“Global Allergy Forum” – International think tank on the subject of allergies

Instigated by CK-CARE (Christine Kühne – Centre for Allergy Research and Education), the Global Allergy Forum has now been held in Davos for the third time. From 28 June until 1 July, some 70 world-renowned scientists in the field of allergology and its allied disciplines convened to discuss challenges and possible solutions in the field of atopic dermatitis/eczema.

Atopic dermatitis is the most widespread chronic inflammatory skin disease. Among allergic disorders, atopic dermatitis is considered to be a model disease. However, in children that are affected, a significant proportion (approx. 40%) experience healing before the onset of adolescence. It is believed that this natural healing is at least partly attributable to as yet undiscovered mechanisms that lead to an immune tolerance of environmental factors like allergens. To date, such mechanisms have not yet been investigated systematically. Research in this area will exert a direct impact on the quality of life of patients.

Divided into six working groups, the participants at the GAF 2015 analysed current problem areas such as environmental factors, particularly their impact on the bacterial flora (microbiota) of the skin, the development and course of atopic diseases, plus prevention strategies.

In the “Psycho-Neuro-Immunological Aspects/Itching” working group, the importance and problems of itching as a primary symptom of atopic dermatitis was a clear-cut subject for elaboration. Compared with pain research, there are major shortcomings in the research undertaken into itching. Itching as a dimension of suffering is not taken seriously by many non-sufferers, nor by society. Progress however can be expected by imaging methods that can visualise the processing of itching by the brain; the same methods have also revealed surprising results about the involvement of hitherto unsuspected regions of the brain in this sensation.
In their investigation of environmental factors, the “Environment/Microbiota” working group looked into outdoor air pollutants but also focused on cutaneous microbiota. Here, a great deal of research work is still undertaken into individual differences, into the actual role of skin surface microbes (“beneficial or harmful”) as well as into the potential therapeutic implications of external applications of probiotic bacteria to support anti-inflammatory therapies. Even the relationship between dietary intake, the gastro-intestinal tract and skin microbiota constitutes a new research area.

The “Skin Barrier” working group built on the rapid progress made in recent years; in particular the discovery that, as a result of specific mutations, dryness of the skin and barrier dysfunctionalities can be attributable to genetic factors; (i.e. a mutation in the gene for the epidermal protein filaggrin will lead to a high predisposition to the development of atopic eczema). The group called for further research into an improved and standardised measurement of barrier functions in daily clinical routines as well as intervention studies into correcting malfunctioning barriers (keyword: skin care).

The “Epidemiology and Standardisation” working group turned its attention to epidemiological research methods, where improvements to measuring instruments would lead to a better diagnosis of the disease but also to measurements of the severity of the eczema. The starting point for such investigations should be a database for neurodermatitis at a population level. Such a database does not yet exist. The clear definition of subgroups in the disease as well as an understanding of the roles of prenatal influences and the effects of various intervention programmes appears to be equally important. A need for healthcare research in the field of neurodermatitis appears to be pressing. There is also a lack of basic epidemiological knowledge in the medical profession.

In the “Immune Deviation” working group the importance of immunological but also pharmacological research to correct and remedy aberrant immune responses was underscored. The scope of this critical research also extends to the examination of comorbidities, i.e. the simultaneous emergence of other diseases. New therapeutic approaches also include biologics, i.e. an antibody against the interleukin 4 receptor, as well as inhibitors of kinases and phosphodiesterases. The induction of immunological tolerances to common allergens remains a long-term objective. Encouraging results in allergen-specific immunotherapy (desensitisation) and in neurodermatitis have already been achieved.

A further group addressed the enormous chasm between the scientific progress that has been made in dermatology and allergology and the translation of this knowledge in the everyday work of doctors and the lives of patients. There is a lack of information for key target groups such as physicians, healthcare professionals, patient organisations and, not least, political decision-makers. That’s why it is imperative to improve educational activities at all levels and for a multitude of target groups. The aim of the discussions in this working group was to arrive at concepts and actions that would close this information gap.

The results and findings of the 3rd Global Allergy Forum are summarised in the third “Davos Declaration”. It reflects the current state of research, education, healthcare and knowledge transfer, as well as put forward concrete proposals for improving the situation in allergology.

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.