[{"command":"openDialog","selector":"#drupal-modal","settings":null,"data":"\u003Cdiv id=\u0022republish_modal_form\u0022\u003E\u003Cform class=\u0022modal-form-example-modal-form ecl-form\u0022 data-drupal-selector=\u0022modal-form-example-modal-form\u0022 action=\u0022\/en\/article\/modal\/11816\u0022 method=\u0022post\u0022 id=\u0022modal-form-example-modal-form\u0022 accept-charset=\u0022UTF-8\u0022\u003E\u003Cp\u003EHorizon articles can be republished for free under the Creative Commons Attribution 4.0 International (CC BY 4.0) licence.\u003C\/p\u003E\n \u003Cp\u003EYou must give appropriate credit. We ask you to do this by:\u003Cbr \/\u003E\n 1) Using the original journalist\u0027s byline\u003Cbr \/\u003E\n 2) Linking back to our original story\u003Cbr \/\u003E\n 3) Using the following text in the footer: This article was originally published in \u003Ca href=\u0027#\u0027\u003EHorizon, the EU Research and Innovation magazine\u003C\/a\u003E\u003C\/p\u003E\n \u003Cp\u003ESee our full republication guidelines \u003Ca href=\u0027\/horizon-magazine\/republish-our-stories\u0027\u003Ehere\u003C\/a\u003E\u003C\/p\u003E\n \u003Cp\u003EHTML for this article, including the attribution and page view counter, is below:\u003C\/p\u003E\u003Cdiv class=\u0022js-form-item form-item js-form-type-textarea form-item-body-content js-form-item-body-content ecl-form-group ecl-form-group--text-area form-no-label ecl-u-mv-m\u0022\u003E\n \n\u003Cdiv\u003E\n \u003Ctextarea data-drupal-selector=\u0022edit-body-content\u0022 aria-describedby=\u0022edit-body-content--description\u0022 id=\u0022edit-body-content\u0022 name=\u0022body_content\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea ecl-text-area\u0022\u003E\u003Ch2\u003E The hunt for clues to immune-system disorders\u003C\/h2\u003E\u003Cp\u003EIn mid-2015 and early 2016 in Finland, a group of scientists became interested in inspecting doormats.\u003C\/p\u003E\u003Cp\u003EThe pursuit, while seemingly unusual, had a serious aim: to determine whether a higher mix of microbes typically found in rural environments might protect against the development of type 1 diabetes, an immune-system disorder.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EMicrobe mixes\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003EThe study is part of a research project that received EU funding to examine links between immune-system illnesses and external environmental factors. These factors, grouped as the \u201cexposome\u201d, include microbes as well as air quality, chemicals, diet and urbanisation.\u003C\/p\u003E\u003Cp\u003EThe researchers found that the risk of developing diabetes was higher in urban locations than rural ones \u2013 but that not all rural areas can be regarded the same way.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003ERural areas in Finland with relatively little snow on the ground have a greater diversity of environmental microbes. A large mix of such organisms, known collectively as the microbiome, in an area is often linked to better human health. These microbes may, for example, protect against pathogenic microorganisms and toxins when a person is exposed to them in the environment or digests them in food.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003E\u2018Snow cover seemed to reduce the microbiome a lot,\u2019 said Professor Heikki Hy\u00f6ty, a researcher in virology at Tampere University in Finland.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EHy\u00f6ty leads the EU project, which is called\u0026nbsp;\u003Ca href=\u0022https:\/\/cordis.europa.eu\/project\/id\/874864\u0022\u003EHEDIMED\u003C\/a\u003E \u2013\u0026nbsp;an acronym for Human Exposomic Determinants of Immune Mediated Diseases.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EIt runs for five years until the end of 2024 and brings together universities, research centres and companies in countries that range from Austria and the Czech Republic to Switzerland and the US.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EFinnish footprints\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003EThe study of rural and urban environments in Finland highlights the complexities involved in such research and the difficulties of drawing simple lessons.\u003C\/p\u003E\u003Cp\u003E\u003Cblockquote class=\u0022tw-text-center tw-text-blue tw-font-bold tw-text-2xl lg:tw-w-1\/2 tw-border-2 tw-border-blue tw-p-12 tw-my-8 lg:tw-m-12 lg:tw--ml-16 tw-float-left\u0022\u003E\n \u003Cspan class=\u0022tw-text-5xl tw-rotate-180\u0022\u003E\u201c\u003C\/span\u003E\n \u003Cp class=\u0022tw-font-serif tw-italic\u0022\u003EI hope that we find at least one common determinant in these diseases.\u003C\/p\u003E\n \u003Cfooter\u003E\n \u003Ccite class=\u0022tw-not-italic tw-font-normal tw-text-sm tw-text-black\u0022\u003EProfessor Heikki Hy\u00f6ty, HEDIMED\u003C\/cite\u003E\n \u003C\/footer\u003E\n\u003C\/blockquote\u003E\n\u003C\/p\u003E\u003Cp\u003EBut it also signals potentially big benefits for public healthcare from the effort.