A rinite alérgica (RA) é a mais comum doença mediada por IgE, que afeta aproximadamente 500 milhões de pessoas em todo o mundo. A RA é a expressão clínica da ligação entre anticorpos do tipo IgE e antígenos na mucosa nasal resultando em inflamação. Estes anticorpos foram detectados na secreção nasal de pacientes com rinite alérgica. Na abordagem da doença, temos a imunoterapia específica (IT) como único tratamento imunomodulatório antígeno específico. Foi demonstrado que IT gera uma diminuição da resposta tardia ao alérgeno tanto na pele como na mucosa do trato respiratório e esta redução se correlaciona com diminuição no número de células infiltrando os tecidos e na quantidade de mediadores inflamatórios. Objetivo: Determinar a resposta local de IgE específica e IgG4 específica no lavado nasal de pacientes com rinite alérgica antes e após o tratamento com imunoterapia alérgeno específica para Dermatophagoides pteronyssinus por um período de 6 meses; determinar a resposta inflamatória padrão Th1/ Th2/ Th17 e avaliar escore de sintomas e contagem de células no lavado nasal. Método: Selecionamos pacientes sensibilizados ao Dermatophagoides pteronissinus com diagnóstico de rinite alérgica persistente. Realizamos as analises de sintomas nasais através da escala NIS e antes de iniciar o tratamento estes indivíduos realizaram provocação nasal com alérgeno e coleta de lavado nasal. Após 6 meses de tratamento IT e placebo estes pacientes foram reavaliados. Realizamos a analise de Imunoglobulinas (IgE especifica para Der p1 e 2, IgE total, e IgG4 especifica para Der p 1), contagem de células totais, citocinas padrão Th1/Th2 e Th17. Resultados: Analisamos 19 pacientes no grupo imunoterapia e 17 no grupo placebo. A avaliação dos sintomas pela escala NIS após 6 meses de intervenção, demonstrou diferença significativa nos grupos placebo e imunoterapia, em favor da IT. A concentração do extrato utilizado na provocação nasal foi maior no grupo imunoterapia após os 6 meses de tratamento mas sem significância estatística. Quanto a dosagem das imunoglobulinas observamos diminuição da IgE total após a intervenção assim como da contagem de células totais no lavado nasal. A dosagem das citocinas livres no lavado nasal não sofreram alterações significativas. Na provocação nasal observamos aumento de IL-13, IL-10 em ambos os grupos, independente da fase de tratamento. Conclusão: Não observamos nenhuma resposta local de IgE específica e IgG4 específica no lavado nasal de pacientes com rinite alérgica antes e após o tratamento com imunoterapia alérgeno específica para Dermatophagoides pteronyssinus por um período de 6 meses. Houve melhora no escore de sintomas e diminuição da IgE total e da contagem de células no lavado nasal / Allergic rhinitis (AR) is the most common disease mediated by IgE, affecting approximately 500 million people worldwide. The AR is the clinical expression of the link between the IgE-antibodies and antigens in the nasal mucosa resulting in inflammation. Such antibodies were detected in nasal secretions of allergic rhinitis patients. As treatment for this morbidity there is specific immunotherapy (IT) as only immunomodulatory specific antigen approach. It was demonstrated that IT generates a decrease in the late response to the allergen both in the skin and in the mucosa of the respiratory tract and this reduction correlates with the decrease in the number of infiltrating cells and in the amount of inflammatory mediators. Objective: To determine the local response of specific IgE and IgG4 in nasal lavage fluids of patients with allergic rhinitis before and after treatment with specific allergen immunotherapy to house dust mite for a period of 6 months; determine the standard inflammatory response of Th1 / Th2 / Th17 and evaluate symptom score and cell counts in nasal lavage. Method: We selected patients sensitized to Dermatophagoides pteronissinus diagnosed with persistent allergic rhinitis. Nasal symptoms were assessed by Nasal Index Score, and before treatment, allergen nasal challenge and collection of nasal lavage fluid were performed. After 6 months of treatment or placebo, the patients were reevaluated. IgE specific for Der p 1 and 2, total IgE and IgG4 specific for Der p 1, total cell count were determined as well as Th1 / Th2 and Th17 cytokines. Results: We analyzed 19 patients in the immunotherapy group and 17 in the placebo group. The evaluation of symptoms by NIS scale after 6 months of intervention showed significant differences in favor of the immunotherapy group. The concentration of the extract used in the nasal challenge was higher in the immunotherapy group after 6 months of treatment but without statistical significance. The total IgE decreased after the intervention as well as the total cell count in nasal lavage. The dosage of the free cytokines in nasal lavage fluid did not change significantly. In the nasal provocation we observe an increasing in IL-13 and IL-10 in both treatment groups. Conclusion: We observed no local changes in specific IgG4 or specific IgE response in nasal lavage fluid of patients with allergic rhinitis before and after treatment with specific allergen immunotherapy to house dust mite for a period of 6 months. There was an improvement in symptom scores and a decreased of total IgE and cell counts in nasal lavage

