1
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Agache I, Annesi-Maesano I, Cecchi L, Biagioni B, Chung KF, Clot B, D'Amato G, Damialis A, Del Giacco S, Dominguez-Ortega J, Galàn C, Gilles S, Holgate S, Jeebhay M, Kazadzis S, Nadeau K, Papadopoulos N, Quirce S, Sastre J, Tummon F, Traidl-Hoffmann C, Walusiak-Skorupa J, Jutel M, Akdis CA. EAACI guidelines on environmental science for allergy and asthma: The impact of short-term exposure to outdoor air pollutants on asthma-related outcomes and recommendations for mitigation measures. Allergy 2024; 79:1656-1686. [PMID: 38563695 DOI: 10.1111/all.16103] [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: 02/15/2024] [Revised: 03/08/2024] [Accepted: 03/10/2024] [Indexed: 04/04/2024]
Abstract
The EAACI Guidelines on the impact of short-term exposure to outdoor pollutants on asthma-related outcomes provide recommendations for prevention, patient care and mitigation in a framework supporting rational decisions for healthcare professionals and patients to individualize and improve asthma management and for policymakers and regulators as an evidence-informed reference to help setting legally binding standards and goals for outdoor air quality at international, national and local levels. The Guideline was developed using the GRADE approach and evaluated outdoor pollutants referenced in the current Air Quality Guideline of the World Health Organization as single or mixed pollutants and outdoor pesticides. Short-term exposure to all pollutants evaluated increases the risk of asthma-related adverse outcomes, especially hospital admissions and emergency department visits (moderate certainty of evidence at specific lag days). There is limited evidence for the impact of traffic-related air pollution and outdoor pesticides exposure as well as for the interventions to reduce emissions. Due to the quality of evidence, conditional recommendations were formulated for all pollutants and for the interventions reducing outdoor air pollution. Asthma management counselled by the current EAACI guidelines can improve asthma-related outcomes but global measures for clean air are needed to achieve significant impact.
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Affiliation(s)
- Ioana Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - Isabella Annesi-Maesano
- Institute Desbrest of Epidemiology and Public Health, University of Montpellier and INSERM, Montpellier, France
| | - Lorenzo Cecchi
- Centre of Bioclimatology, University of Florence, Florence, Italy
| | - Benedetta Biagioni
- Allergy and Clinical Immunology Unit San Giovanni di Dio Hospital, Florence, Italy
| | - Kian Fan Chung
- National Hearth & Lung Institute, Imperial College London, London, UK
| | - Bernard Clot
- Federal office of meteorology and climatology MeteoSwiss, Payerne, Switzerland
| | - Gennaro D'Amato
- Respiratory Disease Department, Hospital Cardarelli, Naples, Italy
- University of Naples Federico II Medical School of Respiratory Diseases, Naples, Italy
| | - Athanasios Damialis
- Department of Ecology, School of Biology, Faculty of Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato, Italy
| | - Javier Dominguez-Ortega
- Department of Allergy, La Paz University Hospital, IdiPAZ, and CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
| | - Carmen Galàn
- Inter-University Institute for Earth System Research (IISTA), International Campus of Excellence on Agrifood (ceiA3), University of Córdoba, Córdoba, Spain
| | - Stefanie Gilles
- Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Stephen Holgate
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Mohamed Jeebhay
- Occupational Medicine Division and Centre for Environmental & Occupational Health Research, University of Cape Town, Cape Town, South Africa
| | - Stelios Kazadzis
- Physikalisch-Meteorologisches Observatorium Davos, World Radiation Center, Davos, Switzerland
| | - Kari Nadeau
- John Rock Professor of Climate and Population Studies, Department of Environmental Health, Center for Climate, Health, and the Global Environment, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Nikolaos Papadopoulos
- Allergy and Clinical Immunology Unit, Second Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
- Division of Evolution and Genomic Sciences, University of Manchester, Manchester, UK
| | - Santiago Quirce
- Department of Allergy, La Paz University Hospital, IdiPAZ, and CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
| | - Joaquin Sastre
- Allergy Service, Fundación Jiménez Díaz, Faculty of Medicine Universidad Autónoma de Madrid and CIBERES, Instituto Carlos III, Ministry of Science and Innovation, Madrid, Spain
| | - Fiona Tummon
- Respiratory Disease Department, Hospital Cardarelli, Naples, Italy
- University of Naples Federico II Medical School of Respiratory Diseases, Naples, Italy
| | - Claudia Traidl-Hoffmann
- Department of Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
- Institute of Environmental Medicine, Helmholtz Center Munich-German Research Center for Environmental Health, Augsburg, Germany
- Christine Kühne Center for Allergy Research and Education, Davos, Switzerland
| | - Jolanta Walusiak-Skorupa
- Department of Occupational Diseases and Environmental Health, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Marek Jutel
- Department of Clinical Immunology, Wrocław Medical University, and ALL-MED Medical Research Institute, Wroclaw, Poland
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University Zurich, Davos, Switzerland
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2
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Banwell N, Michel S, Senn N. Greenspaces and Health: Scoping Review of studies in Europe. Public Health Rev 2024; 45:1606863. [PMID: 38831866 PMCID: PMC11144923 DOI: 10.3389/phrs.2024.1606863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 04/22/2024] [Indexed: 06/05/2024] Open
Abstract
Objectives Access to greenspaces and contact with nature can promote physical activity and have positive effects on physical and mental health. This scoping literature review aims to examine current evidence linking greenspaces and (a) behaviour change, (b) health outcomes and (c) co-benefits. Methods This review was conducted in accordance with the PRISMA scoping review guidelines. Searches were conducted through PubMed and EMBASE databases for studies published between 2000 and March 2023 with a focus on Europe. Results 122 scientific articles and grey literature reports were identified. Access to greenspaces is positively associated with physical and mental health, and reduced risk of all-cause mortality and some non-communicable diseases. Greenspace quality is associated with increased physical activity and reduced risk of obesity. Nature-based therapies or green prescription are effective in improving mental health outcomes and overall health. Importantly, numerous co-benefits of greenspaces are identified. Conclusion Increasing access to greenspaces for populations with particular attention to greenspace quality is important for co-benefits. Responsible governance and use of greenspaces are crucial to minimize public health risks and human disturbance of nature.
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Affiliation(s)
- Nicola Banwell
- Interdisciplinary Centre for Research in Ethics (CIRE), University of Lausanne, Lausanne, Switzerland
| | - Sarah Michel
- Department of Family Medicine, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Nicolas Senn
- Department of Family Medicine, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
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3
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Antó JM. Human health and the health of Planet Earth go together. J Intern Med 2024; 295:695-706. [PMID: 38420693 DOI: 10.1111/joim.13774] [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] [Indexed: 03/02/2024]
Abstract
The emergence of the planetary health approach was highlighted by the report of The Rockefeller Foundation-Lancet Commission on Planetary Health in 2015 and changed how we comprehend human well-being. The report advocates integrating the health of other living beings and Earth's natural systems as intrinsic components of human health. Drawing on over three decades of experience in respiratory epidemiology and environmental health, this article outlines how my perspective on human health underwent a transformative shift upon reading the abovementioned report. The planetary health approach offers a lens through which human health issues and potential solutions can be understood within the context of the Anthropocene. It addresses the pressing existential challenges arising from humanity's transgression of planetary limits. Embracing the planetary health paradigm within the field of health sciences can catalyze transformative changes essential for cultivating a sustainable and equitable future.
