Research at the Centre for Allergy Research
There are many ongoing research projects in the allergy and asthma area at the Karolinska Institutet. See below for summaries of several ongoing studies.
On our Swedish site you can find more information about allergy and asthma research at KI.
The FOODHE project - Food allergy to milk, egg or wheat raises Swedish household costs
Results recently published by researchers from the Centre for Allergy Research show that having a food allergy to either cows’ milk, hens’ eggs and, or, wheat gives rise to considerable costs for Swedish households. These increased yearly household costs amount to 8000 Euro (72 000 SEK) for allergic adults, 4800 Euro (42 500 SEK) for allergic adolescents and 4000 Euro (35 000 SEK) for allergic children, compared to households without such allergies.
Food allergy is a common problem worldwide and affects a substantial part of the population. Currently, it is estimated that 1-2% of adults and 5-8% of children have doctor-diagnosed food allergy in western Europe, but as many as 30% of the publication experience any kind of food insensitivity. Food allergy has a significant impact on the daily life of those who suffer from it, as food is such a central aspect of social life, and it has been shown to significantly decrease the quality of life among those that are affected.
The cost of food allergy, both for individuals, households and for society are thought to be substantial. However, so far only very few studies have been carried out in this area, and none in Sweden. The Centre for Allergy Research therefore initiated the Health Economics of Food Allergy (FOODHE) project, in order to study the cost of food allergy in Sweden.
Adults, children (0-12 years) and adolescents (13-17) and their families were invited to participate. In total 222 families with one family member with doctor-diagnosed allergy to either cows’ milk, hens’ eggs and, or, wheat participated. A control group of 235 families without such allergy were also invited to participate. All families answered a questionnaire with detailed questions about household costs. The questionnaire captured total household costs related to the food allergy, including direct costs (e.g. food and living, health care insurance, medications, travel to doctor’s appointments) and indirect costs (e.g. lost time for being unable to perform domestic tasks, seeking food allergy-related information, shopping and preparing food, as well as lost earnings and lost days at school/work).
The mean annual total household costs (direct + indirect costs) were higher in families with a food-allergic child (by 3961 EUR, or about 35 000 SEK), adolescent (by 4792 EUR, or about 42 500 SEK), or adults (by 8164 EUR, or about 72 000 SEK) compared to those without such allergy. For households with children with food allergy to milk, egg or wheat, the total higher costs were due to both direct costs (including the cost of food and equipment for preparing food, the cost of medications, and costs related to health care visits) and indirect costs (in particular lost time due to health care visits and time spent seeking information on food allergy, as well as lost working or school days). For households with an allergic adult the increased costs were mainly due to indirect costs (in particular lost time due to sickness, food shopping and preparing food, health care visits, and seeking information).
In summary, the raised costs associated with cows’ milk, hens’ eggs and, or, wheat allergy are substantial and pose a significant burden to Swedish households. This is the first time such costs have been calculated in Sweden, and is one of the first studies in the world in this area.
About the FOODHE study group
Project manager of the FOODHE project is Prof. Staffan Ahlstedt at the Centre for Allergy Research. Other members of the group are based at the Karolinska Institutet in Stockholm, The University of Umeå, The Sachs’ Children and Youth Hospital at Södersjukhuset in Stockholm, The Sahlgrenska University Hospital in Gothenburg, the Linnaeus University in Kalmar, the Swedish Council on Health Technology Assessment (SBU) in Stockholm, and at the Swedish Asthma and Allergy Foundation.
Links to four publications from the FOODHE study:
For more information about the study, please contact:
Environmental factors contribute to the development of allergies and asthma by changing genes
A thesis defended recently at KI by Nathalie Acevedo pinpoints to epigenetic differences between healthy individuals and patients affected by allergies and asthma. Epigenetic mechanisms contribute to the pathogenesis of allergic diseases by altering genes that are of significance in the responses to environmental factors.
During the last decades there has been a dramatic increase in the prevalence of allergic diseases worldwide. It is thought that changes in the environment play a role in this increase. Such environmental changes could for instance be pollution, changes in lifestyle or reduced biodiversity. The research area of epigenetics has recently received a lot of attention. Epigenetics means the mechanism by which genes alter their expression as a result of for instance environmental factors, which in turn can give rise to heritable changes in cells and molecules. Regarding allergy, it is thought that such epigenetic changes can contribute to the development of allergic symptoms.
The aim of the recently defended thesis by Nathalie Acevedo was to study epigenetic mechanisms in patients with allergy and asthma. She found epigenetic differences in the blood cells of healthy adults compared to adults with atopic eczema, and she also identified the genes in which these differences occurred. A sub-population of defense cells (called memory leukocytes) contained the epigenetic differences. These genes could in the future potentially serve as markers for a better characterisation of the patients with atopic eczema, or be candidate targets for new treatments. Nathalie Acevedo also found epigenetic differences between healthy children and asthmatic children in a gene implicated in the activation of lymphocytes. These epigenetic differences provide insights into the mechanism that makes some young children more susceptible to develop asthma after viral respiratory infections.
