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  • 1
    In: Clinical & Experimental Allergy, Wiley, Vol. 47, No. 5 ( 2017-05), p. 665-674
    Abstract: Atopic allergy has been more common among schoolchildren in Finland, as compared to Russian Karelia. These adjacent regions show one of the most contrasting socio‐economical differences in the world. Objective We explored changes in allergy from school age to young adulthood from 2003 to 2010/2012 in these two areas. The skin and nasal microbiota were also compared. Methods Randomly selected children from Finnish ( n = 98) and Russian Karelia ( n = 82) were examined in 2003, when the children were 7–11 years of age, and again in 2010 (Finnish Karelia) and 2012 (Russian Karelia). We analysed self‐reported allergy symptoms and sensitization to common allergens by serum sIgE values. The skin (volar forearm) and nasal mucosa microbiota, collected in 2012 (aged 15–20 years), identified from DNA samples, were compared with multivariate methods. Results Asthma, hay fever, atopic eczema, self‐reported rhinitis, as well as atopic sensitization, were threefold to 10‐fold more common in Finland, as compared to Russian Karelia. Hay fever and peanut sensitization were almost non‐existent in Russia. These patterns remained throughout the 10‐year follow‐up. Skin microbiota, as well as bacterial and fungal communities in nasal mucosa, was contrastingly different between the populations, best characterized by the diversity and abundance of genus Acinetobacter ; more abundant and diverse in Russia. Overall, diversity was significantly higher among Russian subjects ( P skin 〈 0.0001, P nasal‐bacteria 〈 0.0001 and P nasal‐fungi 〈 0.01). Allergic diseases were not associated with microbial diversity in Finnish subjects. Conclusions and Clinical Relevance Differences in allergic phenotype, developed in early life, remain between populations. A parallel difference in the composition of skin and nasal microbiota suggests a potential underlying mechanism. Our results also suggest that high abundance and diversity of Acinetobacter might contribute to the low allergy prevalence in Russia. Implications of early‐life exposure to Acinetobacter should be further investigated.
    Type of Medium: Online Resource
    ISSN: 0954-7894 , 1365-2222
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2017
    detail.hit.zdb_id: 2186232-1
    detail.hit.zdb_id: 2004469-0
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  • 2
    Online Resource
    Online Resource
    European Respiratory Society (ERS) ; 2010
    In:  European Respiratory Journal Vol. 35, No. 6 ( 2010-06-01), p. 1416-1418
    In: European Respiratory Journal, European Respiratory Society (ERS), Vol. 35, No. 6 ( 2010-06-01), p. 1416-1418
    Type of Medium: Online Resource
    ISSN: 0903-1936 , 1399-3003
    Language: English
    Publisher: European Respiratory Society (ERS)
    Publication Date: 2010
    detail.hit.zdb_id: 2834928-3
    detail.hit.zdb_id: 1499101-9
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  • 3
    In: Allergy, Wiley, Vol. 66, No. 8 ( 2011-08), p. 1122-1123
    Type of Medium: Online Resource
    ISSN: 0105-4538
    URL: Issue
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    Language: English
    Publisher: Wiley
    Publication Date: 2011
    detail.hit.zdb_id: 2003114-2
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  • 4
    In: Clinical & Experimental Allergy, Wiley, Vol. 45, No. 5 ( 2015-05), p. 891-901
    Abstract: The Finnish and Russian Karelia are adjacent areas in northern Europe, socio‐economically distinct but geoclimatically similar. The Karelia Allergy Study was commenced in 1998 to characterize the allergy profiles in the two areas. Allergy prevalence had increased in Finland since the early 1960s, but the situation in Russia was unknown. The key finding was that allergic symptoms and diseases were systematically more common in Finnish children and adults than in their Russian counterparts. For example, in the early 2000s, hay fever in school children was almost non‐existent in Russian Karelia, and only 2% were sensitized to birch pollen compared with 27% in Finnish Karelia. Adult birth cohorts showed that among those born in the 1940s, the sensitization to pollens and pets was at the same low level in both countries, but among younger generation born in the late 1970s, the difference was already manifold. Seropositivity to some pathogens, microbial content in house dust and drinking water seemed to confer allergy protection in Russia. In subsequent studies, it became apparent that on the Finnish side, healthy children had a more biodiverse living environment as well as greater diversity of certain bacterial classes on their skin than atopic children. Abundance of skin commensals, especially Acinetobacter (gammaproteobacteria), associated with anti‐inflammatory gene expression in blood leucocytes. In vivo experiments with the mouse model demonstrated that intradermally applied A cinetobacter protected against atopic sensitization and lung inflammation. These observations support the notion that the epidemic of allergy and asthma results from reduced exposure to natural environments with rich microbiota, changed diet and sedentary lifestyle. Genetic studies have confirmed strong influence of lifestyle and environment. With our results from the Karelia study, a 10‐year National Allergy Programme was started in 2008 to combat the epidemic in Finland.
