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Koffert A, Liippo J, Löyttyniemi E, Savolainen J. Clinical outcome and component-specific antibody levels in egg allergic children after lightened oral immunotherapy. Allergol Immunopathol (Madr) 2024; 52:44-59. [PMID: 38186193 DOI: 10.15586/aei.v52i1.805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 04/07/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE To evaluate the clinical outcome of lightened version of egg oral immunotherapy (OIT) and to analyze egg allergen component-specific antibody levels during short up-dosing with egg white powder and maintenance by egg in daily diet. PATIENTS AND METHODS Eighteen egg-allergic children received egg powder with short up--dosing and they maintained tolerance using egg in daily diet. Seventeen egg-allergic children served as a control group. Component-resolved analysis of serum immunoglobulin E (IgE), IgA1, IgA2, and IgG4 levels were determined at inclusion, after up-dosing and after 1 year of immunotherapy. Skin-prick tests were performed at inclusion and after 1 year of therapy. RESULTS All 18 patients in the egg OIT group were successfully desensitized. Desensitization was achieved on average in 4.5 months. In the control group, only two children tolerated egg in oral food challenge after 1 year. Of the measured immune markers, smaller wheal diameters in skin-prick testing, reduction in component-specific IgE levels, and increase in component-specific IgA1, IgA2, and IgG4 levels were associated with desensitization. CONCLUSION A lightened egg OIT is effective and safe in children with egg allergy. Increase in all egg component-specific IgA1, IgA2 and IgG4 levels and decrease in all egg component--specific IgE levels were observed after 12 months of OIT.
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Affiliation(s)
- Anna Koffert
- Department of Dermatology, University of Turku and Turku University Hospital, Turku, Finland;
| | - Jussi Liippo
- Department of Dermatology, University of Turku and Turku University Hospital, Turku, Finland
| | | | - Johannes Savolainen
- Department of Pulmonary Diseases and Clinical Allergology, University of Turku and Turku University Hospital, Turku, Finland
- Department of Pediatrics, Turku University Hospital, Turku, Finland
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2
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Kivistö JE, de Blok BF, Protudjer JLP, Ojaniemi I, Karjalainen J, Huhtala H, Dunn Galvin A. Validation of the Finnish version of the food allergy quality of life questionnaire-parent form (F-FAQLQ-PF). Acta Paediatr 2024; 113:91-97. [PMID: 37548086 DOI: 10.1111/apa.16937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/08/2023] [Accepted: 08/03/2023] [Indexed: 08/08/2023]
Abstract
AIM Specific questionnaires about food allergy and health-related quality of life (HRQoL) have been developed and validated in several languages, but not Finnish. We aimed to validate the Finnish Food Allergy Quality of Life Questionnaire-Parent Form (FAQLQ-PF) for children under age 13 years. METHODS The original FAQLQ-PF and Food Allergy Independent Measure (FAIM) were translated into Finnish per World Health Organisation guidelines and tested by 72 parents of children under age 13 years with suspected severe peanut or tree nut allergy who were recruited at Allergy Centre in Tampere University Hospital in Tampere, Finland. We calculated the construct validity of the questionnaire by calculating the coefficients between the two measures and used Cronbach's alpha to establish the internal consistency. RESULTS The FAQLQ-PF showed strong correlations with domain structure and internal consistency, based on Spearman's correlations (rho) for the HRQoL questions, FAIM questions and FAIM mean values. The total questionnaire score correlated significantly with the mean FAIM (rho = 0.95, p < 0.001) and individual FAIM questions. The FAQLQ-PF and domains had good or excellent internal consistency (Cronbach's alpha >0.70). CONCLUSION The Finnish FAQLQ-PF demonstrated good construct validity and excellent internal consistency for measuring food allergy HRQoL in children under age 13 years.
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Affiliation(s)
- J E Kivistö
- Allergy Centre, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Tampere Center for Child Health Research, University of Tampere, Tampere, Finland
| | - B Flokstra de Blok
- General Practitioners Research Institute, Groningen, The Netherlands
- University Medical Center Groningen, Groningen Research Institute Asthma and COPD (GRIAC), University of Groningen, Groningen, The Netherlands
- University Medical Center Groningen, Beatrix Children's Hospital, Department of Pediatric Pulmonology and Pediatric Allergology, University of Groningen, Groningen, The Netherlands
| | - J L P Protudjer
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
- The Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- George and Fay Yee Centre for Healthcare Innovation, Winnipeg, Manitoba, Canada
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - I Ojaniemi
- Allergy Centre, Tampere University Hospital, Tampere, Finland
| | - J Karjalainen
- Allergy Centre, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - H Huhtala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - A Dunn Galvin
- School of Applied Psychology, University College Cork, Cork, Ireland
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3
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Heikkilä JM, Bergman P, Jantunen J, Salimäki J, Pohjanoksa-Mäntylä M, Kauppi P. Are there differences in the patient-reported medication-related problems among asthma and allergy patients? A community pharmacy survey in Finland. BMC Public Health 2023; 23:1570. [PMID: 37596587 PMCID: PMC10436668 DOI: 10.1186/s12889-023-16423-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 07/31/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND A medication-related problem is an event involving medication that interferes with desired health outcomes. Those are largely studied among asthma patients, but little is known about medication-related problems among allergy patients. The objective of this study was to determine the most common patient-reported medication-related problems among asthma patients compared to allergy patients during the self-management of diseases. The other objective was to identify how demographic variables and the received treatment information influence reported problems. METHODS A nationwide survey was conducted in Finnish community pharmacies (n = 785) in September 2016. The survey targeted patients buying prescription medicines for asthma or allergy. RESULTS Responses were received from 46% of targeted pharmacies from 956 respondents. At least one medication problem was reported by 24% of asthma patients and 12% of allergy patients. The most common problems among asthma patients were having problems taking medicines on time (16%), problems in the administration technique (7%) and in the use of the inhaler (4%). Among allergy patients, 10% reported problems remembering to take medicines on time. Severe asthma and allergy increased the risk for medication-related problems (OR 1.20, 95% CI 1.04-1.40 and OR 1.17, 95% CI 1.0-1.37). A higher age and less education were associated with fewer reported medication-related problems among both patient groups. CONCLUSIONS Asthma patients reported more medication-related problems than allergy patients. Among both investigated patient groups, remembering to take medicines on time was the most common. Health care professionals should educate younger patients but also older and less educated asthma and allergy patients to recognize and, to solve medication-related problems. In addition, severe asthma patients still need medication counseling.
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Affiliation(s)
- Juha Markus Heikkilä
- Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland.
| | - Paula Bergman
- Biostatistics Unit, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Juha Jantunen
- Allergy, Skin and Asthma Federation, Helsinki, Finland
| | | | - Marika Pohjanoksa-Mäntylä
- Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
| | - Paula Kauppi
- Pulmonary Department, Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland
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4
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Haahtela T, Alenius H, Auvinen P, Fyhrquist N, von Hertzen L, Jousilahti P, Karisola P, Laatikainen T, Lehtimäki J, Paalanen L, Ruokolainen L, Saarinen K, Valovirta E, Vasankari T, Vlasoff T, Erhola M, Bousquet J, Vartiainen E, Mäkelä MJ. A short history from Karelia study to biodiversity and public health interventions. FRONTIERS IN ALLERGY 2023; 4:1152927. [PMID: 36998574 PMCID: PMC10043497 DOI: 10.3389/falgy.2023.1152927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 02/21/2023] [Indexed: 03/15/2023] Open
Abstract
Contact with natural environments enriches the human microbiome, promotes immune balance and protects against allergies and inflammatory disorders. In Finland, the allergy & asthma epidemic became slowly visible in mid 1960s. After the World War II, Karelia was split into Finnish and Soviet Union (now Russia) territories. This led to more marked environmental and lifestyle changes in the Finnish compared with Russian Karelia. The Karelia Allergy Study 2002–2022 showed that allergic conditions were much more common on the Finnish side. The Russians had richer gene-microbe network and interaction than the Finns, which associated with better balanced immune regulatory circuits and lower allergy prevalence. In the Finnish adolescents, a biodiverse natural environment around the homes associated with lower occurrence of allergies. Overall, the plausible explanation of the allergy disparity was the prominent change in environment and lifestyle in the Finnish Karelia from 1940s to 1980s. The nationwide Finnish Allergy Programme 2008–2018 implemented the biodiversity hypothesis into practice by endorsing immune tolerance, nature contacts, and allergy health with favorable results. A regional health and environment programme, Nature Step to Health 2022–2032, has been initiated in the City of Lahti, EU Green Capital 2021. The programme integrates prevention of chronic diseases (asthma, diabetes, obesity, depression), nature loss, and climate crisis in the spirit of Planetary Health. Allergic diseases exemplify inappropriate immunological responses to natural environment. Successful management of the epidemics of allergy and other non-communicable diseases may pave the way to improve human and environmental health.
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Affiliation(s)
- Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
- Correspondence: Tari Haahtela
| | - Harri Alenius
- Human Microbiome Research (HUMI), Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Petri Auvinen
- DNA Sequencing and GenomicsLaboratory, Institute of Biotechnology, Helsinki, Finland
| | - Nanna Fyhrquist
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Pekka Jousilahti
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Piia Karisola
- Human Microbiome Research (HUMI), Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Tiina Laatikainen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | | | - Laura Paalanen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Lasse Ruokolainen
- Department of Biosciences, University of Helsinki, Helsinki, Finland
| | | | - Erkka Valovirta
- Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland
- Allergy Clinic, Terveystalo, Turku, Finland
| | - Tuula Vasankari
- Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland
- Finnish Lung Health Association (FILHA), Helsinki, Finland
| | - Tiina Vlasoff
- North Karelia Centre for Public Health, Joensuu, Finland
| | - Marina Erhola
- Pirkanmaa Joint Authority for Health Services and Social Welfare, Tampere, Finland
| | - Jean Bousquet
- Institute of Allergology, Charité — Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
- University Hospital Montpellier, Montpellier, France
| | - Erkki Vartiainen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Mika J. Mäkelä
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
- University of Helsinki, Helsinki, Finland
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5
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Metsälä J, Vuorinen AL, Takkinen HM, Peltonen EJ, Ahonen S, Åkerlund M, Tapanainen H, Mattila M, Toppari J, Ilonen J, Veijola R, Haahtela T, Knip M, Kaila M, Virtanen SM. Longitudinal consumption of fruits and vegetables and risk of asthma by 5 years of age. Pediatr Allergy Immunol 2023; 34:e13932. [PMID: 36974649 DOI: 10.1111/pai.13932] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/16/2023] [Accepted: 02/21/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Fruit and vegetable consumption has been linked to a decreased risk of asthma, but prospective evidence on longitudinal consumption in childhood is scarce. We aimed to investigate the association between fruit and vegetable consumption in childhood and the risk of asthma by the age of 5 years, and to explore the role of processing of fruits and vegetables in the Finnish Type 1 Diabetes Prediction and Prevention Allergy Study. METHODS Child's food consumption was assessed by 3-day food records completed at the age of 3 and 6 months, and 1, 2, 3, 4, and 5 years, and asthma and allergies by a validated modified version of the ISAAC questionnaire at the age of 5 years. Consumption of processed and unprocessed fruits and vegetables was calculated. Joint models with a current value association structure for longitudinal and time-to-event data were used for statistical analyses. RESULTS Of the 3053 children, 184 (6%) developed asthma by the age of 5 years. The risk of asthma was not associated with the consumption of all fruits and vegetables together (HR 1.00, 95%CI 0.99-1.01 per consumption of 1 g/MJ, adjusted for energy and other covariates), or with most subgroups. Weak inverse associations were seen between all leafy vegetables and asthma (HR = 0.87, 0.77-0.99), and unprocessed vegetables and nonatopic asthma (HR = 0.90, 95% CI 0.81-0.98). CONCLUSION Total consumption of fruits and vegetables in childhood was not associated with the development of asthma by the age of 5 years. Weak inverse associations found for vegetables need to be confirmed or rejected in future studies.
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Affiliation(s)
- Johanna Metsälä
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Anna-Leena Vuorinen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland
| | - Hanna-Mari Takkinen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland
- Research, Development and Innovation Center, Tampere University Hospital, Tampere, Finland
| | - Essi J Peltonen
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland
- Research, Development and Innovation Center, Tampere University Hospital, Tampere, Finland
| | - Suvi Ahonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland
- Research, Development and Innovation Center, Tampere University Hospital, Tampere, Finland
| | - Mari Åkerlund
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland
- Research, Development and Innovation Center, Tampere University Hospital, Tampere, Finland
| | - Heli Tapanainen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Markus Mattila
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland
- Research, Development and Innovation Center, Tampere University Hospital, Tampere, Finland
| | - Jorma Toppari
- Research Centre for Integrative Physiology and Pharmacology, Institute of Biomedicine, and Centre for Population Health Research, University of Turku, and Department of Pediatrics, Turku University Hospital, Turku, Finland
| | - Jorma Ilonen
- Immunogenetics Laboratory, Institute of Biomedicine, University of Turku, Turku, Finland
| | - Riitta Veijola
- Department of Paediatrics, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Mikael Knip
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Center for Child Health Research, Tampere University, Tampere University Hospital, Tampere, Finland
| | - Minna Kaila
- Public Health Medicine, University of Helsinki, Helsinki, Finland
- Department of Paediatrics, Tampere University Hospital, Tampere, Finland
| | - Suvi M Virtanen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland
- Research, Development and Innovation Center, Tampere University Hospital, Tampere, Finland
- Center for Child Health Research, Tampere University, Tampere University Hospital, Tampere, Finland
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6
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Kivistö JE, Protudjer JLP, Karjalainen J, Bergström A, Huhtala H, Korppi M, Melén E. Paediatric asthma hospitalisations continue to decrease in Finland and Sweden between 2015 and 2020. Thorax 2023; 78:thorax-2022-219539. [PMID: 36593115 DOI: 10.1136/thorax-2022-219539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 12/11/2022] [Indexed: 01/03/2023]
Abstract
We previously reported a decreasing incidence of paediatric asthma hospitalisations in Finland, but a rather stable trend in Sweden, between 2005 and 2014. We now aimed to investigate the incidence of paediatric asthma hospitalisations in these countries between 2015 and 2020, using Finland's National Hospital Discharge Register and Sweden's National Patient Register, which cover all hospitalisations in the respective countries. From 2015 to 2019, the incidence of paediatric asthma hospitalisations decreased by 36.7% in Finland and by 39.9% in Sweden and are increasingly approaching parity. In 2020, despite differences in COVID-19-related restrictions, asthma hospitalisations decreased by over 40%, thus warranting future research on the subject.
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Affiliation(s)
- Juho E Kivistö
- Allergy Centre, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Tampere Center for Child Health Research, University of Tampere, Tampere, Finland
| | - Jennifer L P Protudjer
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
- The Children's Hospital Research, Institute of Manitoba, Winnipeg, Manitoba, Canada
- George and Fay Yee Centre for Healthcare Innovation, Winnipeg, Manitoba, Canada
- Centre for Allergy Research, KarolinskaInstitutet, Stockholm, Sweden
| | - Jussi Karjalainen
- Allergy Centre, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Anna Bergström
- Institute of Environmental Medicine, KarolinskaInstitutet, Stockholm, Sweden
| | - Heini Huhtala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Matti Korppi
- Tampere Center for Child Health Research, University of Tampere, Tampere, Finland
| | - Erik Melén
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
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7
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Gherasim A, Beck M, Dietsch F, Meyer M, Domis N, De Blay F. Évaluation clinique de l’efficacité d’un masque chirurgical dans la réduction des symptômes d’asthme et de rhinite, chez des sujets allergiques au pollen de bouleau dans la chambre d’exposition environnementale ALYATEC. REVUE FRANÇAISE D'ALLERGOLOGIE 2022. [DOI: 10.1016/j.reval.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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AlergiaPT: A Portuguese media campaign to inspire people with allergies to make a positive change in their life. Porto Biomed J 2022; 7:e169. [PMID: 35146176 PMCID: PMC8824408 DOI: 10.1097/j.pbj.0000000000000169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 08/25/2021] [Indexed: 11/25/2022] Open
Abstract
Allergic diseases comprise a significant cause of morbidity worldwide and a substantial burden on the health and medical systems of both developed and emerging economies. Although highly prevalent, relatively severe, and largely impactful on the quality of life of patients, allergic diseases are commonly trivialized. Increasing awareness of the relevance of allergic diseases as a major public health problem might lead to an improved acknowledgment by governments and health authorities. Based on the positive impact that media campaigns might have on health-related behaviors, as well as the large use of social media by different types of users, social media might be used as a powerful tool for spreading awareness and education even more effective than traditional face-to-face communication. Therefore, we aimed to develop a social media-based communication program, the AlergiaPT, reaching all stakeholders, to increase the awareness of allergic diseases tackling the causes, prevention, control, and economic impact. The AlergiaPT will provide user-generated and interactive content toward engagement, include both long-form and short-form video productions toward education, as well as stories and time-sensitive content toward empowerment. It will be targeted to all populations, engaging different stakeholders. Contents will address the 5 campaign goals: i) allergy health is promoted; ii) tolerance is actively reinforced, and avoidance reduced; iii) treatment control and guided self-management of patients of asthma, rhinitis, food allergy, and atopic eczema are strengthened; iv) recognition and treatment of severe allergy and anaphylaxis are improved, and v) indoor air quality is promoted. Engagement on the campaign will be promoted through stepwise educational takeaways meetings using different social media, and targeting all audience groups, by promoting the organization of resources for common goals and the involvement of social media to improve public awareness. The impact of AlergiaPT will be assessed through google analytics.
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González‐Rodríguez MI, Nurminen N, Kummola L, Laitinen OH, Oikarinen S, Parajuli A, Salomaa T, Mäkelä I, Roslund MI, Sinkkonen A, Hyöty H, Junttila IS. Effect of inactivated nature‐derived microbial composition on mouse immune system. Immun Inflamm Dis 2022; 10:e579. [PMID: 34873877 PMCID: PMC8926502 DOI: 10.1002/iid3.579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/04/2021] [Accepted: 11/22/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction The hygiene hypothesis suggests that decrease in early life infections due to increased societal‐level hygiene standards subjects one to allergic and autoimmune diseases. In this report, we have studied the effect of sterilized forest soil and plant‐based material on mouse immune system and gut microbiome. Methods Inbred C57Bl/6 mice maintained in normal sterile environment were subjected to autoclaved forest soil‐derived powder in their bedding for 1 h a day for 3 weeks. Immune response was measured by immune cell flow cytometry, serum cytokine enzyme‐linked immunoassay (ELISA) and quantitative polymerase chain reaction (qPCR) analysis. Furthermore, the mouse gut microbiome was analyzed by sequencing. Results When compared to control mice, mice treated with soil‐derived powder had decreased level of pro‐inflammatory cytokines namely interleukin (IL)−17F and IL‐21 in the serum. Furthermore, splenocytes from mice treated with soil‐derived powder expressed less IL‐1b, IL‐5, IL‐6, IL‐13, and tumor necrosis factor (TNF) upon cell activation. Gut microbiome appeared to be stabilized by the treatment. Conclusions These results provide insights on the effect of biodiversity on murine immune system in sterile environment. Subjecting mice to soil‐based plant and microbe structures appears to elicit immune response that could be beneficial, for example, in type 2 inflammation‐related diseases, that is, allergic diseases.
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Affiliation(s)
| | - Noora Nurminen
- Faculty of Medicine and Health Technology Tampere University Tampere Finland
| | - Laura Kummola
- Faculty of Medicine and Health Technology Tampere University Tampere Finland
- Department of Clinical Microbiology Fimlab Laboratories Finland
| | - Olli H. Laitinen
- Faculty of Medicine and Health Technology Tampere University Tampere Finland
| | - Sami Oikarinen
- Faculty of Medicine and Health Technology Tampere University Tampere Finland
| | - Anirudra Parajuli
- Department of Medicine, Karolinska Institutet Center for infectious medicine (CIM) Huddinge Sweden
| | - Tanja Salomaa
- Faculty of Medicine and Health Technology Tampere University Tampere Finland
| | - Iida Mäkelä
- Department of Garden Technologies, Horticulture Technologies Natural Resources Institute Finland Finland
| | - Marja I. Roslund
- Ecosystems and Environment Research Programme University of Helsinki Helsinki Finland
| | - Aki Sinkkonen
- Department of Garden Technologies, Horticulture Technologies Natural Resources Institute Finland Finland
| | - Heikki Hyöty
- Faculty of Medicine and Health Technology Tampere University Tampere Finland
- Department of Clinical Microbiology Fimlab Laboratories Finland
| | - Ilkka S. Junttila
- Faculty of Medicine and Health Technology Tampere University Tampere Finland
- Department of Clinical Microbiology Fimlab Laboratories Finland
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10
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Haahtela T, Jantunen J, Saarinen K, Tommila E, Valovirta E, Vasankari T, Mäkelä MJ. Managing the allergy and asthma epidemic in 2020s-Lessons from the Finnish experience. Allergy 2022; 77:2367-2380. [PMID: 35202479 PMCID: PMC9546028 DOI: 10.1111/all.15266] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 12/13/2022]
Abstract
In Finland, a systematic public health programme was implemented from 2008 to 2018 to mitigate the burden of allergic disorders by revisiting the prevention strategy. Allergy health and contacts with natural environment were emphasized to promote immunological and psychological resilience instead of poorly justified avoidance. Allergy management practices were improved and low‐valued recommendations for care, for example for food allergy, were revised. Patients and families were empowered to use guided self‐management to proactively stop symptom exacerbations. A professional non‐governmental organization implemented the nationwide education for healthcare and patient NGOs for patients, families and lay public. In healthcare, the work supporting allergic patients and families was organized towards common goals and integrated into everyday work without extra costs. Reaching the predefined goals was followed by employing the national healthcare registers and questionnaire surveys. Governmental bodies contributed with kick‐off funding, which was supplemented by private funding. International collaboration, for example with the European patient organization (EFA), increased awareness of the Finnish action and predisposed it for peer review. The 10‐year results are favourable, patients are less disabled, practices and attitudes in healthcare have changed, and major cost savings have been obtained. Views of the lay public and patients are slow to move, however. Local multidisciplinary allergy teams were set up to continue the activities also after the Programme. Changes in environment and lifestyle in the last 50 years are the main reasons for the allergy rise. The Finnish experience may help to manage allergic diseases, improve nature relatedness in the fast‐urbanizing world, combat nature loss and reduce the disease burden.
