RESEARCHERS FROM A*STAR AND NUS IMPLICATE HOUSE DUST MITES AS THE MAIN CAUSE OF RESPIRATORY ALLERGIES IN SINGAPORE

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MEDIA RELEASE 07 Feb 2014 RESEARCHERS FROM A*STAR AND NUS IMPLICATE HOUSE DUST MITES AS THE MAIN CAUSE OF RESPIRATORY ALLERGIES IN SINGAPORE Study findings provide a basis for developing effective allergy mitigation strategies and improve quality of life for sufferers 1 In the first comprehensive adult allergy cohort study in Singapore, scientists and clinicians from A*STAR s Singapore Immunology Network (SIgN) and the National University of Singapore (NUS) have discovered that the primary cause of respiratory allergies in Singapore is the exposure to the house dust mite. The results carry potential implications in the management of asthma and allergic rhinitis 1 in tropical urban environments. The findings of the study were published as open access in the latest issue of the journal Allergy. 2 According to the World Health Organisation, it is estimated that approximately 300 million people suffer from asthma worldwide 2 and even more are affected by allergic rhinitis 3. Both conditions are now increasingly common in Southeast Asian populations. The new study revealed that close to 15% of Singapore s adult population are being affected by asthma and nearly 40% are troubled by allergic rhinitis. 3 The research team, comprising scientists from SIgN and NUS, conducted a large scale cohort study with approximately 8,000 participants. Reactivity to a panel of 12 common allergens was evaluated by a skin prick test or by measuring the level of allergy-associated Immunoglobulin E (IgE). IgE is a class of antibodies that is raised upon reaction to an allergen. The findings showed that approximately 80% of those surveyed were reactive to house dust mites, and only minor reactivity to any other allergen. This high rate of reactions from house dust mites are strongly correlated with increased rates of allergic rhinitis and asthma in Singapore. 1 Allergic rhinitis is an inflammatory reaction of the nasal airways due to an allergic reaction. It is very commonly referred to as Hay Fever 2 World Health Organization. Global surveillance, prevention and control of chronic respiratory diseases: a comprehensive approach, 2007. 3 World Health Organization. White Book on Allergy 2011-2012 Executive Summary.

4 The study further found that participants who originate from non-tropical countries had low sensitisation rates for house dust mites when they first arrived in Singapore, but these rates increased as they spend more time here. This increase was accompanied by an increase in airway allergies. Migrants from countries that have similar tropical climate, such as Malaysia, showed comparable rates as Singaporeans, pointing again to house dust mites as primary environmental cause. 5 These findings address the widening problem of allergy and asthma in tropical countries. The results suggest that changes in lifestyle resulting in more time spent indoors increase our exposure to high loads of house dust mite allergens, which translates into a dominant cause of respiratory allergic diseases in Southeast Asia. With the identification of this trigger and its dominance in Singapore, scientists can develop more effective allergen-specific desensitisation strategies as well as environmental interventions aiming at the reduction of the house dust mite-load. 6 Said Prof Olaf Rotzschke, the lead investigator of the study at SIgN, Rather than relying on statistics from other countries, we have managed to pin point the cause of airway allergies in Singapore. We believe that results from this study will help to understand the differences of allergies in the tropics and other parts of the world. Knowledge of the allergic trigger together with a nearly complete sensitisation of the local population provides the perfect basis for the future exploration of the molecular and genetic factors that ultimately determine if the response to an allergen progresses into an allergic syndrome." 7 Research Associate Professor Wang De Yun, from the department of Otolaryngology at the NUS Yong Loo Lin School of Medicine, said, Given the increasing prevalence of airway allergic diseases in Singapore and Southeast Asian countries, this study is truly a breakthrough in understanding why there are such high number of allergic rhinitis patients in Singapore. Knowing the cause is the first step in developing more effective interventions to improve the quality of life for asthma and allergic rhinitis sufferers. 8 Prof Laurent Renia, Acting Executive Director of SIgN, said, This study is a perfect example of clinicians and scientists collaborating to investigate and tackle a very important public health problem, each bringing to the table very different, yet important domain knowledge.

