Asthma is the largest chronic childhood disease. There is no cure for asthma. The lungs of children with asthma are constantly inflamed due to an excessive reaction of their immune system to inhaled, harmless substances. Immunologists found evidence that asthma among children can be prevented when the immune system is educated in the right way in the first years after birth. This is why the Lung Foundation Netherlands has brought the top scientists in immunology together in the Asthma Prevention Consortium.
Solutions in readily accessible products
Within 5 years the Asthma Prevention Consortium can prove that a special follow-up milk product for babies can protect children against asthma. This is one route that is already in the clinical phase. Overall the Consortium concentrates on four routes to find solutions for asthma.
A huge unique selling point of our approach is that the solutions will not have to be a medicine and that we expect our solutions to become widely applicable and readily accessible for children in products ready to be introduced in the market.
Educate the immune system
Top scientists from Europe and Australia collaborate in the Consortium to develop products which re-educate the immune system. These products reintroduce crucial, benign microorganisms which we seem to have lost in modern life: commensals. Scientists have discovered that commensals, that we collect from nature after birth, educate our immune system and prevent severe allergic reactions.
Back to nature
Since the start of urbanization, the number and diversity of commensals have decreased, while allergic reactions and asthma among children has increased significantly. Children growing up in traditional, rural farm communities, like the Amish in the US or small family farm communities in Germany and Switzerland, rarely develop asthma. Research has shown that these children come into contact with commensals much more often.
The Consortium aims to bring back nature to our urbanized lifestyle by re-introducing commensals to young children and thus prevent them from developing asthma. Do you see, like us, this special milk product on the shelf in the supermarket? With your help it will become a reality in the near future.
The Asthma Prevention Consortium has set itself a target for 2024:
- To have a clinically proven milk product based on minimally processed farm milk that can protect a significant group of children against asthma and allergies. This special milk product will be market-ready.
- To have a predictive diagnostic test showing which children would benefit from additional protection in addition to the special milk product.
- To have an additional preventive treatment based on farm dust, worm parasites and/or nutritional supplements.
The consortium's scope includes five promising subprojects:
Farm milk-based product to prevent asthma
Commensals, microorganisms on and in our body that protect us against their harmful cousins, influence our immune system on a daily basis. The discovery that these important commensals can flourish when children drink raw farm milk has inspired researchers in the design of a product that may prevent asthma.
This product is a baby milk powder made from minimally processed farm milk. The challenge is to produce such a milk powder that is safe for consumption while retaining the preventive properties of the original raw farm milk. The researchers will test its preventive effects in a placebocontrolled randomised intervention trial involving 2700 children. Children will drink the test milk, or normal shop milk as a comparator, from the age of six months up to their third birthday. The researchers will evaluate the frequencies of respiratory tract infections during intervention, and clinical symptoms of allergies and eczema at the age of 3 years, followed by the diagnosis of asthma at the age of 5 years. This extensive and unique trial is a significant challenge for both researchers and young families. It may lead to a major breakthrough!
- Consortium Partner: Ludwig-Maximilians-Universität München
- Research: Clinical trial to investigate the preventive effects of raw farm milk with minimal processing in 2700 babies and toddlers
- Funding requirement: €1.5 million
To predict is to prevent
The researchers involved in the clinical trial (research project 1) estimate that farm milk should be able to prevent asthma in 10 to 15% of children who currently develop asthma. This means thousands of children will then be protected. However, some children may still develop asthma despite the beneficial effects of the minimally processed milk.
The researchers predict that these children may benefit from (additional) treatment with farm dust, worm parasite derivatives and/or a modified diet. Preferably, these children should be identified at an early (st)age before disease has been established. Therefore, the researchers intend to develop a unique diagnostic test, allowing them to pinpoint those children at risk. They will determine which microorganisms can be found in the children over time, which immune-associated genes have become active and which ones have not. As a result, each child will be characterised by its own unique blueprint. This new diagnostic test will be used at a very young age (< 1 year old) to identify which children may benefit from additional treatment(s) in addition to minimally processed farm milk with the aim of reaching full protection against asthma in each child. This personalised approach will allow medical doctors to apply individually-based treatment strategies.
- Consortium Partners: Leiden University Medical Centre, Monash University, LMU Munich
- Research: Development of a diagnostic test to predict which children require (extra) treatment
- Funding requirement: €800,000
Farm dust to fight viruses
Children who grow up on family-run farms suffer significantly less from asthma and allergies compared to children who grow up in urban areas. An equally remarkable fact is that they suffer less from (severe) viral respiratory tract infections during their first year of life. Not only because they often drink farm milk, but also because they inhale the farm dust.
Frequent and severe viral respiratory tract infections during the first year of life increase the risk of developing asthma at a later stage. There are indications that farm dust can protect against these viral infections. The researchers will investigate the mechanism involved in the farm dust-induced protection against viral respiratory tract infections
by for example RS virus and rhinovirus, and thereby against asthma. This knowledge may lead to application of the beneficial effects of farm dust for children in urbanised areas.
- Consortium Partners: Ghent University, Leiden University Medical Center, Essen University Hospital
- Research: Identification of the mechanism behind the protective effects of barnyard dust
- Funding requirement: €1.3 million
Children’s diet against asthma
We know that good nutrition is essential for our health. However, the relationship between specific nutrients and healthy lungs is still largely unknown. Scientists will investigate the production of certain gut-specific molecules by the intestinal flora to gain a better understanding of this relationship.
These specific molecules, known as metabolites, are produced by our intestinal bacteria when we eat a high-fibre diet containing complex sugar structures such as can be found in milk, fruit and vegetables. It is thought that they contribute to a higher tolerance of allergenic particles in the lungs, thereby providing protection against asthma and allergies.
The researchers will investigate whether eating a modified diet may result in unique changes in intestinal flora and metabolite production. And whether or not this plays a key role in protecting against childhood asthma. They will focus on the causal relationship between a special diet and the absence of respiratory tract complaints. This research will point at the beneficial effects of a modified diet that can help to prevent asthma.
- Consortium Partner: Monash University
- Research: The effect of modified diet on intestinal flora and the lungs
- Funding requirement: €1 million
Therapeutic worm molecules
Worm parasites used to be a normal element in our intestinal flora. In tropical countries, various worm parasites are still common. Strikingly enough,
fewer children suffer from asthma in rural areas of those countries and worms may be of influence.
Worm parasites have an inhibitory effect on the human immune system. The parasite has developed a range of mechanisms to ensure its own survival. The researchers intend to use this ‘tool box’ to create a healthy balance in the immune system and prevent it from overreacting to harmless foreign substances. In previous studies, scientists have shown that specific molecules secreted by worms can have a beneficial effect on the immune system and certain tissue cells in the lung. The researchers will synthesise
these worm molecules and test their effectiveness in preventing asthma and inhibiting respiratory tract infections by using mouse models. In addition, the researchers will further identify new ‘therapeutic’ worm molecules that may act in a slightly different way. The ultimate goal is to create a potent cocktail of different molecules, which may target a large variety of immune cells and structural cells in the lung. This fundamental research is the first important step towards testing new and promising therapeutic worm-based approaches in humans.
- Consortium Partners: University of Glasgow, University of Edinburgh, Leiden University Medical Center
- Research: Synthesise and test worm molecules which pacify our immune system and our lungs
- Funding requirement: €1.4 million