Gender-specific development of asthma and allergies in the context of the farm-effect.

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Asthma is a common complex chronic disease in childhood and adolescence also causing a substantial burden of disease in adult life. Previous studies have shown a gender-specific development of asthma, the underlying mechanisms are yet unknown. In childhood, boys develop asthma more compared to girls; during adolescence this ratio inverts. While this patterns seems to be similar for atopic eczema, there is much less evidence for a sex-specific development of allergic rhinitis.Attempts to explain the gender-specific development of asthma include hormonal factors, lung growth, diagnostic practices, but also environmental exposures. An interesting explanation is offered by looking at the hygiene hypothesis under gender medicine aspects: girls and boys differ in hygiene standards and practices which may contribute to a gender-specific development of asthma and allergies. One prominent and well-documented proxy for the hygiene hypothesis is the protective effect of exposure to farming environments for asthma an allergies. However, to date there is no study on the gender-specific development of asthma and allergies in this context.Own preparatory work suggest that the gender-specific development of asthma differs between adolescents with and without exposure to farm environments. This grant proposal comprises the conduction of a prospective cohort study on an already (over the past seven years) well-characterised, population-based cohort. For the next three years, questionnaire-based data on the development of asthma and the course of asthma symptoms, the progression through puberty, and the exposure to farm environments will be assessed. The aim of the study is the detailed description of the gender-sepcific development of asthma in the context of the farm-effect as well as the determination of potential causes of different courses of disease.The results of this long-term study will contribute to a better understanding of the complex development of asthma in childhood and adolescence. In particular, groups with supposedly heterogenous courses of disease will be identified. This is a requirement for actual recommendations of preventive actions and also for targeted, cost-effective diagnostic and therapeutic measures.