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Affiliation(s)
- Josep M Antó
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
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4
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Saarenpää M, Roslund MI, Nurminen N, Puhakka R, Kummola L, Laitinen OH, Hyöty H, Sinkkonen A. Urban indoor gardening enhances immune regulation and diversifies skin microbiota - A placebo-controlled double-blinded intervention study. ENVIRONMENT INTERNATIONAL 2024; 187:108705. [PMID: 38688234 DOI: 10.1016/j.envint.2024.108705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/26/2024] [Accepted: 04/25/2024] [Indexed: 05/02/2024]
Abstract
According to the hygiene and biodiversity hypotheses, frequent exposure to environmental microbiota, especially through soil contact, diversifies commensal microbiota, enhances immune modulation, and ultimately lowers the risk of immune-mediated diseases. Here we test the underlying assumption of the hygiene and biodiversity hypotheses by instructing volunteers to grow edible plants indoors during the winter season when natural exposure to environmental microbiota is low. The one-month randomized, placebo-controlled double-blind trial consisted of two treatments: participants received either microbially diverse growing medium or visually similar but microbially poor growing medium. Skin microbiota and a panel of seven immune markers were analyzed in the beginning of the trial and after one month. The diversity of five bacterial phyla (Bacteroidetes, Planctomycetes, Proteobacteria, Cyanobacteria, and Verrucomicrobia) and one class (Bacteroidia) increased on the skin of participants in the intervention group while no changes were observed in the placebo group. The number of nodes and edges in the co-occurrence networks of the skin bacteria increased on average three times more in the intervention group than in the placebo group. The plasma levels of the immunomodulatory cytokine interleukin 10 (IL-10) increased in the intervention group when compared with the placebo group. A similar trend was observed in the interleukin 17A (IL-17A) levels and in the IL-10:IL-17A ratios. Participants in both groups reported high satisfaction and adherence to the trial. The current study provides evidence in support of the core assumption of the hygiene and biodiversity hypotheses of immune-mediated diseases. Indoor urban gardening offers a meaningful and convenient approach for increasing year-round exposure to environmental microbiota, paving the way for other prophylactic practices that might help prevent immune-mediated diseases.
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Affiliation(s)
- Mika Saarenpää
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, 15140 Lahti, Finland; Natural Resources Institute Finland, Turku and Helsinki, Finland.
| | - Marja I Roslund
- Natural Resources Institute Finland, Turku and Helsinki, Finland.
| | - Noora Nurminen
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön Katu 34, 33520 Tampere, Finland.
| | - Riikka Puhakka
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, 15140 Lahti, Finland.
| | - Laura Kummola
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön Katu 34, 33520 Tampere, Finland.
| | - Olli H Laitinen
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön Katu 34, 33520 Tampere, Finland.
| | - Heikki Hyöty
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön Katu 34, 33520 Tampere, Finland.
| | - Aki Sinkkonen
- Natural Resources Institute Finland, Turku and Helsinki, Finland.
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5
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Zhao C, Liu X, Tan H, Yin S, Su L, Du B, Khalid M, Sinkkonen A, Hui N. Neighborhood garden's age shapes phyllosphere microbiota associated with respiratory diseases in cold seasons. ENVIRONMENTAL SCIENCE AND ECOTECHNOLOGY 2024; 18:100315. [PMID: 37886031 PMCID: PMC10598728 DOI: 10.1016/j.ese.2023.100315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 09/04/2023] [Accepted: 09/11/2023] [Indexed: 10/28/2023]
Abstract
Neighborhood gardens serve as sensitive sites for human microbial encounters, with phyllosphere microbes directly impacting our respiratory health. Yet, our understanding remains limited on how factors like season, garden age, and land use shape the risk of respiratory diseases (RDs) tied to these garden microbes. Here we examined the microbial communities within the phyllosphere of 72 neighborhood gardens across Shanghai, spanning different seasons (warm and cold), garden ages (old and young), and locales (urban and rural). We found a reduced microbial diversity during the cold season, except for Gammaproteobacteria which exhibited an inverse trend. While land use influenced the microbial composition, urban and rural gardens had strikingly similar microbial profiles. Alarmingly, young gardens in the cold season hosted a substantial proportion of RDs-associated species, pointing towards increased respiratory inflammation risks. In essence, while newer gardens during colder periods show a decline in microbial diversity, they have an increased presence of RDs-associated microbes, potentially escalating respiratory disease prevalence. This underscores the pivotal role the garden age plays in enhancing both urban microbial diversity and respiratory health.
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Affiliation(s)
- Chang Zhao
- School of Agriculture and Biology, Shanghai Jiao Tong University, 800 Dongchuan Rd., 200240, Shanghai, China
- Shanghai Yangtze River Delta Eco-Environmental Change and Management Observation and Research Station, Ministry of Science and Technology, Ministry of Education, 800 Dongchuan Rd., 200240, Shanghai, China
- Shanghai Urban Forest Ecosystem Research Station, National Forestry and Grassland Administration, 800 Dongchuan Rd., 200240, Shanghai, China
| | - Xinxin Liu
- School of Agriculture and Biology, Shanghai Jiao Tong University, 800 Dongchuan Rd., 200240, Shanghai, China
- Shanghai Yangtze River Delta Eco-Environmental Change and Management Observation and Research Station, Ministry of Science and Technology, Ministry of Education, 800 Dongchuan Rd., 200240, Shanghai, China
- Shanghai Urban Forest Ecosystem Research Station, National Forestry and Grassland Administration, 800 Dongchuan Rd., 200240, Shanghai, China
| | - Haoxin Tan
- School of Agriculture and Biology, Shanghai Jiao Tong University, 800 Dongchuan Rd., 200240, Shanghai, China
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Lahti, Finland
| | - Shan Yin
- School of Agriculture and Biology, Shanghai Jiao Tong University, 800 Dongchuan Rd., 200240, Shanghai, China
| | - Lantian Su
- School of Agriculture and Biology, Shanghai Jiao Tong University, 800 Dongchuan Rd., 200240, Shanghai, China
| | - Baoming Du
- School of Agriculture and Biology, Shanghai Jiao Tong University, 800 Dongchuan Rd., 200240, Shanghai, China
| | - Muhammad Khalid
- Department of Biology, College of Science and Technology, Wenzhou-Kean University, Wenzhou, China
| | - Aki Sinkkonen
- Department of Garden Technologies, Horticulture Technologies, Natural Resources Institute Finland, Helsinki, Finland
| | - Nan Hui
- School of Agriculture and Biology, Shanghai Jiao Tong University, 800 Dongchuan Rd., 200240, Shanghai, China
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Lahti, Finland
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6
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Seastedt H, Nadeau K. Factors by which global warming worsens allergic disease. Ann Allergy Asthma Immunol 2023; 131:694-702. [PMID: 37689112 PMCID: PMC10873081 DOI: 10.1016/j.anai.2023.08.610] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/16/2023] [Accepted: 08/20/2023] [Indexed: 09/11/2023]
Abstract
Increased use of fossil fuels has led to global warming with concomitant increases in the severity and frequency of extreme weather events such as wildfires and sand and dust storms. These changes have led to increases in air pollutants such as particulate matter and greenhouse gases. Global warming is also associated with increases in pollen season length and pollen concentration. Particulate matter, greenhouse gases, and pollen synergistically increase the incidence and severity of allergic diseases. Other indirect factors such as droughts, flooding, thunderstorms, heat waves, water pollution, human migration, deforestation, loss of green space, and decreasing biodiversity (including microbial diversity) also affect the incidence and severity of allergic disease. Global warming and extreme weather events are expected to increase in the coming decades, and further increases in allergic diseases are expected, exacerbating the already high health care burden associated with these diseases. There is an urgent need to mitigate and adapt to the effects of climate change to improve human health. Human health and planetary health are connected and the concept of One Health, which is an integrated, unifying approach to balance and optimize the health of people, animals, and the environment needs to be emphasized. Clinicians are trusted members of the community, and they need to take a strong leadership role in educating patients on climate change and its adverse effects on human health. They also need to advocate for policy changes that decrease the use of fossil fuels and increase biodiversity and green space to enable a healthier and more sustainable future.