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Affiliation(s)
- Tari Haahtela
- Skin and Allergy Hospital Helsinki University Hospital University of Helsinki Helsinki Finland
| | - Juha Jantunen
- Allergy, Skin and Asthma Federation Helsinki Finland
| | | | - Erja Tommila
- Finnish Lung Health Association (FILHA) Helsinki Finland
| | - Erkka Valovirta
- Department of Lung Diseases and Clinical Allergology University of Turku, and Allergy ClinicTerveystalo Turku Finland
| | | | - Mika J. Mäkelä
- Skin and Allergy Hospital Helsinki University Hospital University of Helsinki Helsinki Finland
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11
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Guan K, Zhu W, Sha L, Liu C, Zhao J, Yin J, Chen Y. Prevalence of Sensitization to Aeroallergens in Greater Beijing Region Children With Respiratory Allergy. Front Pediatr 2022; 10:848357. [PMID: 35664864 PMCID: PMC9161292 DOI: 10.3389/fped.2022.848357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 04/29/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To evaluate the prevalence and distribution of sensitization to aeroallergens in children with atopic diseases. METHODS We conducted skin prick test on 9,527 pediatric patients (aged 0-17 years) with atopic diseases in allergy department of Children's Hospital affiliated with the Capital Institute of Pediatrics. Positive rates of aeroallergens were compared among the different groups. RESULTS Boys (69.5%) had a higher positive rate in SPT results than girls (59.8%; χ2 = 91.7, P < 0.01), and the prevalence of sensitization to aeroallergens increased from 56.1% in the 0-5 year group, to 73.0% in patients above 12 years. Japanese hop (36.2%) and D. farinae (28.1%) were the most common outdoor and indoor aeroallergens, respectively. From low to high age groups, the positive detection rates of D. farinae were 20.3, 30.6, and 33.5%, respectively, followed by D. pteronyssinus (15.7, 24.8, and 30.0%) and cat dander (8.6, 19.8, and 27.9%, respectively), while dog dander and cockroach showed the same trend. The top three positive detection rates of outdoor aeroallergens were Alternaria (30.9%), Japanese Hop (26.7%), and Artemisia (23.7%) in the preschool age group. With regard to patients aged 6 to 11 years, the three most common were Japanese hop (39.2%), Alternaria (36.4%), and Fraxinus pollen (34.4%). Japanese hop (43.8%), Sabina (41.1%), and birch pollen (39.6%) became increasingly common allergens among adolescents. There were more patients with strongly positive reactions to Alternaria in AS (χ2 = 10.2, P < 0.01) and AS with AR groups (χ2 =9.7, P < 0.01) than those in the AR group. Asthmatic patients had significantly higher multiple positive reactions than those with AR (P < 0.01). Asthmatic patients had a much higher prevalence of HDM, animal dander, and Alternaria than those with allergic rhinitis (P < 0.05). CONCLUSION The prevalence of sensitization to aeroallergens increased with age in children with atopic diseases in Greater Beijing Region. Alternaria was the predominant allergen before 5 years of age, and tree pollen had delayed sensitization in adolescents. Sensitization to perennial allergens such as HDM, cats, and Alternaria was more strongly associated with asthma risk. Sensitization to more than one allergen significantly affected asthmatic patients.
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Affiliation(s)
- Kai Guan
- Department of Allergy, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.,Peking Union Medical College, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Disease, Beijing, China.,National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China
| | - Wenjing Zhu
- Department of Allergy, Children's Hospital of Capital Institute of Pediatrics, Beijing, China
| | - Li Sha
- Department of Allergy, Children's Hospital of Capital Institute of Pediatrics, Beijing, China
| | - Chuanhe Liu
- Department of Allergy, Children's Hospital of Capital Institute of Pediatrics, Beijing, China
| | - Jing Zhao
- Department of Allergy, Children's Hospital of Capital Institute of Pediatrics, Beijing, China
| | - Jia Yin
- Department of Allergy, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.,Peking Union Medical College, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Disease, Beijing, China.,National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China
| | - Yuzhi Chen
- Department of Allergy, Children's Hospital of Capital Institute of Pediatrics, Beijing, China
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Jantunen J, Kauppi P, Linna M, Mäkelä M, Pelkonen A, Haahtela T. Real-world evidence of reduced disability costs during the Finnish Allergy Programme 2008-2018. Allergy 2021; 76:3817-3819. [PMID: 34460940 DOI: 10.1111/all.15070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Juha Jantunen
- Allergy, Skin and Asthma Federation Helsinki Finland
| | - Paula Kauppi
- Skin and Allergy Hospital Helsinki University Hospital University of Helsinki Helsinki Finland
| | - Miika Linna
- Healthcare Engineering, Management and Architecture Institute Aalto University Espoo Finland
| | - Mika Mäkelä
- Skin and Allergy Hospital Helsinki University Hospital University of Helsinki Helsinki Finland
| | - Anna Pelkonen
- Skin and Allergy Hospital Helsinki University Hospital University of Helsinki Helsinki Finland
| | - Tari Haahtela
- Skin and Allergy Hospital Helsinki University Hospital University of Helsinki Helsinki Finland
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13
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Haahtela T, Alenius H, Lehtimäki J, Sinkkonen A, Fyhrquist N, Hyöty H, Ruokolainen L, Mäkelä MJ. Immunological resilience and biodiversity for prevention of allergic diseases and asthma. Allergy 2021; 76:3613-3626. [PMID: 33959980 DOI: 10.1111/all.14895] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/27/2021] [Accepted: 04/29/2021] [Indexed: 02/07/2023]
Abstract
Increase of allergic conditions has occurred at the same pace with the Great Acceleration, which stands for the rapid growth rate of human activities upon earth from 1950s. Changes of environment and lifestyle along with escalating urbanization are acknowledged as the main underlying causes. Secondary (tertiary) prevention for better disease control has advanced considerably with innovations for oral immunotherapy and effective treatment of inflammation with corticosteroids, calcineurin inhibitors, and biological medications. Patients are less disabled than before. However, primary prevention has remained a dilemma. Factors predicting allergy and asthma risk have proven complex: Risk factors increase the risk, while protective factors counteract them. Interaction of human body with environmental biodiversity with micro-organisms and biogenic compounds as well as the central role of epigenetic adaptation in immune homeostasis have given new insight. Allergic diseases are good indicators of the twisted relation to environment. In various non-communicable diseases, the protective mode of the immune system indicates low-grade inflammation without apparent cause. Giving microbes, pro- and prebiotics, has shown some promise in prevention and treatment. The real-world public health programme in Finland (2008-2018) emphasized nature relatedness and protective factors for immunological resilience, instead of avoidance. The nationwide action mitigated the allergy burden, but in the lack of controls, primary preventive effect remains to be proven. The first results of controlled biodiversity interventions are promising. In the fast urbanizing world, new approaches are called for allergy prevention, which also has a major cost saving potential.
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Affiliation(s)
- Tari Haahtela
- Skin and Allergy Hospital Helsinki University HospitalUniversity of Helsinki Helsinki Finland
| | - Harri Alenius
- Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
- Department of Bacteriology and Immunology Medicum University of Helsinki Helsinki Finland
| | | | - Aki Sinkkonen
- Natural Resources Institute Finland, Horticulture Technologies Turku Finland
| | - Nanna Fyhrquist
- Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
- Department of Bacteriology and Immunology Medicum University of Helsinki Helsinki Finland
| | - Heikki Hyöty
- Faculty of Medicine and Health Technology Tampere University Tampere Finland
- Fimlab Laboratories Pirkanmaa Hospital District Tampere Finland
| | - Lasse Ruokolainen
- Lasse Ruokolainen Department of Biosciences University of Helsinki Helsinki Finland
| | - Mika J. Mäkelä
- Skin and Allergy Hospital Helsinki University HospitalUniversity of Helsinki Helsinki Finland
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14
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Heikkilä JM, Bergman P, Jantunen J, Salimäki J, Kauppi P, Pohjanoksa-Mäntylä M. Are there differences in the treatment information received to support guided self-management between asthma and allergy patients?: A community pharmacy survey in Finland. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2021; 3:100040. [PMID: 35480604 PMCID: PMC9030715 DOI: 10.1016/j.rcsop.2021.100040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 06/22/2021] [Accepted: 06/22/2021] [Indexed: 10/26/2022] Open
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15
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The Global Alliance against Chronic Respiratory Diseases: journey so far and way ahead. Chin Med J (Engl) 2021; 133:1513-1515. [PMID: 32530880 PMCID: PMC7386342 DOI: 10.1097/cm9.0000000000000851] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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16
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Haahtela T, Valovirta E, Saarinen K, Jantunen J, Lindström I, Kauppi P, Laatikainen T, Pelkonen A, Salava A, Tommila E, Bousquet J, Vasankari T, Mäkelä MJ. The Finnish Allergy Program 2008-2018: Society-wide proactive program for change of management to mitigate allergy burden. J Allergy Clin Immunol 2021; 148:319-326.e4. [PMID: 33965232 DOI: 10.1016/j.jaci.2021.03.037] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/03/2021] [Accepted: 03/24/2021] [Indexed: 12/20/2022]
Abstract
A 10-year national program to improve prevention and management of allergic diseases and asthma was implemented in Finland (population 5.5. million) in 2008-2018. The main aim was to reduce the long-term burden of these conditions. The strategy was changed from traditional avoidance to tolerance and resilience of the population. Health was endorsed instead of medicalization of mild symptoms. Disease severity was reevaluated, and disabling clinical manifestations were given high priority. For health care, 5 quantitative goals and 1 qualitative goal were set. For each of the goals, specific tasks, tools, and outcome evaluation were stipulated. During the program, 376 educational sessions gathered 24,000 health care participants. An information campaign targeted the lay public, and social media was used to contact people. In the 10 years of the program, the prevalence of allergic diseases and asthma leveled off. Asthma caused fewer symptoms and less disability, and 50% fewer hospital days. Food allergy diets in day care and schools decreased by half. Occupational allergies were reduced by 45%. In 2018, the direct and indirect costs of allergic diseases and asthma ranged from €1.5 billion to €1.8 billion, with the 2018 figures being 30% less than in the respective figures in 2007. The Finnish proactive and real-world intervention markedly reduced the public health burden of allergic disorders. The allergy paradigm was revisited to improve management with systematic education.
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Affiliation(s)
- Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
| | - Erkka Valovirta
- Department of Lung Diseases and Clinical Allergology, University of Turku, Turku, Finland; Allergy Clinic, Suomen Terveystalo Oy, Turku, Finland
| | | | - Juha Jantunen
- Allergy, Skin, and Asthma Federation, Helsinki, Finland
| | | | - Paula Kauppi
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | | | - Anna Pelkonen
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Alexander Salava
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Erja Tommila
- Finnish Lung Health Association, Helsinki, Finland
| | - Jean Bousquet
- Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin, Germany; University Hospital, Montpellier, France; MACVIA France, Montpellier, France
| | | | - Mika J Mäkelä
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
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17
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Halonen JI, Erhola M, Furman E, Haahtela T, Jousilahti P, Barouki R, Bergman Å, Billo NE, Fuller R, Haines A, Kogevinas M, Kolossa-Gehring M, Krauze K, Lanki T, Vicente JL, Messerli P, Nieuwenhuijsen M, Paloniemi R, Peters A, Posch KH, Timonen P, Vermeulen R, Virtanen SM, Bousquet J, Antó JM. A call for urgent action to safeguard our planet and our health in line with the helsinki declaration. ENVIRONMENTAL RESEARCH 2021; 193:110600. [PMID: 33307082 DOI: 10.1016/j.envres.2020.110600] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 12/03/2020] [Accepted: 12/04/2020] [Indexed: 05/21/2023]
Abstract
In 2015, the Rockefeller Foundation-Lancet Commission launched a report introducing a novel approach called Planetary Health and proposed a concept, a strategy and a course of action. To discuss the concept of Planetary Health in the context of Europe, a conference entitled: "Europe That Protects: Safeguarding Our Planet, Safeguarding Our Health" was held in Helsinki in December 2019. The conference participants concluded with a need for action to support Planetary Health during the 2020s. The Helsinki Declaration emphasizes the urgency to act as scientific evidence shows that human activities are causing climate change, biodiversity loss, land degradation, overuse of natural resources and pollution. They threaten the health and safety of human kind. Global, regional, national, local and individual initiatives are called for and multidisciplinary and multisectorial actions and measures are needed. A framework for an action plan is suggested that can be modified for local needs. Accordingly, a shift from fragmented approaches to policy and practice towards systematic actions will promote human health and health of the planet. Systems thinking will feed into conserving nature and biodiversity, and into halting climate change. The Planetary Health paradigm ‒ the health of human civilization and the state of natural systems on which it depends ‒ must become the driver for all policies.
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Affiliation(s)
- Jaana I Halonen
- Finnish Institute for Health and Welfare, Helsinki, Finland.
| | | | - Eeva Furman
- Finnish Environment Institute, Helsinki, Finland
| | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Finland
| | | | - Robert Barouki
- Université de Paris, Inserm UMR S-1124, 75006, Paris, France
| | - Åke Bergman
- Department of Environmental Science, Stockholm University, Stockholm, Sweden; School of Science and Technology, MTM, Örebro University, Örebro, Sweden
| | - Nils E Billo
- Global Alliance Against Chronic Respiratory Disease Finland, Helsinki, Finland
| | | | - Andrew Haines
- Department of Public Health, Environments and Society and Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Manolis Kogevinas
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Kinga Krauze
- European Regional Centre for Ecohydrology of the Polish Academy of Sciences, Łódź, Poland
| | - Timo Lanki
- Finnish Institute for Health and Welfare, Helsinki, Finland; University of Eastern Finland, Kuopio, Finland
| | | | - Peter Messerli
- Centre for Development and Environment (CDE), University of Bern, Bern, Switzerland; Wyss Academy for Nature, University of Bern, Bern, Switzerland
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany; Ludwig-Maximilians Universität München, Germany
| | | | | | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Netherlands
| | - Suvi M Virtanen
- Finnish Institute for Health and Welfare, Helsinki, Finland; Faculty of Social Sciences, Unit of Health Sciences, Tampere University; Center for Child Health Research, Tampere University and Tampere University Hospital; and The Science Center of Pirkanmaa Hospital District, Tampere, Finland
| | - Jean Bousquet
- Centre Hospitalier Universitaire de Montpellier, 34295, Montpellier, France; Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, 10117, Berlin, Germany; Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, 10178 Berlin, Germany
| | - Josep M Antó
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
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18
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Levy ML. Risks of poor asthma outcome in 14,405 children and young people in London. NPJ Prim Care Respir Med 2021; 31:3. [PMID: 33514720 PMCID: PMC7846552 DOI: 10.1038/s41533-020-00215-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 12/07/2020] [Indexed: 11/09/2022] Open
Abstract
This is a 12-month retrospective data analysis (2018/19) of asthma risk factors in 350 North West London general practices. Fourteen thousand four hundred and five of the 482,029 (40% female) children and young people (CYP) had diagnosed asthma. Exacerbations are as follows: (i) 749 (5%) CYP had 797 hospital admissions; 32 (<1%) had 2-6; (ii) 910 (6%) had 1168 recorded asthma attacks; 170 (1%) had 2-12; (iii) 1485 (10%) had 2123 oral corticosteroid courses; 408 (3%) had 2-11. Excess short-acting bronchodilators were prescribed in over half of the CYP. Of the 10,077 (70%) CYP prescribed inhaled corticosteroid preventers, 7279 (72%) were issued with <4 ICS inhaler prescriptions during the year; these CYP accounted for 11% of the admission spells. In all, 30% of CYP had poor symptom control. At least 10% of the CYP having had recent attacks are at risk and dashboards such as those available in North West London could easily facilitate recognition of risk and optimisation of care.
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19
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Hua L, Yang F, Chen Q, Liu Q, Ji R, Liu H, Ye J, Zhang J, Zhang J, Bao Y. Association of a four-gene model with allergic diseases: Two-year follow-up of a birth cohort study. IMMUNITY INFLAMMATION AND DISEASE 2020; 9:239-245. [PMID: 33277970 PMCID: PMC7860525 DOI: 10.1002/iid3.385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 11/18/2020] [Indexed: 01/29/2023]
Abstract
Background Our previous study has developed a four‐gene model involving IL13 rs20541, IL4 rs2243250, ADRB2 rs1042713, and FCER1B rs569108 associated with asthma and atopy in Chinese Han children. However, whether the gene model is associated with allergies in early life has yet to be determined. This study aimed to apply the gene model in a birth cohort to investigate its associations with the development of allergic diseases in Chinese Han toddlers. Methods Five hundred and ninety‐seven children from a birth cohort completing 2‐year follow‐up were included. Epidemiologic information and cord blood were collected. Children were genotyped for the above polymorphisms and divided into high or low genetic risk groups based on the genotypes. Subjects were followed at 6, 12, and 24 months, with information on allergic diseases collected via standard questionnaires and assessed by specialists. Results Two hundred and eighty‐four children were divided into a high‐risk group and 313 into a low‐risk group. Between the two groups, a significant difference was only found in delivery mode among all the subject characteristics (p = .025). After stratification for delivery mode, children at high risk were more likely to develop eczema (relative risk [RR] = 1.46, p = .040) over 2 years of follow‐up compared with those at low risk. No significant associations were found between genetic risk and food allergy, wheezing and allergic rhinitis (p > .05). Conclusion The gene model was significantly associated with the development of eczema in Chinese Han toddlers. Long‐term follow‐up along with functional and replication studies on the gene model are still needed in future.
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Affiliation(s)
- Li Hua
- Department of Pediatric Pulmonology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fen Yang
- Department of Pediatric Pulmonology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qian Chen
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Quanhua Liu
- Department of Pediatric Pulmonology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruoxu Ji
- Department of Pediatric Pulmonology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haipei Liu
- Department of Pediatric Pulmonology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianmin Ye
- Department of Pediatric Pulmonology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianhua Zhang
- Department of Pediatric Pulmonology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yixiao Bao
- Department of Pediatric Pulmonology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Tonxin Pediatric Clinic, Shanghai, China
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Abstract
PURPOSE OF REVIEW Both asthma and anaphylaxis are recognized noncommunicable hypersensitivity conditions, which should be correctly diagnosed and treated/controlled in order to decrease avoidable deaths. Nevertheless, their association is not completely clear. We here propose to review the current and new evidence-based data of asthma and anaphylaxis in the view of the new knowledge in the field that can support the quality practice and empower allergists and health professionals in treating symptoms and preventing death. RECENT FINDINGS Hypersensitivity life-threatening conditions, such as anaphylaxis and asthma can coexist, mimic or worse each other. Asthma itself is not a strong predictor of more severe anaphylaxis. However, poor asthma control associated with more severe anaphylaxis reactions in all ages. In children, asthma is associated with the severity and recurrences of anaphylactic reactions. SUMMARY Although recent data point for the association between asthma and anaphylaxis, we still do not have harmonized evidence to confirm if we are dealing with two independent comorbidities one worsening each other. However, as far as this review is covering two relevant public health problems in the field of allergy, it is mandatory put in place decisions supporting recommendations to better manage the affected patients and reduce the risk.General strategies should include regular notification of this association, optimization of the classification and coding for anaphylaxis and asthma (new ICD 11 allergy codes) in order to harmonize epidemiological stratified data, early diagnosis of asthma in childhood, regular investigation of asthma in cases of anaphylaxis and optimization of the asthma control and lung function for all patients with indication to provocation tests, desensitization or allergen immunotherapy regardless to the trigger. Implementation of these strategies will involve national and international support for ongoing efforts in relationship with networks of centres of excellence to provide personalized management for the most at-risk patients and prevent death.
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21
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Fast and slow health crises of Homo urbanicus: loss of resilience in communicable diseases, like COVID-19, and non-communicable diseases. Porto Biomed J 2020; 5:e073. [PMID: 32734013 PMCID: PMC7386547 DOI: 10.1097/j.pbj.0000000000000073] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 01/29/2023] Open
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Bousquet J, Anto JM, Haahtela T, Jousilahti P, Erhola M, Basagaña X, Czarlewski W, Odemyr M, Palkonen S, Sofiev M, Velasco C, Bedbrook A, Delgado R, Kouznetsov R, Mäkelä M, Palamarchuk Y, Saarinen K, Tommila E, Valovirta E, Vasankari T, Zuberbier T, Annesi-Maesano I, Benveniste S, Mathieu-Dupas E, Pépin JL, Picard R, Zeng S, Ayache J, Calves Venturos N, Micheli Y, Jullian-Desayes I, Laune D. Digital transformation of health and care to sustain Planetary Health: The MASK proof-of-concept for airway diseases-POLLAR symposium under the auspices of Finland's Presidency of the EU, 2019 and MACVIA-France, Global Alliance against Chronic Respiratory Diseases (GARD, WH0) demonstration project, Reference Site Collaborative Network of the European Innovation Partnership on Active and Healthy Ageing. Clin Transl Allergy 2020; 10:24. [PMID: 32577216 PMCID: PMC7304084 DOI: 10.1186/s13601-020-00321-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 05/16/2020] [Indexed: 01/07/2023] Open
Abstract
In December 2019, a conference entitled “Europe That Protects: Safeguarding Our Planet, Safeguarding Our Health” was held in Helsinki. It was co-organized by the Finnish Institute for Health and Welfare, the Finnish Environment Institute and the European Commission, under the auspices of Finland’s Presidency of the EU. As a side event, a symposium organized as the final POLLAR (Impact of air POLLution on Asthma and Rhinitis) meeting explored the digital transformation of health and care to sustain planetary health in airway diseases. The Finnish Allergy Programme collaborates with MASK (Mobile Airways Sentinel NetworK) and can be considered as a proof-of-concept to impact Planetary Health. The Good Practice of DG Santé (The Directorate-General for Health and Food Safety) on digitally-enabled, patient-centred care pathways is in line with the objectives of the Finnish Allergy Programme. The ARIACARE-Digital network has been deployed in 25 countries. It represents an example of the digital cross-border exchange of real-world data and experience with the aim to improve patient care. The integration of information technology tools for climate, weather, air pollution and aerobiology in mobile Health applications will enable the development of an alert system. Citizens will thus be informed about personal environmental threats, which may also be linked to indicators of Planetary Health and sustainability. The digital transformation of the public health policy was also proposed, following the experience of the Agency for Health Quality and Assessment of Catalonia (AQuAS).
