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

德国统一提供了独特的机会，研究从低到高发病率的特应性疾病和潜在的潜在环境危险因素在人口中的过渡。产生的主要假设是：·微生物暴露保护免受特应性疾病（“卫生假说”）。营养因素会导致特应性疾病。·这些关联受到遗传多态性的影响。目前正经历转型阶段的国家（例如，智利）提供了验证这些假设的独特机会，包括：·扩展到更详细的风险分析。虽然GDR研究中的暴露主要基于卫生暴露的替代标志物，但现在可以评估特定微生物暴露的作用;最近的问卷调查研究表明，炎症性肠病（IBD）中的“卫生假说”的作用需要通过客观测量来验证;·评估不同“基因库”中环境和遗传因素之间的相互依赖性。因此，拟议研究的关键要素是：（一个用于哮喘，第二个用于IBD）评估“卫生”和营养的特定标志物对疾病的影响;·基因比较-这一新的知识将有助于制定有效的有针对性的干预战略，帮助制止转型期国家哮喘和IBD的近期增加，并减轻全球范围内的疾病。

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.