Allergy and Clinical Immunology in the Czech Republic

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Allergy and Clinical Immunology in the Czech
Republic

• Anna Šedivá,
• Institute of Immunology,
• Second Medical Faculty
• University Hospital Motol,
• Prague, Czech Republic

Combating Allergy and Astma in Europe Issues
and Perspectives, on 17th November in Brussels.
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Allergy and Clinical Immunology

• The field of allergy and clinical immunology is
  one of the fastest growing areas among medical
  sciences in the Czech Republic.
• Both allergy and immunology are building up on
  the long time tradition in our countries.

Lodinová-Zádníková R, Cukrowska B,
Tlaskalova-Hogenova H. Oral administration of
probiotic Escherichia coli after birth reduces
frequency of allergies and repeated infections
later in life (after 10 and 20 years). Int Arch
Allergy Immunol. 2003 Jul131(3)209-11
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Allergic diseases in the Czech Republic
Population 10 millions Current prevalence of
allergy in general is almost 32 according to the
latest available statistical data, with asthma 8
and atopic dermatitis 12, with even higher
number in the youngest age groups.
Major problems and potential contribution to
European research growing number of
patients increasing problems in young age
genetic and pathogenetic studies environmental
factors improved diagnostics and therapies
1996 2001 2006
Alergy 16.9 24.7 31.8
Alergic Rhinitis 5.7 13.7 15.1
Asthma 3.8 6.7 8.2
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Increasing number of patients

• Contribution to international cohorts
• CIPA Czech Initiative for Asthma
• CARO Czech Alliance for Chronic Respiratory
  Diseases
• PRACTALL and ERS Task Force on childhood wheezing

Allergy. 2008 Jan63(1)5-34. Diagnosis
and treatment of asthma in childhood a PRACTALL
consensus report. Bacharier LB, Boner A, Carlsen
KH, Eigenmann PA, Frischer T, Götz M, Helms PJ,
Hunt J, Liu A, Papadopoulos N, Platts-Mills T,
Pohunek P, Simons FE, Valovirta E, Wahn U,
Wildhaber J European Pediatric Asthma Group Eur
Respir J. 2008 Oct32(4)1096-110. Definition,
assessment and treatment of wheezing disorders in
preschool children an evidence-based
approach. Brand PL, Baraldi E, Bisgaard H, Boner
AL, Castro-Rodriguez JA, Custovic A, de Blic J,
de Jongste JC, Eber E, Everard ML, Frey U, Gappa
M, Garcia-Marcos L, Grigg J, Lenney W, Le Souëf
P, McKenzie S, Merkus PJ, Midulla F, Paton JY,
Piacentini G, Pohunek P, Rossi GA, Seddon P,
Silverman M, Sly PD, Stick S, Valiulis A, van
Aalderen WM, Wildhaber JH, Wennergren G, Wilson
N, Zivkovic Z, Bush A.
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Genetic and pathogenetic studies
Hum Immunol. 2008 Apr-May69(4-5)306-13.
Haplotype analysis of the endothelial nitric
oxide synthase gene in asthma. J Hum Genet.
200752(2)152-8. Interleukin-18 and its three
gene polymorphisms relating to allergic rhinitis.
J Hum Genet. 200651(11)977-83. Polymorphisms
of the CD14 gene and atopic phenotypes in Czech
patients with IgE-mediated allergy. Holla LI et
al. Department of Pathophysiology, Medical
Faculty, Masaryk University Brno, Brno, Czech
Republic Severe form of atopic dermatitis in
childhood clinical outcome and cytokine gene
polymorphisms - a prospective study. Pediatric
Allergy adn Immunology, submitted. Kayserová J.,
Šedivá A. et al. Institute of Immunology,
University Hospital Motol, Prague, Czech Republic

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Environmental factors

• Air polution
• Mutat Res. 2001 Sep 20496(1-2)207-28
• Biomarkers of genotoxicity of urban air
  pollution. Overview and descriptive data from a
  molecular epidemiology study on populations
  exposed to moderate-to-low levels of polycyclic
  aromatic hydrocarbons the AULIS project.
• Kyrtopoulos SA, Georgiadis P, Autrup H,
  Demopoulos NA, Farmer P, Haugen A, Katsouyanni K,
  Lambert B, Ovrebo S, Sram R, Stephanou G, Topinka
  J.
• Institute of Experimental Medicine, Prague,
  Czech Republic.
• New study in 2008 200 children from urban and
  rural areas
• Food allergy
• Proteomics. 2008 Apr8(8)1677-91. Proteomic
  analysis of wheat proteins recognized by IgE
  antibodies of allergic patients.
• Int Arch Allergy Immunol. 2002 Jun128(2)77-89.
  Mucosal immunity its role in defense and
  allergy.
• Department of Immunology and Gnotobiology,
  Institute of Microbiology v.v.i, Czech Academy of
  Sciences, Prague, Czech Republic

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Improved diagnostics and therapies

• Application of global protocols
• Focus on compound resolve diagnostic and therapy
  with recombinant allergens, followed with
  functional basophil activation tests (BAT) and
  specific IgG investigation as a marker of
  successful immunomodulation therapy. University
  Centre for Allergology and Clinical Immunology,
  Medical faculty of Masaryk University, St. Anne
  University Hospital, Brno, Czech Republic
• Sedivá A, Kayserová J, Vernerová E, Poloucková
  A, Capková S, Spísek R, Bartunková J.
• Anti-CD20 (rituximab) treatment for atopic
  eczema.
• J Allergy Clin Immunol. 2008 Jun121(6)1515-6

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DC in allergy
The role of dendritic cells in allergic
response Dendritic cells in allergic patients,
morphology and function of moDCs in response to
ligands and allergens Potential role of lectins
as receptors for allergens

Allergic patients have an increased expression of
DC-SIGN on iDC, with subsequent significant
decrease induced by OVA or birch allergen,
associated, however, with increaded IL-6
production in patients compared to controls OVA
binds C lectin receptor on DCs
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Combatting Allergy and Asthma

• Global Initiative