Dietary strategies for allergy prevention in children

There is still no treatment that can fully cure children with asthma and allergic diseases. Treatments are concentrated on tackling the symptoms. The symptoms can thus be relieved but the treatments usually have to be taken by patients for very long periods of time or even their whole lives. The best long-term therapy is still the avoidance of the causative allergen, e.g. certain foods.

As yet no effective strategies for preventing allergies have been found by researchers. There is hence a need to develop new approaches.

The prevention of allergies by means of diet in early childhood is one such approach that deserves consideration. Until recently prevention simply involved advising people to avoid certain foods, especially in infancy and early childhood. However, the latest recommendations no longer point in this direction. This is because it has not been proved that leaving out certain foods or introducing them at a later stage can actually prevent allergies. On the contrary, new proposals concentrate on the fact that early contact with allergens can induce immune tolerance. For instance, a time window might be opened in early childhood for preventing the development of allergies.

In our study on farmers’ children (PASTURE/EFRAIM) we have already shown that varied baby food in the first year of life reduces the risk of atopic dermatitis. We also demonstrated the same effect for asthma, food allergy and allergic sensitisation. Independently of these findings, we were also able to show the protective effect of supplementary baby food, mainly dairy products (e.g. yoghurt), introduced in the first year of life (as described in the Newsletter of October 2012).

Our findings from the farmers’ children study support the hypothesis that early contact with different allergens in the child’s intestinal tract is necessary for immune tolerance to develop. The nature of the diet, the gut flora and the immune response are closely interconnected. One possible explanation for the protective effect might be the early colonisation of the gut with microbes and their metabolic products. It has already been shown that what are known as short-chain fatty acids, metabolic products of certain intestinal bacteria, have an anti-inflammatory effect. These short chain fatty acids are generated by the fermentation of carbohydrates in the intestinal tract but they are also contained in food. One of these fatty acids, butyrate, is found in the triglycerides of cow’s milk. Therefore the natural butyrate content is high in dairy products.

We observed the preventive effect of short-chain fatty acids for the first time in the mouse model of allergic respiratory inflammation (similar to asthma).We gave the short-chain fatty acids orally to the mice throughout the duration of the experiment. In a healthy lung there are normally only a few macrophages passing through the lung. As soon as an allergy is triggered, the cell count in the lung rises sharply, which is mainly due to the migration of eosinophilic cells. We flushed out the lungs of mice in our allergy model and counted the cells they contained. We were able to demonstrate that the administration of short-chain fatty acids can markedly reduce the number of cells contained in the bronchoalveolar lavage (BAL, washing out the lung).

Messengers typical of an allergy also decrease markedly due to the administration of short-chain fatty acids, which further confirms the protective effect of these fatty acids in allergy.

These promising results in the mouse model have prompted us to tackle further projects along these lines. There are plans to administer short-chain fatty acids in combination with a butyrate boosting substrate as well as butyrate-producing probiotics.

In the study on farmers’ children we plan to investigate the level of short-chain fatty acids in stool samples from the first year of life. The link between fatty acid content and diet is to be investigated.

The results outlined above point to possible avenues for developing effective dietary strategies for the prevention of allergic diseases.

Claudio Rhyner, PhD appointed as the new Managing Director

On 1 October 2020, Claudio Rhyner succeeded Dr. Georg Schäppi as Managing Director of CK-CARE. Georg Schäppi was appointed CEO at the University Children’s Hospital Zurich as of 1 December, 2020.

Claudio Rhyner was born and grew up in Davos. After studying chemistry and molecular biology, he graduated specialising in asthma and allergy research. He was active in fundamental scientific research, including as head of the research “Vaccine Development” group at the SIAF (Swiss Institute of Allergy and Asthma Research). In this capacity he published numerous publications and filed several patents. After holding a leading position in a SME in molecular diagnostics, he became CEO of Biosciences Davos. Biosciences Davos is a spin-off organisation of CK-CARE in the field of biobanking and is part of the Medizincampus Davos. He continues to hold this position.

In his private life, Claudio Rhyner is actively engaged in politics and culture in the Davos community. He also completed a postgraduate degree in the field of management of small and medium-sized companies at the University St. Gallen.

