Professor Sir Stephen Holgate has called for urgent action to tackle a global rise in allergy cases.
It comes amid warnings that 70 percent of people in the UK could have food allergies by 2060.
Tackling the allergy epidemic
Prof Holgate is MRC Clinical Professor of Immunopharmacology at the University of Southampton and a researcher at the NIHR Southampton Biomedical Research Centre. He spoke about the urgent need to tackle the problem in a keynote speech at the BSACI Global Allergy Symposium.
He explained how environmental factors are fuelling a worldwide allergy epidemic. These include the loss of biodiversity, pollution, changes in diet and urbanisation.
An urgent, worldwide programme of clinical trials, he said, is essential to turn the tide. He said these should focus on developing immunity in babies and young children.
“Prevention is best achieved in the womb and in early life, because a developing child is very receptive to having its immune response shaped,” comments Prof Holgate. “We are talking about training an immune response similar to our learnings from the COVID-19 vaccination programme.”
His speech pointed to the development of mass programmes to halt and reverse the rise in allergies. These could potentially use bacterial extracts similar to those encountered in livestock farm dust, or minimally-processed cow’s milk as treatments. Both treatments have shown promise in pilot studies.
Inspired by a royal event
Prof Holgate's talk was based on the findings of a recent landmark workshop. The workshop, at Dumfries House in Scotland, was hosted by the then-Prince of Wales in September 2022.
The two-day event was called Understanding the Environmental Causes of Allergic Disease to Identify Effective Interventions. Sixteen world-leading allergy experts from the UK, US, Finland, Germany and Hong Kong attended.
Professor Holgate led the workshop. It was organised by The Natasha Allergy Research Foundation, set up by the parents of Natasha Ednan-Laperouse. Natasha died aged 15 in 2016 from anaphylaxis, the most severe form of allergic reaction.
Losing contact with animals
At the symposium, Prof Holgate said studies carried out across the world show a loss of biodiversity is driving the rise in allergies. Biodiversity is the all the different kinds of life in one area, the variety of animals, plants, fungi, and even microorganisms like bacteria that make up our natural world. This includes studies in Africa, China, the United States, Germany and South East Asia. Other studies show livestock farming and other aspects of a rural environment protect against the development of allergy.
He cited a study of 1,300 German children, published last summer. Those brought up on traditional farms were protected against allergy reactions. In another example from the US, two immigrant communities with common ancestry - the Hutterites and Amish - adopted different lifestyles. The Amish stuck to traditional family farming on single farms, working manually in cattle sheds. The Hutterites adopted the American communal farming lifestyle, using mechanical farming.
“If we look at prevalence of asthma and allergy, you will see a huge difference. The Amish are hugely protected, the Hutterites are not,” says Professor Holgate. Similar results have been reported across the globe, where communities have chosen different and more traditional lifestyles.
Professor Holgate adds: “Where humans come into close contact with animals, the farm environment can protect against the development of allergy. High exposure to environmental microbes leads to protection against the early development of allergic disease. In contrast, decreased biodiversity is a major driver in diminishing the protective immune reactions.”
Stopping the 'relentless rise' in allergies
One in three people in the UK now has an allergy, and the numbers continue to rise. These conditions range food and drug allergies to asthma and eczema.
Between two to three million people in the UK are living with food allergies. Hospital admissions for anaphylaxis caused by food allergies have tripled over the last 20 years, according to recent research in the British Medical Journal.
Prof Holgate warns that on the current trajectory, 70 per cent of the UK population could have food allergies by 2060. He is calling for global action.
He says: “The support of King Charles and Natasha’s Foundation in bringing together allergy scientists has enabled us to come up with a plea, to help us stop the relentless rise of allergies across our populations.
“What are needed now are large global clinical trials to determine whether modifying the lung and gut microbiome in early life through trained immunity can protect against the development of allergy.”
Nadim Ednan-Laperouse OBE, co-founder of The Natasha Allergy Research Foundation, said:
“It is quite clear that loss of biodiversity and the environment are key factors affecting the huge rise in the numbers of people with allergies. There is no time to lose in confronting the allergy and environment crisis. It is crucial that new landmark studies in this field are fully funded now. We, at Natasha's Foundation, intend to play our full role in delivering on the urgent actions required.”
BSACI Chief Executive Fiona Rayner said:
“Our understanding of the environmental factors that cause allergies and the effective interventions is a huge breakthrough. We therefore call upon our global colleagues to undertake clinical trials to protect and prevent the further development of allergies.”