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-05-17T14:40:56Z No. of bitstreams: 1 anaclaudiacarvalhogouveia.pdf: 2060044 bytes, checksum: a2757483182ff953fdffbf86f346380b (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-06-28T14:35:33Z (GMT) No. of bitstreams: 1 anaclaudiacarvalhogouveia.pdf: 2060044 bytes, checksum: a2757483182ff953fdffbf86f346380b (MD5) / Made available in DSpace on 2016-06-28T14:35:33Z (GMT). No. of bitstreams: 1 anaclaudiacarvalhogouveia.pdf: 2060044 bytes, checksum: a2757483182ff953fdffbf86f346380b (MD5) Previous issue date: 2012-08-30 / FAPEMIG - Fundação de Amparo à Pesquisa do Estado de Minas Gerais / A asma alérgica é uma doença inflamatória crônica das vias aéreas, caracterizada por uma resposta de hipersensibilidade imediata, obstrução brônquica, inflamação pulmonar e níveis elevados de IgE. A doença é mediada principalmente por uma resposta imunológica alérgeno-específica tipo Th2. Nas últimas décadas, a prevalência da asma alérgica tem aumentado significativamente, sobretudo nos países desenvolvidos. A Hipótese da Higiene atribui este aumento a uma menor exposição a determinados microrganismos durante a infância, quando o amadurecimento adequado do sistema imunológico requer estímulos que induzam respostas imunológicas de perfil Th1, fundamentais para o equilíbrio de respostas Th2 exacerbadas. Diversos trabalhos epidemiológicos parecem comprovar esta hipótese, evidenciando a existência de uma relação inversa entre o contato com microrganismos indutores de uma resposta Th1 e o desenvolvimento de asma alérgica. Paralelamente, estudos em modelos murinos constataram que o tratamento com Mycobacterium bovis BCG (BCG) reduz respostas Th2 alérgenoespecíficas. No entanto, os mecanismos pelos quais a micobactéria inibe o desenvolvimento da resposta alérgica são ainda pouco conhecidos. Este estudo avaliou o efeito da administração do BCG sobre a resposta imunológica ocorrida na alergia pulmonar em camundongos BALB/c previamente sensibilizados e desafiados com OVA. Vinte e quatro horas após o último desafio, o sangue e o lavado broncoalveolar foram coletados para análises de imunoglobulinas e contagem de células, respectivamente. Adicionalmente, os pulmões foram submetidos à análise histológica, avaliação da atividade de EPO e dosagens de citocinas e quimiocinas, assim como avaliação da expressão de CTLA-4, Foxp3 e IL-10 por citometria de fluxo. Os resultados obtidos indicam que o tratamento com BCG melhorou o processo alérgico através da redução dos principais parâmetros relacionados à resposta Th2, como o infiltrado eosinofílico pulmonar, a atividade de EPO, IL-4, IL-13, CCL11, além de IgE e IgG1 específicas anti-OVA. Por outro lado, a administração da micobactéria aumentou os níveis de IFN-γ, IL-10 e TGF-β, além das expressões de Foxp3 e CTLA-4 pelos linfócitos T CD4+. Paralelamente, houve um aumento na produção de IL-10 pelos linfócitos T CD8+. Esses dados sugerem que, além da indução de uma resposta imune Th1, a ação imunomoduladora do BCG está relacionada também à indução de mecanismos reguladores. / Atopic asthma is a chronic respiratory disease characterized by airway hyperresponsiveness, reversible airway obstruction, lung inflammation, and high levels of allergen-specific IgE, driven by allergen-specific Th2 cells. The increasing prevalence of allergic diseases, particularly in industrialized countries, has led to the hygiene hypothesis, which states that the newborn infant’s immune system is skewed toward Th2 responses and needs timely and appropriate environmental stimulus to create a balanced immune response. Supporting this hypothesis, epidemiological and experimental evidence has shown an inverse correlation between Th1-induced microbial infections and atopic asthma. Similarly, some animal studies have demonstrated that exposure to Mycobacterium tuberculosis or to environmental mycobacteria is able to protect against the development of allergic responses. However the exact mechanism underlying this inhibition still remains poorly understood. This study aimed to evaluate the ability of BCG to suppress an established allergic response in a mouse model of OVA-induced airway inflammation. To achieve this, OVA sensitized and challenged BALB/c mice were twice treated with BCG via nasal and 21 days after the first treatment, mice were rechallenged with OVA. Twenty-four hours after the last challenge, blood samples were collected to detect anti-OVA immunoglobulin isotypes, and bronchoalveolar lavage (BAL) was harvested for cell count. Additionally, lungs were collected for histological analysis, detection of EPO activity and measurement of cytokines and chemokines. The expression of CTLA-4, Foxp3 and IL-10 was also determined in lung tissue by flow cytometry. The data indicated that BCG treatment was able to inhibit an established allergic Th2-response by decreasing the allergen-induced eosinophilic inflammation, EPO activity, levels of IL-4, IL-13, CCL11 and serum levels of IgE and IgG1. Mycobacteria treatment increased lung levels of IFN-γ, IL-10 and TGF-β, and expressions of Foxp3 and CTLA-4 in CD4+T cells. Additionally, an increased production of IL-10 by CD8+ T cells was observed, even though no detectable changes in CD4+IL-10+ was noticed. Altogether, these results suggest that the mechanism underlying the down-regulatory effects of BCG on OVA-induced airway inflammation appear to be associated with the induction of both Th1 and T regulatory immune responses.

