Allergic and respiratory diseases affect a relevant segment of the population resulting in significant social and economic burden and their prevalence is increasing worldwide. Taking the most known diseases, according to the World Health Organization (WHO), there are now at least 300 million people suffering from asthma and over 200 million people suffering from COPD that includes chronic bronchitis and emphysema. In terms of mortality, each year in the world there are almost 250,000 asthma-related deaths and COPD ranks at the 5th leading cause of death. In addition, a WHO/World Bank projection to 2020 brings COPD to the 3rd leading cause of death with 4.7 million deaths. Although other allergic and respiratory diseases like rhinitis, drug allergy, pulmonary interstitial diseases … are also very common at the population level, although their impact has still to be estimated.

EPAR’s* three main research aims consist in: the identification of allergic and respiratory phenotypes/endotypes and their distribution; the determination of the role of environmental risk factors in the aggravation and the development of endotype/phenotypes and diseases in view to explain the augmentation of the prevalence of these conditions in the past decades using an exposomic approach taking into account the entire lifespan; and the implementation of appropriate management, care and prevention measures for these diseases. Among the main modifiers of the relationship between the exposome and allergic and respiratory diseases, the influence of medical treatment (including immunotherapy) on the evolution of these diseases is taken into account.

Epigenetics as an intermediate factor that can be influenced by the exposome and in turn acts on the gene - environment interactions is a crucial step in understanding the development of allergic and respiratory diseases. The progress of the project is based on the development of new methods of evaluation of human exposure (expology) and of statistics applied to the impact of the exposome on allergies and respiratory diseases (DAG, predictive models, EWAS, machine learning, deep learning ...) with the help of massive data including routine health databases. EPAR has developed an European Environmental database containing information on major stressors (air pollution, soil contaminant, water quality, consumption products, diet…) (EDMS).

EPAR is currently involved in the following research projects: EU FP7-ENV HEALS (as IP) www.heals-eu.eu, INTIMIC EarlyFood (WP leader), EIT-Health POLLAR (WP leader), OBIWAN FPI, EPISARC, Cohort of birth EDEN, birth cohort ELFE, ASTHM'CHILD, PAALM, BALISTIC, Registry of severe Sarcoidosis, OQAI.

* Located in Paris (faculty of medicine Saint-Antoine, hospitals Trousseau and Tenon) and Montpellier (CHU)