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Affiliation(s)
- Jean Bousquet
- Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Dermatology and Allergy, Berlin Institute of Health, Comprehensive Allergy Center, Berlin, Germany.,MACVIA-France, Montpellier, France.,CHU Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
| | - Josep M Anto
- ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital and Helsinki University, Helsinki, Finland
| | | | - Marina Erhola
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Xavier Basagaña
- ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | | | - Mikaëla Odemyr
- EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - Susanna Palkonen
- EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - Mikael Sofiev
- Finnish Meteorological Institute (FMI), Helsinki, Finland
| | - César Velasco
- Agency for Health Quality and Assessment of Catalonia (AQuAS), Barcelona, Spain.,Obukhov Institute for Atmospheric Physics, Moscow, Russia
| | | | | | - Rostislav Kouznetsov
- Finnish Meteorological Institute (FMI), Helsinki, Finland.,Obukhov Institute for Atmospheric Physics, Moscow, Russia
| | - Mika Mäkelä
- Skin and Allergy Hospital, Helsinki University Hospital and Helsinki University, Helsinki, Finland
| | | | | | - Erja Tommila
- Finnish Lung Health Association (Filha), Helsinki, Finland
| | - Erkka Valovirta
- Department of Lung Diseases and Clinical Immunology, University of Turku and Terveystalo Allergy Clinic, Turku, Finland
| | - Tuula Vasankari
- FILHA, Finnish Lung Health Association, Helsinki, and Turku University, Turku, Finland
| | - Torsten Zuberbier
- Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Dermatology and Allergy, Berlin Institute of Health, Comprehensive Allergy Center, Berlin, Germany
| | - Isabella Annesi-Maesano
- Epidemiology of Allergic and Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and Public Health, INSERM and Sorbonne Universités, Medical School Saint Antoine, Paris, France
| | - Samuel Benveniste
- National Center of Expertise in Cognitive Stimulation (CEN STIMCO), Broca Hospital, Paris, France.,Mines ParisTech CRI-PSL Research University, Fontainebleau, France
| | | | - Jean-Louis Pépin
- Laboratoire HP2, Grenoble, INSERM, U1042 and CHU de Grenoble, Université Grenoble Alpes, Grenoble, France
| | - Robert Picard
- Conseil Général de l'Economie Ministère de l'Economie, de l'Industrie et du Numérique, Paris, France
| | | | - Julia Ayache
- National Center of Expertise in Cognitive Stimulation (CEN STIMCO), Broca Hospital, Paris, France.,Institute of Psychology, Memory and Cognition Laboratory, Paris Descartes University, Sorbonne Paris Cité, Boulogne Billancourt, France
| | | | | | - Ingrid Jullian-Desayes
- Laboratoire HP2, Grenoble, INSERM, U1042 and CHU de Grenoble, Université Grenoble Alpes, Grenoble, France
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23
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Monga S, Malik J, Sharma AP, Jan S, Nabi N, Bahadur S. Deranged Pulmonary Function Tests in Allergic Rhinitis in North Indian Patients. CLINICAL MEDICINE INSIGHTS. EAR, NOSE AND THROAT 2019; 12:1179550619888856. [PMID: 31798306 PMCID: PMC6859672 DOI: 10.1177/1179550619888856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 10/24/2019] [Indexed: 11/16/2022]
Abstract
Introduction: Significant associations between allergic rhinitis and bronchial asthma have been established and as a result of bronchial hyper-responsiveness, patients can have deranged pulmonary function tests. We aim to compare previous such studies with the result of our study done in India wherein we identify among allergic rhinitis patients who despite not having overt asthmatic symptoms, have pulmonary function derangements, quite possibly at a subclinical disease level. Materials and Methods: We studied 74 patients of allergic rhinitis and after meticulous clinical work up, they underwent blood tests including hemogram, absolute eosinophil count, and total serum IgE followed by pulmonary function tests. Results: Out of 74 patients 60 (81%) had intermittent allergic rhinitis whereas only 14 (19%) had persistent allergic rhinitis. Pulmonary function tests showed reversible obstruction, ie, >10% improvement in FEV1 with inhaled bronchodilators (as seen in asthma) in 18 (24.3%), mild obstruction in 14, and moderate obstruction in 4 cases. Conclusion: The study emphasizes the importance of pulmonary symptoms and the performance of pulmonary function tests in cases of allergic rhinitis patients to rule out latent asthma.
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Affiliation(s)
- Seema Monga
- Department of Otorhinolaryngology and Head & Neck Surgery, Hamdard Institute of Medical Sciences & Research and HAHC Hospital, Jamia Hamdard University, Delhi, India
| | - Junaid Malik
- Department of Otorhinolaryngology and Head & Neck Surgery, Hamdard Institute of Medical Sciences & Research and HAHC Hospital, Jamia Hamdard University, Delhi, India
| | - Arun Parkash Sharma
- Department of Otorhinolaryngology and Head & Neck Surgery, Hamdard Institute of Medical Sciences & Research and HAHC Hospital, Jamia Hamdard University, Delhi, India
| | - Sabeena Jan
- Department of Otorhinolaryngology and Head & Neck Surgery, Hamdard Institute of Medical Sciences & Research and HAHC Hospital, Jamia Hamdard University, Delhi, India
| | - Nighat Nabi
- Department of Otorhinolaryngology and Head & Neck Surgery, Hamdard Institute of Medical Sciences & Research and HAHC Hospital, Jamia Hamdard University, Delhi, India
| | - Sudhir Bahadur
- Department of Otorhinolaryngology and Head & Neck Surgery, Hamdard Institute of Medical Sciences & Research and HAHC Hospital, Jamia Hamdard University, Delhi, India
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24
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Haahtela T, von Hertzen L, Anto JM, Bai C, Baigenzhin A, Bateman ED, Behera D, Bennoor K, Camargos P, Chavannes N, de Sousa JC, Cruz A, Do Céu Teixeira M, Erhola M, Furman E, Gemicioğlu B, Gonzalez Diaz S, Hellings PW, Jousilahti P, Khaltaev N, Kolek V, Kuna P, La Grutta S, Lan LTT, Maglakelidze T, Masjedi MR, Mihaltan F, Mohammad Y, Nunes E, Nyberg A, Quel J, Rosado-Pinto J, Sagara H, Samolinski B, Schraufnagel D, Sooronbaev T, Tag Eldin M, To T, Valiulis A, Varghese C, Vasankari T, Viegi G, Winders T, Yañez A, Yorgancioğlu A, Yusuf O, Bousquet J, Billo NE. Helsinki by nature: The Nature Step to Respiratory Health. Clin Transl Allergy 2019; 9:57. [PMID: 31695865 PMCID: PMC6822361 DOI: 10.1186/s13601-019-0295-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 10/17/2019] [Indexed: 12/21/2022] Open
Abstract
Background The Nature Step to Respiratory Health was the overarching theme of the 12th General Meeting of the Global Alliance against Chronic Respiratory Diseases (GARD) in Helsinki, August 2018. New approaches are needed to improve respiratory health and reduce premature mortality of chronic diseases by 30% till 2030 (UN Sustainable Development Goals, SDGs). Planetary health is defined as the health of human civilization and the state of the natural systems on which it depends. Planetary health and human health are interconnected, and both need to be considered by individuals and governments while addressing several SDGs. Results The concept of the Nature Step has evolved from innovative research indicating, how changed lifestyle in urban surroundings reduces contact with biodiverse environments, impoverishes microbiota, affects immune regulation and increases risk of NCDs. The Nature Step calls for strengthening connections to nature. Physical activity in natural environments should be promoted, use of fresh vegetables, fruits and water increased, and consumption of sugary drinks, tobacco and alcohol restricted. Nature relatedness should be part of everyday life and especially emphasized in the care of children and the elderly. Taking “nature” to modern cities in a controlled way is possible but a challenge for urban planning, nature conservation, housing, traffic arrangements, energy production, and importantly for supplying and distributing food. Actions against the well-known respiratory risk factors, air pollution and smoking, should be taken simultaneously. Conclusions In Finland and elsewhere in Europe, successful programmes have been implemented to reduce the burden of respiratory disorders and other NCDs. Unhealthy behaviour can be changed by well-coordinated actions involving all stakeholders. The growing public health concern caused by NCDs in urban surroundings cannot be solved by health care alone; a multidisciplinary approach is mandatory.
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Affiliation(s)
- Tari Haahtela
- 1Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Leena von Hertzen
- 2Department of Dermatology, Allergology and Venereology, Helsinki University Hospital, Helsinki, Finland
| | - Josep M Anto
- ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - Chunxue Bai
- Zhongshan Hospital, Fudan University, Shanghai Respiratory Research Institute, Shanghai, China
| | | | - Eric D Bateman
- 6Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Digambar Behera
- 7Dept. of Pulmonary Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Kazi Bennoor
- Department of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh
| | - Paulo Camargos
- 9Department of Pediatrics, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Niels Chavannes
- 10Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Jaime Correia de Sousa
- 11Life and Health Sciences Research Institute, ICVS, School of Medicine, University of Minho, Braga, Portugal
| | - Alvaro Cruz
- 12ProAR - Nucleo de Excelencia em Asma, Federal University of Bahia, Vitória Da Conquista, Brazil
| | | | - Marina Erhola
- 14National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Eeva Furman
- 15Environmental Policy Centre, Finnish Environment Institute, Helsinki, Finland
| | - Bilun Gemicioğlu
- 16Department of Pulmonary Diseases, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | | | - Peter W Hellings
- 18Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Louvain, Belgium
| | - Pekka Jousilahti
- 14National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Nikolai Khaltaev
- Global Alliance Against Chronic Respiratory Diseases (GARD), Geneva, Switzerland
| | - Vitezslav Kolek
- 20Department of Respiratory Diseases and Tuberculosis, University Hospital Olomouc, Olomouc, Czech Republic
| | - Piotr Kuna
- 21Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - Stefania La Grutta
- 22Istituto per la Ricerca e l'Innovazione Biomedica (IRIB), Consiglio Nazionale delle Ricerche (CNR), Palermo, Italy
| | - Le Thi Tuyet Lan
- Respiratory Care Center, University Medical Center, Ho Chi Minh City, Vietnam
| | - Tamaz Maglakelidze
- 24Pulmonology Department, Ivane Javakhishvili Tbilisi State University, Chapidze Emergency Cardiology Center, Tbilisi, Georgia
| | | | - Florin Mihaltan
- National Institute of Pneumology M. Nasta, Bucharest, Romania
| | - Yousser Mohammad
- 27National Center for Research in Chronic Respiratory Diseases, Tishreen University School of Medicine, Latakia, Syria
| | - Elizabete Nunes
- 28Pulmonology Department, Maputo Central Hospital, Maputo, Mozambique
| | - Arvid Nyberg
- 29FILHA, Finnish Lung Health Association, Helsinki, Finland
| | - Jorge Quel
- Hispanic American Allergy Asthma & Immunology Association, Marina Del Rey, California USA
| | - Jose Rosado-Pinto
- 31Immunoallergology Department, Hospital da Luz Lisboa, Lisbon, Portugal
| | - Hironori Sagara
- 32Division of Allergology & Respiratory Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Boleslaw Samolinski
- 33Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Dean Schraufnagel
- 34Department of Medicine, University of Illinois at Chicago, Chicago, USA
| | - Talant Sooronbaev
- Kyrgyzstan National Centre of Cardiology and Internal Medicine, Euro-Asian Respiratory Society, Bishkek, Kyrgyzstan
| | - Mohamed Tag Eldin
- 36Department of Thoracic Diseases, Ain Shams Faculty of Medicine, Abbassia, Cairo, Egypt
| | - Teresa To
- 37The Hospital for Sick Children, Research Institute and Della Lana School of Public Health, University of Toronto, Toronto, ON Canada
| | - Arunas Valiulis
- 38Clinic of Children's Diseases, Institute of Clinical Medicine, and Department of Public Health, Institute of Health Sciences, Vilnius University, Vilnius, Lithuania
| | | | | | - Giovanni Viegi
- 22Istituto per la Ricerca e l'Innovazione Biomedica (IRIB), Consiglio Nazionale delle Ricerche (CNR), Palermo, Italy.,40Istituto di Fisiologia Clinica CNR, Pisa, Italy
| | - Tonya Winders
- Allergy & Asthma Network, Vienna, VA USA.,Global Allergy & Asthma Patient Platform, Vienna, Austria
| | - Anahi Yañez
- Investigaciones en Alergia y Enfermedades Respiratorias (INAER), Buenos Aires, Argentina
| | - Arzu Yorgancioğlu
- 44Department of Pulmonary Diseases, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Osman Yusuf
- The Allergy and Asthma Institute, Islamabad, Pakistan
| | - Jean Bousquet
- MACVIA-France, Fondation Partenariale FMC VIA-LR, CHRU Arnaud de Villeneuve, Montpellier, France
| | - Nils E Billo
- 29FILHA, Finnish Lung Health Association, Helsinki, Finland.,Global Alliance Against Respiratory Diseases (GARD), Helsinki, Finland
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25
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Haahtela T. A biodiversity hypothesis. Allergy 2019; 74:1445-1456. [PMID: 30835837 DOI: 10.1111/all.13763] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 02/11/2019] [Accepted: 02/18/2019] [Indexed: 02/06/2023]
Abstract
Biodiversity hypothesis states that contact with natural environments enriches the human microbiome, promotes immune balance and protects from allergy and inflammatory disorders. We are protected by two nested layers of biodiversity, microbiota of the outer layer (soil, natural waters, plants, animals) and inner layer (gut, skin, airways). The latter inhabits our body and is colonized from the outer layer. Explosion of human populations along with cultural evolution is profoundly changing our environment and lifestyle. Adaptive immunoregulatory circuits and dynamic homeostasis are at stake in the newly emerged urban surroundings. In allergy, and chronic inflammatory disorders in general, exploring the determinants of immunotolerance is the key for prevention and more effective treatment. Loss of immunoprotective factors, derived from nature, is a new kind of health risk poorly acknowledged until recently. The paradigm change has been implemented in the Finnish allergy programme (2008-2018), which emphasized tolerance instead of avoidance. The first results are promising, as allergy burden has started to reduce. The rapidly urbanizing world is facing serious biodiversity loss with global warming, which are interconnected. Biodiversity hypothesis of health and disease has societal impact, for example, on city planning, food and energy production and nature conservation. It has also a message for individuals for health and well-being: take nature close, to touch, eat, breathe, experience and enjoy. Biodiverse natural environments are dependent on planetary health, which should be a priority also among health professionals.
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Affiliation(s)
- Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital University of Helsinki Helsinki Finland
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26
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Korpela K, Dikareva E, Hanski E, Kolho KL, de Vos WM, Salonen A. Cohort profile: Finnish Health and Early Life Microbiota (HELMi) longitudinal birth cohort. BMJ Open 2019; 9:e028500. [PMID: 31253623 PMCID: PMC6609051 DOI: 10.1136/bmjopen-2018-028500] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
PURPOSE HELMi (Health and Early Life Microbiota) is a longitudinal, prospective general population birth cohort, set up to identify environmental, lifestyle and genetic factors that modify the intestinal microbiota development in the first years of life and their relation to child health and well-being. PARTICIPANTS The HELMi cohort consists of 1055 healthy term infants born in 2016-2018 mainly at the capital region of Finland and their parents. The intestinal microbiota development of the infants is characterised based on nine, strategically selected, faecal samples and connected to extensive online questionnaire-collected metadata at weekly to monthly intervals focusing on the diet, other exposures and family's lifestyle as well as the health and growth of the child. Motor and cognitive developmental screening takes place at 18 months. Infant's DNA sample, mother's breast milk sample and both parent's spot faecal samples have been collected. FINDINGS TO DATE The mean age of the mothers was 32.8 (SD 4.1) and fathers/coparents 34.8 (5.3) years at the time of enrolment. Seventeen percentage (n=180) of the infants were born by caesarean section. Just under half (49%) were firstborns; 50.7% were males. At 3 months of age, 86% of the babies were exclusively breastfed and 2% exclusively formula-fed. FUTURE PLANS The current follow-up from pregnancy to first 24 months will be completed in March 2020, totalling to over 10 000 biological samples and over 50 000 questionnaire entries. The results are expected to identify environmental and host factors that affect early gut microbiota development and health, and hence give indications of how to prevent or reverse microbiota perturbations in infancy. This prospective cohort will be followed up further to identify how the early microbiota relates to later health outcomes, especially weight gain, infections and allergic and other chronic diseases. TRIAL REGISTRATION NUMBER NCT03996304; Pre-results.
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Affiliation(s)
- Katri Korpela
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Evgenia Dikareva
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | | | - Kaija-Leena Kolho
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Children’s Hospital, University of Helsinki, Helsinki, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Willem M de Vos
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Laboratory of Microbiology, Wageningen University, Wageningen, The Netherlands
| | - Anne Salonen
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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27
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Savolainen J, Mascialino B, Pensamo E, Åberg KM, Silvan M, Borres MP, Korhonen K. Structured intervention plan including component-resolved diagnostics helps reducing the burden of food allergy among school-aged children. Pediatr Allergy Immunol 2019; 30:99-106. [PMID: 30346637 DOI: 10.1111/pai.12996] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 09/11/2018] [Accepted: 10/11/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Food allergies can substantially burden patients and families by negatively affecting finances, social relationships, and personal perceptions of health. This study was performed under the Finnish Allergy Programme aimed at reducing avoidance diets to foods in schoolchildren by 50%. The main goal of this study was to investigate how many children could be freed from diet restrictions in a Finnish school district through a diagnostic algorithm including component-resolved diagnostics and food challenge. The secondary aim was to provide a crude estimate of the burden of the elimination food diets in the region, and the savings associated with the proposed intervention. METHODS A total of 205 children on a food avoidance diet according to the school register because of food allergy were invited into the study. One hundred and fifty-seven children were interviewed, tested for IgE to extracts and allergen components and food challenged in respective order. RESULTS After two years, 12 children still had an avoidance diet and three of them were treated successfully with sOTI; the rest suspended their avoidance diet (n = 134) or dropped out of the study (n = 11). The cost of the elimination diets was estimated in 172 700€ per year at start and 13 200€ per year at the end of the study; total savings were 128 400€ yearly. CONCLUSIONS The results demonstrate a 65% reduction of avoidance diets to foods in school-aged children, exceeding the 50% aim of the Finnish Allergy Programme. Therefore, it is possible to actively reduce the number of food allergy diagnoses that remain unmonitored in the society through a tailored diagnostic work-up.
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Affiliation(s)
- Johannes Savolainen
- Department of Pulmonary Diseases and Clinical Allergology, University of Turku and Turku University Hospital, Turku, Finland
| | | | - Elina Pensamo
- Department of Pulmonary Diseases and Clinical Allergology, University of Turku and Turku University Hospital, Turku, Finland
| | - K Magnus Åberg
- Thermo Fisher Scientific, Uppsala, Sweden.,Department of Environmental Science and Analytical Chemistry, Stockholm University, Stockholm, Sweden
| | | | - Magnus P Borres
- Thermo Fisher Scientific, Uppsala, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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28
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Valiulis A, Bousquet J, Veryga A, Suprun U, Sergeenko D, Cebotari S, Borelli D, Pietikainen S, Banys J, Agache I, Billo NE, Bush A, Chkhaidze I, Dubey L, Fokkens WJ, Grigg J, Haahtela T, Julge K, Katilov O, Khaltaev N, Odemyr M, Palkonen S, Savli R, Utkus A, Vilc V, Alasevicius T, Bedbrook A, Bewick M, Chorostowska-Wynimko J, Danila E, Hadjipanayis A, Karseladze R, Kvedariene V, Lesinskas E, Münter L, Samolinski B, Sargsyan S, Sitkauskiene B, Somekh D, Vaideliene L, Valiulis A, Hellings PW. Vilnius Declaration on chronic respiratory diseases: multisectoral care pathways embedding guided self-management, mHealth and air pollution in chronic respiratory diseases. Clin Transl Allergy 2019; 9:7. [PMID: 30705747 PMCID: PMC6348633 DOI: 10.1186/s13601-019-0242-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 01/04/2019] [Indexed: 01/18/2023] Open
Abstract
Background Over 1 billion people suffer from chronic respiratory diseases such as asthma, COPD, rhinitis and rhinosinusitis. They cause an enormous burden and are considered as major non-communicable diseases. Many patients are still uncontrolled and the cost of inaction is unacceptable. A meeting was held in Vilnius, Lithuania (March 23, 2018) under the patronage of the Ministry of Health and several scientific societies to propose multisectoral care pathways embedding guided self-management, mHealth and air pollution in selected chronic respiratory diseases (rhinitis, chronic rhinosinusitis, asthma and COPD). The meeting resulted in the Vilnius Declaration that was developed by the participants of the EU Summit on chronic respiratory diseases under the leadership of Euforea. Conclusion The Vilnius Declaration represents an important step for the fight against air pollution in chronic respiratory diseases globally and has a clear strategic relevance with regard to the EU Health Strategy as it will bring added value to the existing public health knowledge.
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Affiliation(s)
- A Valiulis
- 1Department of Public Health, Clinic of Children's Diseases, and Institute of Health Sciences, Vilnius University Institute of Clinical Medicine, Vilnius, Lithuania.,European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium
| | - J Bousquet
- 3MACVIA-France, Fondation partenariale FMC VIA-LR, CHU Montpellier, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France.,INSERM U 1168, VIMA : Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, France.,5UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, Montigny le Bretonneux, France.,Euforea, Brussels, Belgium.,7Charité, Berlin, Germany
| | - A Veryga
- Minister of Health, Vilnius, Lithuania
| | - U Suprun
- Minister of Health, Kiev, Ukraine
| | - D Sergeenko
- Minister of Labour, Health and Social Affairs, Tbilisi, Georgia
| | - S Cebotari
- Minister of Health, Labour and Social Protection, Chișinău, Moldova
| | | | | | - J Banys
- Lithuianian Academy of Sciences, Vilnius, Lithuania
| | - I Agache
- 15Faculty of Medicine, Transylvania University, Brasov, Romania
| | - N E Billo
- Global Alliance Against Chronic Respiratory Diseases (GARD), Joensuu, Finland
| | - A Bush
- 17Imperial College and Royal Brompton Hospital, London, UK
| | - I Chkhaidze
- 18Department of Pediatrics, and Iashvili Central Children's Hospital, Tbilisi State Medical University, Tbilisi, Georgia
| | - L Dubey
- 19Faculty of Postgraduate Education, Lviv National Medical University by Danylo Halytsky, Lviv, Ukraine
| | - W J Fokkens
- 20Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, The Netherlands
| | - J Grigg
- 21Centre for Genomics and Child Health, Blizard Institute, Queen Mary University of London, London, UK
| | - T Haahtela
- 22Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - K Julge
- 23Children's Clinic, Tartu University Institute of Clinical Medicine, Tartu, Estonia
| | - O Katilov
- Vinnytsa National Medical University by Mykola Pyrogov, Vinnytsa, Ukraine
| | - N Khaltaev
- Global Alliance Against Chronic Respiratory Diseases (GARD-WHO), Geneva, Switzerland
| | - M Odemyr
- 26European Federation of Allergy and Airways Diseases Patients' Associations (EFA), Brussels, Belgium
| | - S Palkonen
- 26European Federation of Allergy and Airways Diseases Patients' Associations (EFA), Brussels, Belgium
| | - R Savli
- 26European Federation of Allergy and Airways Diseases Patients' Associations (EFA), Brussels, Belgium
| | - A Utkus
- 27Department of Human and Medical Genetics, Institute of Biomedical Sciences, Vilnius University Faculty of Medicine, Vilnius, Lithuania.,Association of Medical Schools in Europe, Berlin, Germany
| | - V Vilc
- State Institute of Phtysiopulmonology by Chiril Draganiuk, Chisinau, Moldova
| | - T Alasevicius
- 1Department of Public Health, Clinic of Children's Diseases, and Institute of Health Sciences, Vilnius University Institute of Clinical Medicine, Vilnius, Lithuania.,European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium
| | - A Bedbrook
- 3MACVIA-France, Fondation partenariale FMC VIA-LR, CHU Montpellier, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
| | - M Bewick
- iQ4U Consultants Ltd, London, UK
| | - J Chorostowska-Wynimko
- 31Department of Genetics and Clinical Immunology, National Institute of Tuberculosis and Lung Diseases, Warsaw, Poland
| | - E Danila
- 32Clinic of Chest Diseases, Immunology and Allergology, Centre of Pulmonology and Allergology, Institute of Clinical Medicine, Vilnius University Medical Faculty, Vilnius, Lithuania
| | - A Hadjipanayis
- 33Medical School, European University of Cyprus, Nicosia, Cyprus
| | - R Karseladze
- 34Tbilisi State University Faculty of Medicine, Tbilisi, Georgia
| | - V Kvedariene
- 35Clinic of Infectious Chest Diseases, Dermatology and Allergology, Institute of Biomedical Sciences, Institute of Clinical Medicine, Vilnius University Faculty of Medicine, Vilnius, Lithuania
| | - E Lesinskas
- 36Clinic of ENT and Eye Diseases, Institute of Clinical Medicine, Vilnius University Medical Faculty, Vilnius, Lithuania
| | - L Münter
- Danish Commitee for Health Education, Copenhagen East, Denmark
| | - B Samolinski
- 38Department of Prevention of Envinronmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - S Sargsyan
- 39Institute of Child and Adolescent Health at Arabkir Medical Centre, Yerevan State Medical University, Yerevan, Armenia
| | - B Sitkauskiene
- 40Department of Immunology and Allergology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - D Somekh
- European Health Futures Forum (EHFF), Dromahair, Ireland
| | - L Vaideliene
- 42Clinic of Children's Diseases, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - A Valiulis
- 43Department of Rehabilitation, Physical and Sports Medicine, Institute of Health Sciences, Vilnius University Medical Faculty, Vilnius, Lithuania
| | - P W Hellings
- Euforea, Brussels, Belgium.,44Department of Otorhinolaryngology, University Hospital Leuven, Leuven, Belgium.,45Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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29
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Holmberg Fagerlund B, Helseth S, Andersen LF, Småstuen MC, Glavin K. Parental concerns of allergy or hypersensitivity and the infant's diet. Nurs Open 2019; 6:136-143. [PMID: 30534403 PMCID: PMC6279714 DOI: 10.1002/nop2.195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 06/30/2018] [Accepted: 07/14/2018] [Indexed: 11/07/2022] Open
Abstract
AIM To investigate a possible association between children's current diet and parents' reported avoidance of appropriate foods in the child's diet at the age of 10 months, due to fears of allergic or hypersensitivity reactions. DESIGN A cross-sectional study. METHODS In 10 randomly selected municipalities willing to participate, 686 children represented by their parents visiting the child health centre were enrolled in the study. From January 2015-January 2017, 440 (64%) parents completed a semi-quantitative food frequency questionnaire concerning their child. RESULTS Thirty-four percent of parents reported that they avoided introducing some food items due to fears of allergy or hypersensitivity in their child. A statistically significant relationship emerged between this reporting and parents wanting more information about food for infants and toddlers. However, the reported fear was not associated with dietary restrictions regarding actual feeding of the child.