Allergy, as one of the worldwide most frequent pathologies, belongs to illnesses with constantly growing incidence among young children. Identification of prognostic markers pointing to increased risk of allergy development, allows introduction of early preventive measures. Probiotic supplementation could be one the preventive measure. It has been shown that introduction of selected probiotic strains or mixtures can prevent development of allergy. In this diploma thesis, the capacity of probiotic strain Escherichia coli O83:K24:H31 (E. coli O83) to support maturation of dendritic cells and polarization of immune responses was tested. Introduction of this probiotic vaccine called Colinfant Newborn appears to be suitable preventive measure, lowering allergy incidence in children with predisposition to development of allergy. The capacity of E. coli O83 to support maturation of the two main subpopulations of dendritic cells (myeloid dendritic cells - mDC and plasmacytoid dendritic cells - pDC) in cord blood of newborns of healthy mothers (children with relatively low risk for allergy development) and allergic mothers (children with relatively high risk for allergy development) was measured by flow cytometry. The presence of cytokines and transcription factors characteristic for particular...

Notre volonté d'économiser l'énergie nous pousse à vivre dans un environnement confiné favorisant les acariens et les micro-organismes. L'objectif de la thèse est de caractériser la contamination en acariens et en micro-organismes des logements de patients présentant des pathologies respiratoires, d'évaluer l'influence des interactions acariens/moisissures sur l'exposition aux allergènes et de comprendre les facteurs favorisant la pollution biologique de l'air intérieur. Afin de disposer d'un outil commun aux acariens et aux micro-organismes, un modèle innovant de quantification des acariens pas qPCR a été mis au point. Les acariens de stockage sont sous-estimés et les mesures d'éviction doivent être appliquées à l'ensemble de l'habitat. L'observation des interactions acariens/moisissures a montré une vraie relation symbiotique: dispersion des moisissures et apports des nutriments essentiels aux acariens. La contamination des logements de producteurs laitiers atteint de BPCO a été comparée à celle de producteurs laitiers sains, de patients BPCO non­-agriculteurs et de sujets sains non-agriculteurs. L'exposition agricole est abondante et spécifique à certains micro­organismes caractéristiques de la ferme et la sensibilité IgG à Wallemia sebi est spécifique des producteurs laitiers BPCO Le suivi de l'impact du compostage sur la qualité biologique de l'air intérieur a démontré une augmentation des concentrations en acariens de stockage et certaines moisissures circonscrite au bio-seau. De nouveaux indicateurs communs aux acariens, aux moisissures et aux bactéries devraient nous permettre de progresser dans la détermination de la relation dose/effet. / Our will to save energy leads us to live in a confined environment providing the ideal conditions to mites and microorganisms development. The aim of the thesis is to characterize mites and microorganisms contamination of dwellings from patients suffering respiratory diseases, to estimate the influence of the interactions between various organic communities on the allergens exposure and to understand the factors increasing the biological pollution ofindoor air. To evaluate our exposition, we needed to quantify mites and microorganisms with a common tool and an innovative quantification mode! of domestic mites by qPCR was developed. The presence of storage mites is overemphasized in dwellings of allergie patients and the eviction measures of mites should be applied into any rooms of dwellings. The contamination of dairy fanners' dwellings suffering from COPD was compared with that ofhealthy dairy fanners, COPC patients non-farmers and healthy non-fanners. In dwellings, the dairy fanners' exposure was important and specific ofth1 fanning environment. The lgG sensitivity to Wallemia sebi was significantly specific of dairy fanners suffering from COPD. The impact of the composting on the biological air quality was evaluated and the concentrations in storage mites and some molds increased significantly only in a confined area around the waste bin. New common indicators of domestic mites, molds and bacteria should allow us to progress in the determination of the dose-response relationship for the different allergens and their possible synergie effects.