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Affiliation(s)
- Hana Seastedt
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Palo Alto, California
| | - Kari Nadeau
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
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7
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Losol P, Sokolowska M, Hwang YK, Ogulur I, Mitamura Y, Yazici D, Pat Y, Radzikowska U, Ardicli S, Yoon JE, Choi JP, Kim SH, van de Veen W, Akdis M, Chang YS, Akdis CA. Epithelial Barrier Theory: The Role of Exposome, Microbiome, and Barrier Function in Allergic Diseases. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2023; 15:705-724. [PMID: 37957791 PMCID: PMC10643858 DOI: 10.4168/aair.2023.15.6.705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/18/2023] [Accepted: 10/07/2023] [Indexed: 11/15/2023]
Abstract
Allergic diseases are a major public health problem with increasing prevalence. These immune-mediated diseases are characterized by defective epithelial barriers, which are explained by the epithelial barrier theory and continuously emerging evidence. Environmental exposures (exposome) including global warming, changes and loss of biodiversity, pollution, pathogens, allergens and mites, laundry and dishwasher detergents, surfactants, shampoos, body cleaners and household cleaners, microplastics, nanoparticles, toothpaste, enzymes and emulsifiers in processed foods, and dietary habits are responsible for the mucosal and skin barrier disruption. Exposure to barrier-damaging agents causes epithelial cell injury and barrier damage, colonization of opportunistic pathogens, loss of commensal bacteria, decreased microbiota diversity, bacterial translocation, allergic sensitization, and inflammation in the periepithelial area. Here, we review scientific evidence on the environmental components that impact epithelial barriers and microbiome composition and their influence on asthma and allergic diseases. We also discuss the historical overview of allergic diseases and the evolution of the hygiene hypothesis with theoretical evidence.
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Affiliation(s)
- Purevsuren Losol
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Medical Research Center, Seoul National University, Seoul, Korea
- Department of Molecular Biology and Genetics, School of Biomedicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Yu-Kyoung Hwang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Ismail Ogulur
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Yasutaka Mitamura
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Duygu Yazici
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Yagiz Pat
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Urszula Radzikowska
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Sena Ardicli
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Jeong-Eun Yoon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jun-Pyo Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sae-Hoon Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Medical Research Center, Seoul National University, Seoul, Korea
| | - Willem van de Veen
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Yoon-Seok Chang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Medical Research Center, Seoul National University, Seoul, Korea.
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
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8
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Kummola L, González-Rodríguez MI, Marnila P, Nurminen N, Salomaa T, Hiihtola L, Mäkelä I, Laitinen OH, Hyöty H, Sinkkonen A, Junttila IS. Comparison of the effect of autoclaved and non-autoclaved live soil exposure on the mouse immune system : Effect of soil exposure on immune system. BMC Immunol 2023; 24:29. [PMID: 37689649 PMCID: PMC10492337 DOI: 10.1186/s12865-023-00565-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 08/29/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND . Lack of exposure to the natural microbial diversity of the environment has been linked to dysregulation of the immune system and numerous noncommunicable diseases, such as allergies and autoimmune disorders. Our previous studies suggest that contact with soil material, rich in naturally occurring microbes, could have a beneficial immunoregulatory impact on the immune system in mice and humans. However, differences in the immunomodulatory properties of autoclaved, sterile soil material and non-autoclaved, live soil material have not been compared earlier. RESULTS . In this study, we exposed C57BL/6 mice to autoclaved and live soil powders that had the same rich microbiota before autoclaving. We studied the effect of the soil powders on the mouse immune system by analyzing different immune cell populations, gene expression in the gut, mesenteric lymph nodes and lung, and serum cytokines. Both autoclaved and live soil exposure were associated with changes in the immune system. The exposure to autoclaved soil resulted in higher levels of Rorγt, Inos and Foxp3 expression in the colon. The exposure to live soil was associated with elevated IFN-γ concentration in the serum. In the mesenteric lymph node, exposure to live soil reduced Gata3 and Foxp3 expression, increased the percentage of CD8 + T cells and the expression of activation marker CD80 in XCR1+SIRPα- migratory conventional dendritic cell 1 subset. CONCLUSIONS . Our results indicate that exposure to the live and autoclaved soil powders is not toxic for mice. Exposure to live soil powder slightly skews the immune system towards type 1 direction which might be beneficial for inhibiting type 2-related inflammation. Further studies are warranted to quantify the impact of this exposure in experimental type 2 inflammation.
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Affiliation(s)
- Laura Kummola
- Faculty of Medicine and Health Technology, Tampere University, Tampere, 33014, Finland
| | | | - Pertti Marnila
- Natural Resources Institute Finland (Luke), Jokioinen, Finland
| | - Noora Nurminen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, 33014, Finland
| | - Tanja Salomaa
- Faculty of Medicine and Health Technology, Tampere University, Tampere, 33014, Finland
- Fimlab Laboratories, Arvo-Building, Rm F326, Arvo Ylpön katu 34, Tampere, 33520, Finland
| | - Lotta Hiihtola
- Faculty of Medicine and Health Technology, Tampere University, Tampere, 33014, Finland
- Fimlab Laboratories, Arvo-Building, Rm F326, Arvo Ylpön katu 34, Tampere, 33520, Finland
| | - Iida Mäkelä
- Natural Resources Institute Finland (Luke), Jokioinen, Finland
| | - Olli H Laitinen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, 33014, Finland
| | - Heikki Hyöty
- Faculty of Medicine and Health Technology, Tampere University, Tampere, 33014, Finland
| | - Aki Sinkkonen
- Natural Resources Institute Finland (Luke), Jokioinen, Finland
| | - Ilkka S Junttila
- Faculty of Medicine and Health Technology, Tampere University, Tampere, 33014, Finland.