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Affiliation(s)
- Bettina Holmberg Fagerlund
- Department of Nursing and Health Promotion, Faculty of Health SciencesOsloMet – Oslo Metropolitan UniversityOsloNorway
| | - Sølvi Helseth
- Department of Nursing and Health Promotion, Faculty of Health SciencesOsloMet – Oslo Metropolitan UniversityOsloNorway
| | - Lene Frost Andersen
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of MedicineUniversity of OsloOsloNorway
| | - Milada Cvancarova Småstuen
- Department of Nursing and Health Promotion, Faculty of Health SciencesOsloMet – Oslo Metropolitan UniversityOsloNorway
| | - Kari Glavin
- Department of HealthVID Specialized UniversityOsloNorway
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Ylitalo-Heikkilä M, Virkkula P, Sintonen H, Lundberg M, Roine RP, Hytönen M. Different rhinologic diseases cause a similar multidimensional decrease in generic health-related quality of life. Clin Otolaryngol 2018; 43:1487-1493. [DOI: 10.1111/coa.13190] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 06/11/2018] [Accepted: 07/08/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Maija Ylitalo-Heikkilä
- Department of Otorhinolaryngology - Head and Neck Surgery; Helsinki University Hospital and University of Helsinki; Helsinki Finland
| | - Paula Virkkula
- Department of Otorhinolaryngology - Head and Neck Surgery; Helsinki University Hospital and University of Helsinki; Helsinki Finland
| | - Harri Sintonen
- Department of Public Health; University of Helsinki; Helsinki Finland
| | - Marie Lundberg
- Department of Otorhinolaryngology - Head and Neck Surgery; Helsinki University Hospital and University of Helsinki; Helsinki Finland
| | - Risto P. Roine
- Research Centre for Comparative Effectiveness and Patient Safety; University of Eastern Finland; Kuopio Finland
- Group Administration; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - Maija Hytönen
- Department of Otorhinolaryngology - Head and Neck Surgery; Helsinki University Hospital and University of Helsinki; Helsinki Finland
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31
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Demoly P, Bosse I, Fontaine JF, Bonniaud P, Just J. Allergologie : une spécialité à l’heure des parcours de soins. REVUE FRANCAISE D ALLERGOLOGIE 2018. [DOI: 10.1016/j.reval.2018.04.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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32
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Voice Disorders and Voice Knowledge in Choir Singers. J Voice 2018; 34:157.e1-157.e8. [PMID: 30104126 DOI: 10.1016/j.jvoice.2018.07.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 06/30/2018] [Accepted: 07/02/2018] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Singers have reported higher prevalence of vocally harmful behaviors, vocal symptoms, and voice disorders than nonsingers have. The purpose of this study was to investigate the prevalence of voice disorders among choir singers and to discover the risk factors associated with voice disorders. Another purpose was to explore the choir singers' knowledge about the anatomy and physiology of the voice, and voice ergonomics. METHODS Three hundred and fifteen adult choir singers, 65% women, and 35% men, completed a web-questionnaire. The questionnaire included demographic questions and questions about vocal symptoms, risk factors for voice disorders, and voice knowledge. RESULTS Twenty one percent of the participants experienced two or more frequently occurring vocal symptoms, which was defined as having a functional voice disorder. Choir singers with a vocally demanding profession were almost twice as likely to report several frequently occurring vocal symptoms. Health-related risk factors, such as inhalant allergy and asthma, had a significant relation with the number of vocal symptoms. The overall voice knowledge among the choir singers seemed limited. CONCLUSIONS The prevalence of voice disorders among choir singers seems to be similar to the prevalence rate among professional voice users. Choir singers with a vocally demanding profession are at a higher risk of developing a functional voice disorder. The results of this study raise the importance of educating choir singers about the voice, in order to prevent development of voice disorders.
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33
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Heikkilä JM, Parkkamäki S, Salimäki J, Westermarck S, Pohjanoksa-Mäntylä M. Community pharmacists' knowledge of COPD, and practices and perceptions of medication counseling of COPD patients. Int J Chron Obstruct Pulmon Dis 2018; 13:2065-2074. [PMID: 30013334 PMCID: PMC6037276 DOI: 10.2147/copd.s159726] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background and purpose COPD is one of the leading causes of morbidity and mortality worldwide. Although medication counseling interventions by pharmacists have been found to support the management of COPD, little is known about pharmacists’ knowledge concerning COPD and regular practices and perceptions concerning medication counseling of COPD patients. The purpose of this study was to research these topics among Finnish community pharmacists. Materials and methods In January 2017, an electronic survey was e-mailed to Finnish community pharmacies (n=741) via the Association of the Finnish Pharmacies. One pharmacist from each pharmacy, preferably a specialist in asthma, was invited to answer the survey. Results Completed responses were received from 263 pharmacists (response rate =35%), of whom 196 pharmacists were specialists in asthma. Response rate among asthma pharmacists was 42%. Pharmacists were positive about their role in medication counseling and in support of the self-management of COPD patients. COPD-related knowledge was self-assessed as being good and was on a good level in respect of basic facts. However, almost half (46%) of the pharmacists did not know that COPD is considered a national public health issue, and ~50% of the pharmacists were not familiar with the current care guideline on COPD. Medication counseling was found to be more medicinal product-driven and less advisory concerning lifestyle changes such as smoking cessation and physical exercise. Conclusion Although the pharmacists’ knowledge of COPD was good on general topics, there were some gaps in their knowledge on the current care guideline and status of the disease. Pharmacists should more systematically individually target medication counseling according to patients’ needs. In addition, lifestyle treatments, including smoking cessation and physical exercise, should be part of the medication counseling.
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Affiliation(s)
- Juha Markus Heikkilä
- Faculty of Pharmacy, Division of Pharmacology and Pharmacotherapy, University of Helsinki, Helsinki, Finland, .,Hartola Pharmacy, Hartola, Finland,
| | | | | | | | - Marika Pohjanoksa-Mäntylä
- Faculty of Pharmacy, Division of Pharmacology and Pharmacotherapy, University of Helsinki, Helsinki, Finland,
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34
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Ryan D, Gerth van Wijk R, Angier E, Kristiansen M, Zaman H, Sheikh A, Cardona V, Vidal C, Warner A, Agache I, Arasi S, Fernandez-Rivas M, Halken S, Jutel M, Lau S, Pajno G, Pfaar O, Roberts G, Sturm G, Varga EM, Van Ree R, Muraro A. Challenges in the implementation of the EAACI AIT guidelines: A situational analysis of current provision of allergen immunotherapy. Allergy 2018; 73:827-836. [PMID: 28850687 DOI: 10.1111/all.13264] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2017] [Indexed: 12/30/2022]
Abstract
PURPOSE The European Academy of Allergy and Clinical Immunology (EAACI) has produced Guidelines on Allergen Immunotherapy (AIT). We sought to gauge the preparedness of primary care to participate in the delivery of AIT in Europe. METHODS We undertook a mixed-methods, situational analysis. This involved a purposeful literature search and two surveys: one to primary care clinicians and the other to a wider group of stakeholders across Europe. RESULTS The 10 papers identified all pointed out gaps or deficiencies in allergy care provision in primary care. The surveys also highlighted similar concerns, particularly in relation to concerns about lack of knowledge, skills, infrastructural weaknesses, reimbursement policies and communication with specialists as barriers to evidence-based care. Almost all countries (92%) reported the availability of AIT. In spite of that, only 28% and 44% of the countries reported the availability of guidelines for primary care physicians and specialists, respectively. Agreed pathways between specialists and primary care physicians were reported as existing in 32%-48% of countries. Reimbursement appeared to be an important barrier as AIT was only fully reimbursed in 32% of countries. Additionally, 44% of respondents considered accessibility to AIT and 36% stating patient costs were barriers. CONCLUSIONS Successful working with primary care providers is essential to scaling-up AIT provision in Europe, but to achieve this, the identified barriers must be overcome. Development of primary care interpretation of guidelines to aid patient selection, establishment of disease management pathways and collaboration with specialist groups are required as a matter of urgency.
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Affiliation(s)
- D. Ryan
- Asthma UK Centre for Applied Research; Usher Institute of Population Health Sciences and Informatics; The University of Edinburgh Medical School; Edinburgh UK
| | - R. Gerth van Wijk
- Allergy Section; Department of Internal Medicine; Erasmus MC; Rotterdam The Netherlands
| | - E. Angier
- GPwSI in Allergy; Department of Clinical Immunology and Allergy; Northern General Hospital; Sheffield UK
| | - M. Kristiansen
- Section for Health Services Research; Department of Public Health; University of Copenhagen; Copenhagen K Denmark
| | - H. Zaman
- Senior Lecturer in Pharmacy Practice; Faculty of Life Sciences; School of Pharmacy and Medical Sciences; University of Bradford; Bradford UK
| | - A. Sheikh
- Asthma UK Centre for Applied Research; Usher Institute of Population Health Sciences and Informatics; The University of Edinburgh Medical School; Edinburgh UK
| | - V. Cardona
- Allergy Section; Department of Internal Medicine; Hospital Vall d'Hebron; Barcelona Spain
| | - C. Vidal
- Allergy Department and Faculty of Medicine; Complejo Hospitalario Universitario de Santiago; Santiago de Compostela University; Santigo Spain
| | - A. Warner
- Head of Clinical Services, Allergy UK; Planwell House; LEFA Business Park; Sidcup Kent UK
| | - I. Agache
- Faculty of Medicine; Department of Allergy and Clinical Immunology; Transylvania University Brasov; Brasov Romania
| | - S. Arasi
- Allergy Unit; Department of Pediatrics; University of Messina; Messina Italy
- Department of Pediatric Pneumology and Immunology; Charité Universitätsmedizin; Berlin Germany
| | | | - S. Halken
- Hans Christian Andersen Children's Hospital; Odense University Hospital; Odense Denmark
| | - M. Jutel
- Wroclaw Medical University; ALL-MED Medical Research Institute; Wrocław Poland
| | - S. Lau
- Department of Pediatric Pneumology and Immunology; Charité Universitätsmedizin; Berlin Germany
| | - G. Pajno
- Allergy Unit; Department of Pediatrics; University of Messina; Messina Italy
| | - O. Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery; Universitätsmedizin Mannheim; Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
- Center for Rhinology and Allergology; Wiesbaden Germany
| | - G. Roberts
- The David Hide Asthma and Allergy Research Centre; St Mary's Hospital; Newport Isle of Wight UK
- NIHR Respiratory Biomedical Research Unit; University Hospital Southampton NHS Foundation Trust; Southampton UK
- Faculty of Medicine; University of Southampton; Southampton UK
| | - G. Sturm
- Department of Dermatology and Venerology; Medical University of Graz; Graz Austria
- Outpatient Allergy Clinic Reumannplatz; Vienna Austria
| | - E. M. Varga
- Department of Paediatric and Adolescent Medicine; Respiratory and Allergic Disease Division; Medical University of Graz; Graz Austria
| | - R. Van Ree
- Departments of Experimental Immunology and of Otorhinolaryngology; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
| | - A. Muraro
- Department of Mother and Child Health; The Referral Centre for Food Allergy Diagnosis and Treatment Veneto Region; University of Padua; Padua Italy
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35
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Hellings PW, Borrelli D, Pietikainen S, Agache I, Akdis C, Bachert C, Bewick M, Botjes E, Constantinidis J, Fokkens W, Haahtela T, Hopkins C, Illario M, Joos G, Lund V, Muraro A, Pugin B, Seys S, Somekh D, Stjärne P, Valiulis A, Valovirta E, Bousquet J. European Summit on the Prevention and Self-Management of Chronic Respiratory Diseases: report of the European Union Parliament Summit (29 March 2017). Clin Transl Allergy 2017; 7:49. [PMID: 29299230 PMCID: PMC5745781 DOI: 10.1186/s13601-017-0186-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 12/15/2017] [Indexed: 01/19/2023] Open
Abstract
On March 29, 2017, a European Summit on the Prevention and Self-Management of Chronic Respiratory Diseases (CRD) was organized by the European Forum for Research and Education in Allergy and Airway Diseases. The event took place in the European Parliament of Brussels and was hosted by MEP David Borrelli and MEP Sirpa Pietikainen. The aim of the Summit was to correspond to the needs of the European Commission and of patients suffering from CRD to join forces in Europe for the prevention and self-management. Delegates of the European Rhinologic Society, European Respiratory Society, European Academy of Allergy and Clinical Immunology, European Academy of Paediatrics, and European Patients Organization EFA all lectured on their vision and action plan to join forces in achieving adequate prevention and self-management of CRD in the context of Precision Medicine. Recent data highlight the preventive capacity of education on optimal care pathways for CRD. Self-management and patient empowerment can be achieved by novel educational on-line materials and by novel mobile health tools enabling patients and doctors to monitor and optimally treat CRDs based on the level of control. This report summarizes the contributions of the representatives of different European academic stakeholders in the field of CRD.
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Affiliation(s)
- Peter W. Hellings
- Department of Otorhinolaryngology, University Hospitals Leuven, KU Leuven, Louvain, Belgium
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
| | - David Borrelli
- Italian Member of the European Parliament, EFDD Group, Brussels, Belgium
| | | | - Ioana Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - Cezmi Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
- Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Claus Bachert
- Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium
| | | | - Erna Botjes
- EFA - European Federation of Allergy and Airways Diseases Patients’ Associations, Brussels, Belgium
| | - Jannis Constantinidis
- 1st Department of ORL, Head and Neck Surgery, Aristotle University, Thessaloníki, Greece
| | - Wytske Fokkens
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
| | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - Claire Hopkins
- ENT Department, Guy’s and St Thomas’ Hospitals, London, UK
| | - Maddalena Illario
- Division for Health Innovation, Campania Region and Federico II University Hospital Naples (R&D and DISMET), Naples, Italy
| | - Guy Joos
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Valerie Lund
- Royal National Throat, Nose and Ear Hospital, University College London Hospitals, London, UK
| | - Antonella Muraro
- Food Allergy Referral Centre Veneto Region, Department of Women and Child Health, Padua General University Hospital, Padua, Italy
| | - Benoit Pugin
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
| | - Sven Seys
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
- Lab of Clinical Immunology, Department of Immunology and Microbiology, KU Leuven, Brussels, Belgium
| | - David Somekh
- European Health Futures Forum (EHFF), Isle of Wright, UK
| | - Pär Stjärne
- Rhinology Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
| | - Arunas Valiulis
- Vilnius University Clinic of Children’s Diseases and Public Health Institute, Vilnius, Lithuania
- European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium
| | - Erkka Valovirta
- Department of Lung Diseases and Clinical Allergology, Univ. of Turku, and Allergy Clinic, Terveystalo, Turku, Finland
| | - Jean Bousquet
- MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
- INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, Villejuif, Montigny le Bretonneux, France
- EUFOREA aisbl, 132, Ave. Brand Whitlock, 1200 Brussels, Belgium
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Hämäläinen N, Nwaru BI, Erlund I, Takkinen HM, Ahonen S, Toppari J, Ilonen J, Veijola R, Knip M, Kaila M, Virtanen SM. Serum carotenoid and tocopherol concentrations and risk of asthma in childhood: a nested case-control study. Clin Exp Allergy 2017; 47:401-409. [PMID: 28198577 DOI: 10.1111/cea.12904] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 01/07/2017] [Accepted: 02/01/2017] [Indexed: 01/27/2023]
Abstract
BACKGROUND The antioxidant hypothesis regarding the risk of asthma in childhood has resulted in inconsistent findings. Some data indicate that the role of antioxidants in childhood asthma risk may have a critical time window of effect, but only a well-designed longitudinal cohort study can clarify this hypothesis. OBJECTIVE To study the longitudinal associations between serum carotenoid and tocopherol concentrations during the first 4 years of life and asthma risk by the age of 5 years. METHODS Based on a case-control design nested within a Finnish birth cohort, 146 asthma cases were matched to 270 controls on birth time, sex, genetic risk, and birth place. Non-fasting blood samples were collected at the ages of 1, 1.5, 2, 3, and 4 years and serum carotenoids and tocopherols were analysed. Parents reported the presence and age at start of persistent doctor-diagnosed asthma in the child at the age of 5 years. Data analyses were conducted using generalized estimating equations. RESULTS We did not find strong associations between serum carotenoids and tocopherols and the risk of asthma based on age-specific and longitudinal analyses. Both lower and higher quarters of α-carotene and γ-tocopherol increased the risk of asthma. CONCLUSIONS The current findings do not support the suggestion that the increased prevalence of asthma may be a consequence of decreased intake of antioxidant nutrients. Moreover, we did not confirm any critical time window of impact of antioxidants on asthma risk. Replication of these findings in similar longitudinal settings will strengthen this evidence base.
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Affiliation(s)
- N Hämäläinen
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - B I Nwaru
- School of Health Sciences, University of Tampere, Tampere, Finland.,Asthma UK Centre for Applied Research, Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - I Erlund
- The Genomics and Biomarkers Unit, Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - H-M Takkinen
- School of Health Sciences, University of Tampere, Tampere, Finland.,Nutrition Unit, Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - S Ahonen
- School of Health Sciences, University of Tampere, Tampere, Finland.,Tampere Center for Child Health Research, School of Medicine, Tampere University Hospital, University of Tampere, Tampere, Finland.,The Science Centre of Pirkanmaa Hospital District, Tampere, Finland
| | - J Toppari
- Department of Physiology, Institute of Biomedicine, University of Turku, Turku, Finland.,Department of Pediatrics, Turku University Hospital, Turku, Finland
| | - J Ilonen
- Immunogenetics Laboratory, Faculty of Medicine, University of Turku and Turku University Hospital, Turku, Finland.,Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland
| | - R Veijola
- Department of Pediatrics, PEDEGO Research Unit, Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - M Knip
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland.,Research Programs Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
| | - M Kaila
- Public Health Medicine, University of Helsinki and Helsinki University Hospital, University of Helsinki, Helsinki, Finland.,Department of Pediatrics, Tampere University Hospital, Tampere, Finland
| | - S M Virtanen
- School of Health Sciences, University of Tampere, Tampere, Finland.,Nutrition Unit, Department of Health, National Institute for Health and Welfare, Helsinki, Finland.,Tampere Center for Child Health Research, School of Medicine, Tampere University Hospital, University of Tampere, Tampere, Finland.,The Science Centre of Pirkanmaa Hospital District, Tampere, Finland
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37
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Khaltaev N. GARD, a new way to battle with chronic respiratory diseases, from disease oriented programmes to global partnership. J Thorac Dis 2017; 9:4676-4689. [PMID: 29268538 DOI: 10.21037/jtd.2017.11.91] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Initiated by World Health Organization (WHO) Global Chronic Respiratory Disease (CRD)-oriented programmes, Global Initiative on Asthma (GINA), GOLD-Global Initiative for Chronic Obstructive Pulmonary Disease (COPD), Allergic Rhinitis and its Impact on Asthma (ARIA), and Practical Approach to Lung Health (PAL) have catalyzed creation of the Global Alliance Against CRD (GARD). Forty-five countries sharing GARD's goal to reduce the burden of CRD joint GARD. In 20 countries with reliable death estimates, CRD mortality has been analyzed in 2000, 2005, 2010 and 2015. Dramatic decline in CRD mortality is seen in Kyrgyzstan, Netherlands, Italy and Republic of Korea (69%, 55%, 48%, and 48%). Positive trend in COPD mortality is seen for Lithuania (36% decline) and Spain (21%). In France, Japan, Mexico, Romania and Costa Rica, positive trend for asthma mortality is obvious from 2000 to 2015 from about 40% in France and Romania, 50% and Mexico and Czech Republic, 65% in Japan and 69% in Belgium. In Costa Rica zero asthma mortality was registered in 2015. In Czechia and Belgium decline is seen from 2000 to 2005, which then stabilized in Czech Republic and went further down in Belgium. In Finland initially, low asthma mortality remains practically unchanged with slight decline in 2015. In other countries analyzed, we did not see any positive trend in CRD mortality. In all countries with positive CRD dynamic WHO introduced activities remained active, they have been taken into local guidelines and practice and supported national authorities in implementing these evidence-based guidelines. Before GARD launch WHO initiated activities produced a good basis for further GARD movement and by 2010 we see a visible positive trend in CRD mortality in success countries. By 2015 when WHO noncommunicable disease (NCD) Global Action Plan 2013-2020 rollouts globally dramatic decline in total CRD mortality and particularly in Asthma and COPD mortality became obvious. Global disease oriented programmes, national and international partnerships combined with the Global NCD Action Plan most probable produce a positive synergistic effect on the mortality from CRD.