La voie des RLR (RIG-I like Receptors) joue un rôle essentiel dans la détection des virus à ARN, déclenchant une réponse immunitaire antivirale grâce au recrutement de la protéine adaptatrice mitochondriale MAVS (Mitochondrial AntiViral Signaling protein). Nous avons mis en évidence que les souris déficientes pour la protéine MAVS (MAVS KO) présentaient un phénotype proallergénique dans un modèle d'inflammation stérile d'hypersensibilité retardée de contact (HSRC) qui reproduit la dermatite allergique de contact (DAC) chez l'homme. Nous avons caractérisé le système immunitaire des souris MAVS KO en condition d'équilibre et durant la réponse d'HSRC. Nous avons identifié un rôle du microbiote intestinal des souris MAVS KO dans l'exacerbation de réponse d'HSRC et mis en évidence une dysbiose du microbiote bactérien. Nous avons démontré que la dysbiose était responsable du phénotype inflammatoire observé, phénotype transmissible à des souris sauvages par des expériences de cohébergement et de transplantation fécale. Cette dysbiose induit une augmentation de la perméabilité intestinale chez les souris MAVS KO lors de la réponse d'HSRC, aboutissant à une translocation bactérienne dans les organes lymphoïdes et à la modulation des réponses immunitaires à l'origine de l'exacerbation de réponse d'hypersensibilité. La 2ème partie de ma thèse vise à étudier les conséquences de la déficience en MAVS sur le métabolisme glucidique. Nos expériences ont démontré que les souris MAVS KO développaient une surcharge pondérale et une insulino-résistance sous régime riche en lipides et sucrose, dépendants de la dysbiose intestinale. Au niveau cellulaire, une altération des interactions aux points de contact entre la mitochondrie et le réticulum endoplasmique a été observée. Nos résultats permettent d'envisager le développement de nouvelles approches thérapeutiques des pathologies allergiques et métaboliques humaines par la modulation du microbiote intestinal / RIG-I like receptors (RLRs) play a major role in response to cytosolic viral RNAs by initiating an antiviral immune response through the recruitment of the mitochondrial adaptor protein MAVS (Mitochondrial AntiViral Signaling protein). We showed that MAVS-deficient mice developed an exacerbated response in a sterile inflammatory model of Contact Hypersensitivity (CHS), that reproduces the pathophysiology of allergic contact dermatitis (ACD) in human. We characterized the immune system of MAVS KO mice at steady state and during CHS response. We found that MAVS deficiency leads to changes in the gut bacterial composition suggesting an unexpected role of the RLR pathway in the regulation of intestinal homeostasis. We demonstrated that intestinal dysbiosis is responsible for the increased CHS response, and showed that the inflammatory phenotype of MAVS KO mice can be transferred to WT mice by cohousing and fecal transplantation. We demonstrated that the dysbiotic gut microbiota exerts its effect due to an increased intestinal permeability during DTH sensitization. The ensuing bacterial translocation within lymphoid organs enhances characteristic cytokines production that increases CHS response. The 2nd part of my thesis aimed to study the consequences of MAVS deficiency on glucose metabolism. Our experiments showed that MAVS KO mice exhibit disorders of glucose homeostasis during high fat diet (HFD) associated with the development of overweight and insulin resistance. We also observed alterations of MAM (Mitochondria-associated endoplasmic reticulum membranes), contact poins between mitochondria and endoplasmic reticulum. Recent preliminary data suggested that the metabolic disorders associated with MAVS deficiency are due to intestinal dysbiosis. Our results highlight a new role for the RLR pathway and allow to consider the development of new therapeutic approaches to human allergic and metabolic diseases by modulation of the intestinal microbiota

La tolérance périphérique vis-à-vis de molécules potentiellement allergéniques en contact avec la peau joue un rôle essentiel pour prévenir le développement de l’eczéma allergique de contact (EAC). Au cours de ma thèse, j'ai contribué à l'identification des mécanismes et des acteurs responsables de l'induction de la tolérance par voie cutanée et à préciser le rôle respectif des sous-populations de cellules dendritiques (DC) cutanées dans la rupture de la tolérance et l'induction de lymphocytes T (LT) CD8+ initiant l'EAC. A l'aide d'un modèle murin d'induction de tolérance aux haptènes, j’ai pu montrer que les cellules de Langerhans (LC) épidermiques sont les cellules clés pour induire la tolérance cutanée et empêcher le développement d'un EAC médié par les LT CD8+. En effet, suite à l’application épicutanée d’un allergène/haptène faible, le DNTB, les LC migrent de la peau aux ganglions lymphatiques pour présenter l’antigène aux LT CD8+. Des expériences de déplétion in