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EThe immune system is a network of cells, tissues and organs that work together to protect the body against infections. Multiple disorders ranging from allergies and asthma to diabetes and rheumatoid arthritis can result when the system fails to function properly.\u003C\/p\u003E\u003Cp\u003EIn their study, the researchers in Finland took samples in August 2015 and February 2016 from special doormats placed in the entrances of homes of children in their first year of life.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EDoormats were chosen as the way to collect information because they absorb a wide range of organisms when people enter the home. The months of August and February were picked because they ensured specimens from both summer and winter.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EThe homes were located in rural and urban locations\u0026nbsp;around Turku on Finland\u2019s southern coast, in Tampere farther north and in Oulu just south of the Arctic Circle.\u003C\/p\u003E\u003Cp\u003EOnly rural areas showed the sort of higher bacterial\u0026nbsp;richness often associated with health benefits, according to\u0026nbsp;Hy\u00f6ty.\u003C\/p\u003E\u003Cp\u003EHe said the development of immune-system disorders may be influenced by multiple external factors \u2013 for instance, not only whether a location is rural or urban but what the local climatic conditions are.\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003ENetwork forces\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003EHEDIMED is part of the\u0026nbsp;\u003Ca href=\u0022https:\/\/www.humanexposome.eu\/\u0022\u003EEuropean Human Exposome Network (EHEN)\u003C\/a\u003E, nine EU research projects that together create the world\u2019s largest collaboration on the exposome.\u003C\/p\u003E\u003Cp\u003EThe goal is to deepen understanding of the impact of environmental exposure on health, including immune-system disorders.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EAs a whole, such disorders are widespread. Allergies, for example, are estimated to affect around\u0026nbsp;\u003Ca href=\u0022https:\/\/www.npr.org\/sections\/health-shots\/2023\/05\/30\/1178433166\/theresa-macphail-allergic-allergies\u0022\u003Ea third\u003C\/a\u003E of people worldwide.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003ENonetheless, many immune disorders are poorly understood.\u003C\/p\u003E\u003Cp\u003EHy\u00f6ty said he recognised earlier in his career that more research was needed into the effects of the exposome, with genetics alone unable to explain rapid increases in immune diseases.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003E\u2018Everybody was studying genes and their relationship to the immune response in type 1 diabetes, but there seemed not too many who were interested in the exposome,\u2019 he said. \u2018I realised that, if we could find environmental factors that explain the increase in these conditions, we may also find a way to prevent them.\u2019\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EHigh hopes\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003EIn another\u0026nbsp;\u003Ca href=\u0022https:\/\/link.springer.com\/article\/10.1007\/s00248-022-02157-8\u0022\u003Estudy\u003C\/a\u003E, HEDIMED researchers found that different agricultural methods and locations strongly affect microbial diversity in apples and blueberries.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EFruits grown in the wild and in home gardens generally had greater diversity, while commercial horticulture made the microbiome less varied.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EThis finding highlights how the method and location of food production may play a role in gut health and should be explored in future research on immune disorders, according to Hy\u00f6ty.\u003C\/p\u003E\u003Cp\u003EMeanwhile, he said the HEDIMED team has plenty of\u0026nbsp;numbers to crunch.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EResearchers are analysing data from large cohorts including altogether 350 000 pregnant women and 28 000 children tracked from birth.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EBecause the process of contracting an immune disorder begins early in life, the focus is on the foetal and childhood exposome.\u003C\/p\u003E\u003Cp\u003EHy\u00f6ty thinks uncovering even a single factor behind various immune disorders would make it easier to prevent them.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003E\u2018I hope that we find at least one common determinant in these diseases,\u2019 he said. \u2018That would be a huge breakthrough.\u2019\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EMolecular markers\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003EImproving the treatment of immune-system disorders is something that Dr Marta Alarc\u00f3n-Riquelme, scientific director at genomics centre GENYO in Spain, has in her sights.