House dust mite (Copyright: Dr. Chew Fook Tim, NUS) Notes for Editor: The research findings described in this media release can be found in the 24 January, 2014 issue of Allergy Journal, under the title, Allergic airway diseases in a tropical urban environment are driven by dominant mono-specific sensitization against house dust mites by A. K. Andiappan 1, K. J. Puan 1, B. Lee 1, A. Nardin 1, M. Poidinger 1, J. Connolly 1, F. T. Chew 2, D. Y. Wang 3, & O. Rotzschke 1. 1 SIgN (Singapore Immunology Network), A*STAR (Agency for Science, Technology and Research). 2 Department of Biological Sciences, National University of Singapore. 3 Department of Otolaryngology, National University of Singapore, Singapore. Full text of the article can be accessed from http://onlinelibrary.wiley.com/doi/10.1111/all.12364/full. AGENCY FOR SCIENCE, TECHNOLOGY AND RESEARCH (A*STAR) For media queries and clarifications, please contact: Petrina Ho (Ms) Senior Officer, Corporate Communications Agency for Science, Technology and Research Tel: (+65) 6826 6258 Email: petrina_ho@a-star.edu.sg

Crystal MK (Ms) Senior Assistant Manager, Communications Office National University Health System Tel: (+65) 6772 3986 Email: crystal_mk@nuhs.edu.sg About the Agency for Science, Technology and Research (A*STAR) The Agency for Science, Technology and Research (A*STAR) is Singapore's lead public sector agency that fosters world-class scientific research and talent to drive economic growth and transform Singapore into a vibrant knowledge-based and innovation driven economy. In line with its mission-oriented mandate, A*STAR spearheads research and development in fields that are essential to growing Singapore s manufacturing sector and catalysing new growth industries. A*STAR supports these economic clusters by providing intellectual, human and industrial capital to its partners in industry. A*STAR oversees 20 biomedical sciences and physical sciences and engineering research entities, located in Biopolis and Fusionopolis as well as their vicinity. These two R&D hubs, house a bustling and diverse community of local and international research scientists and engineers from A*STAR s research entities as well as a growing number of corporate laboratories. For more information about A*STAR, please visit www.a-star.edu.sg. About the Singapore Immunology Network (SIgN) The Singapore Immunology Network (SIgN), officially inaugurated on 15 January 2008, is a research consortium under the Agency for Science, Technology and Research (A*STAR) s Biomedical Research Council. The mandate of SIgN is to advance human immunology research and participate in international efforts to combat major health problems. Since its launch, SIgN has grown rapidly and currently includes 250 scientists from 26 different countries around the world working under 28 renowned principal investigators. At SIgN, researchers investigate immunity during infection and various inflammatory conditions including cancer and are supported by cutting edge technological research platforms and core services. Through this, SIgN aims to build a strong platform in basic human immunology research for better translation of research findings into clinical applications. SIgN also sets out to establish productive links with local and international institutions, and encourage the exchange of ideas and expertise between academic, industrial and clinical partners and thus contribute to a vibrant research environment in Singapore. For more information about SIgN, please visit www.sign.a-star.edu.sg.

About the National University of Singapore (NUS) A leading global university centred in Asia, the National University of Singapore (NUS) is Singapore s flagship university, which offers a global approach to education and research, with a focus on Asian perspectives and expertise. NUS has 16 faculties and schools across three campuses. Its transformative education includes a broad-based curriculum underscored by multi-disciplinary courses and cross-faculty enrichment. Over 37,000 students from 100 countries enrich the community with their diverse social and cultural perspectives. NUS has three Research Centres of Excellence (RCE) and 23 university-level research institutes and centres. It is also a partner in Singapore s fifth RCE. NUS shares a close affiliation with 16 national-level research institutes and centres. Research activities are strategic and robust, and NUS is well-known for its research strengths in engineering, life sciences and biomedicine, social sciences and natural sciences. It also strives to create a supportive and innovative environment to promote creative enterprise within its community. For more information, please visit www.nus.edu.sg.