vivo et de transfert adoptif montrent que les LC sont responsables de la suppression de l’EAC en prévenant la différentiation des LT CD8+ spécifiques de l'allergène en cellules T cytotoxiques via deux mécanismes complémentaires: i) l’anergie/délétion des LT CD8+ et ii) l'activation de LT régulateurs Foxp3+ exprimant ICOS. Après avoir identifié des conditions d'immunisation conduisant au développement d'un EAC au DNTB, j'ai montré que la rupture de tolérance à ce type d'allergène est associée à i) à des modifications phénotypiques des LC épidermiques, ii) au recrutement rapide de monocytes inflammatoires Gr1+ dans la peau et iii) à une capacité équivalente des LC et des DC dermiques Langerin- à présenter l'allergène aux LT CD8+ dans les ganglions. Dans cette situation, les LC jouent un rôle pro-inflammatoire puisque leur déplétion réduit de manière dramatique l'induction de LT CD8+ effecteurs et l'EAC. Ces résultats indiquent que les LC jouent un rôle essentiel à la fois dans la prévention et dans l’induction de l’EAC, et que leur fonction tolérogène ou stimulatrice est vraisemblablement conditionnée par le microenvironnement cutané lors de la pénétration de l’allergène / Induction of peripheral tolerance to potentially allergenic molecules in contact with the skin is essential to prevent the development of allergic contact dermatitis (ACD). During my PhD, I contributed to the identification of the mechanisms and actors responsible for the induction of skin tolerance and clarified the respective roles of dendritic cell (DC) subsets in the breakdown of skin tolerance leading to the priming of cytotoxic CD8+ T cells and developpement of ACD. Using a mouse model of cutaneous tolerance to a model weak allergen, we show that epidermal Langerhans cells (LC) are essential to induce CD8+ T cell tolerance and prevent the development of ACD. Indeed, following the epicutaneous delivery of the weak allergen/hapten DNTB, LC were found to migrate from skin to draining lymph nodes to present the allergen to CD8+ T cells. Depletion and adoptive transfer experiments revealed that LC protect from development of ACD by preventing the priming of allergenspecific cytotoxic CD8+ T cells via two complementary mechanisms: i) anergy/deletion of allergen-specific CD8+ T cells and ii) activation of highly suppressive Foxp3+ regulatory T cells expressing ICOS. We identified DNTB skin delivery conditions that allow for CD8+ T cell priming and initiation of ACD. Breakdown of tolerance to this weak allergen was associated with i) phenotypic modifications of epidermal LC, ii) recruitment of inflammatory monocytes to the skin and iii) allergen presentation to CD8+ T cells by both LC and dermal Langerin- DC. In addition, LC are involved in tolerance breakdown as their depletion prior to skin immunization abrogated induction of CD8+ effector cells and ACD. These results demonstrate that LC are essential for both the induction of skin tolerance to weak skin allergens and for the induction of ACD, and suggest that their tolerogenic versus immuno-stimulatory function is likely dictated by signals from the skin microenvironment after penetration of the allergen

Contexte : Les dermatoses professionnelles sont l’une des principales causes de pathologies professionnelles en Europe, et dans près de 80% des cas, elles concernent des dermatites de contact professionnelles (DCP). Les DCP comprennent les dermatites allergiques de contact (DAC), les dermatites irritatives de contact (DIC) et les urticaires de contact (UC). En France, les secteurs et nuisances à risque de DCP et les tendances chronologiques de DCP sont très peu documentés. Objectifs : 1) étudier les tendances observées au fil du temps vis-à-vis du nombre de cas de dermatoses professionnelles, des secteurs d’activité concernés et des nuisances mises en cause, 2) mettre en évidence des secteurs ou des postes à risque de dermatoses professionnelles. Méthode : Ce travail de thèse s’appuie sur le réseau français RNV3P (Réseau national de vigilance et de prévention des pathologies professionnelles) qui assure le suivi des évènements de santé liés au travail sur l’ensemble du territoire, en centralisant les informations recueillies dans ses 32 centres de consultations de pathologies professionnelles (CCPP). Les analyses ont porté sur les DAC, les DIC et les UC en lien probable ou certain avec le travail et recensées dans le RNV3P entre 2001 et 2010. L’analyse des évolutions temporelles a été réalisée à partir des rapports de cote de signalement (Reporting Odds-Ratio, ROR). Deux méthodes statistiques ont été utilisées : le coefficient de corrélation de rang de Kendall sur les ROR estimés chaque année et le modèle logistique calculant la variation annuelle des cas. Résultats : Les 5990 cas de DCP notifiés touchent plus fréquemment les femmes, dans des tranches d'âges jeunes. Les principaux secteurs mis en cause pour les trois DCP se