\u003C\/p\u003E\u003Cp\u003E\u003Cblockquote class=\u0022tw-text-center tw-text-blue tw-font-bold tw-text-2xl lg:tw-w-1\/2 tw-border-2 tw-border-blue tw-p-12 tw-my-8 lg:tw-m-12 lg:tw--ml-16 tw-float-left\u0022\u003E\n \u003Cspan class=\u0022tw-text-5xl tw-rotate-180\u0022\u003E\u201c\u003C\/span\u003E\n \u003Cp class=\u0022tw-font-serif tw-italic\u0022\u003EA large number of people remain undiagnosed for a long time.\u003C\/p\u003E\n \u003Cfooter\u003E\n \u003Ccite class=\u0022tw-not-italic tw-font-normal tw-text-sm tw-text-black\u0022\u003EDr Marta Alarc\u00f3n-Riquelme, 3TR\u003C\/cite\u003E\n \u003C\/footer\u003E\n\u003C\/blockquote\u003E\n\u003C\/p\u003E\u003Cp\u003EShe leads an EU-funded project taking a new approach: looking at the molecular mechanisms behind\u0026nbsp;patients\u2019 individual\u0026nbsp;responses to treatments rather than classifying the diseases by their final effect on organs.\u003C\/p\u003E\u003Cp\u003ECalled\u0026nbsp;\u003Ca href=\u0022https:\/\/cordis.europa.eu\/project\/id\/831434\u0022\u003E3TR\u003C\/a\u003E, the seven-year project is due to run until the end of August 2026. As a public-private partnership under Europe\u2019s \u003Ca href=\u0022https:\/\/www.imi.europa.eu\/\u0022\u003EInnovative Medicines Initiative\u003C\/a\u003E, 3TR also receives industry funding and includes pharmaceutical companies such as AstraZeneca and Sanofi.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EThe research focuses on seven illnesses: asthma, Crohn\u2019s disease, chronic obstructive pulmonary disease, inflammatory bowel disease, lupus, multiple sclerosis and rheumatoid arthritis.\u003C\/p\u003E\u003Cp\u003EThey can be severe and require lifelong management. Lupus, for example, creates joint pain, fatigue and rashes.\u003C\/p\u003E\u003Cp\u003E\u2018Diseases like lupus can be life-threatening,\u2019 Alarc\u00f3n-Riquelme said.\u003C\/p\u003E\u003Cp\u003EShe said that treatments for immune disorders are often a case of trial and error. Patients frequently fail to respond to medication, even if they have the same diagnosis as someone who gets better with the same treatment.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003E\u2018They\u2019re also insidious diseases, which means they start earlier than can clinically be seen,\u2019 said Alarc\u00f3n-Riquelme. \u2018A large number of people remain undiagnosed for a long time but, in the meantime, have symptoms that could benefit from the right treatments.\u2019\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003ETailor-made treatments\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003EBy identifying the molecular basis of non-responsiveness, 3TR hopes that more personalised and effective therapies can ultimately be created for patients regardless of their diagnosis.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EGiving the right treatment from the start could reduce the severity of the disease\u2019s effects or even prevent them.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003E\u2018The idea is that this patient has this molecular signature, so this treatment is what\u2019s going to work,\u2019 said Alarc\u00f3n-Riquelme.\u003C\/p\u003E\u003Cp\u003E3TR has been recruiting around 3 000 patients for its investigations across the seven illnesses.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EThe team is collecting and analysing data from blood, other fluids and tissue throughout the treatment process and aims to find biomarkers predicting therapy response. Researchers also plan to create a centralised platform containing molecular and clinical information to aid future treatment.\u003C\/p\u003E\u003Cp\u003EIn the meantime, the team has been making headway in identifying molecular signatures in the diseases.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EIn lupus, for example, activity in certain sets of genes was found to be related to drug response, long-term remission of symptoms and relapse.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EDuring the project, the researchers have also made progress in identifying\u0026nbsp;\u003Ca href=\u0022https:\/\/erj.ersjournals.com\/content\/59\/2\/2100142\u0022\u003Ebiomarkers for asthma\u003C\/a\u003E and made advances in the areas of inflammatory bowel disease and rheumatoid arthritis, according to Alarc\u00f3n-Riquelme.\u003C\/p\u003E\u003Cp\u003EShe believes that, with further progress in the coming years, 3TR can help spur major healthcare advances.\u003C\/p\u003E\u003Cp\u003E\u2018We hope that the project will aid faster appropriate treatment by improving recognition of what a patient requires at a given time,\u2019 Alarc\u00f3n-Riquelme said.\u003C\/p\u003E\u003Cp\u003E\u003Cem\u003EResearch in this article was funded by the EU\u2019s Horizon Programme. The views of the interviewees don\u2019t necessarily reflect those of the European Commission. 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