- Fimlab Laboratories, Arvo-Building, Rm F326, Arvo Ylpön katu 34, Tampere, 33520, Finland.
- Northern Finland Laboratory Centre (NordLab), Oulu, 90220, Finland.
- Research Unit of Biomedicine, University of Oulu, Oulu, 90570, Finland.
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9
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Voor T, Pärtel M, Peet A, Saare L, Hyöty H, Knip M, Davison J, Zobel M, Tillmann V. Atopic sensitization in childhood depends on the type of green area around the home in infancy. Clin Exp Allergy 2023; 53:850-853. [PMID: 37038920 DOI: 10.1111/cea.14317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 04/12/2023]
Affiliation(s)
- Tiia Voor
- Children's Clinic of Tartu University Hospital, Tartu, Estonia
- Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Meelis Pärtel
- Institute of Ecology and Earth Sciences, University of Tartu, Tartu, Estonia
| | - Aleksandr Peet
- Children's Clinic of Tartu University Hospital, Tartu, Estonia
- Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Liisa Saare
- Children's Clinic of Tartu University Hospital, Tartu, Estonia
- Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Heikki Hyöty
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Fimlab Laboratories, Tampere, Finland
| | - Mikael Knip
- Pediatric Research Centre, New Children's Hospital, Helsinki University Hospital, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - John Davison
- Institute of Ecology and Earth Sciences, University of Tartu, Tartu, Estonia
| | - Martin Zobel
- Institute of Ecology and Earth Sciences, University of Tartu, Tartu, Estonia
| | - Vallo Tillmann
- Children's Clinic of Tartu University Hospital, Tartu, Estonia
- Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
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10
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Agache I, Laculiceanu A, Spanu D, Grigorescu D. The Concept of One Health for Allergic Diseases and Asthma. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2023; 15:290-302. [PMID: 37188486 DOI: 10.4168/aair.2023.15.3.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/05/2023] [Accepted: 04/05/2023] [Indexed: 05/17/2023]
Abstract
The worldwide prevalence of allergic disease is rising as a result of complex gene-environment interactions that shape the immune system and host response. Climate change and loss of biodiversity are existential threats to humans, animals, plants, and ecosystems. While there is significant progress in the development of targeted therapeutic options to treat allergies and asthma, these approaches are inadequate to meet the challenges faced by climate change. The exposomic approach is needed with the recognition of the bidirectional effect between human beings and the environment. All stakeholders need to work together toward mitigating the effects of climate change and promoting a One Health concept in order to decrease the burden of asthma and allergy and to improve immune health. Healthcare professionals should strive to incorporate One Health counseling, environmental health precepts, and advocacy into their practice.
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Affiliation(s)
- Ioana Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania.
| | | | - Daniela Spanu
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - Dan Grigorescu
- Faculty of Medicine, Transylvania University, Brasov, Romania
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11
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Skin, gut, and sand metagenomic data on placebo-controlled sandbox biodiversity intervention study. Data Brief 2023; 47:109003. [PMID: 36915639 PMCID: PMC10006422 DOI: 10.1016/j.dib.2023.109003] [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: 01/30/2023] [Accepted: 02/15/2023] [Indexed: 02/24/2023] Open
Abstract
The metagenomic data presented in this article are related to the published research of "A Placebo-controlled double-blinded test of the biodiversity hypothesis of immune-mediated diseases: Environmental microbial diversity elicits changes in cytokines and increase in T regulatory cells in young children" This database contains 16S ribosomal RNA (rRNA) metagenomics of sandbox sand and skin and gut microbiota of children in the intervention and placebo daycares. In intervention daycares, children aged 3-5 years were exposed to playground sand enriched with microbially diverse soil. In placebo daycares, children were exposed to visually similar as in intervention daycares, but microbially poor sand colored with peat. Sand, skin and gut metagenomics were analyzed at baseline and after 14 and 28 days of intervention by high throughput sequencing of bacterial 16S rRNA gene on the Illumina MiSeq platform. This dataset shows how skin bacterial community composition, including classes Gammaproteobacteria and Bacilli, changed, and how the relative abundance of over 30 bacterial genera shifted on the skin of children in the intervention treatment, while no shifts occurred in the placebo group.
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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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Bernard-Verdier M, Seitz B, Buchholz S, Kowarik I, Lasunción Mejía S, Jeschke JM. Grassland allergenicity increases with urbanisation and plant invasions. AMBIO 2022; 51:2261-2277. [PMID: 35594005 PMCID: PMC9481851 DOI: 10.1007/s13280-022-01741-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 02/21/2022] [Accepted: 04/15/2022] [Indexed: 06/15/2023]
Abstract
Pollen allergies have been on the rise in cities, where anthropogenic disturbances, warmer climate and introduced species are shaping novel urban ecosystems. Yet, the allergenic potential of these urban ecosystems, in particular spontaneous vegetation outside parks and gardens, remains poorly known. We quantified the allergenic properties of 56 dry grasslands along a double gradient of urbanisation and plant invasion in Berlin (Germany). 30% of grassland species were classified as allergenic, most of them being natives. Urbanisation was associated with an increase in abundance and diversity of pollen allergens, mainly driven by an increase in allergenic non-native plants. While not inherently more allergenic than native plants, the pool of non-natives contributed a larger biochemical diversity of allergens and flowered later than natives, creating a broader potential spectrum of allergy. Managing novel risks to urban public health will involve not only targeted action on allergenic non-natives, but also policies at the habitat scale favouring plant community assembly of a diverse, low-allergenicity vegetation. Similar approaches could be easily replicated in other cities to provide a broad quantification and mapping of urban allergy risks and drivers.