distribuent différemment en fonction du sexe et sont, par ordre décroissant de fréquence : santé et action sociale, services personnels, construction, métallurgie et travail des métaux, administrations publiques, services fournis principalement aux entreprises, commerce et réparation automobile, hôtellerie et restauration. Les DCP associées aux cosmétiques (savons ou substances parfumantes) et les biocides augmentent significativement dans le secteur de la santé et de l’action sociale ; les produits de coiffure et les cosmétiques (savons essentiellement) augmentent dans celui des services personnels, essentiellement parmi les coiffeuses. On observe une montée des cas de DAC aux résines époxy dans la construction sur la période et les DIC liées au ciment dans ce secteur ne baissent pas. Les cas de DAC aux métaux augmentent dans le secteur des services fournis aux entreprises (personnels de nettoyage). Nos résultats ont aussi montré une hausse des DAC liées aux isothiazolinones, quel que soit le secteur (+38%) et une baisse des DIC liées à l’action de lavage des mains (utilisation itérative des savons). Par ailleurs, nos données ont objectivé l’impact de mesures réglementaires ou de politiques visant à prévenir les DCP : la mise en place de la directive européenne « Ciment » (2003/53/CE) en 2005 s’est accompagnée d’une réduction de moitié des cas de DAC et une baisse similaire a été observée à partir des données du réseau britannique EPIDERM, confortant nos conclusions ; la campagne de substitution des gants en latex dans le secteur de soins au milieu des années 2000 est suivie d’une réduction significative de la notification des cas d’UC. Conclusion : Ces résultats démontrent, avec l’exemple des dermatoses professionnelles, la capacité du RNV3P à orienter les politiques nationales en matière de prévention des risques professionnels et à en évaluer l’efficacité. / Background: In Europe, occupational skin disease is one of the major causes of work-related diseases, among them occupational contact dermatitis (OCD) accounts for 80% of all cases of OSD reported, but data about sectors and agents at risk remains sparse. Objectives: 1) to study OCD trends in terms of industrial activities and main causal agents, 2) to describe industrial sectors or occupations at risk of OCD. Method: Data were collected from the French National Network of Occupational Disease Surveillance and Prevention (RNV3P) during 2001-2010 period, based on the 32 French Occupational and Environmental Disease Consultation Centres. All allergic contact dermatitis (ACD), irritative contact dermatitis (ICD) and contact urticaria (CU) probably or certainly work-related were included in the study. Trends were examined (i) on annual crude numbers of OCD and (ii) on reported odds-ratios of OCD calculated using logistic regression models. Results: 5990 OCD cases were included and concerned more frequently young age classes among women and older age classes among men. Industrial sectors more commonly involved in OCD concerned in decreasing order: health and social work activities, personal service activities, construction, metal industry, public administrations, other business activities, retail trade and repair of motor vehicles, and hotels and restaurants. According to trend analysis of OCD cases, cosmetics (including soaps and fragrances) and biocides increased significantly in health and social work activities; hairdressing products and cosmetics (mainly soaps) in personal service activities (including primarily hairdressers). In construction sector, ACD due to epoxy resins increased during the study period and concomitantly, ICD attributed to cement did not decrease underlying the lack of prevention in this sector at risk. ACD due to metals increased in other business activities mainly occupied by cleaning staff. We showed a rise of ACD due to isothiazolinone compounds whatever the sector. Besides, we have shown the impact of regulatory measures or prevention campaign on OCD: (i) a significant reduction by almost half in the occurrence of ACD attributed to chromate in cement which coincides with the implementation of the European Cement directive and we obtained similar results to a study based on the UK EPIDERM network; (ii) the effectiveness of latex exposure prevention measures for health care workers since half of 2000s and (iii) the wide use of disinfection with an alcohol-based solution in health and social work activity followed by a significant reduction of ICD due to iterative handwashing with soap. Conclusion: RNV3P data allowed to highlight causal agents involved in sectors most at risk of OCD. These results might help intervention policy in health and safety at work and allergy prevention. They also showed the effectiveness of preventative intervention on OCD, suggesting that RNV3P reporting scheme is useful in France to evaluate intervention policy in health and safety at work.