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Affiliation(s)
- Nikolai Khaltaev
- Global Alliance against Chronic Respiratory Diseases, Geneva, Switzerland
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38
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Tanno LK, Haahtela T, Calderon MA, Cruz A, Demoly P. Implementation gaps for asthma prevention and control. Respir Med 2017; 130:13-19. [PMID: 29206628 DOI: 10.1016/j.rmed.2017.07.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 06/29/2017] [Accepted: 07/07/2017] [Indexed: 12/22/2022]
Abstract
Asthma and allergic diseases can start in childhood and persist throughout life, but could also be manifested later, at any time for still misunderstood reasons. They are major chronic multifactorial respiratory diseases, for which prevention, early diagnosis and treatment is recognized as a priority for the Europe's public health policy and the United Nations. Given that allergy triggers (including infections, rapid urbanization leading to loss in biodiversity, pollution and climate changes) are not expected to change in a foreseeable future, it is imperative that steps are taken to develop, strengthen and optimize preventive and treatment strategies. Currently there are good treatments for asthma, several risk factors are known (e.g., allergies, rhinitis, tobacco smoke) and tools to control the disease have been developed. However, we are still uncertain how to prevent patients from developing asthma and allergic diseases. In this paper, we list the positive and negative experiences in this field as well as analyze the missing links in the process. This critical analysis will be the basis of setting-up an effective program for prevention and making, a process labeled as "implementation gaps".
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Affiliation(s)
- Luciana K Tanno
- Hospital Sírio Libanês, São Paulo, Brazil; Division of Allergy, Department of Pulmonology, University Hospital of Montpellier, Montpellier, and Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Universités, Paris, France.
| | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Central Hospital, FI-00029 Helsinki, Finland
| | - Moises A Calderon
- Section of Allergy and Clinical Immunology, Imperial College London, National Heart and Lung Institute, Royal Brompton Hospital, London, United Kingdom
| | - Alvaro Cruz
- ProAR-Núcleo de Excelência em Asma da Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Pascal Demoly
- Division of Allergy, Department of Pulmonology, University Hospital of Montpellier, Montpellier, and Pierre Louis Institute of Epidemiology and Public Health, Sorbonne Universités, Paris, France
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39
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Hoffmann HJ, Valovirta E, Pfaar O, Moingeon P, Schmid JM, Skaarup SH, Cardell LO, Simonsen K, Larché M, Durham SR, Sørensen P. Novel approaches and perspectives in allergen immunotherapy. Allergy 2017; 72:1022-1034. [PMID: 28122129 DOI: 10.1111/all.13135] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2017] [Indexed: 01/01/2023]
Abstract
In this review, we report on relevant current topics in allergen immunotherapy (AIT) which were broadly discussed during the first Aarhus Immunotherapy Symposium (Aarhus, Denmark) in December 2015 by leading clinicians, scientists and industry representatives in the field. The aim of this symposium was to highlight AIT-related aspects of public health, clinical efficacy evaluation, mechanisms, development of new biomarkers and an overview of novel therapeutic approaches. Allergy is a public health issue of high socioeconomic relevance, and development of evidence-based action plans to address allergy as a public health issue ought to be on national and regional agendas. The underlying mechanisms are in the focus of current research that lays the ground for innovative therapies. Standardization and harmonization of clinical endpoints in AIT trials as well as current knowledge about potential biomarkers have substantiated proof of effectiveness of this disease-modifying therapeutic option. Novel treatments such as peptide immunotherapy, intralymphatic immunotherapy and use of recombinant allergens herald a new age in which AIT may address treatment of allergy as a public health issue by reaching a large fraction of patients.
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Affiliation(s)
- H. J. Hoffmann
- Department of Clinical Medicine; HEALTH; Aarhus University; Aarhus Denmark
- Department of Respiratory Diseases and Allergy; Aarhus University Hospital; Aarhus Denmark
| | - E. Valovirta
- Department of Lung Diseases and Clinical Immunology; University of Turku; Turku Finland
- Filha; Finnish Lung Health Association; Helsinki Finland
- Terveystalo Allergy Clinic Turku; Finland
| | - O. Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery; Medical Faculty Mannheim; Universitätsmedizin Mannheim; Heidelberg University; Mannheim Germany
- Center for Rhinology and Allergology; Wiesbaden Germany
| | - P. Moingeon
- Research and Development; StallergenesGreer; Antony Cedex France
| | - J. M. Schmid
- Department of Clinical Medicine; HEALTH; Aarhus University; Aarhus Denmark
- Department of Respiratory Diseases and Allergy; Aarhus University Hospital; Aarhus Denmark
| | - S. H. Skaarup
- Department of Clinical Medicine; HEALTH; Aarhus University; Aarhus Denmark
- Department of Respiratory Diseases and Allergy; Aarhus University Hospital; Aarhus Denmark
| | - L.-O. Cardell
- Division of ENT Diseases; Department of Clinical Sciences, Intervention and Technology; Karolinska Institutet; Stockholm Sweden
- Department of ENT Diseases; Karolinska University Hospital; Stockholm Sweden
| | - K. Simonsen
- Anergis SA; BioPole III; Epalinges Switzerland
| | - M. Larché
- Clinical Immunology & Allergy and Respirology Divisions; Department of Medicine; McMaster University; Hamilton ON Canada
- Firestone Institute for Respiratory Health; McMaster University; Hamilton ON Canada
| | - S. R. Durham
- Allergy and Clinical Immunology; National Heart and Lung Institute; Imperial College London; London UK
| | - P. Sørensen
- Research and Development; StallergenesGreer; Antony Cedex France
- Department of Biomedicine; HEALTH; Aarhus University & Research; Aarhus Denmark
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40
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Haahtela T, Valovirta E, Bousquet J, Mäkelä M. The Finnish Allergy Programme 2008-2018 works. Eur Respir J 2017. [PMID: 28642312 DOI: 10.1183/13993003.00470-2017] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Erkka Valovirta
- Dept of Lung Diseases and Clinical Allergology, University of Turku, and Allergy Clinic, Terveystalo, Turku, Finland
| | - Jean Bousquet
- MACVIA-France, Contre les Maladies Chroniques pour un Vieillissement Actif en France, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France.,INSERM U 1168, VIMA: Ageing and chronic diseases Epidemiological and public health approaches, Villejuif, Université Versailles Saint-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France
| | - Mika Mäkelä
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
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Bousquet J, Barbara C, Bateman E, Bel E, Bewick M, Chavannes NH, Cruz AA, Haahtela T, Hellings PW, Khaltaev N, Lodrup Carlsen K, Muraro A, Cordeiro CR, Rosado-Pinto J, Samolinski B, Strandberg T, Valiulis A, Yorgancioglu A, Zuberbier T. AIRWAYS-ICPs (European Innovation Partnership on Active and Healthy Ageing) from concept to implementation. Eur Respir J 2017; 47:1028-33. [PMID: 27037308 DOI: 10.1183/13993003.01856-2015] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 11/09/2015] [Indexed: 11/05/2022]
Affiliation(s)
- Jean Bousquet
- University Hospital, Montpellier, France MACVIA-LR, Contre les Maladies Chroniques pour un VIeillissement Actif en Languedoc Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France INSERM, VIMA: Ageing and chronic diseases Epidemiological and public health approaches, U1168, Paris, and UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, Versailles, France GARD, Global Alliance against Chronic Respiratory Diseases (GARD) EIP on AHA Commitment for Action
| | - Cristina Barbara
- EIP on AHA Commitment for Action PNDR, Portuguese National Programme for Respiratory Diseases, Faculdade de Medicina de Lisboa, Lisbon, Portugal
| | - Eric Bateman
- GARD, Global Alliance against Chronic Respiratory Diseases (GARD) Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Elisabeth Bel
- Department of Respiratory Medicine, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands ERS Past President, European Respiratory Society
| | - Mike Bewick
- Deputy National Medical Director, NHS England, UK
| | - Niels H Chavannes
- GARD, Global Alliance against Chronic Respiratory Diseases (GARD) Dept of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands International Primary Care Respiratory Group
| | - Alvaro A Cruz
- GARD, Global Alliance against Chronic Respiratory Diseases (GARD) ProAR - Nucleo de Excelencia em Asma, Federal University of Bahia, Brasil and GARD Executive Committee
| | - Tari Haahtela
- EIP on AHA Commitment for Action Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - Peter W Hellings
- Laboratory of Clinical Immunology, Dept of Microbiology and Immunology, KU Leuven, Leuven, Belgium EAACI, European Academy of Allergy and Clinical Immunology
| | - Nikolai Khaltaev
- GARD, Global Alliance against Chronic Respiratory Diseases (GARD)
| | - Karin Lodrup Carlsen
- EIP on AHA Commitment for Action Dept of Paediatrics, Oslo University Hospital, Oslo, Norway Faculty of Medicine, University of Oslo, Institute of Clinical Medicine, Oslo, Norway
| | - Antonella Muraro
- EAACI, European Academy of Allergy and Clinical Immunology Dept of Women and Child Health, Food Allergy Referral Centre Veneto Region, Padua General University Hospital, Padua, Italy
| | | | - Jose Rosado-Pinto
- GARD, Global Alliance against Chronic Respiratory Diseases (GARD) Serviço de Imunoalergologia, Hospital da Luz, Lisbon, Portugal
| | - Boleslaw Samolinski
- EIP on AHA Commitment for Action Dept of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Poland
| | - Timo Strandberg
- Dept of Paediatrics, Universities of Helsinki and Oulu, Finland European Union Geriatric Medicine Society, EUGMS Helsinki University Central Hospital, Helsinki, Finland
| | - Arunas Valiulis
- GARD, Global Alliance against Chronic Respiratory Diseases (GARD) Vilnius University Clinic of Children's Diseases, Vilnius, Lithuania European Academy of Pediatrics (EAP/UEMS-SP)
| | - Arzu Yorgancioglu
- GARD, Global Alliance against Chronic Respiratory Diseases (GARD) EIP on AHA Commitment for Action Dept of Pulmonology, Celal Bayar University, Manisa, Turkey Turkish Thoracic Society
| | - Torsten Zuberbier
- Allergy-Centre-Charité at the Department of Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany Secretary General of the Global Allergy and Asthma European Network (GA2LEN)
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Abstract
OBJECTIVES The incidence and prevalence of allergies worldwide has been increasing and allergy services globally are unable to keep up with this increase in demand. This systematic review aims to understand the delivery of allergy services worldwide, challenges faced and future directions for service delivery. METHODS A systematic scoping review of Ovid, EMBASE, HMIC, CINAHL, Cochrane, DARE, NHS EED and INAHTA databases was carried out using predefined inclusion and exclusion criteria. Data on the geographical region, study design and treatment pathways described were collected, and the findings were narratively reported. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. RESULTS 205 publications were screened and 27 selected for review. Only 3 were prospective studies, and none included a control group. There were no eligible publications identified from North America, Africa, Australia and most parts of Asia. Most publications relate to allergy services in the UK. In general, allergy services globally appear not to have kept pace with increasing demand. The review suggests that primary care practitioners are not being adequately trained in allergy and that there is a paucity of appropriately trained specialists, especially in paediatric allergy. There appear to be considerable barriers to service improvement, including lack of political will and reluctance to allocate funds from local budgets. CONCLUSIONS Demand for allergy services appears to have significantly outpaced supply. Primary and secondary care pathways in allergy seem inadequate leading to poor referral practices, delays in patient management and consequently poor outcomes. Improvement of services requires strong public and political engagement. There is a need for well-planned, prospective studies in this area and a few are currently underway. There is no evidence to suggest that any given pathway of service provision is better than another although data from a few long-term, prospective studies look very promising.
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Affiliation(s)
- Lavanya Diwakar
- Health Economics Unit, University of Birmingham, Birmingham, UK
| | - Carole Cummins
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Richard Lilford
- Population Evidence and Technologies Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Tracy Roberts
- Health Economics Unit, University of Birmingham, Birmingham, UK
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Mechanisms of the Development of Allergy (MeDALL): Introducing novel concepts in allergy phenotypes. J Allergy Clin Immunol 2017; 139:388-399. [DOI: 10.1016/j.jaci.2016.12.940] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 12/04/2016] [Accepted: 12/16/2016] [Indexed: 11/19/2022]
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Haahtela T, Herse F, Karjalainen J, Klaukka T, Linna M, Leskelä RL, Selroos O, Reissell E. The Finnish experience to save asthma costs by improving care in 1987-2013. J Allergy Clin Immunol 2016; 139:408-414.e2. [PMID: 27979429 DOI: 10.1016/j.jaci.2016.12.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 11/29/2016] [Accepted: 12/02/2016] [Indexed: 10/20/2022]
Abstract
The Finnish National Asthma Program 1994-2004 markedly improved asthma care in the 1990s. We evaluated the changes in costs during 26 years from 1987 to 2013. Direct and indirect costs were calculated by using data from national registries. Costs from both the societal and patient perspectives were included. The costs were based on patients with persistent, physician-diagnosed asthma verified by lung function measurements. We constructed minimum and maximum scenarios to assess the effect of improved asthma care on total costs. The number of patients with persistent asthma in the national drug reimbursement register increased from 83,000 to 247,583. Improved asthma control reduced health care use and disability, resulting in major cost savings. Despite a 3-fold increase in patients, the total costs decreased by 14%, from €222 million to €191 million. Costs for medication and primary care visits increased, but overall annual costs per patient decreased by 72%, from €2656 to €749. The theoretical total cost savings for 2013, comparing actual with predicted costs, were between €120 and €475 million, depending on the scenario used. The Finnish Asthma Program resulted in significant cost savings at both the societal and patient levels during a 26-year period.
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Affiliation(s)
- Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland.
| | | | | | - Timo Klaukka
- Department of Research, Social Insurance Institute, Helsinki, Finland
| | | | | | | | - Eeva Reissell
- National Institute for Health and Welfare, Helsinki, Finland
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Calderon MA, Demoly P, Casale T, Akdis CA, Bachert C, Bewick M, Bilò BM, Bohle B, Bonini S, Bush A, Caimmi DP, Canonica GW, Cardona V, Chiriac AM, Cox L, Custovic A, De Blay F, Devillier P, Didier A, Di Lorenzo G, Du Toit G, Durham SR, Eng P, Fiocchi A, Fox AT, van Wijk RG, Gomez RM, Haathela T, Halken S, Hellings PW, Jacobsen L, Just J, Tanno LK, Kleine-Tebbe J, Klimek L, Knol EF, Kuna P, Larenas-Linnemann DE, Linneberg A, Matricardi M, Malling HJ, Moesges R, Mullol J, Muraro A, Papadopoulos N, Passalacqua G, Pastorello E, Pfaar O, Price D, Del Rio PR, Ruëff R, Samolinski B, Scadding GK, Senti G, Shamji MH, Sheikh A, Sisul JC, Sole D, Sturm GJ, Tabar A, Van Ree R, Ventura MT, Vidal C, Varga EM, Worm M, Zuberbier T, Bousquet J. Allergy immunotherapy across the life cycle to promote active and healthy ageing: from research to policies: An AIRWAYS Integrated Care Pathways (ICPs) programme item (Action Plan B3 of the European Innovation Partnership on active and healthy ageing) and the Global Alliance against Chronic Respiratory Diseases (GARD), a World Health Organization GARD research demonstration project. Clin Transl Allergy 2016; 6:41. [PMID: 27895895 PMCID: PMC5120439 DOI: 10.1186/s13601-016-0131-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Accepted: 11/02/2016] [Indexed: 12/17/2022] Open
Abstract
Allergic diseases often occur early in life and persist throughout life. This life-course perspective should be considered in allergen immunotherapy. In particular it is essential to understand whether this al treatment may be used in old age adults. The current paper was developed by a working group of AIRWAYS integrated care pathways for airways diseases, the model of chronic respiratory diseases of the European Innovation Partnership on active and healthy ageing (DG CONNECT and DG Santé). It considered (1) the political background, (2) the rationale for allergen immunotherapy across the life cycle, (3) the unmet needs for the treatment, in particular in preschool children and old age adults, (4) the strategic framework and the practical approach to synergize current initiatives in allergen immunotherapy, its mechanisms and the concept of active and healthy ageing.
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Affiliation(s)
- M A Calderon
- National Heart and Lung Institute, Royal Brompton Hospital NHS, Imperial College London, London, UK
| | - P Demoly
- Unité d'allergologie, Département de Pneumologie et AddictologieHôpital Arnaud de Villeneuve, CHRU de Montpellier, Sorbonne Universités, UPMC Paris 06, UMR-S 1136, IPLESP, Equipe EPAR, 75013 Paris, France
| | - T Casale
- University of South Florida Morsani College of Medicine, Tampa, FL USA
| | - C A Akdis
- Christine Kühne Center for Allergy Research and Education (CK-CARE), Swiss Institute of Allergy and Asthma Research (SIAF)University of Zurich, Davos, Switzerland
| | - C Bachert
- Upper Airways Research Laboratory (URL), ENT Department, University Hospital Ghent, Ghent, Belgium
| | - M Bewick
- iQ4U consultants Ltd, London, UK
| | - B M Bilò
- Allergy Unit, Department of Internal Medicine, University Hosp Ospedali Riuniti, Ancona, Italy
| | - B Bohle
- Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - S Bonini
- Second University of Naples and IFT-CNR, Rome, Italy
| | - A Bush
- National Heart and Lung Institute, Royal Brompton Hospital NHS, Imperial College London, London, UK
| | - D P Caimmi
- Unité d'allergologie, Département de Pneumologie et AddictologieHôpital Arnaud de Villeneuve, CHRU de Montpellier, Sorbonne Universités, UPMC Paris 06, UMR-S 1136, IPLESP, Equipe EPAR, 75013 Paris, France
| | - G W Canonica
- Allergy and Respiratory Diseases Clinic, DIMI, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - V Cardona
- Allergy Section, Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - A M Chiriac
- Division of Allergy, Hôpital Arnaud de Villeneuve, Department of Pulmonology, University Hospital of Montpellier, Montpellier - UPMC Univ Paris 06, UMRS 1136, Equipe - EPAR - IPLESP, Sorbonne Universités, Paris, France
| | - L Cox
- Nova Southeastern University, Ft. Lauderdale, FL USA
| | - A Custovic
- National Heart and Lung Institute, Royal Brompton Hospital NHS, Imperial College London, London, UK
| | - F De Blay
- Allergy Division, Chest Disease Department, University Hospital of Strasbourg, Strasbourg, France
| | - P Devillier
- University Versailles Saint-Quentin and Clinical Pharmacology Unit, UPRES EA 220, Department of Airway Diseases, Foch Hospital, Suresnes, France
| | - A Didier
- Respiratory Diseases Department, Rangueil-Larrey Hospital, Toulouse, France
| | - G Di Lorenzo
- Dipartimento BioMedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), University of Palermo, Palermo, Italy
| | - G Du Toit
- Guy's and St. Thomas' NHS Trust, Kings College, London, UK
| | - S R Durham
- Allergy and Clinical Immunology Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - P Eng
- Department of Pediatric Pulmonology and Allergy, Children's Hospital, Aarau, Switzerland
| | - A Fiocchi
- Division of Allergy, Department of Pediatrics, Bambino Gesù Pediatric Hospital, Vatican City, Rome, Italy
| | - A T Fox
- King's College London Allergy Academy, London, UK
| | - R Gerth van Wijk
- Section of Allergology, Department of Internal Medicine, Erasmus Medical Center, Building Rochussenstraat, Rotterdam, The Netherlands
| | - R M Gomez
- Unidad Alergia and Asma, Hospital San Bernardo, Salta, Argentina
| | - T Haathela
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - S Halken
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - P W Hellings
- Clinical Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, KU Leuven, Louvain, Belgium
| | - L Jacobsen
- Allergy Learning and Consulting, Secretary Immunotherapy Interest Group EAACI, Copenhagen, Denmark
| | - J Just
- Allergology Department, Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand-Trousseau, INSERM, UMR_S 1136, Sorbonne Universités, UPMC Univ Paris, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe EPAR, Paris, France
| | - L K Tanno
- Hospital Sírio Libanês, São Paulo, Brazil ; University Hospital of Montpellier, Montpellier, France ; UPMC Paris 06, UMR-S 1136, IPLESP, Equipe EPAR, Sorbonne Universités, Paris, France
| | - J Kleine-Tebbe
- Allergy and Asthma Center Westend, Outpatient Clinic and Clinical Research Center, Ackermann, Hanf, & Kleine-Tebbe, Berlin, Germany
| | - L Klimek
- Center for Rhinology and Allergology, German Society for Otorhinolaryngology HNS, Wiesbaden, Germany
| | - E F Knol
- Departments of Immunology and Dermatology/Allergology, University Medical Center Utrecht, Heidelberglaan, Utrecht, The Netherlands
| | - P Kuna
- Medical University of Lodz, Lodz, Poland
| | | | - A Linneberg
- Research Centre for Prevention and Health, The Capital Region of Denmark, Copenhagen, Denmark ; Department of Clinical Experimental Research, Rigshospitalet, Copenhagen, Denmark ; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - M Matricardi
- Pediatric Pneumology and Immunology, Charité Medical University, Berlin, Germany
| | - H J Malling
- Danish Allergy Centre, Allergy Clinic, Gentofte University Hospital, Hellerup, Denmark
| | - R Moesges
- IMSIE, Klinikum der Universität zu Köln A. ö. R., Cologne, Germany
| | - J Mullol
- Unitat de Rinologia i Clínica de l'Olfacte, ENT Department, Hospital Clínic, Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, Barcelona, Catalonia Spain
| | - A Muraro
- Department of Women and Child Health, Food Allergy Referral Centre Veneto Region, Padua General University Hospital, Padua, Italy
| | - N Papadopoulos
- Allergy Unit, 2nd Pediatric Clinic, University of Athens, Athens, Greece
| | - G Passalacqua
- Allergy and Respiratory Diseases, IRCCS San Martino-IST, Univesity of Genoa, Genoa, Italy
| | - E Pastorello
- ASST Grande Ospedale Metropolitano Niguarda, P.zza Ospedale Maggiore, Milan, Italy
| | - O Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim, Mannheim, Germany ; Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany ; Center for Rhinology and Allergology, Wiesbaden, Germany
| | - D Price
- Division of Applied Health Sciences, Primary Care Respiratory Medicine, Academic Primary Care, University of Aberdeen, Aberdeen, Scotland, UK ; Research in Real Life (RiRL), Oakington, Cambridge, UK ; Optimum Patient Care Ltd, Singapore, Singapore
| | | | - R Ruëff
- Department of Dermatology and Allergology, Ludwig-Maximillian University, Munich, Germany
| | - B Samolinski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - G K Scadding
- Royal National Throat, Nose and Ear Hospital, London, UK ; University College London, London, UK
| | - G Senti
- Clinical Trials Center, University Hospital of Zurich, Zurich, Switzerland
| | - M H Shamji
- Immunomodulation and Tolerance Group, Allergy and Clinical Immunology, Inflammation, Repair and Development Section, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK ; MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - A Sheikh
- Asthma UK Centre for Applied Research, Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG UK
| | | | - D Sole
- Programa de Pòs-Graduação em Pediatria e Ciências Aplicadas à Pediatria, Departamento de Pediatria EPM, UNIFESP, São Paulo, Brazil
| | - G J Sturm
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria ; Allergy Outpatient Clinic Reumannplatz, Vienna, Austria
| | - A Tabar
- Servicio de Alergologia, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - R Van Ree
- Departments of Experimental Immunology and Otorhinolaryngology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - M T Ventura
- Unit of Geriatric Immunoallergology, Interdisciplinary Department of Medicine, University of Bari Medical School, Bari, Italy
| | - C Vidal
- Allergy Department, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - E M Varga
- Respiratory and Allergic Disease Division, Department of Paediatrics, Medical University of Graz, Graz, Austria
| | - M Worm
- Allergie-Centrum-Charité, Klinik für Dermatologie, Venerologie und Allergologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - T Zuberbier
- Allergie-Centrum-Charité, Klinik für Dermatologie, Venerologie und Allergologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - J Bousquet
- University Hospital of Montpellier, Montpellier, France ; Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Paris, France ; INSERM, VIMA, U1168, Ageing and Chronic Diseases, Epidemiological and Public Health Approaches, Paris, France ; UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, Versailles Cedex, France ; CHRU, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
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Bousquet J, Anto JM, Akdis M, Auffray C, Keil T, Momas I, Postma D, Valenta R, Wickman M, Cambon‐Thomsen A, Haahtela T, Lambrecht BN, Lodrup Carlsen KC, Koppelman GH, Sunyer J, Zuberbier T, Annesi‐Maesano I, Arno A, Bindslev‐Jensen C, De Carlo G, Forastiere F, Heinrich J, Kowalski ML, Maier D, Melén E, Palkonen S, Smit HA, Standl M, Wright J, Asarnoj A, Benet M, Ballardini N, Garcia‐Aymerich J, Gehring U, Guerra S, Hohman C, Kull I, Lupinek C, Pinart M, Skrindo I, Westman M, Smagghe D, Akdis C, Albang R, Anastasova V, Anderson N, Bachert C, Ballereau S, Ballester F, Basagana X, Bedbrook A, Bergstrom A, Berg A, Brunekreef B, Burte E, Carlsen KH, Chatzi L, Coquet JM, Curin M, Demoly P, Eller E, Fantini MP, Gerhard B, Hammad H, Hertzen L, Hovland V, Jacquemin B, Just J, Keller T, Kerkhof M, Kiss R, Kogevinas M, Koletzko S, Lau S, Lehmann I, Lemonnier N, McEachan R, Mäkelä M, Mestres J, Minina E, Mowinckel P, Nadif R, Nawijn M, Oddie S, Pellet J, Pin I, Porta D, Rancière F, Rial‐Sebbag A, Saeys Y, Schuijs MJ, Siroux V, Tischer CG, Torrent M, Varraso R, De Vocht J, Wenger K, Wieser S, Xu C. Paving the way of systems biology and precision medicine in allergic diseases: the MeDALL success story: Mechanisms of the Development of ALLergy; EU FP7-CP-IP; Project No: 261357; 2010-2015. Allergy 2016; 71:1513-1525. [PMID: 26970340 PMCID: PMC5248602 DOI: 10.1111/all.12880] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2016] [Indexed: 01/06/2023]
Abstract
MeDALL (Mechanisms of the Development of ALLergy; EU FP7-CP-IP; Project No: 261357; 2010-2015) has proposed an innovative approach to develop early indicators for the prediction, diagnosis, prevention and targets for therapy. MeDALL has linked epidemiological, clinical and basic research using a stepwise, large-scale and integrative approach: MeDALL data of precisely phenotyped children followed in 14 birth cohorts spread across Europe were combined with systems biology (omics, IgE measurement using microarrays) and environmental data. Multimorbidity in the same child is more common than expected by chance alone, suggesting that these diseases share causal mechanisms irrespective of IgE sensitization. IgE sensitization should be considered differently in monosensitized and polysensitized individuals. Allergic multimorbidities and IgE polysensitization are often associated with the persistence or severity of allergic diseases. Environmental exposures are relevant for the development of allergy-related diseases. To complement the population-based studies in children, MeDALL included mechanistic experimental animal studies and in vitro studies in humans. The integration of multimorbidities and polysensitization has resulted in a new classification framework of allergic diseases that could help to improve the understanding of genetic and epigenetic mechanisms of allergy as well as to better manage allergic diseases. Ethics and gender were considered. MeDALL has deployed translational activities within the EU agenda.