Atopic dermatitis: an expanding therapeutic pipeline for a complex disease

Our founder, Prof. Thomas Bieber, published an important contribution in the treatment of AD:

Atopic dermatitis (AD) is a common chronic inflammatory skin disease with a complex pathophysiology that underlies a wide spectrum of clinical phenotypes. AD remains challenging to treat owing to the limited response to available therapies. However, recent advances in understanding of disease mechanisms have led to the discovery of novel potential therapeutic targets and drug candidates

In addition to regulatory approval for the IL-4Ra inhibitor dupilumab, the anti-IL-13 inhibitor tralokinumab and the JAK1/2 inhibitor baricitinib in Europe, there are now more than 70 new compounds in development. This Review assesses the various strategies and novel agents currently being investigated for AD and highlights the potential for a precision medicine approach to enable prevention and more effective long-term control of this complex disease.

read more…

Kühne-Foundation Annual Report 2020

“Key priority of the Kühne Foundation is the support for training, further education as well as research and science in the area of logistics. This also includes Humanitarian Logistics and a project concentrating on free global trade.
Another focal point is our medicine funding through research, therapy, and education in the fields of allergology and cardiology. In Davos, Switzerland, we operate the Hochgebirgsklinik, a renowed rehabilitation hospital owned by us, and various research institutions. In the cultural sector, we support leading opera houses and concert halls and belong to the main sponsors of the Salzburg Festival and Lucerne Festival.”

Prof. Dr. h.c. Klaus-Michael Kühne

Covid-19 risk increases with airborne pollen

When airborne pollen levels are higher, increased SARS-CoV-2 infection rates can be observed. These results were determined by a large-scale study conducted by an international team headed by researchers at the Technical University of Munich (TUM) and the Helmholtz Zentrum München. Members of high-risk groups could protect themselves by watching pollen forecasts and wearing dust filter masks.

In the spring of 2020, the outbreak of the coronavirus pandemic appeared to coincide with the tree pollen season in the northern hemisphere. These observations prompted an international team of researchers to conduct an extensive investigation: The scientists wanted to know whether there is a demonstrable link between airborne pollen concentrations and SARS-CoV-2 infection rates.

Pollen is a significant environmental factor influencing infection rates
Based on CK-CARE research and under the leadership of first author Athanasios Damialis, the team at the Chair of Environmental Medicine at TUM collected data on airborne pollen concentrations, weather conditions and SARS-CoV-2 infections – taking into consideration the variation of infection rates from one day to another and the total number of positive tests. In their calculations, the team also included data on population density and the effects of lockdown measures. The 154 researchers analyzed pollen data from 130 stations in 31 countries on five continents.

„Wearing a particle filtering mask when pollen concentrations are high can keep both the virus and pollen out of the airways.”— Prof. Claudia Traidl-Hoffmann

The team showed that airborne pollen can account for, on average, 44 percent of the variation in infection rates, with humidity and air temperature also playing a role in some cases. During intervals without lockdown regulations, infection rates were on average 4 percent higher with every increase of 100 grains of airborne pollen per cubic meter. In some German cities, concentrations of up to 500 pollen grains per cubic meter per day were recorded during the study – which led to an overall increase in infection rates of more than 20 percent. In regions where lockdown rules were in effect, however, the infection numbers were on average only half as high at comparable pollen concentrations.

Continuing Medical Education Activities for Improved Management of Allergy

Effectiveness and sustainability of continuing medical education activities are, in general, a huge challenge. Given the frequency of allergic diseases, the increasing prevalence, the burden of the disease, the degree of suffering and the age of onset, there is a need for paediatricians to have in-depth knowledge and skills in allergology. We developed a needs-based course for Swiss paediatricians in primary care, where the relevant competencies are acquired in modular, multi-method learning activities.

The teaching is focused on filling gaps and aims at a behavioural change. To facilitate this change and the transfer of acquired competence into daily practice, a commitment-to-change (CTC) strategy was introduced. Paediatricians found four key elements decisive to change their clinical practice: problem-oriented, reflective, situated learning and convenience in learning/applying. Allergy education should help physicians to improve their knowledge, skills and attitudes in order to better perform and provide improved care to their allergy patients.

For more details please refer to the “Letter to the Editor” published by D. Straub Piccirillo, P. Schmid-Grendelmeier, M. Hitzler, R. Lauener in Allergy. 2018 Jun;73(6):1351-1353. doi: 10.1111/all.13443. Epub 2018 Apr 17.