There are no nationwide, comprehensive public health programmes on allergic disorders with set goals and systematic follow-up. The Finnish initiative is based on the idea that the so called allergy epidemic in modern, urban societies is caused by inadequately developed or broken tolerance. The immune system is not trained to make the difference between danger and non-danger (allergy) or the difference between self and non-self (autoimmune diseases). The immune dysfunction leads to inappropriate inflammatory responses and clinical symptoms. The 10-year implementation programme is aimed to reduce burden of allergies both at the individual and societal levels. This is done by increasing both immunological and psychological tolerance and changing attitudes to support health instead of medicalising common and mild allergy symptoms. Severe forms of allergy are in special focus, e.g. asthma attacks are prevented proactively by improving disease control with the help of guided self-management. Networking of allergy experts with primary care doctors and nurses as well with pharmacists is the key for effective implementation. Non-governmental organizations have started a campaign to increase allergy awareness and knowledge among patients and general public. It is time to act, when allergic individuals are becoming a majority of Western populations and their numbers are in rapid increase worldwide. The first results of the Finnish Programme indicate that allergy burden can be reduced with relatively simple means.
Asthma ; Follow-Up Studies ; Humans ; Hypersensitivity ; Immune System ; Immune Tolerance ; Pharmacists ; Primary Health Care ; Public Health ; Self Care

BACKGROUND: Asthma and allergies are common and cause substantial burden in symptoms and suffering, hospitalizations and medication costs. However, despite the high prevalence, asthma burden has already decreased in Finland in 2000s. OBJECTIVE: We carried out an asthma barometer survey in all Finnish pharmacies to study changes in asthma severity and control, and use of health care services from 2001 to 2010. METHODS: Asthma severity, comorbid allergic conditions, and use of medication and health care services were assessed in subjects who purchased asthma or allergy medication from the pharmacies all across the country during one week in 2001 and again in 2010. In 2001, 3,062 patients (mean age, 49 years), and in 2010, 1,114 patients (mean age, 51 years) participated. RESULTS: In 2001 90% and in 2010 73% of the respondents reported physician-diagnosed asthma and were entitled to special reimbursement for their drug costs, i.e., they needed regular maintenance treatment. In 2001, 10% of the asthmatics regarded their disease as severe, compared with 4% in 2010, while the figures for mild asthma were 45% and 62%, respectively (p < 0.001). The proportion of patients needing emergency care during the last year decreased from 34% (2001) to 14% (2010) (p < 0.001) and the need for hospitalizations from 18% to 6% (p < 0.001). Smoking reduced from 24% to 18% among asthmatics ( p = 0.002). In 2010, risk factors for severe asthma were older age, comorbid atopic eczema, and food allergy. CONCLUSION: During ten years, self-reported asthma severity has reduced and disease control improved in Finland.
Asthma ; Delivery of Health Care ; Dermatitis, Atopic ; Drug Costs ; Drug Therapy ; Emergency Medical Services ; Emergency Treatment ; Finland ; Food Hypersensitivity ; Hospitalization ; Humans ; Hypersensitivity ; Pharmacies ; Prevalence ; Risk Factors ; Smoke ; Smoking ; Surveys and Questionnaires

PURPOSE: We investigated maternal genetic effects of four IL-4/IL-13 pathway genes as well as their interactions with the "Western or Eastern lifestyles/environments" on IgE in Karelian children. METHODS: This study included 609 children and their mothers. Total IgE levels in children and mothers were measured and 10 single nucleotide polymorphisms (SNPs) in IL-4, IL-4Ra, IL-13, and STAT6 were genotyped in mothers and their children. RESULTS: The maternal G allele of IL-13 130 (rs20541) was significantly (P=0.001) associated with decreased IgE in children in the Karelian population (Pooling Finnish and Russian children), as well as in Finnish (P=0.030) and Russian children (P=0.018). The IgE levels were significantly (P=0.001) higher in Russian children whose mothers were homozygous for the G allele of the IL-4Ra 50 (rs1805010) SNP than that in Russian children of mothers who were AG heterozygotes or AA homozygotes. After accounting for children's genotypes, we observed interactive effects on children's IgE for maternal IL-13 130 genotypes (P=0.014) and maternal IL-4Ra 50 genotypes (P=0.0003) with "Western or Eastern" lifestyles/environments. With the adjustment for multiple comparisons using a false discovery rate (FDR) of 0.05, the interactive effect of the maternal IL-4Ra50 SNP was significant. CONCLUSION: Maternal genetic variants in IL-4/IL-13 pathway genes, such as IL-13 130 and IL-4Ra50, influenced IgE levels in school children that were independent of the children's genetic effects. These effects differ in "Western or Eastern" environments.
Alleles ; Child ; Genotype ; Heterozygote ; Homozygote ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Interleukin-13 ; Interleukin-4 ; Mothers ; Polymorphism, Single Nucleotide

PURPOSE: We investigated maternal genetic effects of four IL-4/IL-13 pathway genes as well as their interactions with the "Western or Eastern lifestyles/environments" on IgE in Karelian children. METHODS: This study included 609 children and their mothers. Total IgE levels in children and mothers were measured and 10 single nucleotide polymorphisms (SNPs) in IL-4, IL-4Ra, IL-13, and STAT6 were genotyped in mothers and their children. RESULTS: The maternal G allele of IL-13 130 (rs20541) was significantly (P=0.001) associated with decreased IgE in children in the Karelian population (Pooling Finnish and Russian children), as well as in Finnish (P=0.030) and Russian children (P=0.018). The IgE levels were significantly (P=0.001) higher in Russian children whose mothers were homozygous for the G allele of the IL-4Ra 50 (rs1805010) SNP than that in Russian children of mothers who were AG heterozygotes or AA homozygotes. After accounting for children's genotypes, we observed interactive effects on children's IgE for maternal IL-13 130 genotypes (P=0.014) and maternal IL-4Ra 50 genotypes (P=0.0003) with "Western or Eastern" lifestyles/environments. With the adjustment for multiple comparisons using a false discovery rate (FDR) of 0.05, the interactive effect of the maternal IL-4Ra50 SNP was significant. CONCLUSION: Maternal genetic variants in IL-4/IL-13 pathway genes, such as IL-13 130 and IL-4Ra50, influenced IgE levels in school children that were independent of the children's genetic effects. These effects differ in "Western or Eastern" environments.
Alleles ; Child ; Genotype ; Heterozygote ; Homozygote ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Interleukin-13 ; Interleukin-4 ; Mothers ; Polymorphism, Single Nucleotide

No abstract available.
Nose ; Rhinitis, Allergic