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Affiliation(s)
- J. Bousquet
- University Hospital Montpellier France
- MACVIA‐LR Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc‐Roussillon European Innovation Partnership on Active and Healthy Ageing Reference Site France
- INSERM VIMA: Ageing and Chronic Diseases, Epidemiological and Public Health Approaches UVSQ Université Versailles St‐Quentin‐en‐Yvelines Paris France
| | - J. M. Anto
- Centre for Research in Environmental Epidemiology (CREAL) ISGLoBAL Barcelona Spain
- IMIM (Hospital del Mar Research Institute) Barcelona Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) Barcelona Spain
- Universitat Pompeu Fabra (UPF) Barcelona Spain
| | - M. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - C. Auffray
- European Institute for Systems Biology and Medicine CNRS‐ENS‐UCBL Université de Lyon Lyon France
| | - T. Keil
- Institute of Social Medicine, Epidemiology and Health Economics Charité–Universitätsmedizin Berlin Berlin Germany
- Institute for Clinical Epidemiology and Biometry University of Wuerzburg Wuerzburg Germany
| | - I. Momas
- Department of Public Health and Health Products Paris Descartes University‐Sorbonne Paris Cité Paris France
- Paris Municipal Department of Social Action, Childhood, and Health Paris France
| | - D.S. Postma
- Department of Pulmonary Medicine and Tuberculosis GRIAC Research Institute University Medical Center Groningen University of Groningen Groningen the Netherlands
| | - R. Valenta
- Division of Immunopathology Department of Pathophysiology and Allergy Research Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - M. Wickman
- Sachs’ Children and Youth Hospital, Södersjukhuset Stockholm and Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
| | - A. Cambon‐Thomsen
- UMR Inserm U1027 and Université de Toulouse III Paul Sabatier Toulouse France
| | - T. Haahtela
- Skin and Allergy Hospital Helsinki University Hospital Helsinki Finland
| | - B. N. Lambrecht
- VIB Inflammation Research Center Ghent University Ghent Belgium
| | - K. C. Lodrup Carlsen
- Department of Paediatrics Faculty of Medicine Institute of Clinical Medicine Oslo University Hospital University of Oslo Oslo Norway
| | - G. H. Koppelman
- Department of Pediatric Pulmonology and Pediatric Allergology Beatrix Children's Hospital GRIAC Research Institute University Medical Center Groningen University of Groningen Groningen the Netherlands
| | - J. Sunyer
- Centre for Research in Environmental Epidemiology (CREAL) ISGLoBAL Barcelona Spain
- IMIM (Hospital del Mar Research Institute) Barcelona Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) Barcelona Spain
- Universitat Pompeu Fabra (UPF) Barcelona Spain
| | - T. Zuberbier
- Secretary General of the Global Allergy and Asthma European Network (GALEN) Allergy‐Centre‐Charité at the Department of Dermatology Charité–Universitätsmedizin Berlin Berlin Germany
| | | | - A. Arno
- Onmedic Networks Barcelona Spain
| | - C. Bindslev‐Jensen
- Department of Dermatology and Allergy Centre Odense University Hospital Odense Denmark
| | - G. De Carlo
- EFA European Federation of Allergy and Airways Diseases Patients’ Associations Brussels Belgium
| | - F. Forastiere
- Department of Epidemiology Regional Health Service Lazio Region Rome Italy
| | - J. Heinrich
- Institute of Epidemiology I German Research Centre for Environmental Health Helmholtz Zentrum München Neuherberg Germany
| | - M. L. Kowalski
- Department of Immunology, Rheumatology and Allergy Medical University of Lodz Lodz Poland
| | - D. Maier
- Biomax Informatics AG Munich Germany
| | - E. Melén
- Department of Pulmonary Medicine and Tuberculosis GRIAC Research Institute University Medical Center Groningen University of Groningen Groningen the Netherlands
- Stockholm County Council Centre for Occupational and Environmental Medicine Stockholm Sweden
| | - S. Palkonen
- EFA European Federation of Allergy and Airways Diseases Patients’ Associations Brussels Belgium
| | - H. A. Smit
- Julius Center of Health Sciences and Primary Care University Medical Center Utrecht University of Utrecht Utrecht the Netherlands
| | - M. Standl
- Institute of Epidemiology I German Research Centre for Environmental Health Helmholtz Zentrum München Neuherberg Germany
| | - J. Wright
- Bradford Institute for Health Research Bradford Royal Infirmary Bradford UK
| | - A. Asarnoj
- Clinical Immunology and Allergy Unit Department of Medicine Solna Karolinska Institutet Stockholm Sweden
- Astrid Lindgren Children's Hospital Department of Pediatric Pulmonology and Allergy Karolinska University Hospital Stockholm Sweden
| | - M. Benet
- Centre for Research in Environmental Epidemiology (CREAL) ISGLoBAL Barcelona Spain
| | - N. Ballardini
- Sachs’ Children and Youth Hospital, Södersjukhuset Stockholm and Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
- St John's Institute of Dermatology King's College London London UK
| | - J. Garcia‐Aymerich
- Centre for Research in Environmental Epidemiology (CREAL) ISGLoBAL Barcelona Spain
- IMIM (Hospital del Mar Research Institute) Barcelona Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) Barcelona Spain
- Universitat Pompeu Fabra (UPF) Barcelona Spain
| | - U. Gehring
- Institute for Risk Assessment Sciences Utrecht University Utrecht the Netherlands
| | - S. Guerra
- Centre for Research in Environmental Epidemiology (CREAL) ISGLoBAL Barcelona Spain
| | - C. Hohman
- Institute of Social Medicine, Epidemiology and Health Economics Charité–Universitätsmedizin Berlin Germany
| | - I. Kull
- Sachs’ Children and Youth Hospital, Södersjukhuset Stockholm and Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
- Department of Clinical Science and Education, Södersjukhuset Karolinska InstitutetStockholm Sweden
| | - C. Lupinek
- Division of Immunopathology Department of Pathophysiology and Allergy Research Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - M. Pinart
- Centre for Research in Environmental Epidemiology (CREAL) ISGLoBAL Barcelona Spain
| | - I. Skrindo
- Department of Paediatrics Faculty of Medicine Institute of Clinical Medicine Oslo University Hospital University of Oslo Oslo Norway
| | - M. Westman
- Department of Clinical Science, Intervention and Technology Karolinska Institutet Stockholm Sweden
- Department of ENT Diseases Karolinska University Hospital Stockholm Sweden
| | | | - C. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - R. Albang
- Biomax Informatics AG Munich Germany
| | - V. Anastasova
- UMR Inserm U1027 and Université de Toulouse III Paul Sabatier Toulouse France
| | - N. Anderson
- Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
| | - C. Bachert
- ENT Department Ghent University Hospital Gent Belgium
| | - S. Ballereau
- European Institute for Systems Biology and Medicine CNRS‐ENS‐UCBL Université de Lyon Lyon France
| | - F. Ballester
- Environment and Health Area Centre for Public Health Research (CSISP) CIBERESP Department of Nursing University of Valencia Valencia Spain
| | - X. Basagana
- Centre for Research in Environmental Epidemiology (CREAL) ISGLoBAL Barcelona Spain
| | - A. Bedbrook
- MACVIA‐LR Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc‐Roussillon European Innovation Partnership on Active and Healthy Ageing Reference Site France
| | - A. Bergstrom
- Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
| | - A. Berg
- Research Institute Department of Pediatrics Marien‐Hospital Wesel Germany
| | - B. Brunekreef
- Julius Center of Health Sciences and Primary Care University Medical Center Utrecht University of Utrecht Utrecht the Netherlands
| | - E. Burte
- INSERM VIMA: Ageing and Chronic Diseases, Epidemiological and Public Health Approaches UVSQ Université Versailles St‐Quentin‐en‐Yvelines Paris France
| | - K. H. Carlsen
- Department of Paediatrics Oslo University Hospital University of Oslo Oslo Norway
| | - L. Chatzi
- Department of Social Medicine Faculty of Medicine University of Crete Heraklion Crete Greece
| | - J. M. Coquet
- VIB Inflammation Research Center Ghent University Ghent Belgium
| | - M. Curin
- Division of Immunopathology Department of Pathophysiology and Allergy Research Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - P. Demoly
- Department of Respiratory Diseases Montpellier University Hospital France
| | - E. Eller
- Department of Dermatology and Allergy Centre Odense University Hospital Odense Denmark
| | - M. P. Fantini
- Department of Medicine and Public Health Alma Mater Studiorum–University of Bologna Bologna Italy
| | | | - H. Hammad
- VIB Inflammation Research Center Ghent University Ghent Belgium
| | - L. Hertzen
- Skin and Allergy Hospital Helsinki University Hospital Helsinki Finland
| | - V. Hovland
- Department of Paediatrics Oslo University Hospital University of Oslo Oslo Norway
| | - B. Jacquemin
- Centre for Research in Environmental Epidemiology (CREAL) ISGLoBAL Barcelona Spain
| | - J. Just
- Allergology Department Centre de l'Asthme et des Allergies Hôpital d'Enfants Armand‐Trousseau (APHP) Sorbonne Universités Institut Pierre Louis d'Epidémiologie et de Santé Publique Paris France
| | - T. Keller
- Institute of Social Medicine, Epidemiology and Health Economics Charité–Universitätsmedizin Berlin Germany
| | - M. Kerkhof
- Department of Pulmonary Medicine and Tuberculosis GRIAC Research Institute University Medical Center Groningen University of Groningen Groningen the Netherlands
| | - R. Kiss
- Division of Immunopathology Department of Pathophysiology and Allergy Research Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - M. Kogevinas
- Centre for Research in Environmental Epidemiology (CREAL) ISGLoBAL Barcelona Spain
- IMIM (Hospital del Mar Research Institute) Barcelona Spain
- CIBER Epidemiología y Salud Pública (CIBERESP) Barcelona Spain
- Universitat Pompeu Fabra (UPF) Barcelona Spain
| | - S. Koletzko
- Division of Paediatric Gastroenterology and Hepatology Ludwig Maximilians University of Munich Munich Germany
| | - S. Lau
- Department for Pediatric Pneumology and Immunology Charité Medical University Berlin Germany
| | - I. Lehmann
- Department of Environmental Immunology/Core Facility Studies Helmholtz Centre for Environmental Research, UFZ Leipzig Germany
| | - N. Lemonnier
- European Institute for Systems Biology and Medicine CNRS‐ENS‐UCBL Université de Lyon Lyon France
| | - R. McEachan
- Bradford Institute for Health Research Bradford Royal Infirmary Bradford UK
| | - M. Mäkelä
- Skin and Allergy Hospital Helsinki University Hospital Helsinki Finland
| | - J. Mestres
- Chemotargets SL and Chemogenomics Laboratory GRIB Unit IMIM‐Hospital del Mar and University Pompeu Fabra Barcelona Catalonia Spain
| | - E. Minina
- Biomax Informatics AG Munich Germany
| | - P. Mowinckel
- Department of Paediatrics Oslo University Hospital University of Oslo Oslo Norway
| | - R. Nadif
- INSERM VIMA: Ageing and Chronic Diseases, Epidemiological and Public Health Approaches UVSQ Université Versailles St‐Quentin‐en‐Yvelines Paris France
| | - M. Nawijn
- Department of Pediatric Pulmonology and Pediatric Allergology Beatrix Children's Hospital GRIAC Research Institute University Medical Center Groningen University of Groningen Groningen the Netherlands
| | - S. Oddie
- Bradford Institute for Health Research Bradford Royal Infirmary Bradford UK
| | - J. Pellet
- European Institute for Systems Biology and Medicine CNRS‐ENS‐UCBL Université de Lyon Lyon France
| | - I. Pin
- Département de Pédiatrie CHU de Grenoble Grenoble Cedex 9 France
| | - D. Porta
- Department of Epidemiology Regional Health Service Lazio Region Rome Italy
| | - F. Rancière
- Department of Public Health and Health Products Paris Descartes University‐Sorbonne Paris Cité Paris France
| | - A. Rial‐Sebbag
- UMR Inserm U1027 and Université de Toulouse III Paul Sabatier Toulouse France
| | - Y. Saeys
- VIB Inflammation Research Center Ghent University Ghent Belgium
| | - M. J. Schuijs
- VIB Inflammation Research Center Ghent University Ghent Belgium
| | | | - C. G. Tischer
- Institute of Epidemiology I German Research Centre for Environmental Health Helmholtz Zentrum München Neuherberg Germany
| | - M. Torrent
- Centre for Research in Environmental Epidemiology (CREAL) ISGLoBAL Barcelona Spain
- ib‐salut Area de Salut de Menorca Spain
| | - R. Varraso
- INSERM VIMA: Ageing and Chronic Diseases, Epidemiological and Public Health Approaches UVSQ Université Versailles St‐Quentin‐en‐Yvelines Paris France
| | - J. De Vocht
- EFA European Federation of Allergy and Airways Diseases Patients’ Associations Brussels Belgium
| | - K. Wenger
- Biomax Informatics AG Munich Germany
| | - S. Wieser
- Division of Immunopathology Department of Pathophysiology and Allergy Research Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - C. Xu
- Department of Pulmonary Medicine and Tuberculosis GRIAC Research Institute University Medical Center Groningen University of Groningen Groningen the Netherlands
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Erkkola M, Saloheimo T, Hauta-alus H, Kukkonen AK, Virta S, Kronberg-Kippilä C, Vaara E, Pelkonen AS, Fogelholm M, Mäkelä MJ. Burden of allergy diets in Finnish day care reduced by change in practices. Allergy 2016; 71:1453-60. [PMID: 27117067 DOI: 10.1111/all.12902] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Nonessential allergy diets in children with mild symptoms may harm the development of immunological tolerance and impose a burden on families and day care. We aimed to reduce the high prevalence of allergy diets in day care by reforming the practices for inquiring about need of special diets from parents. METHODS We developed a new special diet form and an information leaflet based on the new allergy guidelines. The new form was implemented into 40 Finnish day care centres in the capital region in 2013-2015. The questionnaires on practices concerning special diets in day care centres and allergy knowledge were collected from the personnel. RESULTS After 2 years, the new special diet form was used by 64% of families with food-allergic children, and the prevalence of allergy diets in day care centres decreased by 43% to 4.3% (IQ range 3.05-5.96). A significant decrease was found in the prevalence of all basic (milk, grains, egg) and most other allergy diets (P for trend < 0.01). The new practice was well accepted by day care and kitchen personnel. Lack of updated allergy knowledge was noted among day care personnel. CONCLUSIONS The burden of allergy diets in day care settings could be decreased by simple pragmatic changes based on current allergy guidelines. Old allergy attitudes persisted among day care personnel, indicating the need for continuous education.
