Immunological resilience and biodiversity for prevention of allergic diseases and asthma

Abstract

Increase of allergic conditions has occurred at the same pace with the Great Acceleration, which stands for the rapid growth rate of human activities upon earth from 1950s. Changes of environment and lifestyle along with escalating urbanization are acknowledged as the main underlying causes. Secondary (tertiary) prevention for better disease control has advanced considerably with innovations for oral immunotherapy and effective treatment of inflammation with corticosteroids, calcineurin inhibitors, and biological medications. Patients are less disabled than before. However, primary prevention has remained a dilemma. Factors predicting allergy and asthma risk have proven complex: Risk factors increase the risk, while protective factors counteract them. Interaction of human body with environmental biodiversity with micro-organisms and biogenic compounds as well as the central role of epigenetic adaptation in immune homeostasis have given new insight. Allergic diseases are good indicators of the twisted relation to environment. In various non-communicable diseases, the protective mode of the immune system indicates low-grade inflammation without apparent cause. Giving microbes, pro-and prebiotics, has shown some promise in prevention and treatment. The real-world public health programme in Finland (2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018) emphasized nature relatedness and protective factors for immunological resilience, instead of avoidance. The nationwide action mitigated the allergy burden, but in the lack of controls, primary preventive effect remains to be proven. The first results of controlled biodiversity interventions are promising. In the fast urbanizing world, new approaches are called for allergy prevention, which also has a major cost saving potential.

Advances and highlights in asthma in 2021

“…Diet, microbiome and the epithelial barrier are key regulators of the cross‐talk that ensures that immune system adapts to challenges by establishing, maintaining and regulating an appropriate immune response. There is a paradigm shift in prevention, from avoidance to immunological tolerance/resilience as exemplified by the first national programme for prevention (The Finnish Allergy Programme 2008–2018) 119 …”

Indoor green wall affects health-associated commensal skin microbiota and enhances immune regulation: a randomized trial among urban office workers

“…Due to an increased hygiene level 1 , biodiversity loss and irregular soil contacts 2 – 4 the exposure to environmental microbes has reduced in Western cities, which is seen as one of the major reasons for the rise in immune-mediated diseases, such as autoimmune diseases and allergies 5 . Nature-derived microbes that have a commensal relationship with humans contribute to the development and regulation of the human immune system 1 , 4 , 6 – 8 .…”

Effect of inactivated nature‐derived microbial composition on mouse immune system

“…Epidemiological studies have associated the epidemic of immune-mediated disorders, such as allergies and autoimmune diseases, with the adoption of a modern, urban lifestyle. 1,2 Indeed, the prevalence of atopic dermatitis in industrialized countries in the past decades has increased up to 30% in children and 10% in adults. 3 Additionally, the incidence of many autoimmune diseases, such as type 1 diabetes (T1D), celiac disease, and inflammatory bowel diseases (IBDs), has increased concomitantly.…”