The rising of allergic respiratory diseases in a changing world: from climate change to migration

ABSTRACT

Introduction

The rising of allergic respiratory diseases (ARDs) suggests a decisive role of environmental factors, that have dramatically changed in the last decades.

Areas covered

This review addresses various aspects of the external exposome acting on the development, progression, clinical presentation and severity of ARDs. Climate change, air pollution and biodiversity loss act directly and through their complex interactions on atopic risk: reacent foundings on these aspects are discussed herein. The review also focuses on migration studies, underling the possible role of migrant status as an experimental model to study environment effects on atopy onset and progression.

Expert opinion

Future perspective on this topic include prevention and mitigation strategies in regard to pollution and climate change, improvement of environmental monitoring methods, implementation of public health policies, further advances in ‘omics’ research and knowledge, prospective and immunological research on migrant populations and new policies to face human mobility.

KEYWORDS:

• Allergy
• asthma
• environment
• exposome
• climate change
• air pollution
• biodiversity
• mitigation
• prevention

Article highlights

• Allergic respiratory diseases and climate change: direct effects of meteorological factors as well as interactions between meteorological factors, air pollutants and allergens influence the development and severity of allergic respiratory diseases.

• Allergic respiratory diseases and air pollution: indoor and outdoor pollutants interact with aeroallergens and impact allergic respiratory diseases.

• Allergic respiratory diseases and biodiversity loss: the biodiversity loss, the influence of farm environment, the urban-rural gradient of risk and the role of microbiome are connected with allergic respiratory diseases.

• Allergic respiratory diseases and migration: migration studies constitute a performing experimental model of the environment action on atopy onset and progression.

• Future perspective: prevention and mitigation strategies in regards to pollution and climate change are of outstanding importance to human health. Public health policies promoting healthy lifestyle and early diagnosis and treatment of allergies are needed. Methods for environmental monitoring should be improved, especially in regard to aerobiological information, using new technologies and possibly patients and/or citizens reports. Further research in ‘omics’ is a very promising field that will lead to a deeper knowledge of immunological mechanisms leading to atopic diseases and will enable to obtain accurate prevention strategies. Migration studies describing the longitudinal trajectory of allergic diseases onset and development should be promoted to unveil unknown aspects of environment action on human immune system. New policies to face human mobility are needed and migration status should be addressed as a health determinant in near future.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.