Transcript of "Allergy and Clinical Immunology in the Czech Republic"
Allergy and Clinical Immunology in the Czech Republic Anna Šedivá, Institute of Immunology, Second Medical Faculty University Hospital Motol, Prague, Czech Republic „ Combating Allergy and Astma in Europe: Issues and Perspectives“, on 17th November in Brussels.
Allergy and Clinical Immunology <ul><li>The field of allergy and clinical immunology is one of the fastest growing areas among medical sciences in the Czech Republic. </li></ul><ul><li>Both allergy and immunology are building up on the long time tradition in our countries. </li></ul>Lodinová-Zádníková R, Cukrowska B, Tlaskalova-Hogenova H.: Oral administration of probiotic Escherichia coli after birth reduces frequency of allergies and repeated infections later in life (after 10 and 20 years). Int Arch Allergy Immunol. 2003 Jul;131(3):209-11
Allergic diseases in the Czech Republic Population 10 millions Current prevalence of allergy in general is almost 32% according to the latest available statistical data, with asthma 8% and atopic dermatitis 12%, with even higher number in the youngest age groups. Major problems and potential contribution to European research growing number of patients increasing problems in young age – genetic and pathogenetic studies environmental factors improved diagnostics and therapies % 1996 2001 2006 Alergy 16.9 24.7 31.8 Alergic Rhinitis 5.7 13.7 15.1 Asthma 3.8 6.7 8.2
Increasing number of patients <ul><li>Contribution to international cohorts: </li></ul><ul><li>CIPA – Czech Initiative for Asthma </li></ul><ul><li>CARO – Czech Alliance for Chronic Respiratory Diseases </li></ul><ul><li>PRACTALL and ERS Task Force on childhood wheezing </li></ul><ul><li>Allergy. 2008 Jan;63(1):5-34. </li></ul><ul><ul><li>Diagnosis and treatment of asthma in childhood: a PRACTALL consensus report. </li></ul></ul><ul><ul><li>Bacharier LB , Boner A , Carlsen KH , Eigenmann PA , Frischer T , Götz M , Helms PJ , Hunt J , Liu A , Papadopoulos N , Platts - Mills T , Pohunek P , Simons FE , Valovirta E , Wahn U , Wildhaber J ; European Pediatric Asthma Group </li></ul></ul><ul><ul><li>Eur Respir J. 2008 Oct;32(4):1096-110. </li></ul></ul><ul><ul><li>Definition, assessment and treatment of wheezing disorders in preschool children: an evidence-based approach. </li></ul></ul><ul><ul><li>Brand PL , Baraldi E , Bisgaard H , Boner AL , Castro - Rodriguez JA , Custovic A , de Blic J , de Jongste JC , Eber E , Everard ML , Frey U , Gappa M , Garcia - Marcos L , Grigg J , Lenney W , Le Souëf P , McKenzie S , Merkus PJ , Midulla F , Paton JY , Piacentini G , Pohunek P , Rossi GA , Seddon P , Silverman M , Sly PD , Stick S , Valiulis A , van Aalderen WM , Wildhaber JH , Wennergren G , Wilson N , Zivkovic Z , Bush A . </li></ul></ul>
Genetic and pathogenetic studies Hum Immunol. 2008 Apr-May;69(4-5):306-13. Haplotype analysis of the endothelial nitric oxide synthase gene in asthma. J Hum Genet. 2007;52(2):152-8. Interleukin-18 and its three gene polymorphisms relating to allergic rhinitis. J Hum Genet. 2006;51(11):977-83. Polymorphisms of the CD14 gene and atopic phenotypes in Czech patients with IgE-mediated allergy. Holla LI et al.: Department of Pathophysiology, Medical Faculty, Masaryk University Brno, Brno, Czech Republic Severe form of atopic dermatitis in childhood: clinical outcome and cytokine gene polymorphisms - a prospective study . Pediatric Allergy adn Immunology, submitted. Kayserová J . , Šedivá A. et al.: Institute of Immunology, University Hospital Motol, Prague, Czech Republic
Expulsion the Celts by the expansion of German tribes and of the Roman Empire Bohemia Macek Jr et al. Am J Hum Genet 49: A2703, 1991
Environmental factors <ul><li>Air polution: </li></ul><ul><li>Mutat Res. 2001 Sep 20;496(1-2):207-28 </li></ul><ul><li>Biomarkers of genotoxicity of urban air pollution. Overview and descriptive data from a molecular epidemiology study on populations exposed to moderate-to-low levels of polycyclic aromatic hydrocarbons: the AULIS project. </li></ul><ul><li>Kyrtopoulos SA , Georgiadis P , Autrup H , Demopoulos NA , Farmer P , Haugen A , Katsouyanni K , Lambert B , Ovrebo S , Sram R , Stephanou G , Topinka J . </li></ul><ul><li>Institute of Experimental Medicine, Prague, Czech Republic. </li></ul><ul><li>New study in 2008: 200 children from urban and rural areas </li></ul><ul><li>Food allergy: </li></ul><ul><li>Proteomics. 2008 Apr;8(8):1677-91. Proteomic analysis of wheat proteins recognized by IgE antibodies of allergic patients. </li></ul><ul><li>Int Arch Allergy Immunol. 2002 Jun;128(2):77-89. Mucosal immunity: its role in defense and allergy. </li></ul><ul><li>Department of Immunology and Gnotobiology, Institute of Microbiology v.v.i, Czech Academy of Sciences, Prague, Czech Republic </li></ul>
Improved diagnostics and therapies <ul><li>Application of global protocols </li></ul><ul><li>Focus on compound resolve diagnostic and therapy with recombinant allergens, followed with functional basophil activation tests (BAT) and specific IgG investigation as a marker of successful immunomodulation therapy. University Centre for Allergology and Clinical Immunology , Medical faculty of Masaryk University , St. Anne University Hospital, Brno, Czech Republic </li></ul><ul><li>Sedivá A, Kayserová J, Vernerová E, Poloucková A, Capková S, Spísek R, Bartůnková J. </li></ul><ul><li>Anti-CD20 (rituximab) treatment for atopic eczema. </li></ul><ul><li>J Allergy Clin Immunol. 2008 Jun;121(6):1515-6 </li></ul>
DC in allergy The role of dendritic cells in allergic response Dendritic cells in allergic patients, morphology and function of moDCs in response to ligands and allergens Potential role of lectins as receptors for allergens Allergic patients have an increased expression of DC-SIGN on iDC, with subsequent significant decrease induced by OVA or birch allergen, associated, however, with increaded IL-6 production in patients compared to controls OVA binds C lectin receptor on DCs iDC + OVA: OVA (red),DC-SIGN (green)
Combatting Allergy and Asthma <ul><li>Global Initiative </li></ul>
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