TY - JOUR
T1 - Alpine altitude climate treatment for severe and uncontrolled asthma
T2 - An EAACI position paper
AU - Fieten, Karin B.
AU - Drijver-Messelink, Marieke T.
AU - Cogo, Annalisa
AU - Charpin, Denis
AU - Sokolowska, Milena
AU - Agache, Ioana
AU - Taborda-Barata, Luís Manuel
AU - Eguiluz-Gracia, Ibon
AU - Braunstahl, Gerrit J.
AU - Seys, Sven F.
AU - van den Berge, Maarten
AU - Bloch, Konrad E.
AU - Ulrich, Silvia
AU - Cardoso-Vigueros, Carlos
AU - Kappen, Jasper H.
AU - Brinke, Anneke ten
AU - Koch, Markus
AU - Traidl-Hoffmann, Claudia
AU - da Mata, Pedro
AU - Prins, David J.
AU - Pasmans, Suzanne G. M. A.
AU - Bendien, Sarah
AU - Rukhadze, Maia
AU - Shamji, Mohamed H.
AU - Couto, Mariana
AU - Oude Elberink, Hanneke
AU - Peroni, Diego G.
AU - Piacentini, Giorgio
AU - Weersink, Els J. M.
AU - Bonini, Matteo
AU - Rijssenbeek-Nouwens, Lucia H. M.
AU - Akdis, Cezmi A.
N1 - Funding Information: CA has received research grants from the Swiss National Science Foundation, Christine Kühne‐Center for Allergy Research and Education, European Commission Horizon's 2020 Framework Programme “CURE,” Novartis Research Institutes, GlaxoSmithKline and AstraZeneca. He took part in the advisory board and received research grants from GlaxoSmithKline, Sanofi/Regeneron, SciBase, and Novartis. He is the Editor‐in‐Chief of Allergy. IA has received payments from Sanofi, Chiesi, Novartis, AZN, Mylan and participated on advisory boards from Sanofi, Chiesi, Novartis, AZN. She is Associate Editor of Allergy and CTA. MS has received research grants from the Swiss National Science Foundation, GlaxoSmithKline, Novartis, and AstraZeneca speaker fee. MC is currently employed by Roche, with no relation to this work. GJB received research grants from AstraZeneca and received payments for consultations and/or speaking at conferences from Novartis, Sanofi, GSK, AstraZeneca, ALK, TEVA, and Chiesi. AC is health director at the Institute Pio XII, Misurina, Italy since June 1, 2020. GP serves on the scientific advisory board to the owner of the Institute Pio XII, Misurina since the beginning of 2020 and received payments for advisory board participation and or speaker fees from GlaxoSmithKline, Novartis, Sanofi, Regeneron, Chiesi, Omron, NOOS, Angelini, Recordati, Pediatrica, OMPharma, MSD. AtB received research grants from AstraZeneca, GSK, TEVA and received payments for consultations and/or speaking at conferences from AstraZeneca, GSK, Novartis, SanofiGenzyme, and TEVA. SS is currently employed by Galenus Health, with no relation to this work. The other authors declare they have no conflict of interest. Funding Information: This work was funded by the European Academy of Allergy and Clinical Immunology. 1 20 1 Funding Information: This work was funded by the European Academy of Allergy and Clinical Immunology. We want to acknowledge Prof. Dr. Elisabeth Bel for critical reading of the manuscript. Open Access Funding provided by Universitat Zurich. [Correction added on 14-May-2022, after first online publication: CSAL funding statement has been added.] Publisher Copyright: © 2022 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.
PY - 2022/7/1
Y1 - 2022/7/1
N2 - Currently available European Alpine Altitude Climate Treatment (AACT) programs combine the physical characteristics of altitude with the avoidance of environmental triggers in the alpine climate and a personalized multidisciplinary pulmonary rehabilitation approach. The reduced barometric pressure, oxygen pressure, and air density, the relatively low temperature and humidity, and the increased UV radiation at moderate altitude induce several physiological and immunological adaptation responses. The environmental characteristics of the alpine climate include reduced aeroallergens such as house dust mites (HDM), pollen, fungi, and less air pollution. These combined factors seem to have immunomodulatory effects controlling pathogenic inflammatory responses and favoring less neuro-immune stress in patients with different asthma phenotypes. The extensive multidisciplinary treatment program may further contribute to the observed clinical improvement by AACT in asthma control and quality of life, fewer exacerbations and hospitalizations, reduced need for oral corticosteroids (OCS), improved lung function, decreased airway hyperresponsiveness (AHR), improved exercise tolerance, and improved sinonasal outcomes. Based on observational studies and expert opinion, AACT represents a valuable therapy for those patients irrespective of their asthma phenotype, who cannot achieve optimal control of their complex condition despite all the advances in medical science and treatment according to guidelines, and therefore run the risk of falling into a downward spiral of loss of physical and mental health. In the light of the observed rapid decrease in inflammation and immunomodulatory effects, AACT can be considered as a natural treatment that targets biological pathways.
AB - Currently available European Alpine Altitude Climate Treatment (AACT) programs combine the physical characteristics of altitude with the avoidance of environmental triggers in the alpine climate and a personalized multidisciplinary pulmonary rehabilitation approach. The reduced barometric pressure, oxygen pressure, and air density, the relatively low temperature and humidity, and the increased UV radiation at moderate altitude induce several physiological and immunological adaptation responses. The environmental characteristics of the alpine climate include reduced aeroallergens such as house dust mites (HDM), pollen, fungi, and less air pollution. These combined factors seem to have immunomodulatory effects controlling pathogenic inflammatory responses and favoring less neuro-immune stress in patients with different asthma phenotypes. The extensive multidisciplinary treatment program may further contribute to the observed clinical improvement by AACT in asthma control and quality of life, fewer exacerbations and hospitalizations, reduced need for oral corticosteroids (OCS), improved lung function, decreased airway hyperresponsiveness (AHR), improved exercise tolerance, and improved sinonasal outcomes. Based on observational studies and expert opinion, AACT represents a valuable therapy for those patients irrespective of their asthma phenotype, who cannot achieve optimal control of their complex condition despite all the advances in medical science and treatment according to guidelines, and therefore run the risk of falling into a downward spiral of loss of physical and mental health. In the light of the observed rapid decrease in inflammation and immunomodulatory effects, AACT can be considered as a natural treatment that targets biological pathways.
KW - altitude
KW - asthma
KW - climate
KW - environment
KW - pulmonary rehabilitation
UR - http://www.scopus.com/inward/record.url?scp=85124763033&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/all.15242
DO - https://doi.org/10.1111/all.15242
M3 - Article
C2 - 35113452
SN - 0105-4538
VL - 77
SP - 1991
EP - 2024
JO - Allergy: European Journal of Allergy and Clinical Immunology
JF - Allergy: European Journal of Allergy and Clinical Immunology
IS - 7
ER -