    Type of Medium: Online Resource
    ISSN: 0954-7894 , 1365-2222
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2015
    detail.hit.zdb_id: 2186232-1
    detail.hit.zdb_id: 2004469-0
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  • 5
    In: Allergy, Wiley, Vol. 64, No. 9 ( 2009-09), p. 1333-1341
    Abstract: Background:  Finnish Karelians have a higher prevalence of allergic disease than Russian Karelians. As both populations are generally from the same ethnic group, the Karelian population offers a unique opportunity to analyse genetic and allergic disease interactions between ‘Western’ and ‘Eastern’ environments. Objectives:  We investigated associations between allergic diseases and CD14 and CC16 polymorphisms in Finnish vs Russian Karelian women. Methods:  Adult female Karelians (330 Finnish and 274 Russian) were recruited, examined for a range of symptoms and conditions including rhinitis, itchy rash, asthma and atopy and genotyped for CD14 C‐159T and CC16 A38G. Results:  For both CD14 C‐159T and CC16 A38G, the risk allele for atopic phenotypes in Finnish Karelia was the protective allele in Russian Karelia. For CD14 C‐159T, an interactive effect on ever itchy rash ( P interaction  = 0.004), itchy rash 〈 12 mo ( P interaction  = 0.001) and dry cough at night in the past 12 months ( 〈 12 months) ( P interaction  = 0.011) was found; the risk allele was C in Russians and T in Finns. For CC16 A38G, an interaction was significant for ever rhinitis ( P interaction  = 0.006), rhinitis 〈 12 mo ( P interaction  = 0.004), and marginally significant for ever hayfever ( P interaction  = 0.07), allergic eye symptoms 〈 12 mo ( P interaction  = 0.09); their risk allele was G in Russians and A in Finns. Conclusion:  An Eastern vs Western environment appears to exert an effect via opposite alleles on risk of allergic diseases in adult women.
    Type of Medium: Online Resource
    ISSN: 0105-4538 , 1398-9995
    URL: Issue
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    Language: English
    Publisher: Wiley
    Publication Date: 2009
    detail.hit.zdb_id: 2003114-2
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  • 6
    In: Allergy, Wiley, Vol. 64, No. 5 ( 2009-05), p. 678-701
    Abstract:  In similarity to many other western countries, the burden of allergic diseases in Finland is high. Studies worldwide have shown that an environment rich in microbes in early life reduces the subsequent risk of developing allergic diseases. Along with urbanization, such exposure has dramatically reduced, both in terms of diversity and quantity. Continuous stimulation of the immune system by environmental saprophytes via the skin, respiratory tract and gut appears to be necessary for activation of the regulatory network including regulatory T‐cells and dendritic cells.  Substantial evidence now shows that the balance between allergy and tolerance is dependent on regulatory T‐cells. Tolerance induced by allergen‐specific regulatory T‐cells appears to be the normal immunological response to allergens in non atopic healthy individuals. Healthy subjects have an intact functional allergen‐specific regulatory T‐cell response, which in allergic subjects is impaired. Evidence on this exists with respect to atopic dermatitis, contact dermatitis, allergic rhinitis and asthma. Restoration of impaired allergen‐specific regulatory T‐cell response and tolerance induction has furthermore been demonstrated during allergen‐specific subcutaneous and sublingual immunotherapy and is crucial for good therapeutic outcome. However, tolerance can also be strengthened unspecifically by simple means, e.g. by consuming farm milk and spending time in nature.  Results so far obtained from animal models indicate that it is possible to restore tolerance by administering the allergen in certain circumstances both locally and systemically. It has become increasingly clear that continuous exposure to microbial antigens as well as allergens in foodstuffs and the environment is decisive, and excessive antigen avoidance can be harmful and weaken or even prevent the development of regulatory mechanisms.  Success in the Finnish Asthma Programme was an encouraging example of how it is possible to reduce both the costs and morbidity of asthma. The time, in the wake of the Asthma Programme, is now opportune for a national allergy programme, particularly as in the past few years, fundamentally more essential data on tolerance and its mechanisms have been published. In this review, the scientific rationale for the Finnish Allergy Programme 2008–2018 is outlined. The focus is on tolerance and how to endorse tolerance at the population level.
