Asthma and inflammatory bowel disease in changing environments - Two faces of the same story?

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The German reunification offered the unique opportunity to study the transition from low to high prevalence of atopic diseases and potential underlying environmental risk factors in a population. The major hypotheses generated were:• Microbial exposure protects from atopic diseases (“Hygiene hypothesis”).• Nutritional factors contribute to atopic diseases.• These associations are modified by genetic polymorphisms.Countries which currently experience a stage of transition alike (e.g., Chile) offer the unique opportunity to validate these hypothese including:• Extension to more detailed analysis of exposure. Whilst exposure in the GDR studies were mainly based on surrogate markers of hygiene exposure, nowadays the role of specific microbial exposures can be assessed;• Extension to other conditions. Recent questionnaire studies have suggested a role for the “hygiene hypothesis” in inflammatory bowel diseases (IBD) which needs to be verified by objective measurements;• Assessment of the interdependencies between environmental and genetic factors in a different “genetic pool”.The key elements of the proposed study are therefore• Two case-control studies in Chile (one for asthma, second for IBD) assessing the impact of specific markers of “hygiene” and nutrition on disease;• Assessment of genetic polymorphisms potentially related to the occurrence of asthma and IBD in Chile;• Comparison of gene-environment interactions between Chile and Germany related to asthma and IBD.This novel knowledge will contribute to effective targeted intervention strategies helping to stop the recent increase in asthma and IBD in countries in transition and to reduce the burden of disease worldwide.