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Affiliation(s)
- M. Erkkola
- Division of Nutrition; Department of Food and Environmental Sciences; University of Helsinki; Helsinki Finland
| | - T. Saloheimo
- Division of Nutrition; Department of Food and Environmental Sciences; University of Helsinki; Helsinki Finland
| | - H. Hauta-alus
- Division of Nutrition; Department of Food and Environmental Sciences; University of Helsinki; Helsinki Finland
| | - A. K. Kukkonen
- Skin and Allergy Hospital; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - S. Virta
- Division of Nutrition; Department of Food and Environmental Sciences; University of Helsinki; Helsinki Finland
| | - C. Kronberg-Kippilä
- Division of Nutrition; Department of Food and Environmental Sciences; University of Helsinki; Helsinki Finland
| | - E. Vaara
- Division of Nutrition; Department of Food and Environmental Sciences; University of Helsinki; Helsinki Finland
| | - A. S. Pelkonen
- Skin and Allergy Hospital; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - M. Fogelholm
- Division of Nutrition; Department of Food and Environmental Sciences; University of Helsinki; Helsinki Finland
| | - M. J. Mäkelä
- Skin and Allergy Hospital; University of Helsinki and Helsinki University Hospital; Helsinki Finland
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48
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Bousquet J, Farrell J, Crooks G, Hellings P, Bel EH, Bewick M, Chavannes NH, de Sousa JC, Cruz AA, Haahtela T, Joos G, Khaltaev N, Malva J, Muraro A, Nogues M, Palkonen S, Pedersen S, Robalo-Cordeiro C, Samolinski B, Strandberg T, Valiulis A, Yorgancioglu A, Zuberbier T, Bedbrook A, Aberer W, Adachi M, Agusti A, Akdis CA, Akdis M, Ankri J, Alonso A, Annesi-Maesano I, Ansotegui IJ, Anto JM, Arnavielhe S, Arshad H, Bai C, Baiardini I, Bachert C, Baigenzhin AK, Barbara C, Bateman ED, Beghé B, Kheder AB, Bennoor KS, Benson M, Bergmann KC, Bieber T, Bindslev-Jensen C, Bjermer L, Blain H, Blasi F, Boner AL, Bonini M, Bonini S, Bosnic-Anticevitch S, Boulet LP, Bourret R, Bousquet PJ, Braido F, Briggs AH, Brightling CE, Brozek J, Buhl R, Burney PG, Bush A, Caballero-Fonseca F, Caimmi D, Calderon MA, Calverley PM, Camargos PAM, Canonica GW, Camuzat T, Carlsen KH, Carr W, Carriazo A, Casale T, Cepeda Sarabia AM, Chatzi L, Chen YZ, Chiron R, Chkhartishvili E, Chuchalin AG, Chung KF, Ciprandi G, Cirule I, Cox L, Costa DJ, Custovic A, Dahl R, Dahlen SE, Darsow U, De Carlo G, De Blay F, Dedeu T, Deleanu D, De Manuel Keenoy E, Demoly P, Denburg JA, Devillier P, Didier A, Dinh-Xuan AT, Djukanovic R, Dokic D, Douagui H, Dray G, Dubakiene R, Durham SR, Dykewicz MS, El-Gamal Y, Emuzyte R, Fabbri LM, Fletcher M, Fiocchi A, Fink Wagner A, Fonseca J, Fokkens WJ, Forastiere F, Frith P, Gaga M, Gamkrelidze A, Garces J, Garcia-Aymerich J, Gemicioğlu B, Gereda JE, González Diaz S, Gotua M, Grisle I, Grouse L, Gutter Z, Guzmán MA, Heaney LG, Hellquist-Dahl B, Henderson D, Hendry A, Heinrich J, Heve D, Horak F, Hourihane JOB, Howarth P, Humbert M, Hyland ME, Illario M, Ivancevich JC, Jardim JR, Jares EJ, Jeandel C, Jenkins C, Johnston SL, Jonquet O, Julge K, Jung KS, Just J, Kaidashev I, Kaitov MR, Kalayci O, Kalyoncu AF, Keil T, Keith PK, Klimek L, Koffi N’Goran B, Kolek V, Koppelman GH, Kowalski ML, Kull I, Kuna P, Kvedariene V, Lambrecht B, Lau S, Larenas-Linnemann D, Laune D, Le LTT, Lieberman P, Lipworth B, Li J, Lodrup Carlsen K, Louis R, MacNee W, Magard Y, Magnan A, Mahboub B, Mair A, Majer I, Makela MJ, Manning P, Mara S, Marshall GD, Masjedi MR, Matignon P, Maurer M, Mavale-Manuel S, Melén E, Melo-Gomes E, Meltzer EO, Menzies-Gow A, Merk H, Michel JP, Miculinic N, Mihaltan F, Milenkovic B, Mohammad GMY, Molimard M, Momas I, Montilla-Santana A, Morais-Almeida M, Morgan M, Mösges R, Mullol J, Nafti S, Namazova-Baranova L, Naclerio R, Neou A, Neffen H, Nekam K, Niggemann B, Ninot G, Nyembue TD, O’Hehir RE, Ohta K, Okamoto Y, Okubo K, Ouedraogo S, Paggiaro P, Pali-Schöll I, Panzner P, Papadopoulos N, Papi A, Park HS, Passalacqua G, Pavord I, Pawankar R, Pengelly R, Pfaar O, Picard R, Pigearias B, Pin I, Plavec D, Poethig D, Pohl W, Popov TA, Portejoie F, Potter P, Postma D, Price D, Rabe KF, Raciborski F, Radier Pontal F, Repka-Ramirez S, Reitamo S, Rennard S, Rodenas F, Roberts J, Roca J, Rodriguez Mañas L, Rolland C, Roman Rodriguez M, Romano A, Rosado-Pinto J, Rosario N, Rosenwasser L, Rottem M, Ryan D, Sanchez-Borges M, Scadding GK, Schunemann HJ, Serrano E, Schmid-Grendelmeier P, Schulz H, Sheikh A, Shields M, Siafakas N, Sibille Y, Similowski T, Simons FER, Sisul JC, Skrindo I, Smit HA, Solé D, Sooronbaev T, Spranger O, Stelmach R, Sterk PJ, Sunyer J, Thijs C, To T, Todo-Bom A, Triggiani M, Valenta R, Valero AL, Valia E, Valovirta E, Van Ganse E, van Hage M, Vandenplas O, Vasankari T, Vellas B, Vestbo J, Vezzani G, Vichyanond P, Viegi G, Vogelmeier C, Vontetsianos T, Wagenmann M, Wallaert B, Walker S, Wang DY, Wahn U, Wickman M, Williams DM, Williams S, Wright J, Yawn BP, Yiallouros PK, Yusuf OM, Zaidi A, Zar HJ, Zernotti ME, Zhang L, Zhong N, Zidarn M, Mercier J. Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5). Clin Transl Allergy 2016; 6:29. [PMID: 27478588 PMCID: PMC4966705 DOI: 10.1186/s13601-016-0116-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 06/02/2016] [Indexed: 01/16/2023] Open
Abstract
Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) focuses on the integrated care of chronic diseases. Area 5 (Care Pathways) was initiated using chronic respiratory diseases as a model. The chronic respiratory disease action plan includes (1) AIRWAYS integrated care pathways (ICPs), (2) the joint initiative between the Reference site MACVIA-LR (Contre les MAladies Chroniques pour un VIeillissement Actif) and ARIA (Allergic Rhinitis and its Impact on Asthma), (3) Commitments for Action to the European Innovation Partnership on Active and Healthy Ageing and the AIRWAYS ICPs network. It is deployed in collaboration with the World Health Organization Global Alliance against Chronic Respiratory Diseases (GARD). The European Innovation Partnership on Active and Healthy Ageing has proposed a 5-step framework for developing an individual scaling up strategy: (1) what to scale up: (1-a) databases of good practices, (1-b) assessment of viability of the scaling up of good practices, (1-c) classification of good practices for local replication and (2) how to scale up: (2-a) facilitating partnerships for scaling up, (2-b) implementation of key success factors and lessons learnt, including emerging technologies for individualised and predictive medicine. This strategy has already been applied to the chronic respiratory disease action plan of the European Innovation Partnership on Active and Healthy Ageing.
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Affiliation(s)
- J. Bousquet
- CHRU, University Hospital, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
- MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc Roussilon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
- INSERM, VIMA: Ageing and Chronic Diseases, Epidemiological and Public Health Approaches, U1168, Paris, France
- UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, Paris, France
| | - J. Farrell
- Department of Health, Social Services and Public Safety, Belfast, Northern Ireland, UK
| | - G. Crooks
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site, Scottish Centre for Telehealth and Telecare, NHS 24, Glasgow, UK
| | - P. Hellings
- Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Louvain, Belgium
- European Academy of Allergy and Clinical Immunology, Zurich, Switzerland
| | - E. H. Bel
- Department of Respiratory Medicine, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
- European Respiratory Society, Lausanne, Switzerland
| | | | - N. H. Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- Global Alliance Against Chronic Respiratory Diseases (GARD), Cape Town, South Africa
- International Primary Care Respiratory Group, Westhill, UK
| | - J. Correia de Sousa
- Life and Health Sciences Research Institute, ICVS, School of Health Sciences, University of Minho, Braga, Portugal
| | - A. A. Cruz
- Global Alliance Against Chronic Respiratory Diseases (GARD), Cape Town, South Africa
- ProAR – Nucleo de Excelencia em Asma, Federal University of Bahia, Bahia, Brazil
- GARD Executive Committee, Bahia, Brazil
| | - T. Haahtela
- EIP on AHA Commitment for Action, Lisbon, Portugal
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - G. Joos
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - N. Khaltaev
- Global Alliance Against Chronic Respiratory Diseases (GARD), Cape Town, South Africa
| | - J. Malva
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Ageing@Coimbra Reference Site, Coimbra, Portugal
| | - A. Muraro
- European Academy of Allergy and Clinical Immunology, Zurich, Switzerland
- Food Allergy Referral Centre Veneto Region, Department of Women and Child Health, Padua General University Hospital, Padua, Italy
| | - M. Nogues
- Caisse Assurance Retraite et Santé Au Travail Languedoc-Roussillon (CARSAT-LR), 34000 Montpellier, France
| | - S. Palkonen
- EFA European Federation of Allergy and Airways Diseases Patients’ Associations, Brussels, Belgium
| | - S. Pedersen
- University of Southern Denmark, Kolding, Denmark
| | | | - B. Samolinski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - T. Strandberg
- Helsinki University, Helsinki University Hospital, Helsinki, Finland
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- European Union GeriatricMedicine Society, EUGMS, Oslo, Norway
| | - A. Valiulis
- Center of Quality of Life Research, Vilnius University Clinic of Children’s Diseases, Vilnius University Public Health Institute, Vilnius, Lithuania
- European Association of Pediatrics (EAP/UEMS-SP), Brussels, Belgium
| | - A. Yorgancioglu
- Global Alliance Against Chronic Respiratory Diseases (GARD), Cape Town, South Africa
- EIP on AHA Commitment for Action, Lisbon, Portugal
- Department of Pulmonology, Celal Bayar University, Manisa, Turkey
- Turkish Thoracic Society, Antalya, Turkey
| | - T. Zuberbier
- Allergy-Centre-Charité at the Department of Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Secretary General of the Global Allergy and Asthma European Network (GA²LEN), Berlin, Germany
| | - A. Bedbrook
- MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc Roussilon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - W. Aberer
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - M. Adachi
- Department of Clinical Research Center, International University of Health and Welfare/Sanno Hospital, Tokyo, Japan
| | - A. Agusti
- Thorax Institute, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
- CIBER Enfermedades Respiratorias, Barcelona, Spain
| | - C. A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - M. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - J. Ankri
- INSERM, VIMA: Ageing and Chronic Diseases, Epidemiological and Public Health Approaches, U1168, Paris, France
- UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, Paris, France
| | - A. Alonso
- Thorax Institute, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
- CIBER Enfermedades Respiratorias, Barcelona, Spain
| | - I. Annesi-Maesano
- EPAR U707 INSERM, Paris, France
- EPAR UMR-S UPMC, Paris VI, Paris, France
| | - I. J. Ansotegui
- Department of Allergy and Immunology, Hospital Quirón Bizkaia, Erandio, Spain
| | - J. M. Anto
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Hospital del Mar Research Institute (IMIM), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Department of Experimental and Health Sciences, University of Pompeu Fabra (UPF), Barcelona, Spain
| | | | - H. Arshad
- David Hide Asthma and Allergy Research Centre, Isle of Wight, UK
| | - C. Bai
- Shanghai Respiratory Research Institute, Vice President of Respiratory Society, Chinese Medical Association, China and Chinese Alliance Against Lung Cancer, Shanghai, China
| | - I. Baiardini
- Allergy and Respiratory Diseases Clinic, DIMI, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy
| | - C. Bachert
- Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium
| | | | - C. Barbara
- Faculdade de Medicina de Lisboa, Portuguese National Programme for Respiratory Diseases (PNDR), Lisbon, Portugal
| | - E. D. Bateman
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - B. Beghé
- Section of Respiratory Disease, Department of Oncology, Haematology and Respiratory Diseases, University of Modena and Reggio Emilia, Modena, Italy
| | - A. Ben Kheder
- Service de pneumologie IV, hôpital Abderrahman Mami, Ariana, 2080 Tunis, Tunisia
| | - K. S. Bennoor
- Department of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh
| | - M. Benson
- Centre for Individualized Medicine, Department of Pediatrics, Faculty of Medicine, LInköping University, Linköping, Sweden
| | - K. C. Bergmann
- Allergy-Centre-Charité at the Department of Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Secretary General of the Global Allergy and Asthma European Network (GA²LEN), Berlin, Germany
| | - T. Bieber
- Department of Dermatology and Allergy, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany
| | - C. Bindslev-Jensen
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - L. Bjermer
- Department of Respiratory Medicine and Allergology, University Hospital, Lund, Sweden
| | - H. Blain
- Department of Geriatrics, Montpellier University Hospital, Montpellier, France
- EA 2991, Euromov, University Montpellier, Montpellier, France
| | - F. Blasi
- Department of Pathophysiology and Transplantation, IRCCS Fondazione Ca’Granda Ospedale Maggiore Policlinico, University of Milan, Via F. Sforza 35, Milan, Italy
| | - A. L. Boner
- Pediatric Department, University of Verona Hospital, Verona, Italy
| | - M. Bonini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - S. Bonini
- Second University of Naples and Institute of Translational Medicine, Italian National Research Council, Naples, Italy
| | - S. Bosnic-Anticevitch
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW Australia
| | - L. P. Boulet
- Quebec Heart and Lung Institute, Laval University, Québec City, QC Canada
| | - R. Bourret
- Directeur Général Adjoint, Montpellier University Hospital, Montpellier, France
| | | | - F. Braido
- Allergy and Respiratory Diseases Clinic, DIMI, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy
| | - A. H. Briggs
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - C. E. Brightling
- Respiratory Biomedical Unit, Institute of Lung Health, University Hospitals of Leicester NHS Trust, Leicestershire, UK
- Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - J. Brozek
- Department of Clinical Epidemiology and Biostatistics, McMaster University, HSC Room 2C16, 1280 Main Street West Hamilton, Hamilton, Canada
| | - R. Buhl
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - P. G. Burney
- National Heart and Lung Institute, Imperial College, London, London, UK
- Wellcome Centre for Global Health, Imperial College, London, London, UK
- MRC-PHE Centre for Environment and Health, Imperial College, London, London, UK
| | - A. Bush
- Imperial College and Royal Brompton Hospital, London, UK
| | | | - D. Caimmi
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - M. A. Calderon
- National Heart and Lung Institute, Imperial College London, Royal Brompton Hospital NHS, London, UK
| | - P. M. Calverley
- Institute of Ageing and Chronic Disease, University of Liverpool and University Hospital Aintree, Liverpool, UK
| | - P. A. M. Camargos
- Department of Pediatrics, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - G. W. Canonica
- Allergy and Respiratory Diseases Clinic, DIMI, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy
| | - T. Camuzat
- Région Languedoc Roussillon, Montpellier, France
| | - K. H. Carlsen
- Department of Paediatrics, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - W. Carr
- Allergy and Asthma Associates of Southern California, Mission Viejo, CA USA
| | - A. Carriazo
- Regional Ministry of Equality, Health and Social Policies of Andalusia, Seville, Spain
| | - T. Casale
- Division of Allergy/Immunology, University of South Florida, Tampa, FL USA
| | - A. M. Cepeda Sarabia
- Allergy and Immunology Laboratory, Metropolitan University, Simon Bolivar University, Barranquilla, Colombia
- Asma e Immunologia, SLaai, Sociedad Latinoamericana de Allergia, Barranquilla, Colombia
| | - L. Chatzi
- Department of Social Medicine, Faculty of Medicine, University of Crete, PO Box 2208, Heraklion, 71003 Crete Greece
| | - Y. Z. Chen
- National Cooperative Group of Paediatric Research on Asthma, Asthma Clinic and Education Center of the Capital Institute of Pediatrics, Peking and Center for Asthma Research and Education, Beijing, China
| | - R. Chiron
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - E. Chkhartishvili
- Chachava Clinic, David Tvildiani Medical University-AIETI Medical School, Grigol Robakidze University, Tbilisi, Georgia
| | - A. G. Chuchalin
- GARD Executive Committee, Bahia, Brazil
- Pulmonolory Research Institute FMBA, Moscow, Russia
| | - K. F. Chung
- National Heart and Lung Institute, Imperial College, London, London, UK
| | - G. Ciprandi
- Medicine Department, IRCCS-Azienda Ospedaliera Universitaria San Martino, Genoa, Italy
| | - I. Cirule
- Latvian Allergy Association, Riga, Latvia
| | - L. Cox
- Department of Medicine, Nova Southeastern University, Davie, FL USA
| | - D. J. Costa
- MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc Roussilon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - A. Custovic
- Department of Paediatrics, Imperial College London, London, UK
| | - R. Dahl
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - S. E. Dahlen
- The Centre for Allergy Research, The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - U. Darsow
- Department of Dermatology and Allergy, Technische Universität München, Munich, Germany
- ZAUM-Center for Allergy and Environment, Helmholtz Center Munich, Technische Universität München, Munich, Germany
| | - G. De Carlo
- EFA European Federation of Allergy and Airways Diseases Patients’ Associations, Brussels, Belgium
| | - F. De Blay
- Allergy Division, Chest Disease Department, University Hospital of Strasbourg, Strasbourg, France
| | - T. Dedeu
- EUREGHA, European Regional and Local Health Association, Brussels, Belgium
- University of Edinburgh, Edinburgh, UK
| | - D. Deleanu
- Allergology and Immunology Discipline, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - P. Demoly
- EPAR U707 INSERM, Paris, France
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - J. A. Denburg
- Department of Medicine, Division of Clinical Immunology and Allergy, McMaster University, Hamilton, ON Canada
| | - P. Devillier
- Laboratoire de Pharmacologie Respiratoire UPRES EA220, Hôpital Foch, Suresnes Université Versailles Saint-Quentin, Suresnes, France
| | - A. Didier
- Respiratory Diseases Department, Rangueil-Larrey Hospital, Toulouse, France
| | - A. T. Dinh-Xuan
- Service de physiologie respiratoire, Hôpital Cochin, Université Paris-Descartes, Assistance publique-Hôpitaux de Paris, Paris, France
| | - R. Djukanovic
- NIHR Southampton Respiratory Biomedical Research Unit, Faculty of Medicine, University Southampton, Southampton, UK
| | - D. Dokic
- Medical Faculty Skopje, University Clinic of Pulmology and Allergy, Skopje, Republic Macedonia
| | - H. Douagui
- Service de Pneumo-Allergologie, Centre Hospitalo-Universitaire de Béni-Messous, Algers, Algeria
| | - G. Dray
- Ecole des Mines, Alès, France
| | - R. Dubakiene
- Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - S. R. Durham
- Allergy and Clinical Immunology Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - M. S. Dykewicz
- Section of Allergy and Immunology, Saint Louis University School of Medicine, Saint Louis, MO USA
| | - Y. El-Gamal
- Pediatric Allergy and Immunology Unit, Ain Shams University, Cairo, Egypt
| | - R. Emuzyte
- Clinic of Children’s Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | | | | | - A. Fiocchi
- Division of Allergy, Department of Pediatric Medicine, The Bambino Gesù Children’s Research Hospital Holy See, Rome, Italy
| | - A. Fink Wagner
- Global Allergy and Asthma Platform (GAAPP), Altgasse 8-10, 1130 Vienna, Austria
| | - J. Fonseca
- Center for Health Technology and Services Research - CINTESIS, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
- Allergy Unit, CUF Porto Instituto & Hospital, Porto, Portugal
| | - W. J. Fokkens
- Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands
| | - F. Forastiere
- Department of Epidemiology, Regional Health Service Lazio Region, Rome, Italy
| | - P. Frith
- Repatriation General Hospital, Adelaide, SOUTH AUSTRALIA Australia
| | - M. Gaga
- Athens Chest Hospital, Athens, Greece
| | - A. Gamkrelidze
- National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - J. Garces
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
| | - J. Garcia-Aymerich
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Hospital del Mar Research Institute (IMIM), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Department of Experimental and Health Sciences, University of Pompeu Fabra (UPF), Barcelona, Spain
| | - B. Gemicioğlu
- Department of Pulmonary Diseases, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - J. E. Gereda
- Allergy and Immunology Division, Clinica Ricardo Palma, Lima, Peru
| | - S. González Diaz
- Universidad Autónoma de Nuevo León, San Nicolás De La Garza, Mexico
| | - M. Gotua
- Center of Allergy and Immunology, Georgian Association of Allergology and Clinical Immunology, Tbilisi, Georgia
| | - I. Grisle
- Latvian Association of Allergists, Center of Tuberculosis and Lung Diseases, Riga, Latvia
| | - L. Grouse
- Faculty of the Department of Neurology, University of Washington School of Medicine, St. Louis, MO USA
| | - Z. Gutter
- University Hospital Olomouc – National eHealth Centre, Olomouc, Czech Republic
| | - M. A. Guzmán
- Immunology and Allergy Division, Clinical Hospital, University of Chile, Santiago, Chile
| | - L. G. Heaney
- Centre for Infection and Immunity, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - B. Hellquist-Dahl
- Department of Respiratory Diseases, Odense University Hospital, Odense, Denmark
| | - D. Henderson
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site, Scottish Centre for Telehealth and Telecare, NHS 24, Glasgow, UK
| | - A. Hendry
- NHS Scotland, Edinburgh, Scotland, UK
| | - J. Heinrich
- Institute of Epidemiology I, German Research Centre for Environmental Health, Helmholtz Zentrum München, Neuherberg, Germany
| | - D. Heve
- MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc Roussilon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
- Agence Régionale de Santé, 34067 Montpellier Cedex 2, France
| | - F. Horak
- Vienna Challenge Chamber, Vienna, Austria
| | - J. O’. B. Hourihane
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - P. Howarth
- University of Southampton Faculty of Medicine, University Hospital Southampton, Southampton, UK
| | - M. Humbert
- Service de Pneumologie, Hôpital Bicêtre, Inserm UMR_S999, Université Paris-Sud, Le Kremlin Bicêtre, France
| | - M. E. Hyland
- School of Psychology, Plymouth University, Plymouth, UK
| | - M. Illario
- Federico II University Hospital/Campania RS, Naples, Italy
| | - J. C. Ivancevich
- Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina
| | - J. R. Jardim
- Universidade Federal de Sao Paulo, São Paulo, Brazil
| | | | - C. Jeandel
- MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc Roussilon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
- Department of Geriatrics, Montpellier University Hospital, Montpellier, France
| | - C. Jenkins
- The George Institute for Global Health, The University of Sydney, Camperdown, Australia
| | - S. L. Johnston
- Airway Disease Infection Section, National Heart and Lung Institute, Imperial College, London, London, UK
- MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - O. Jonquet
- Medical Commission, Montpellier University Hospital, Montpellier, France
| | - K. Julge
- Children’s Clinic of Tartu University Hospital, Tartu, Estonia
| | - K. S. Jung
- Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Gyeonggi-Do, South Korea
| | - J. Just
- Allergology Department, Centre de l’Asthme et des Allergies, Hôpital d’Enfants Armand-Trousseau (APHP), Paris, France
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Equipe EPAR, 75013 Paris, France
| | - I. Kaidashev
- Ukrainian Medical Stomatological Academy, Poltava, Ukraine
| | - M. R. Kaitov
- Federal Medicobiological Agency, Laboratory of Molecular Immunology, Institute of Immunology, National Research Center, Moscow, Russian Federation
| | - O. Kalayci
- Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey
| | - A. F. Kalyoncu
- Immunology and Allergy Division, Department of Chest Diseases, School of Medicine, Hacettepe University, Ankara, Turkey
| | - T. Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - P. K. Keith
- Department of Medicine, McMaster University, Health Sciences Centre 3V47, 1280 Main Street West, Hamilton, Canada
| | - L. Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - B. Koffi N’Goran
- Société de Pneumologie de Langue Française, Espace francophone de Pneumologie, Paris, France
| | - V. Kolek
- Department of Respiratory Medicine, Faculty of Medicine and Dentistry, University Hospital Olomouc, Olomouc, Czech Republic
| | - G. H. Koppelman
- GRIACResearch Institute, Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M. L. Kowalski
- Department of Immunology, Rheumatology and Allergy, Medical University of Lodz, and HARC, Lodz, Poland
| | - I. Kull
- Sachs’ Children’s Hospital, Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - P. Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - V. Kvedariene