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Affiliation(s)
- Maud Bernard-Verdier
- Institute of Biology, Freie Universität Berlin, Königin-Luise-Straße 1-3, 14195 Berlin, Germany
- Berlin-Brandenburg Institute of Advanced Biodiversity Research (BBIB), Berlin, Germany
- Leibniz Institute of Freshwater Ecology and Inland Fisheries (IGB), Müggelseedamm 301, 12587, Berlin, Germany
| | - Birgit Seitz
- Berlin-Brandenburg Institute of Advanced Biodiversity Research (BBIB), Berlin, Germany
- Department of Ecology, Technische Universität Berlin, Rothenburgstraße 12, 12165 Berlin, Germany
| | - Sascha Buchholz
- Berlin-Brandenburg Institute of Advanced Biodiversity Research (BBIB), Berlin, Germany
- Department of Ecology, Technische Universität Berlin, Rothenburgstraße 12, 12165 Berlin, Germany
- Institute of Landscape Ecology, University of Münster, Heisenbergstraße 2, 48149 Munster, Germany
| | - Ingo Kowarik
- Berlin-Brandenburg Institute of Advanced Biodiversity Research (BBIB), Berlin, Germany
- Department of Ecology, Technische Universität Berlin, Rothenburgstraße 12, 12165 Berlin, Germany
| | - Sara Lasunción Mejía
- Institute of Biology, Freie Universität Berlin, Königin-Luise-Straße 1-3, 14195 Berlin, Germany
- Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Jonathan M. Jeschke
- Institute of Biology, Freie Universität Berlin, Königin-Luise-Straße 1-3, 14195 Berlin, Germany
- Berlin-Brandenburg Institute of Advanced Biodiversity Research (BBIB), Berlin, Germany
- Leibniz Institute of Freshwater Ecology and Inland Fisheries (IGB), Müggelseedamm 301, 12587, Berlin, Germany
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Prenzel F, Treudler R, Lipek T, vom Hove M, Kage P, Kuhs S, Kaiser T, Bastl M, Bumberger J, Genuneit J, Hornick T, Klotz S, Zarnowski J, Boege M, Zebralla V, Simon JC, Dunker S. Invasive Growth of Ailanthus altissima Trees is Associated with a High Rate of Sensitization in Atopic Patients. J Asthma Allergy 2022; 15:1217-1226. [PMID: 36071746 PMCID: PMC9443999 DOI: 10.2147/jaa.s373177] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/15/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Freerk Prenzel
- Leipziger Interdisciplinary Center for Allergy (LICA), Comprehensive Allergy Center, Leipzig, Germany
- University of Leipzig, Medical Center, Department of Pediatrics, Leipzig, Germany
| | - Regina Treudler
- Leipziger Interdisciplinary Center for Allergy (LICA), Comprehensive Allergy Center, Leipzig, Germany
- University of Leipzig, Medical Center, Department of Dermatology, Venerology and Allergy, Leipzig, Germany
| | - Tobias Lipek
- Leipziger Interdisciplinary Center for Allergy (LICA), Comprehensive Allergy Center, Leipzig, Germany
- University of Leipzig, Medical Center, Department of Pediatrics, Leipzig, Germany
| | - Maike vom Hove
- Leipziger Interdisciplinary Center for Allergy (LICA), Comprehensive Allergy Center, Leipzig, Germany
- University of Leipzig, Medical Center, Department of Pediatrics, Leipzig, Germany
| | - Paula Kage
- Leipziger Interdisciplinary Center for Allergy (LICA), Comprehensive Allergy Center, Leipzig, Germany
- University of Leipzig, Medical Center, Department of Dermatology, Venerology and Allergy, Leipzig, Germany
| | - Simone Kuhs
- Leipziger Interdisciplinary Center for Allergy (LICA), Comprehensive Allergy Center, Leipzig, Germany
- University of Leipzig, Medical Center, Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig, Germany
| | - Thorsten Kaiser
- Leipziger Interdisciplinary Center for Allergy (LICA), Comprehensive Allergy Center, Leipzig, Germany
- University of Leipzig, Medical Center, Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig, Germany
| | - Maximilian Bastl
- Medical University of Vienna, Department of Otorhinolaryngology, Vienna, Austria
| | - Jan Bumberger
- Helmholtz-Centre for Environmental Research (UFZ), Department Monitoring and Exploration Technologies, Leipzig, Germany
- Helmholtz-Centre for Environmental Research (UFZ), Research Data Management, Leipzig, Germany
- German Centre for Integrative Biodiversity Research (iDiv) Halle, Jena, Leipzig, Germany
| | - Jon Genuneit
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany
- German Center for Child and Youth Health, Leipzig/ Dresden, Dresden, Germany
| | - Thomas Hornick
- German Centre for Integrative Biodiversity Research (iDiv) Halle, Jena, Leipzig, Germany
- Helmholtz-Centre for Environmental Research (UFZ), Department Physiological Diversity, Leipzig, Germany
| | - Stefan Klotz
- German Centre for Integrative Biodiversity Research (iDiv) Halle, Jena, Leipzig, Germany
- Helmholtz-Centre for Environmental Research (UFZ), Department Community Ecology, Halle, Germany
| | - Julia Zarnowski
- Leipziger Interdisciplinary Center for Allergy (LICA), Comprehensive Allergy Center, Leipzig, Germany
- University of Leipzig, Medical Center, Department of Dermatology, Venerology and Allergy, Leipzig, Germany
| | - Maren Boege
- Leipziger Interdisciplinary Center for Allergy (LICA), Comprehensive Allergy Center, Leipzig, Germany
- University of Leipzig, Medical Center, Department of Otorhinolaryngology, Head and Neck Surgery, Leipzig, Germany
| | - Veit Zebralla
- Leipziger Interdisciplinary Center for Allergy (LICA), Comprehensive Allergy Center, Leipzig, Germany
- University of Leipzig, Medical Center, Department of Otorhinolaryngology, Head and Neck Surgery, Leipzig, Germany
| | - Jan-Christoph Simon
- Leipziger Interdisciplinary Center for Allergy (LICA), Comprehensive Allergy Center, Leipzig, Germany
- University of Leipzig, Medical Center, Department of Dermatology, Venerology and Allergy, Leipzig, Germany
| | - Susanne Dunker
- German Centre for Integrative Biodiversity Research (iDiv) Halle, Jena, Leipzig, Germany
- Helmholtz-Centre for Environmental Research (UFZ), Department Physiological Diversity, Leipzig, Germany
- Correspondence: Susanne Dunker, Helmholtz Centre for Environmental Research – UFZ, Leipzig, Germany, Tel +49 341 9733170, Email
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15
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Roslund MI, Parajuli A, Hui N, Puhakka R, Grönroos M, Soininen L, Nurminen N, Oikarinen S, Cinek O, Kramná L, Schroderus AM, Laitinen OH, Kinnunen T, Hyöty H, Sinkkonen A. A Placebo-controlled double-blinded test of the biodiversity hypothesis of immune-mediated diseases: Environmental microbial diversity elicits changes in cytokines and increase in T regulatory cells in young children. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 242:113900. [PMID: 35930838 DOI: 10.1016/j.ecoenv.2022.113900] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/15/2022] [Accepted: 07/17/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND According to the biodiversity hypothesis of immune-mediated diseases, lack of microbiological diversity in the everyday living environment is a core reason for dysregulation of immune tolerance and - eventually - the epidemic of immune-mediated diseases in western urban populations. Despite years of intense research, the hypothesis was never tested in a double-blinded and placebo-controlled intervention trial. OBJECTIVE We aimed to perform the first placebo-controlled double-blinded test that investigates the effect of biodiversity on immune tolerance. METHODS In the intervention group, children aged 3-5 years were exposed to playground sand enriched with microbially diverse soil, or in the placebo group, visually similar, but microbially poor sand colored with peat (13 participants per treatment group). Children played twice a day for 20 min in the sandbox for 14 days. Sand, skin and gut bacterial, and blood samples were taken at baseline and after 14 days. Bacterial changes were followed for 28 days. Sand, skin and gut metagenome was determined by high throughput sequencing of bacterial 16 S rRNA gene. Cytokines were measured from plasma and the frequency of blood regulatory T cells was defined as a percentage of total CD3 +CD4 + T cells. RESULTS Bacterial richness (P < 0.001) and diversity (P < 0.05) were higher in the intervention than placebo sand. Skin bacterial community, including Gammaproteobacteria, shifted only in the intervention treatment to resemble the bacterial community in the enriched sand (P < 0.01). Mean change in plasma interleukin-10 (IL-10) concentration and IL-10 to IL-17A ratio supported immunoregulation in the intervention treatment compared to the placebo treatment (P = 0.02). IL-10 levels (P = 0.001) and IL-10 to IL-17A ratio (P = 0.02) were associated with Gammaproteobacterial community on the skin. The change in Treg frequencies was associated with the relative abundance of skin Thermoactinomycetaceae 1 (P = 0.002) and unclassified Alphaproteobacteria (P < 0.001). After 28 days, skin bacterial community still differed in the intervention treatment compared to baseline (P < 0.02). CONCLUSIONS This is the first double-blinded placebo-controlled study to show that daily exposure to microbial biodiversity is associated with immune modulation in humans. The findings support the biodiversity hypothesis of immune-mediated diseases. We conclude that environmental microbiota may contribute to child health, and that adding microbiological diversity to everyday living environment may support immunoregulation.
