Presentation on theme: "Combating Allergy and Asthma in Europe: Issues and Perspectives. Erika von Mutius MD MSc Professor of Pediatrics University Childrens Hospital Munich,"— Presentation transcript:
Combating Allergy and Asthma in Europe: Issues and Perspectives. Erika von Mutius MD MSc Professor of Pediatrics University Childrens Hospital Munich, Germany
lowest prevalence in Europe UK-type prevalence Atopic sensitisation in Sobotka and surrounding villages. 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 %
Pakarinen et al, Environ Microbiology 2008 Microbial exposures in Finnish and Russian Karelian homes.
Allergy protection from exposures to stables, farm milk and barns (ALEX Study). OR
DNA extraction denaturation of DNA amplification of the bacterial 16S rRNA gene ds DNA exonuclease digestion ss DNA statistical analysis for significant associations with health outcomes or farm-related exposures scanning gel and transformation into density values mattress dust gel-electrophoresis under non-denaturing conditions
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.
Children 6-12 years Alpine regions and Poland Parental questionnaire Blood sampling: Allergy test, DNA/RNA Indoor and outdoor dust Milk samples Phenotypes Population Exposure Genetics Nasal and throat swabs Lung function GABRIEL Advanced Surveys
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