The findings described in this thesis contribute to our knowledge about the interactions between genes and environment and will further help us in the development of new preventive and therapeutical strategies for allergy and asthma.
For more information about this research please contact:
Will my child grow out of food hypersensitivity?
This is a common question by parents, but it is not always easily answered. A new study by researchers at the Karolinska Institutet helps parents to answer this question. The research was carried out on the BAMSE cohort, a study that has been following children born between 1994-1996 in the Stockholm area.
Despite the fact that the rates of food hypersensitivity are high, the progression of food hypersensitivity from early life to adolescence is not well understood. We wished to better understand this, as well as risk factors for anaphylaxis, the most serious food hypersensitivity reaction, in adolescence.
In the Swedish BAMSE cohort of nearly 2600 children followed from birth to adolescence, we found that 19% of children had food hypersensitivity in early life. More than half (56%) of these children also had food hypersensitivity in adolescence. Food hypersensitivity in early life increased the odds of both food hypersensitivity and anaphylaxis in adolescence. Risk factors for food hypersensitivity in both early life and adolescence included parental history of allergic disease, allergic disease in early life, and sensitisation to foods and/or aeroallergens.
Our research helps to answer the question that parents frequently ask when their young child is diagnosed with food hypersensitivity: Will s/he outgrow it?
These findings were presented at the American Academy of Allergy, Asthma and Immunology’s Annual Meeting in February, 2015. The abstract was also published in the Journal of Allergy and Clinical Immunology, February 2015 Vol. 135, Issue 2, AB37.
No causal relationship between antibiotics treatment during childhood and asthma
There is probably no causal relationship between antibiotics treatment during childhood and asthma. This is one of the conclusions in a thesis that was recently defended at KI by Anne Örtqvist.
Anne Örtqvist made use of twin and sibling studies in her research, and has also studied the causal relationship between birth weight and asthma. In addition, she describes how population-based registers can be used in asthma studies.
KI study on patient lungs reveals new potential target for asthma treatment
A recently completed study by researchers at the Centre for Allergy Research reveals a new potential target for asthma treatment. The study also gives new explanations as to what happens in the lungs of patients who react with asthma symptoms to common painkillers such as aspirin, ibuprofen and diclofenac.
The main finding of the study is that the mediator prostaglandin E2 not only causes widening of the airways during allergy, but it also has a protective effect on the airways via a different pathway. It thereby helps to increase air flow through the lungs. This new finding may open up possibilities for a new potential treatment of allergy and asthma, a disease characterised by recurring narrowing of the airways thereby causing shortness of breath. Prostaglandin E2 is produced in the lung, but its mode of action there has up till now been unclear.
Another finding of the study is that it sheds more light on the mechanism of aspirin-exacerbated respiratory disease. This is a disease that affects 5%-10% of mild asthmatics and up to 24% of patients with more severe asthma. Patients who suffer from this condition do not tolerate common painkillers such as aspirin, ibuprofen and diclofenac. When they ingest these drugs they react with nasal symptoms. They also have chronic rhinosinusitis and often nasal polyps.
The study by CfA researcher Dr. Jesper Säfholm and co-workers was recently accepted for publication in the Journal of Allergy and Clinical Immunology, one of the leading scientific journals in the allergy area. In the study Dr. Säfholm made use of unique human lung material, collected in collaboration with the surgical ward at the Karolinska University Hospital. The study is part of the ongoing ChAMP project (CfA highlights Asthma Markers of Phenotype), supported by the AstraZeneca/Karolinska Institutet Joint Research Programme and the AstraZeneca/SciLifeLab – Joint Research Collaboration. Read more about the ChAMP project here.
More about the results of the study
Prostaglandin E2 (PGE2) is a major product of arachidonic acid metabolism in the lung. The study aimed to elucidate its function with special interest to identify which receptors that mediate the responses. The study was conducted on human small airways isolated from patient undergoing lung surgeries. The results suggest that PGE2 can induce both a constriction and relaxation of the airways and that it has the power to inhibit the activation of mast cells, all mediated via three different receptors; TP, EP4 and EP2, respectively. This bronchoprotective action via the EP2 receptor is a new potential target for treatment of asthma and allergies and could also explain the mechanism behind the elusive aspirin-exacerbated respiratory disease, a condition where the patient gets a severe bronchoconstriction when being subjected to cyclooxygenase inhibitors, such as ibuprofen och diclofenac.
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