Contexte : La prévalence de l'asthme et des allergies a augmenté au cours de ces dernières décennies,en particulier chez les enfants et dans le monde occidental. Cette augmentation de la prévalence estdevenue un problème très grave de santé publique et pourrait être liée à une combinaison deprédisposition génétique, de facteurs environnementaux et des changements dans le mode de vie, ycompris les habitudes alimentaires. Cependant, les études épidémiologiques concernant les maladiesallergiques chez l’enfant en relation avec l'alimentation sont rares.Objectifs : Ce travail analyse la littérature récente traitant l'alimentation, les habitudes alimentaires et lanutrition en relation avec les maladies allergiques chez les enfants en tenant compte de la méthodologieutilisée pour évaluer les habitudes alimentaires. En outre, il évalue en premier lieu l'association entre leshabitudes alimentaires et l'asthme et les maladies allergiques et en deuxième lieu la relation entrel'asthme et le surpoids/l’obésité dans l’étude des six villes françaises.Méthodes : MEDLINE/PubMed et Cochrane Database of Systematic Reviews ont été utilisés pour larevue de la littérature concernant l'alimentation et les maladies allergiques. Des études transversales ontété menées à Bordeaux, Clermont-Ferrand, Créteil, Marseille, Reims, Strasbourg sur 7 432 enfantsscolaires, choisis au hasard et âgés de 9-11 ans. Des questionnaires adressés aux parents, basés surl'Enquête internationale sur l'asthme et les allergies dans l'enfance (ISAAC), ont été utilisés pourrecueillir des informations sur les maladies allergiques et les facteurs de risque potentiels, y compris unquestionnaire de fréquence alimentaire pour évaluer les habitudes alimentaires des enfants. Des testscutanés aux allergènes communs ont été effectués afin d'identifier l'existence d'une hypersensibilitéallergique et des tests d’effort ont été effectués pour évaluer l'asthme à l’effort.Résultats : Les apports moyens de 12 principaux produits alimentaires consommés par les élèves ontété calculées et trois profils alimentaires ont été extraits par analyse en composantes principales:l’alimentation proche du régime méditerranéen, l’alimentation à base d’oméga-3 et de poissons gras etl’alimentation non équilibrée. Les risques relatifs des maladies allergiques ont été estimés par des odds7ratios (OR) et le contrôle des facteurs de confusion a été réalisé par des régressions logistiques. Lessifflements, l’asthme et la rhinite sont plus fréquents chez les garçons que chez les filles. En analysemultivariée, l’alimentation à base d’oméga-3 avait un effet protecteur contre l'asthme vie et l’asthmesévère chez les enfants (OR ajusté: 0,77 ; IC 95%: [0,62 -0,96] et OR ajusté: 0,55 ; IC 95%: [0,32 -0,94]respectivement). L’adhérence à une alimentation proche du régime méditerranéen et riche enantioxydants semble avoir un effet protecteur contre les maladies allergiques. Le surpoids et l’obésitéont été positivement associés avec l’asthme vie chez les enfants ne présentant pas de sifflements (ORajusté: 1,98 ; IC 95%: [1,06 -3,70]) et ont été de même associé positivement avec la rhinite vie et larhinite 12 mois chez les enfants présentant des sifflements (OR ajusté: 1,63 ; IC 95%: [1,09 -2,45] etOR ajusté: 2,20 ; IC 95%: [1,13 -4,27] respectivement), mais pas avec l’asthme à l’effort.Conclusion: Dans l'ensemble, l'adhésion à un régime alimentaire sain, y compris les antioxydants et lesoméga-3 semble avoir un effet protecteur sur l'asthme et les allergies chez les enfants. Le surpoids etl’obésité a été associé significativement avec l’asthme chez les enfants non atopiques et la rhiniteallergique chez les enfants atopiques. Des études prospectives longitudinales sont donc nécessaires pourpouvoir évaluer les relations de causalité. / Background: The prevalence of asthma and allergy has risen in recent decades, especially amongchildren and in the Western world. This increase in prevalence has become a serious public healthproblem and might be related to a combination of genetic predisposition, environmental factors, andlifestyle changes, including dietary habits. However, epidemiological studies concerning childhood dietrelatedallergic diseases are scarce.Objectives: This work reviews published literature dealing with diet, dietary patterns and nutrition inrelation with allergic diseases among children taking into account the methodology used to evaluatedietary patterns. Moreover, it assesses primary the association between food patterns and asthma andallergic diseases and secondary the relation between asthma and overweight/obesity in the French SixCities Study.Methods: MEDLINE/PubMed and Cochrane Database of Systematic Reviews were used for theliterature review concerning diet and allergic diseases. Cross-sectional studies were conducted inBordeaux, Clermont-Ferrand, Créteil, Marseille, Reims, and Strasbourg among 7432 randomly selectedschoolchildren aged 9-11 years. Parental questionnaires, based on the International Study on Asthmaand Allergies in Childhood (ISAAC), were used to collect information on allergic diseases and potentialrisk factors including a food frequency questionnaire to evaluate dietary habits. Skin prick testing tocommon allergens was performed to identify the existence of an allergic