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The correspondence letter delineates a dichotomy between the common paradigm of asthma inception in susceptible individuals being due to epithelial junctional complex dysfunction as assessed by albumin concentrations in the airway lumen (discussed in Löser et al1) and reported findings of unchanged or decreased epithelial permeability in patients measured by clearance of aerosolized radiolabeled diethylenetriaminepentaacetic acid. Whether epithelial barrier dysfunction is a basic feature of asthma and allergic rhinitis and whether albumin concentrations measured in the airways correlate with epithelial permeability is a matter of debate.

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