Combating Allergy and Asthma in Europe: Issues and Perspectives.

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Presentation transcript:

Combating Allergy and Asthma in Europe: Issues and Perspectives. Erika von Mutius MD MSc Professor of Pediatrics University Children‘s Hospital Munich, Germany

WROCŁAW

Atopic sensitisation in Sobotka and surrounding villages. UK-type prevalence lowest prevalence in Europe Sozanska et al, Allergy 2007

Lifetime residence and atopy. Sozanska et al, Allergy 2007

Prevalence of atopy in Karelian children. % von Hertzen et al, JACI 2006

Microbial exposures in Finnish and Russian Karelian homes. Pakarinen et al, Environ Microbiology 2008

Allergy protection from exposures to stables, farm milk and barns (ALEX Study). OR

amplification of the bacterial 16S rRNA gene mattress dust ds DNA mattress dust DNA extraction exonuclease digestion ss DNA denaturation of DNA gel-electrophoresis under non-denaturing conditions statistical analysis for significant associations with health outcomes or farm-related exposures scanning gel and transformation into density values

Study the Microbiome in Environmental Samples by Pyrosequencing. The ‚New Age of Molecular Diagnostics for Microbial Agents‘ (R. Whitley in NEJM March 2008). The most comprehensive method to detect bacteria, viruses, fungi of all known and unknown species. Will identify the most solid, so far unexplored, candidates. Margulies et al, Nature 2005; Whitley NEJM 2008, Palacios et al, NEJM 2008.

GABRIEL Advanced Surveys Children 6-12 years Alpine regions and Poland Population Parental questionnaire Phenotypes Lung function Blood sampling: Allergy test, DNA/RNA Genetics Nasal and throat swabs Exposure Indoor and outdoor dust Milk samples

GABRIEL Advanced Survey Design Stage I: Recruitment in alpine areas Recruitment questionnaire to large populations (N=135,359). Participation rate: 80.7%. Randomisation: Random sample of full consent group Stage II: Main study Comprehensive questionnaire, blood samples (IgE, genetics), dust samples, nasal swabs (n=9,668) Randomisation: Random sample in area with strongest effects (Germany) Stage III: In depth environmental exposure Collection of multiple dust samples, milk samples, throat swabs and measurement of lung function (n=895)

GABRIEL exposure assessment. Because of restricted funding only possible in 225 subjects (26.2% of subjects in Stage III) Bacterial exposure by 16 sRNA Viable bacteria Endotoxin Muramic acid CpG DNA Fungal exposure by 16 sRNA

Vision for FP7: Comprehensive characterisation of allergy protective environments (Alpine Areas, Eastern Europe, China). Test identified allergy protective microbes / compounds in experimental studies. Develop novel prevention strategies