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      European Summit on the Prevention and Self-Management of Chronic Respiratory Diseases: report of the European Union Parliament Summit (29 March 2017)

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          Abstract

          On March 29, 2017, a European Summit on the Prevention and Self-Management of Chronic Respiratory Diseases (CRD) was organized by the European Forum for Research and Education in Allergy and Airway Diseases. The event took place in the European Parliament of Brussels and was hosted by MEP David Borrelli and MEP Sirpa Pietikainen. The aim of the Summit was to correspond to the needs of the European Commission and of patients suffering from CRD to join forces in Europe for the prevention and self-management. Delegates of the European Rhinologic Society, European Respiratory Society, European Academy of Allergy and Clinical Immunology, European Academy of Paediatrics, and European Patients Organization EFA all lectured on their vision and action plan to join forces in achieving adequate prevention and self-management of CRD in the context of Precision Medicine. Recent data highlight the preventive capacity of education on optimal care pathways for CRD. Self-management and patient empowerment can be achieved by novel educational on-line materials and by novel mobile health tools enabling patients and doctors to monitor and optimally treat CRDs based on the level of control. This report summarizes the contributions of the representatives of different European academic stakeholders in the field of CRD.

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          Allergic Rhinitis and its Impact on Asthma (ARIA): Achievements in 10 years and future needs

          Allergic rhinitis (AR) and asthma represent global health problems for all age groups. Asthma and rhinitis frequently coexist in the same subjects. Allergic Rhinitis and its Impact on Asthma (ARIA) was initiated during a World Health Organization workshop in 1999 (published in 2001). ARIA has reclassified AR as mild/moderate-severe and intermittent/persistent. This classification closely reflects patients' needs and underlines the close relationship between rhinitis and asthma. Patients, clinicians, and other health care professionals are confronted with various treatment choices for the management of AR. This contributes to considerable variation in clinical practice, and worldwide, patients, clinicians, and other health care professionals are faced with uncertainty about the relative merits and downsides of the various treatment options. In its 2010 Revision, ARIA developed clinical practice guidelines for the management of AR and asthma comorbidities based on the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) system. ARIA is disseminated and implemented in more than 50 countries of the world. Ten years after the publication of the ARIA World Health Organization workshop report, it is important to make a summary of its achievements and identify the still unmet clinical, research, and implementation needs to strengthen the 2011 European Union Priority on allergy and asthma in children. Copyright © 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.
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            Impaired barrier function in patients with house dust mite-induced allergic rhinitis is accompanied by decreased occludin and zonula occludens-1 expression.

            Tight junction (TJ) defects have recently been associated with asthma and chronic rhinosinusitis. The expression, function, and regulation of nasal epithelial TJs remain unknown in patients with allergic rhinitis (AR).
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              Time to abandon the hygiene hypothesis: new perspectives on allergic disease, the human microbiome, infectious disease prevention and the role of targeted hygiene

              Aims: To review the burden of allergic and infectious diseases and the evidence for a link to microbial exposure, the human microbiome and immune system, and to assess whether we could develop lifestyles which reconnect us with exposures which could reduce the risk of allergic disease while also protecting against infectious disease. Methods: Using methodology based on the Delphi technique, six experts in infectious and allergic disease were surveyed to allow for elicitation of group judgement and consensus view on issues pertinent to the aim. Results: Key themes emerged where evidence shows that interaction with microbes that inhabit the natural environment and human microbiome plays an essential role in immune regulation. Changes in lifestyle and environmental exposure, rapid urbanisation, altered diet and antibiotic use have had profound effects on the human microbiome, leading to failure of immunotolerance and increased risk of allergic disease. Although evidence supports the concept of immune regulation driven by microbe–host interactions, the term ‘hygiene hypothesis’ is a misleading misnomer. There is no good evidence that hygiene, as the public understands, is responsible for the clinically relevant changes to microbial exposures. Conclusion: Evidence suggests a combination of strategies, including natural childbirth, breast feeding, increased social exposure through sport, other outdoor activities, less time spent indoors, diet and appropriate antibiotic use, may help restore the microbiome and perhaps reduce risks of allergic disease. Preventive efforts must focus on early life. The term ‘hygiene hypothesis’ must be abandoned. Promotion of a risk assessment approach (targeted hygiene) provides a framework for maximising protection against pathogen exposure while allowing spread of essential microbes between family members. To build on these findings, we must change public, public health and professional perceptions about the microbiome and about hygiene. We need to restore public understanding of hygiene as a means to prevent infectious disease.
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                Author and article information

