Allergic diseases go under the research microscope Allergic diseases are very common among children in the western world, and they have a serious impact on quality of life for both patients and their families. Professor Bianca Schaub tells us about her research on the immunological mechanisms behind allergic diseases, and its importance for the development of preventive strategies. Around one in four children in the western world suffers from allergic diseases and the prevalence continues to rise, representing a significant public health problem. While a number of factors are thought to be involved in the development of allergic diseases, over recent decades a lot of attention has centered on the pre-natal environment, as well as the environment in the early months and years of life. “It has become apparent that these factors are probably more important than was previously thought,” says Professor Bianca Schaub. As head of the research group on allergy and immunology at Ludwig-MaximiliansUniversität München (LMU Munich), Professor Schaub aims to probe deeper into the development of allergic diseases, focusing on four. “The four major diseases which we are looking at are food allergies, atopic dermatitis, asthma, and hay fever,” she outlines. Environment and immunological tolerance development with a focus on the development of allergic diseases The CHAMP Consortium aims to investigate the determinants of different allergic diseases (food allergy, atopic dermatitis, asthma, hay fever) across the whole pediatric age range. Particular attention will be given to factors determining primary tolerance (no onset of disease) and acquired tolerance (remission of existing disease). We will identify clinically relevant biomarkers predicting early onset, progression and remission. Professor Dr. Bianca Schaub Dr von Hauner Children´s Hospital Munich, LMU Munich Lindwurmstr. 4, 80337 Munich, Germany E: bianca.schaub@med.uni-muenchen.de
Bianca Schaub is head of the Allergy-Immunology research group and Deputy Head of the Asthma and Allergy Department and Attending at the Pulmonary Department of Munich University Children´s Hospital, Munich, Germany. After studying medicine in Munich, Dundee, and Melbourne, she completed her internship and residency training in Pediatrics. After her PostDoctoral Fellowship at Harvard University, Boston, USA she returned to LMU Munich, Germany.
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CHAMP consortium There are thought to be several sub-phenotypes or endotypes - among these diseases, while some children may suffer from more than one condition, so this is a complex area of research. Professor Schaub is Principal Investigator of the CHAMP (CHildhood Allergy and tolerance: bioMarkers and Predictors) consortium, in which large volumes of data have been gathered. “Several national and international birth cohorts are included in CHAMP, with a long-term follow up,” she explains. This provides a solid basis for researchers to investigate the determinants of different allergic diseases. CHAMP focuses on factors determining primary tolerance (no onset of disease) and acquired tolerance (remission of existing disease). The wider goal in research is to identify biomarkers which predict the onset, progression and remission of allergic disease, through which Professor Schaub hopes to lay the foundations for more targeted treatment in future. “My major focus is on the early years of life, and even pre-natally, to better understand the factors which contribute to the early development of allergic diseases. This is with a view to developing preventive strategies and preparing for future clinical trials,” she continues. Uniquely, this consortium has the opportunity to investigate the development and remission of childhood allergies at all stages of childhood immune and organ development. Another major topic of interest is whether immune development, and the different risk or protective factors, are distinct for each allergic disease. “For example, it may be different for food allergies, atopic dermatitis, and hay fever,” explains Professor Schaub. “We are looking at data from children with different allergic disease across distinct age-ranges, from birth, throughout preschool, school-age, and adolescence.”
Gaining novel insights into the early onset of different allergic diseases, as well as natural tolerance and remission, from birth through to adolescence, will lay the ground for future development of preventive strategies. In the long term, this will open up new avenues for the development of novel therapeutic options, which will have a beneficial impact on the lives of patients and their families. In addition to CHAMP, several other projects are ongoing, which assess mechanisms of protection against allergies. “We look at different protective environmental exposures. We have a few very strong cohorts on this, where we see protective environmental exposures,” says Professor Schaub. “For example, microbial exposures in different rural environments.” Researchers are investigating whether an immune system which has been exposed to different environmental exposures in the early years of life - even prenatally - then proves to be more effective in maintaining a healthy balance. The immune system may get primed to develop counter-regulatory mechanisms against known risk factors. “The idea of early microbial stimulation is a diverse general stimulation of different levels of the immune system,” says Professor Schaub. A deeper understanding of allergic diseases would allow researchers to look towards developing improved preventive strategies. One priority is to enable much more individualised treatment. “This is already practiced in other fields of medicine, for example in cancer, where patients get quite targeted therapies,” points out Professor Schaub. The goal of enabling treatment tailored to the needs of the patient is central to Professor Schaub’s future research agenda. “This is a huge field, which is still not specific enough. This is a very important area of research,” she stresses.
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