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Affiliation(s)
- Marja I Roslund
- Natural Resources Institute Finland (Luke), Helsinki and Turku, Finland; Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, FI-15140 Lahti, Finland
| | - Anirudra Parajuli
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, FI-15140 Lahti, Finland
| | - Nan Hui
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, FI-15140 Lahti, Finland
| | - Riikka Puhakka
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, FI-15140 Lahti, Finland
| | - Mira Grönroos
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, FI-15140 Lahti, Finland
| | - Laura Soininen
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, FI-15140 Lahti, Finland
| | - Noora Nurminen
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, FI-33520 Tampere, Finland
| | - Sami Oikarinen
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, FI-33520 Tampere, Finland
| | - Ondřej Cinek
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University, V Úvalu 84, Praha 5, 150 06 Prague, Czech Republic
| | - Lenka Kramná
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University, V Úvalu 84, Praha 5, 150 06 Prague, Czech Republic
| | - Anna-Mari Schroderus
- Department of Clinical Microbiology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Olli H Laitinen
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, FI-33520 Tampere, Finland
| | - Tuure Kinnunen
- Department of Clinical Microbiology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland; Eastern Finland Laboratory Centre (ISLAB), Kuopio, Finland
| | - Heikki Hyöty
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, FI-33520 Tampere, Finland; Fimlab Laboratories, Pirkanmaa Hospital District, Tampere, Finland
| | - Aki Sinkkonen
- Natural Resources Institute Finland (Luke), Helsinki and Turku, Finland.
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One Health: Flächen im Lebensumfeld von Mensch und Tier und ihre Auswirkungen auf Allergie und Asthma. ALLERGO JOURNAL 2022. [DOI: 10.1007/s15007-022-5015-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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17
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Tischer C, Kirjavainen P, Matterne U, Tempes J, Willeke K, Keil T, Apfelbacher C, Täubel M. Interplay between natural environment, human microbiota and immune system: A scoping review of interventions and future perspectives towards allergy prevention. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 821:153422. [PMID: 35090907 DOI: 10.1016/j.scitotenv.2022.153422] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/04/2022] [Accepted: 01/22/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Urbanization and biodiversity loss are linked to chronic disorders, in particular allergic diseases. The aim of this scoping review was to provide a synopsis of intervention studies specifically examining the influence of exposure to natural environments on human microbiota as well as immunological markers as suggested interlink between natural environment and the development of allergic diseases. METHODS We searched PubMed (MEDLINE®) and all references cited in the included studies following the PRISMA statement guidelines. No restrictions regarding age and sex of study participants, language or publication date were made. The protocol was registered at OSF REGISTRIES (https://osf.io/musgr). RESULTS After screening, eight intervention studies were included. The interventions reported were mainly of pilot character and various, ranging from nature-related educational programs, biodiversity interventions in day-cares to short-term contact with soil- and sand-preparations. Most of the studied interventions appeared to increase human microbiota richness and diversity in specific taxa groups in the short-time. Immunological markers were assessed in only two studies. In these, their associations with human microbiota richness were pre-dominantly reported. CONCLUSION There is some evidence that the so-called biodiversity interventions have the potential to diversify human microbiota, at least over a short period. Adequately powered randomized controlled trials with long term follow-up are required to examine sustainable effects on microbiota and immune system.
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Affiliation(s)
- Christina Tischer
- Institute of Clinical Epidemiology and Biometry, University of Wuerzburg, Josef-Schneider-Str. 2 / D7, 97080 Wuerzburg, Germany; State Institute of Health, Bavarian Health and Food Safety Authority, Prinzregentenstrasse 6, 97688 Bad Kissingen, Germany; Finish Institute for Health and Welfare, Environmental Health Unit, PO Box 95, FIN-70701 Kuopio, Finland.
| | - Pirkka Kirjavainen
- Finish Institute for Health and Welfare, Environmental Health Unit, PO Box 95, FIN-70701 Kuopio, Finland; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 1, FI-70210 Kuopio, Finland.
| | - Uwe Matterne
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University, Leipziger Strasse 44, 39120 Magdeburg, Germany.
| | - Jana Tempes
- University of Education Freiburg, Kunzenweg 21, 79117 Freiburg, i.Br, Germany.
| | - Kristina Willeke
- Institute of Clinical Epidemiology and Biometry, University of Wuerzburg, Josef-Schneider-Str. 2 / D7, 97080 Wuerzburg, Germany; State Institute of Health, Bavarian Health and Food Safety Authority, Prinzregentenstrasse 6, 97688 Bad Kissingen, Germany.
| | - Thomas Keil
- Institute of Clinical Epidemiology and Biometry, University of Wuerzburg, Josef-Schneider-Str. 2 / D7, 97080 Wuerzburg, Germany; State Institute of Health, Bavarian Health and Food Safety Authority, Prinzregentenstrasse 6, 97688 Bad Kissingen, Germany; Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Schumannstraße 20 - 21, 10117 Berlin, Germany.
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University, Leipziger Strasse 44, 39120 Magdeburg, Germany.
| | - Martin Täubel
- Finish Institute for Health and Welfare, Environmental Health Unit, PO Box 95, FIN-70701 Kuopio, Finland.
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Haahtela T. Biodiversity for resilience-What is needed for allergic children. Pediatr Allergy Immunol 2022; 33:e13779. [PMID: 35616890 DOI: 10.1111/pai.13779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/17/2022] [Accepted: 04/19/2022] [Indexed: 12/16/2022]
Abstract
What is needed for our children facing unprecedented challenges of modern time? Biodiversity, both for immunological and psychological well-being and resilience. That is also the keyword for the children with allergies and asthma. The cultural evolution with advanced technology and medicine along with major move to urban environment has profoundly changed our lifestyle and surroundings. We are increasingly disconnected from our evolutionary home, soil, natural waters, and air we used to breathe. The ecosystem of human body and mind has been tested, survived, and evolved closely in relation with other ecosystems. For balance and tolerance, immune regulatory circuits need training by microbes, biogenic chemicals, and close relation to natural environment throughout life. This is addressed by the biodiversity hypothesis of tolerance/resilience for health, supported by the pioneering real-world interventions and a few controlled studies. No need to go "back to nature," but we must take natural elements back to our everyday life to breathe, eat, drink, and touch. The change for better is plausible and cost-effective, as shown by the Finnish and other European initiatives, but needs contribution of the whole society.
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Affiliation(s)
- Tari Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
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Agache I, Sampath V, Aguilera J, Akdis CA, Akdis M, Barry M, Bouagnon A, Chinthrajah S, Collins W, Dulitzki C, Erny B, Gomez J, Goshua A, Jutel M, Kizer KW, Kline O, LaBeaud AD, Pali-Schöll I, Perrett KP, Peters RL, Plaza MP, Prunicki M, Sack T, Salas RN, Sindher SB, Sokolow SH, Thiel C, Veidis E, Wray BD, Traidl-Hoffmann C, Witt C, Nadeau KC. Climate change and global health: A call to more research and more action. Allergy 2022; 77:1389-1407. [PMID: 35073410 DOI: 10.1111/all.15229] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 01/06/2022] [Accepted: 01/11/2022] [Indexed: 12/15/2022]
Abstract
There is increasing understanding, globally, that climate change and increased pollution will have a profound and mostly harmful effect on human health. This review brings together international experts to describe both the direct (such as heat waves) and indirect (such as vector-borne disease incidence) health impacts of climate change. These impacts vary depending on vulnerability (i.e., existing diseases) and the international, economic, political, and environmental context. This unique review also expands on these issues to address a third category of potential longer-term impacts on global health: famine, population dislocation, and environmental justice and education. This scholarly resource explores these issues fully, linking them to global health in urban and rural settings in developed and developing countries. The review finishes with a practical discussion of action that health professionals around the world in our field can yet take.
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Affiliation(s)
- Ioana Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - Vanitha Sampath
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, California, USA
| | - Juan Aguilera
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, California, USA
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University Zurich, Davos, Switzerland
| | - Mubeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University Zurich, Davos, Switzerland
| | - Michele Barry
- Center for Innovation in Global Health, Stanford University, Stanford, California, USA
| | - Aude Bouagnon
- Department of Physiology, University of California San Francisco, San Francisco, California, USA
| | - Sharon Chinthrajah
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, California, USA
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Stanford University, Stanford, California, USA
| | - William Collins
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, California, USA
- Division of Hospital Medicine, Stanford University, Stanford, California, USA
| | - Coby Dulitzki
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, California, USA
| | - Barbara Erny
- Department of Internal Medicine, Division of Med/Pulmonary and Critical Care Medicine, Stanford University, Stanford, California, USA
| | - Jason Gomez
- Stanford School of Medicine, Stanford, California, USA
- Stanford Graduate School of Business, Stanford, California, USA
| | - Anna Goshua
- Stanford School of Medicine, Stanford, California, USA
| | - Marek Jutel
- Department of Clinical Immunology, Wroclaw Medical University, Wroclaw, Poland
- "ALL-MED" Medical Research Institute, Wroclaw, Poland
| | | | - Olivia Kline
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, California, USA
| | - A Desiree LaBeaud
- Department of Pediatrics, Division of Infectious Disease, Stanford University, Stanford, California, USA
| | - Isabella Pali-Schöll
- Comparative Medicine, Interuniversity Messerli Research Institute, University of Veterinary Medicine/Medical University/University Vienna, Vienna, Austria
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Immunology and Infectiology, Medical University of Vienna, Vienna, Austria
| | - Kirsten P Perrett
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Pediatrics, University of Melbourne, Parkville, Victoria, Australia
- Royal Children's Hospital, Parkville, Victoria, Australia
| | - Rachel L Peters
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Pediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Maria Pilar Plaza
- Department of Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
- Institute of Environmental Medicine, Helmholtz Center Munich, German Research Center for Environmental Health, Augsburg, Germany
| | - Mary Prunicki
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, California, USA
| | - Todd Sack
- My Green Doctor Foundation, Jacksonville, Florida, USA
| | - Renee N Salas
- Harvard Global Health Institute, Cambridge, Massachusetts, USA
- Center for Climate, Health, and the Global Environment, Harvard T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Sayantani B Sindher
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, California, USA
| | - Susanne H Sokolow
- Woods Institute for the Environment, Stanford University, Stanford, California, USA
- Marine Science Institute, University of California Santa Barbara, Santa Barbara, California, USA
| | - Cassandra Thiel
- Department of Population Health, NYU Grossman School of Medicine, NY, USA
| | - Erika Veidis
- Center for Innovation in Global Health, Stanford University, Stanford, California, USA
| | - Brittany Delmoro Wray
- Center for Innovation in Global Health, Stanford University, Stanford, California, USA
- Woods Institute for the Environment, Stanford University, Stanford, California, USA
- London School of Hygiene and Tropical Medicine Centre on Climate Change and Planetary Health, London, UK
| | - Claudia Traidl-Hoffmann
- Department of Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
- Institute of Environmental Medicine, Helmholtz Center Munich, German Research Center for Environmental Health, Augsburg, Germany
- Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Christian Witt
- Institute of Physiology, Division of Pneumology, Charité-Universitätsmedizin, Berlin, Germany
| | - Kari C Nadeau
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, California, USA
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Stanford University, Stanford, California, USA
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20
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Soininen L, Roslund MI, Nurminen N, Puhakka R, Laitinen OH, Hyöty H, Sinkkonen A. Indoor green wall affects health-associated commensal skin microbiota and enhances immune regulation: a randomized trial among urban office workers. Sci Rep 2022; 12:6518. [PMID: 35444249 PMCID: PMC9021224 DOI: 10.1038/s41598-022-10432-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 03/29/2022] [Indexed: 02/07/2023] Open
Abstract
Urbanization reduces microbiological abundance and diversity, which has been associated with immune mediated diseases. Urban greening may be used as a prophylactic method to restore microbiological diversity in cities and among urbanites. This study evaluated the impact of air-circulating green walls on bacterial abundance and diversity on human skin, and on immune responses determined by blood cytokine measurements. Human subjects working in offices in two Finnish cities (Lahti and Tampere) participated in a two-week intervention, where green walls were installed in the rooms of the experimental group. Control group worked without green walls. Skin and blood samples were collected before (Day0), during (Day14) and two weeks after (Day28) the intervention. The relative abundance of genus Lactobacillus and the Shannon diversity of phylum Proteobacteria and class Gammaproteobacteria increased in the experimental group. Proteobacterial diversity was connected to the lower proinflammatory cytokine IL-17A level among participants in Lahti. In addition, the change in TGF-β1 levels was opposite between the experimental and control group. As skin Lactobacillus and the diversity of Proteobacteria and Gammaproteobacteria are considered advantageous for skin health, air-circulating green walls may induce beneficial changes in a human microbiome. The immunomodulatory potential of air-circulating green walls deserves further research attention.
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Affiliation(s)
- L Soininen
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, 15140, Lahti, Finland
| | - M I Roslund
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, 15140, Lahti, Finland.,Natural Resources Institute Finland, Horticulture Technologies, Turku and Helsinki, Finland
| | - N Nurminen
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland
| | - R Puhakka
- Ecosystems and Environment Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Niemenkatu 73, 15140, Lahti, Finland
| | - O H Laitinen
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland
| | - H Hyöty
- Faculty of Medicine and Health Technology, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland
| | - A Sinkkonen
- Natural Resources Institute Finland, Horticulture Technologies, Turku and Helsinki, Finland.
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21
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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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22
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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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23
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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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24
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Agache I, Eguiluz‐Gracia I, Cojanu C, Laculiceanu A, Giacco S, Zemelka‐Wiacek M, Kosowska A, Akdis CA, Jutel M. Advances and highlights in asthma in 2021. Allergy 2021; 76:3390-3407. [PMID: 34392546 DOI: 10.1111/all.15054] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/09/2021] [Indexed: 12/12/2022]
Abstract
Last year brought a significant advance in asthma management, unyielding to the pressure of the pandemics. Novel key findings in asthma pathogenesis focus on the resident cell compartment, epigenetics and the innate immune system. The precision immunology unbiased approach was supplemented with novel tools and greatly facilitated by the use of artificial intelligence. Several randomised clinical trials and good quality real-world evidence shed new light on asthma treatment and supported the revision of several asthma guidelines (GINA, Expert Panel Report 3, ERS/ATS guidelines on severe asthma) and the conception of new ones (EAACI Guidelines for the use of biologicals in severe asthma). Integrating asthma management within the broader context of Planetary Health has been put forward. In this review, recently published articles and clinical trials are summarised and discussed with the goal to provide clinicians and researchers with a concise update on asthma research from a translational perspective.
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Affiliation(s)
- Ioana Agache
- Faculty of Medicine Transylvania University Brasov Romania
| | - Ibon Eguiluz‐Gracia
- Allergy Unit IBIMA‐Regional University Hospital of MalagaUMA, RETICS ARADyALBIONAND Malaga Spain
| | | | | | - Stefano Giacco
- Department of Medical Sciences and Public Health University of Cagliari Cagliari Italy
| | | | - Anna Kosowska
- Department of Clinical Immunology Wroclaw Medical University Wroclaw Poland
- All‐MED Medical Research Institute Wroclaw Poland
| | - Cezmi A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Marek Jutel
- Department of Clinical Immunology Wroclaw Medical University Wroclaw Poland
- All‐MED Medical Research Institute Wroclaw Poland
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25
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Exploring the Bioactive Sites of New Sulfonamide Metal Chelates for Multi-Drug Resistance: An Experimental Versus Theoretical Design. J Inorg Organomet Polym Mater 2021. [DOI: 10.1007/s10904-021-02135-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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26
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Andersson (AMA, Salo J, Mikkola R, Marik T, Kredics L, Kurnitski J, Salonen H. Melinacidin-Producing Acrostalagmus luteoalbus, a Major Constituent of Mixed Mycobiota Contaminating Insulation Material in an Outdoor Wall. Pathogens 2021; 10:pathogens10070843. [PMID: 34357993 PMCID: PMC8308789 DOI: 10.3390/pathogens10070843] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 11/16/2022] Open
Abstract
Occupants may complain about indoor air quality in closed spaces where the officially approved standard methods for indoor air quality risk assessment fail to reveal the cause of the problem. This study describes a rare genus not previously detected in Finnish buildings, Acrostalagmus, and its species A. luteoalbus as the major constituents of the mixed microbiota in the wet cork liner from an outdoor wall. Representatives of the genus were also present in the settled dust in offices where occupants suffered from symptoms related to the indoor air. One strain, POB8, was identified as A. luteoalbus by ITS sequencing. The strain produced the immunosuppressive and cytotoxic melinacidins II, III, and IV, as evidenced by mass spectrometry analysis. In addition, the classical toxigenic species indicating water damage, mycoparasitic Trichoderma, Aspergillus section Versicolores, Aspergillus section Circumdati, Aspergillus section Nigri, and Chaetomium spp., were detected in the wet outdoor wall and settled dust from the problematic rooms. The offices exhibited no visible signs of microbial growth, and the airborne load of microbial conidia was too low to explain the reported symptoms. In conclusion, we suggest the possible migration of microbial bioactive metabolites from the wet outdoor wall into indoor spaces as a plausible explanation for the reported complaints.
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Affiliation(s)
- (Aino) Maria A. Andersson
- Department of Civil Engineering, Aalto University, P.O. Box 12100, FI-00076 Aalto, Finland; (J.S.); (R.M.); (J.K.); (H.S.)
- Correspondence: ; Tel.: +358-405508934
| | - Johanna Salo
- Department of Civil Engineering, Aalto University, P.O. Box 12100, FI-00076 Aalto, Finland; (J.S.); (R.M.); (J.K.); (H.S.)
| | - Raimo Mikkola
- Department of Civil Engineering, Aalto University, P.O. Box 12100, FI-00076 Aalto, Finland; (J.S.); (R.M.); (J.K.); (H.S.)
| | - Tamás Marik
- Department of Microbiology, Faculty of Science and Informatics, University of Szeged, Közép fasor 52, H-6726 Szeged, Hungary; (T.M.); (L.K.)
| | - László Kredics
- Department of Microbiology, Faculty of Science and Informatics, University of Szeged, Közép fasor 52, H-6726 Szeged, Hungary; (T.M.); (L.K.)
| | - Jarek Kurnitski
- Department of Civil Engineering, Aalto University, P.O. Box 12100, FI-00076 Aalto, Finland; (J.S.); (R.M.); (J.K.); (H.S.)
- Department of Civil Engineering and Architecture, Tallinn University of Technology, Ehitajate tee 5, 19086 Tallinn, Estonia
| | - Heidi Salonen
- Department of Civil Engineering, Aalto University, P.O. Box 12100, FI-00076 Aalto, Finland; (J.S.); (R.M.); (J.K.); (H.S.)
- International Laboratory for Air Quality and Health, Queensland University of Technology, 2 George Street, Brisbane, QLD 4001, Australia
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