- Clinic of Infectious, Chest Diseases, Dermatology and Allergology, Vilnius University, Vilnius, Lithuania
| | - B. Lambrecht
- VIB Inflammation Research Center, Ghent University, Ghent, Belgium
| | - S. Lau
- Department for Pediatric Pneumology and Immunology, Charité Medical University, Berlin, Germany
| | - D. Larenas-Linnemann
- Clínica de Alergia, Asma y Pediatría, Hospital Médica Sur, Ciudad De México, Mexico
| | - D. Laune
- Digi Health, Montpellier, France
| | - L. T. T. Le
- University of Medicine and Pharmacy, Hochiminh City, Vietnam
| | - P. Lieberman
- Divisions of Allergy and Immunology, Departments of Internal Medicine and Pediatrics, University of Tennessee College of Medicine, Germantown, TN USA
| | - B. Lipworth
- Scottish Centre for Respiratory Research, Cardiovascular and Diabetes Medicine, Medical Research Institute, Ninewells Hospital, University of Dundee, Dundee, UK
| | - J. Li
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120 China
| | - K. Lodrup Carlsen
- Department of Paediatrics, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - R. Louis
- Department of Pulmonary Medicine, CHU Sart-Tilman, Liege, Belgium
| | - W. MacNee
- Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Y. Magard
- Service de Pneumo-allergologie, Hôpital Saint-Joseph, Paris, France
| | - A. Magnan
- Service de Pneumologie, UMR INSERM, UMR1087and CNR 6291, l’institut du thorax, University of Nantes, Nantes, France
| | - B. Mahboub
- Department of Pulmonary Medicine, Rashid Hospital, Dubai, UAE
| | - A. Mair
- Scottish Government Health Department, eHealth and Pharmaceuticals, Edinburgh, UK
| | - I. Majer
- Department of Respiratory Medicine, University of Bratislava, Bratislava, Slovakia
| | - M. J. Makela
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - P. Manning
- Department of Medicine (RCSI), Bon Secours Hospital, Glasnevin, Dublin, Ireland
| | - S. Mara
- Cardiovascular and Thoracic Department, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - G. D. Marshall
- Division of Clinical Immunology and Allergy, Laboratory of Behavioral Immunology Research, The University of Mississippi Medical Center, Jackson, MS USA
| | - M. R. Masjedi
- Respiratory Medicine Research, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - M. Maurer
- Allergie-Centrum-Charité at the Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - S. Mavale-Manuel
- Department of Paediatrics, Maputo Central Hospital, Maputo, Mozambique
| | - E. Melén
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - E. Melo-Gomes
- PNDR/Portuguese National Programme for Respiratory Diseases, Lisbon, Portugal
| | - E. O. Meltzer
- Allergy and Asthma Medical Group and Research Center, San Diego, CA USA
| | | | - H. Merk
- Hautklinik - Klinik für Dermatologie & Allergologie, Universitätsklinikum der RWTH Aachen, Aachen, Germany
| | - J. P. Michel
- European Union GeriatricMedicine Society, EUGMS, Oslo, Norway
| | | | - F. Mihaltan
- National Institute of Pneumology M. Nasta, Bucharest, Romania
| | - B. Milenkovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Serbian Association for Asthma and COPD, Belgrade, Serbia
| | - G. M. Y. Mohammad
- National Center for Research in Chronic Respiratory Diseases, Tishreen University School of Medicine, Latakia, Syria
| | - M. Molimard
- Département de Pharmacologie, CHU de Bordeaux, Universite Bordeaux, INSERM U657, Bordeaux Cedex, France
| | - I. Momas
- Department of Public Health and Biostatistics, EA 4064, Paris Descartes University, Paris, France
- Paris Municipal Department of Social Action, Childhood, and Health, Paris, France
| | | | - M. Morais-Almeida
- Allergy and Clinical Immunology Department, Hospital CUF-Descobertas, Lisbon, Portugal
| | - M. Morgan
- National Clinical Director for Respiratory Services, NHS England, Leeds, England, UK
| | - R. Mösges
- Institute of Medical Statistics, Informatics and Epidemiology, Medical Faculty, University of Cologne, Cologne, Germany
| | - J. Mullol
- Sachs’ Children’s Hospital, Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Unitat de Rinologia i Clínica de l’Olfacte, Servei d’ORL, Hospital Clínic, Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain
| | - S. Nafti
- Mustapha Hospital, Algers, Algeria
| | - L. Namazova-Baranova
- Scientific Centre of Children’s Health Under the Russian Academy of Medical Sciences, Moscow, Russia
| | - R. Naclerio
- Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medical Center and The Pritzker School of Medicine, The University of Chicago, Chicago, IL USA
| | - A. Neou
- Allergy-Centre-Charité at the Department of Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Secretary General of the Global Allergy and Asthma European Network (GA²LEN), Berlin, Germany
| | - H. Neffen
- Hospital de Niños Orlando Alassia, Santa Fe, Argentina
| | - K. Nekam
- Hospital of the Hospitaller Brothers in Buda, Budapest, Hungary
| | - B. Niggemann
- Pediatric Pneumology and Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - G. Ninot
- EA4556 Epsylon, Université Montpellier 1, Montpellier, France
| | - T. D. Nyembue
- ENT Department, University Hospital of Kinshasa, Kinshasa, Congo
| | - R. E. O’Hehir
- Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, VIC Australia
- Department of Immunology, Monash University, Melbourne, VIC Australia
| | - K. Ohta
- National Hospital Organization, Tokyo National Hospital, Tokyo, Japan
| | - Y. Okamoto
- Department of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan
| | - K. Okubo
- Department of Otolaryngology, Nippon Medical School, Tokyo, Japan
| | - S. Ouedraogo
- Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso
| | - P. Paggiaro
- Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy
| | - I. Pali-Schöll
- Department of Comparative Medicine, Messerli, Research Institute of the University of Veterinary Medicine and Medical University, Vienna, Austria
| | - P. Panzner
- Department of Immunology and Allergology, Faculty of Medicine and Faculty Hospital in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | - N. Papadopoulos
- Center for Pediatrics and Child Health, Institute of Human Development, Royal Manchester Children’s Hospital, University of Manchester, Manchester, M13 9WL UK
- Allergy Department, 2nd Pediatric Clinic, Athens General Children’s Hospital “P&A Kyriakou”, University of Athens, Athens, 11527 Greece
| | - A. Papi
- Respiratory Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - H. S. Park
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea
| | - G. Passalacqua
- Allergy and Respiratory Diseases Clinic, DIMI, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy
| | - I. Pavord
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - R. Pawankar
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - R. Pengelly
- Department of Health, Social Services and Public Safety, Belfast, Northern Ireland, UK
| | - O. Pfaar
- Center for Rhinology and Allergology, Wiesbaden, Germany
- Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - R. Picard
- Conseil Général de l’Economie. Ministère de l’Economie, de l’Industrie et du Numérique, Paris, France
| | - B. Pigearias
- Société de Pneumologie de Langue Française, Espace francophone de Pneumologie, Paris, France
| | - I. Pin
- Département de pédiatrie, CHU de Grenoble, BP 217, 38043 Grenoble Cedex 9, France
| | - D. Plavec
- Children’s Hospital Srebrnjak, Zagreb, School of Medicine, University J.J. Strossmayer, Osijek, Croatia
| | - D. Poethig
- Im GerontoLab Europe - Europäische Vereinigung für Vitalität und Aktives Altern (eVAA) e.V., Leipzig, Germany
| | - W. Pohl
- Karl Landsteiner Institute for Clinical and Experimental Pneumology, Hietzing Hospital, Wolkersbergenstraße 1, 1130 Vienna, Austria
| | - T. A. Popov
- Clinic of Allergy and Asthma, Medical University Sofia, 1Sv. Georgi Sofiyski St., 1431 Sofia, Bulgaria
| | - F. Portejoie
- MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc Roussilon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - P. Potter
- Allergy Diagnostic and Clinical Research Unit, University of Cape Town Lung Institute, Cape Town, South Africa
| | - D. Postma
- Department of Pulmonary Medicine and Tuberculosis, GRIAC Research Institute, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - D. Price
- Academic Centre of Primary Care, University of Aberdeen, Aberdeen, UK
- Research in Real-Life, Cambridge, UK
| | - K. F. Rabe
- LungenClinic Grosshansdorf, Airway Research Center North, Member of the German Center for Lung Research (DZL), Grosshansdorf, Germany
- Department of Medicine, Christian Albrechts University, Airway Research Center North, Member of the German Center for Lung Research (DZL), Kiel, Germany
| | - F. Raciborski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - F. Radier Pontal
- Conseil Départemental de l’Ordre des Pharmaciens, Maison des Professions Libérales, 34000 Montpellier, France
| | | | - S. Reitamo
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - S. Rennard
- Division of Pulmonary, Critical Care, Sleep and Allergy, University of Nebraska Medical Center, Omaha, NE USA
| | - F. Rodenas
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
| | - J. Roberts
- Salford, Royal NHS Foundation Trust and NHS England North, London, UK
| | - J. Roca
- Thorax Institute, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - L. Rodriguez Mañas
- Hospital Universitario de Getafe-Servicio Madrileño de Salud, Madrid, Spain
| | - C. Rolland
- Association Asthme et Allergie, Paris, France
| | - M. Roman Rodriguez
- Primary Care Respiratory Research Unit, Institutode Investigación Sanitaria de Palma IdisPa, Palma De Mallorca, Spain
| | - A. Romano
- Allergy Unit, Complesso integrato Columbus, Rome, Italy
| | - J. Rosado-Pinto
- Serviço de Imunoalergologia, Hospital da Luz, Lisbon, Portugal
| | - N. Rosario
- Hospital de Clinicas, University of Parana, Curitiba, PR Brazil
| | - L. Rosenwasser
- Department of Allergy, Asthma, and Immunology, Children’s Mercy Hospitals and Clinics and Pediatrics, Medicine University of Misouri-Kansas City School of Medicine, Kansas City, MO USA
| | - M. Rottem
- Division of Allergy Asthma and Clinical Immunology, Emek Medical Center, Afula, Israel
| | - D. Ryan
- Woodbrook Medical Centre, Loughborough, UK
- Honorary Clinical Research Fellow, Allergy and Respiratory Research Group, The University of Edinburgh, Edinburgh, UK
| | - M. Sanchez-Borges
- Allergy and Clinical Immunology Department, Centro Médico-Docente la, Trinidad and Clínica El Avila, 6a transversal Urb, Altamira, piso 8, consultorio 803, Caracas, 1060 Venezuela
| | - G. K. Scadding
- The Royal National TNE Hospital, University College London, London, UK
| | - H. J. Schunemann
- Department of Clinical Epidemiology and Biostatistics, McMaster University, HSC Room 2C16, 1280 Main Street West Hamilton, Hamilton, Canada
| | - E. Serrano
- Otolaryngology and Head and Neck Surgery, CHU Rangueil-Larrey, Toulouse, France
| | - P. Schmid-Grendelmeier
- Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
| | - H. Schulz
- Helmholtz Zentrum München/Institute of Epidemiology I, Neuherberg, Germany
| | - A. Sheikh
- Allergy and Respiratory Research Group, Centre for Population Health Sciences, Medical School, The University of Edinburgh, Edinburgh, UK
| | - M. Shields
- Child Health, Queen’s University Belfast and Royal Belfast Hospital for Sick Children, Belfast, UK
| | - N. Siafakas
- Department of Thoracic Medicine, University Hospital of Heraklion, Crete, Greece
| | - Y. Sibille
- University Hospital of Mont-Godinne, Catholic University of Louvain, Yvoir, Belgium
| | - T. Similowski
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
- INSERM, UMR_S 1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
- Department R3S, AP-HP, Groupe, Paris, France
| | - F. E. R. Simons
- Department of Pediatrics and Child Health, Department of Immunology, Faculty of Medicine, University of Manitoba, Winnipeg, MB Canada
| | - J. C. Sisul
- Sociedad Paraguaya de Alergia Asma e Inmunología, Asunción, Paraguay
| | - I. Skrindo
- Department of Paediatrics, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - H. A. Smit
- Julius Center of Health Sciences and Primary Care, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - D. Solé
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | - T. Sooronbaev
- Kyrgyzstan National Centre of Cardiology and Internal Medicine, Euro-Asian Respiratory Society, Bishkek, Kyrgyzstan
| | - O. Spranger
- Global Allergy and Asthma Platform (GAAPP), Altgasse 8-10, 1130 Vienna, Austria
| | - R. Stelmach
- Pulmonary Division, Heart Institute (InCor), Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil
| | - P. J. Sterk
- Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - J. Sunyer
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Hospital del Mar Research Institute (IMIM), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Department of Experimental and Health Sciences, University of Pompeu Fabra (UPF), Barcelona, Spain
| | - C. Thijs
- Department of Epidemiology, CAPHRI School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - T. To
- Sidkkids hospitala and Institute of Health Policy, Management and Evaluation, Toronto, ON Canada
| | - A. Todo-Bom
- Centre of Pneumology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - M. Triggiani
- Division of Allergy and Clinical Immunology, University of Salerno, Salerno, Italy
| | - R. Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - A. L. Valero
- Pneumology and Allergy Department, Hospital Clínic, Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain
| | - E. Valia
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
| | - E. Valovirta
- Department of Lung Diseases and Clinical Allergology, University of Turku, Turku, Finland
| | - E. Van Ganse
- Unité de Pharmacoépidémiologie, CHU-Lyon - UR 5558 CNRS, Université Claude Bernard, Lyon, Villeurbanne, France
| | - M. van Hage
- Clinical Immunology and Allergy Unit, Department of Medicine Solna, Karolinska Institutet and University Hospital, Stockholm, Sweden
| | - O. Vandenplas
- Department of Chest Medicine, Centre Hospitalier Universitaire Dinant-Godinne, Université Catholique de Louvain, Yvoir, Belgium
| | - T. Vasankari
- FILHA, Finnish Lung Association, Helsinki, Finland
| | - B. Vellas
- Gérontopôle, CHU Toulouse, Toulouse, France
| | - J. Vestbo
- Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
- University Hospital of South Manchester, Manchester NHS Foundation Trust, Manchester, UK
| | - G. Vezzani
- Pulmonary Unit, Department of Cardiology, Thoracic and Vascular Medicine, Arcispedale S.Maria Nuova/IRCCS, Research Hospital, Reggio Emilia, Italy
- Regional Agency for Health and Social Care, Reggio Emilia, Italy
| | - P. Vichyanond
- Division of Allergy and Immunology, Department of Pediatrics, Siriraj Hospital, Mahidol University Faculty of Medicine, Bangkok, 10700 Thailand
| | - G. Viegi
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Via Trieste 41, 56126 Pisa, Italy
- CNR Institute of Biomedicine and Molecular Immunology “A. Monroy”, Via U. La Malfa 153, 90146 Palermo, Italy
| | - C. Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, Marburg, Germany
| | | | - M. Wagenmann
- Department of Otorhinolaryngology, HNO-Klinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - B. Wallaert
- Hôpital Albert Calmette, CHRU, Lille, France
| | - S. Walker
- Asthma UK, Mansell Street, London, UK
| | - D. Y. Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - U. Wahn
- Pediatric Pneumology and Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - M. Wickman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - D. M. Williams
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC USA
| | - S. Williams
- International Primary Care Respiratory Group, Westhill, UK
| | - J. Wright
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - B. P. Yawn
- Department of Research, Olmsted Medical Center, Rochester, MN USA
| | - P. K. Yiallouros
- Cyprus International Institute for Environmental and Public Health in Association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus
- Department of Pediatrics, Hospital “Archbishop Makarios III”, Nicosia, Cyprus
| | - O. M. Yusuf
- The Allergy and Asthma Institute, Lahore, Pakistan
| | - A. Zaidi
- Social Sciences, University of Southampton, Southampton, UK
| | - H. J. Zar
- Department of Paediatrics and Child Health, Red Cross Children’s Hospital, and MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | | | - L. Zhang
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730 China
| | - N. Zhong
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120 China
| | - M. Zidarn
- University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia
| | - J. Mercier
- Department of Physiology, CHRU and Vice President for Research, University Montpellier, Montpellier, France
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Selroos O, Kupczyk M, Kuna P, Łacwik P, Bousquet J, Brennan D, Palkonen S, Contreras J, FitzGerald M, Hedlin G, Johnston SL, Louis R, Metcalf L, Walker S, Moreno-Galdó A, Papadopoulos NG, Rosado-Pinto J, Powell P, Haahtela T. National and regional asthma programmes in Europe. Eur Respir Rev 2016; 24:474-83. [PMID: 26324809 DOI: 10.1183/16000617.00008114] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
This review presents seven national asthma programmes to support the European Asthma Research and Innovation Partnership in developing strategies to reduce asthma mortality and morbidity across Europe. From published data it appears that in order to influence asthma care, national/regional asthma programmes are more effective than conventional treatment guidelines. An asthma programme should start with the universal commitments of stakeholders at all levels and the programme has to be endorsed by political and governmental bodies. When the national problems have been identified, the goals of the programme have to be clearly defined with measures to evaluate progress. An action plan has to be developed, including defined re-allocation of patients and existing resources, if necessary, between primary care and specialised healthcare units or hospital centres. Patients should be involved in guided self-management education and structured follow-up in relation to disease severity. The three evaluated programmes show that, thanks to rigorous efforts, it is possible to improve patients' quality of life and reduce hospitalisation, asthma mortality, sick leave and disability pensions. The direct and indirect costs, both for the individual patient and for society, can be significantly reduced. The results can form the basis for development of further programme activities in Europe.
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Affiliation(s)
- Olof Selroos
- Selroos Medical Consulting (Semeco AB), Ängelholm, Sweden
| | - Maciej Kupczyk
- Dept of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - Piotr Kuna
- Dept of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - Piotr Łacwik
- Dept of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - Jean Bousquet
- National Institute for Health and Medical Research (INSERM), Paris, France
| | - David Brennan
- European Federation of Asthma and Airways Diseases Patients' Association (EFA), Brussels, Belgium
| | - Susanna Palkonen
- European Federation of Asthma and Airways Diseases Patients' Association (EFA), Brussels, Belgium
| | - Javier Contreras
- National Federation of Respiratory Disease Associations (FENAER), Malaga, Spain
| | | | - Gunilla Hedlin
- Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
| | - Sebastian L Johnston
- Airway Disease Infection Section, National Heart and Lung Institute, Imperial College, London, UK
| | - Renaud Louis
- Dept of Pneumology, CHU Sart-Tilman Liège, Liège, Belgium
| | | | | | | | | | | | | | - Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland
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50
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Yepes-Nuñez JJ, Fiocchi A, Pawankar R, Cuello-Garcia CA, Zhang Y, Morgano GP, Ahn K, Al-Hammadi S, Agarwal A, Gandhi S, Beyer K, Burks W, Canonica GW, Ebisawa M, Kamenwa R, Lee BW, Li H, Prescott S, Riva JJ, Rosenwasser L, Sampson H, Spigler M, Terracciano L, Vereda A, Waserman S, Schünemann HJ, Brożek JL. World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P): Vitamin D. World Allergy Organ J 2016; 9:17. [PMID: 27274360 PMCID: PMC4869275 DOI: 10.1186/s40413-016-0108-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 04/21/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence of allergic diseases is approximately 10 % in infants whose parents and siblings do not have allergic diseases and 20-30 % in those with an allergic first-degree relative. Vitamin D is involved in the regulation of the immune system and it may play a role in the development, severity and course of asthma and other allergic diseases. OBJECTIVE The World Allergy Organization (WAO) convened a guideline panel to develop evidence-based recommendations addressing the use of vitamin D in primary prevention of allergic diseases. METHODS Our WAO guideline panel identified the most relevant clinical questions and performed a systematic review of randomized controlled trials and non-randomized studies (NRS), specifically cohort and case-control studies, of vitamin D supplementation for the prevention of allergic diseases. We also reviewed the evidence about values and preferences, and resource requirements (up to January 2015, with an update on January 30, 2016). We followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to develop recommendations. RESULTS Having reviewed the currently available evidence, the WAO guideline panel found no support for the hypothesis that vitamin D supplementation reduces the risk of developing allergic diseases in children. The WAO guideline panel suggest not using vitamin D in pregnant women, breastfeeding mothers, or healthy term infants as a means of preventing the development of allergic diseases. This recommendation does not apply to those mothers and infants who have other indications for prophylactic or therapeutic use of vitamin D. The panel's recommendations are conditional and supported by very low certainty evidence. CONCLUSIONS WAO recommendations about vitamin D supplementation for the prevention of allergic diseases support parents, clinicians and other health care professionals in their decisions whether or not to use vitamin D in preventing allergic diseases in healthy, term infants.
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Affiliation(s)
- Juan José Yepes-Nuñez
- />Department of Clinical Epidemiology & Biostatistics, McMaster University Health Sciences Centre, Room 2C16 1280 Main Street West, Hamilton, L8N 4K1 ON Canada
- />University of Antioquia, School of Medicine, Medellín, Colombia
| | | | - Ruby Pawankar
- />Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Carlos A. Cuello-Garcia
- />Department of Clinical Epidemiology & Biostatistics, McMaster University Health Sciences Centre, Room 2C16 1280 Main Street West, Hamilton, L8N 4K1 ON Canada
- />Tecnologico de Monterrey School of Medicine, Monterrey, Mexico
| | - Yuan Zhang
- />Department of Clinical Epidemiology & Biostatistics, McMaster University Health Sciences Centre, Room 2C16 1280 Main Street West, Hamilton, L8N 4K1 ON Canada
| | - Gian Paolo Morgano
- />Department of Clinical Epidemiology & Biostatistics, McMaster University Health Sciences Centre, Room 2C16 1280 Main Street West, Hamilton, L8N 4K1 ON Canada
| | - Kangmo Ahn
- />Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Suleiman Al-Hammadi
- />Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Arnav Agarwal
- />Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Shreyas Gandhi
- />Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | | | - Wesley Burks
- />Department of Pediatrics, University of North Carolina, Chapel Hill, NC USA
| | | | - Motohiro Ebisawa
- />Department of Allergy, Clinical Research Center for Allergology and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan
| | - Rose Kamenwa
- />Department of Pediatrics and Child Health, Aga Khan University Hospital, Nairobi, Kenya
| | - Bee Wah Lee
- />Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Haiqi Li
- />Department of Primary Child Care, Children’s Hospital, Chongqing Medical University, Chongqing, China
| | - Susan Prescott
- />Department of Immunology, Perth Children’s Hospital, Telethon KIDS Institute, School of Paediatrics and Child Health, University of Western Australia, Crawley, Australia
| | - John J. Riva
- />Department of Clinical Epidemiology & Biostatistics, McMaster University Health Sciences Centre, Room 2C16 1280 Main Street West, Hamilton, L8N 4K1 ON Canada
- />Department of Family Medicine, McMaster University, Hamilton, ON Canada
| | - Lanny Rosenwasser
- />Allergy-Immunology Division, Children’s Mercy Hospital & University of Missouri – Kansas City School of Medicine, Kansas City, MO USA
| | - Hugh Sampson
- />Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | | | - Luigi Terracciano
- />Department of Child and Maternal Medicine, University of Milan Medical School at the Melloni Hospital, Milan, Italy
| | - Andrea Vereda
- />Allergology Department, Hospital Infantil Universitario Niño Jesus, Madrid, Spain
| | - Susan Waserman
- />Department of Medicine, McMaster University, Hamilton, ON Canada
| | - Holger J. Schünemann
- />Department of Clinical Epidemiology & Biostatistics, McMaster University Health Sciences Centre, Room 2C16 1280 Main Street West, Hamilton, L8N 4K1 ON Canada
- />Department of Medicine, McMaster University, Hamilton, ON Canada
| | - Jan L. Brożek
- />Department of Clinical Epidemiology & Biostatistics, McMaster University Health Sciences Centre, Room 2C16 1280 Main Street West, Hamilton, L8N 4K1 ON Canada
- />Department of Medicine, McMaster University, Hamilton, ON Canada
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