hypersensitivity and exercisetest was performed to assess Exercise-Induced Asthma (EIA).Results: The mean intakes of 12 main food items were calculated and three food patterns wereextracted by principal component analysis labeled: the Mediterranean-like diet, the diet rich in omega-3fatty acids and the unhealthy diet. Relative risks of allergic diseases were estimated as odds ratios (OR)and confounders control was performed with multiple logistic regressions. Wheezing, asthma andrhinitis were more prevalent in boys than in girls. In the multivariate analysis, diet rich in omega-3 wasprotective for lifetime and severe asthma in children (adjusted OR: 0.77; 95% CI: [0.62 -0.96] and9adjusted OR: 0.55; 95% CI: [0.32 -0.94] respectively). Adherence to the Mediterranean-like diet rich inantioxidants tended to be protective against allergic diseases. Overweight and obesity were positivelyassociated with lifetime asthma in non-wheezing children (adjusted OR: 1,98 ; 95% CI: [1,06 -3,70])and were also positively associated with lifetime and past year allergic rhinitis in wheezing children(adjusted OR: 1.63; 95% CI: [1.09 -2.45] and adjusted OR: 2.20; 95% CI: [1.13 -4.27] respectively), butwere not associated with EIA.Conclusion: Overall, adherence to a healthy diet including antioxidants and omega-3 fatty acids seemsto have a protective effect on asthma and allergy in childhood. Overweight and obesity weresignificantly associated with asthma in non-atopic children and with allergic rhinitis in atopic children.Prospective longitudinal studies should be necessary for evaluation of causal relations.

Allergic manifestations are increasingly common in infants and children. Accumulating evidence suggests that the ‘epidemic’ increase of childhood allergy may be associated with environmental factors such as stress. Although the impact of stress on the manifestation and exacerbation of allergy has been demonstrated, the underlying mechanisms of stress-induced exacerbation are still obscure. A growing number of studies have suggested an altered hypothalamus-pituitary-adrenal (HPA) axis function to stress in allergic children. It is speculated that a dysfunctional HPA axis in response to stress may facilitate and/or consolidate immunological aberrations and thus, may increase the risk for allergic sensitization and exacerbation especially under stressful conditions. In the present review the potential impact of a hyporesponsive as well as a hyperresponsive HPA axis on the onset and chronification of childhood allergy is summarized. Moreover, potential factors that may contribute to the development of an aberrant HPA axis responsiveness in allergy are discussed. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Denna studie är ett kandidatarbete i informationsdesign som fokuserar på interaktionsdesign. Den syftar specifikt till att utveckla och utvärdera en innovativ applikation som förenklar valet av hudvårdsprodukter för personer med allergier och hudkänslighet. Studien använde en kombination av kvalitativa metoder, inklusive intervjuer och användbarhetstester, och kvantitativa metoder, såsom enkäter, för att samla in data. Denna rapport detaljerar utvecklingsprocessen från forskning och användarstudier genom iterativa design och testfaserna till skapandet av en slutlig högkvalitativ prototyp. Utvecklingen innefattade samråd med experter och potentiella användare för att säkerställa en användarcentrerad designinsats. Olika teorier, inklusive kognitiv belastningsteori och principer för användarcentrerad design, tillämpades för att förbättra applikationens användbarhet. Resultatet av denna studie är en högkvalitativ prototyp av Allergo. Denna applikation innehåller funktioner som en ingrediensscanner, personliga allergilarm, personliga hudvårdsrekommendationer, community-feedback och recensioner samt en rutintracker. Applikationen hjälper användare att snabbt och effektivt identifiera säkra hudvårdsprodukter, vilket främjar en känsla av förtroende och kontroll över deras hudvårdsval. / This study is a bachelor's thesis in information design that focuses on interaction design. It specifically aims to develop and evaluate an innovative application that aims to simplify the choice of skin care products for people with allergies and skin sensitivities.  The study employed a combination of qualitative methods, including interviews and usability testing, and quantitative methods, such as questionnaires, to gather data. This report details the development process from research and user studies through iterative design and testing phases to the creation of a final high-fidelity prototype. The development involved consultations with experts and potential users to ensure a user-centered design approach. Various theories, including Cognitive Load Theory and User-Centered Design principles, were applied to enhance the application's usability. The outcome of this study is a high-fidelity prototype of Allergo. This application integrates features like an ingredient scanner, personal allergy alerts, personalized skincare recommendations, community feedback, and reviews, as well as a routine tracker. The application helps users identify safe skincare products quickly and effectively, fostering a sense of confidence and control over their skincare choices.