    Type of Medium: Online Resource
    ISSN: 0105-4538 , 1398-9995
    URL: Issue
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    Language: English
    Publisher: Wiley
    Publication Date: 2009
    detail.hit.zdb_id: 2003114-2
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  • 7
    In: Allergy, Wiley, Vol. 66, No. 7 ( 2011-07), p. 886-892
    Type of Medium: Online Resource
    ISSN: 0105-4538
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2011
    detail.hit.zdb_id: 2003114-2
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  • 8
    In: Allergy, Wiley, Vol. 62, No. 3 ( 2007-03), p. 288-292
    Abstract: Background and aim:  The influence of microbial quality of drinking water from different sources on the occurrence of atopy has been poorly examined. This study was undertaken to clarify the association between the overall microbial content in drinking water and the occurrence of atopy among schoolchildren from two neighbouring areas with profound differences in living conditions and lifestyles. Methods:  Drinking water samples were obtained from kitchens of nine schools in North Karelia, Finland and of nine schools from Pitkäranta, the Republic of Karelia, Russia. The pupils of these schools were participants of the Karelian Allergy Study. Occurrence of atopy, determined by skin prick test positivity (one or more) to 14 common airborne and food allergens, was measured in all 563 children, aged 7–16 years, from these 18 schools. Water samples were analysed using standard methods for drinking water analyses including viable counts for Escherichia coli , intestinal enterococci, coliform bacteria and heterotrophic bacteria. In addition, total cell counts including both viable and nonviable bacteria, algae and protozoans were assessed using epifluorescence microscope with 4′‐6‐diamidino‐2‐phenylindole (DAPI) staining. Results:  In Finland, 29% of the children were sensitized to birch when compared with 2% of the Russian children ( P   〈  0.0001). Overall, sensitization rates for any of the pollens were 39% and 8% ( P   〈  0.0001), and for any of the allergens 48% and 16%, respectively ( P   〈  0.0001). Because of substantial differences in raw water sources and treatment practices, the total numbers of microbial cells in drinking water were many‐fold higher in Russia than in Finland. A dose–response relationship was found for occurrence of atopy and the DAPI value indicative of microbial cell content in the water ( P   〈  0.0001). Further, multivariate logistic regression analysis revealed that high ( 〉 10 6  cells/ml) and intermediate (10 5 –10 6  cells/ml) DAPI values were associated with reduced risk of atopy (odds ratio 0.34, 95% confidence interval 0.20–0.57 and 0.39, 0.23–0.69, respectively), independently from other factors. Conclusion:  High overall content of micro‐organisms in drinking water may be associated with reduced risk of atopy, independently from other determinants.
    Type of Medium: Online Resource
    ISSN: 0105-4538 , 1398-9995
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2007
    detail.hit.zdb_id: 2003114-2
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  • 9
    In: Allergy, Wiley, Vol. 62, No. 3 ( 2007-03), p. 281-287
    Abstract: Background:  A substantial variation in the association of asthma, rhinitis and eczema with elevated serum allergen‐specific immunoglobulin E (sIgE) levels between different populations has been reported. Here, we wanted to clarify whether these proportions are different in Finnish and Russian Karelia, and compared the ability of questionnaires, skin prick tests (SPT) and sIgE measurements to detect atopic conditions in these adjacent areas with different living conditions. Methods:  Randomly selected schoolchildren, aged 6–16 years, and their mothers from Finland ( n  = 344 children, 344 mothers) and Russia (427 and 284 respectively) participated. SPTs and sIgE measurements to common inhalant and food allergens were performed. The occurrence of asthma, rhinitis, eczema and related symptoms was assessed with an International Study of Asthma and Allergies in Childhood‐based questionnaire. Correlation between SPT and sIgE was estimated using the Spearman correlation coefficient. Results:  The rate of positive sIgE results was significantly higher in Finland among both mothers and children. Seventy‐seven per cent of Finnish children and 43% of Russian children with asthma were sIgE positive. The respective figures for hay fever were 94% and 67%, and for eczema 68% and 41%. This discrepancy was similar but of lower magnitude among mothers. The overall occurrence of asthma, rhinitis and eczema was very low in Russian Karelia. The correlation between SPT and sIgE results was generally good. Conclusion:  Asthma, rhinitis and eczema in Russian Karelia are not only rare but also, to a large extent, have no sIgE component. Therefore, the ability of questionnaires to detect sIgE‐mediated atopic conditions in this area of Russia is poor.
    Type of Medium: Online Resource
    ISSN: 0105-4538 , 1398-9995
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2007
    detail.hit.zdb_id: 2003114-2
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