 10.1016/j.jaip.2021.06.011. Online ahead of print.PMID: 34166845 Free article.
Bonadonna P, Brockow K, Niedoszytko M, Elberink HO, Akin C, Nedoszytko B, Butterfield JH, Alvarez-Twose I, Sotlar K, Schwaab J, Jawhar M, Castells M, Sperr WR, Hermine O, Gotlib J, Zanotti R, Reiter A, Broesby-Olsen S, Bindslev-Jensen C, Schwartz LB, Horny HP, Radia D, Triggiani M, Sabato V, Carter MC, Siebenhaar F, Orfao A, Grattan C, Metcalfe DD, Arock M, Gulen T, Hartmann K, Valent P.J Allergy Clin Immunol Pract. 2021 Jun;9(6):2139-2144. doi: 10.1016/j.jaip.2021.03.041. Epub 2021 Apr 5.PMID: 33831618
Gülen T, Teufelberger A, Ekoff M, Westerberg CM, Lyberg K, Dahlén SE, Dahlén B, Nilsson G. The Journal of allergy and clinical immunology 2021:346-348.
Gulen T, Akin C. Curr Allergy Asthma Rep 2021:21(2):11.
Jarkvist J, Brockow K, Gülen T. J Allergy Clin Immunol Pract 2020:8(9):3093-3101.
Jarkvist J, Salehi C, Akin C, Gülen T. Allergy 2020:75(1):169-177.
Clin Exp Allergy 2017:47(7):909-917.