Effects of Moderate Altitude on Atopic Diseases: A Pilot Study
Abstract
This study investigates the effects of a short-term stay in a moderate-altitude environment on individuals with atopic diseases, including asthma and atopic eczema. Various physiological and immunological parameters were assessed before, during, and after exposure. While some improvements were observed, particularly in pulmonary function, skin-related parameters showed signs of deterioration. These findings suggest that prolonged exposure may be necessary to fully evaluate the benefits of altitude therapy for atopic conditions.
Introduction
Atopic diseases, such as asthma and eczema, are influenced by environmental factors, including air quality, allergen exposure, and climatic conditions. Previous studies have indicated that higher altitudes may provide therapeutic benefits, primarily due to reduced allergen exposure and specific meteorological conditions. This pilot study aims to evaluate the short-term effects of a five-day stay in a mountain climate on patients with atopic diseases.
Methods
Participants & Study Design
Participants diagnosed with asthma or atopic eczema were observed over a five-day period at the Umweltforschungsstation Schneefernerhaus (UFS) on Zugspitze, Bavaria. Their physiological responses were compared to baseline measurements taken prior to the stay.
Assessment Parameters
- Skin Physiology: Hydration, pH, roughness, and transepidermal water loss (TEWL) were measured.
- Pulmonary Function: Spirometry was conducted to assess forced expiratory volume (FEV1), peak expiratory flow (PEF), and other parameters.
- Inflammatory Markers: Blood eosinophils and eosinophilic cationic protein (ECP) were analyzed.
- Quality of Life: Standardized questionnaires (SF-36, DIELH, Eppendorf Itch Questionnaire) were used to assess symptoms and well-being.
Results
Pulmonary Function Improvements
- Significant improvement in FEV1/VC, PEF, MEF 50, and MMFEF 25/75 was observed.
- