Combating Allergy and Asthma in Europe: Issues and Perspectives'

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Combating Allergy and Asthma in Europe Issues
and Perspectives.

• Erika von Mutius MD MSc
• Professor of Pediatrics
• University Childrens Hospital
• Munich, Germany

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Atopic sensitisation in Sobotka and surrounding
villages.
Sozanska et al, Allergy 2007
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Lifetime residence and atopy.
Sozanska et al, Allergy 2007
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Prevalence of atopy in Karelian children.

von Hertzen et al, JACI 2006
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Microbial exposures in Finnish and Russian
Karelian homes.
Pakarinen et al, Environ Microbiology 2008
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Allergy protection from exposures to stables,
farm milk and barns (ALEX Study).
OR
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Study the Microbiome in Environmental Samples by
Pyrosequencing.

• The New Age of Molecular Diagnostics for
  Microbial Agents (R. Whitley in NEJM March
  2008).
• The most comprehensive method to detect bacteria,
  viruses, fungi of all known and unknown species.
• Will identify the most solid, so far unexplored,
  candidates.

Margulies et al, Nature 2005 Whitley NEJM 2008,
Palacios et al, NEJM 2008.
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GABRIEL Advanced Surveys
Children 6-12 years Alpine regions and Poland
Population
Parental questionnaire
Phenotypes
Lung function
Blood sampling Allergy test, DNA/RNA
Genetics
Nasal and throat swabs
Exposure
Indoor and outdoor dust
Milk samples
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GABRIEL Advanced Survey Design

• Stage I Recruitment in alpine areas
• Recruitment questionnaire to large populations
  (N135,359). Participation rate 80.7.
• Randomisation Random sample of full consent
  group
• Stage II Main study
• Comprehensive questionnaire, blood samples (IgE,
  genetics), dust samples, nasal swabs (n9,668)
• Randomisation Random sample in area with
  strongest effects (Germany)
• Stage III In depth environmental exposure
• Collection of multiple dust samples, milk
  samples, throat swabs and measurement of lung
  function (n895)

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GABRIEL exposure assessment.

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

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Vision for FP7

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