                Contributors
                peter.hellings@me.com
                david.borrelli@ep.europa.eu
                sirpa.pietikainen@europarl.europa.eu
                ibrumaru@unitbv.ro
                akdisac@siaf.unizh.ch
                claus.bachert@ugent.be
                mbewick911@yahoo.co.uk
                ernabotjes@gmail.com
                janconst@otenet.gr
                w.j.fokkens@amc.uva.nl
                tari.haahtela@haahtela.fi
                clairehopkins@yahoo.com
                illario@unina.it
                guy.joos@ugent.be
                v.lund@ucl.ac.uk
                muraro@pediatria.unipd.it
                benoit.pugin@euforea.eu
                sven.seys@euforea.eu
                david.somekh@ehff.eu
                par.stjarne@karolinska.se
                arval2691@gmail.com
                erkka.valovirta@terveystalo.com
                jean.bousquet@orange.fr
                Journal
                Clin Transl Allergy
                Clin Transl Allergy
                Clinical and Translational Allergy
                BioMed Central (London )
                2045-7022
                27 December 2017
                27 December 2017
                2017
                : 7
                : 49
                Affiliations
                [1 ]ISNI 0000 0001 0668 7884, GRID grid.5596.f, Department of Otorhinolaryngology, University Hospitals Leuven, , KU Leuven, ; Louvain, Belgium
                [2 ]ISNI 0000000404654431, GRID grid.5650.6, Department of Otorhinolaryngology, , Academic Medical Center, ; Amsterdam, The Netherlands
                [3 ]Italian Member of the European Parliament, EFDD Group, Brussels, Belgium
                [4 ]GRID grid.466652.5, Finnish Member of the European Parliament, ; Brussels, Belgium
                [5 ]Faculty of Medicine, Transylvania University, Brasov, Romania
                [6 ]ISNI 0000 0004 1937 0650, GRID grid.7400.3, Swiss Institute of Allergy and Asthma Research (SIAF), , University of Zurich, ; Davos, Switzerland
                [7 ]Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
                [8 ]ISNI 0000 0004 0626 3303, GRID grid.410566.0, Upper Airways Research Laboratory, ENT Department, , Ghent University Hospital, ; Ghent, Belgium
                [9 ]Q4U Consultants Ltd, London, UK
                [10 ]GRID grid.434606.3, EFA - European Federation of Allergy and Airways Diseases Patients’ Associations, ; Brussels, Belgium
                [11 ]ISNI 0000000109457005, GRID grid.4793.9, 1st Department of ORL, Head and Neck Surgery, , Aristotle University, ; Thessaloníki, Greece
                [12 ]ISNI 0000 0000 9950 5666, GRID grid.15485.3d, Skin and Allergy Hospital, , Helsinki University Hospital, ; Helsinki, Finland
                [13 ]ENT Department, Guy’s and St Thomas’ Hospitals, London, UK
                [14 ]Division for Health Innovation, Campania Region and Federico II University Hospital Naples (R&D and DISMET), Naples, Italy
                [15 ]ISNI 0000 0004 0626 3303, GRID grid.410566.0, Department of Respiratory Medicine, , Ghent University Hospital, ; Ghent, Belgium
                [16 ]ISNI 0000 0004 0612 2754, GRID grid.439749.4, Royal National Throat, Nose and Ear Hospital, , University College London Hospitals, ; London, UK
                [17 ]ISNI 0000 0004 1760 2630, GRID grid.411474.3, Food Allergy Referral Centre Veneto Region, Department of Women and Child Health, , Padua General University Hospital, ; Padua, Italy
                [18 ]European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
                [19 ]ISNI 0000 0001 0668 7884, GRID grid.5596.f, Lab of Clinical Immunology, Department of Immunology and Microbiology, , KU Leuven, ; Brussels, Belgium
                [20 ]European Health Futures Forum (EHFF), Isle of Wright, UK
                [21 ]ISNI 0000 0000 9241 5705, GRID grid.24381.3c, Rhinology Department of Otorhinolaryngology, , Karolinska University Hospital, ; Stockholm, Sweden
                [22 ]ISNI 0000 0001 2243 2806, GRID grid.6441.7, Vilnius University Clinic of Children’s Diseases and Public Health Institute, ; Vilnius, Lithuania
                [23 ]European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium
                [24 ]ISNI 0000 0001 2097 1371, GRID grid.1374.1, Department of Lung Diseases and Clinical Allergology, , Univ. of Turku, and Allergy Clinic, Terveystalo, ; Turku, Finland
                [25 ]MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
                [26 ]ISNI 0000 0001 2323 0229, GRID grid.12832.3a, INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, UMR-S 1168, , Université Versailles St-Quentin-en-Yvelines, ; Villejuif, Montigny le Bretonneux, France
                [27 ]EUFOREA aisbl, 132, Ave. Brand Whitlock, 1200 Brussels, Belgium
                Article
                186
                10.1186/s13601-017-0186-3
                5745781
                b2775838-a41e-4ee6-a0ee-ad1fef86142a
                © The Author(s) 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 23 October 2017
                : 15 December 2017
                Funding
                Funded by: Euforea
                Categories
                Review
                Custom metadata
                © The Author(s) 2017

                Immunology
                advocacy,euforea,asthma,mobile health technology,allergy
                Immunology
                advocacy, euforea, asthma, mobile health technology, allergy

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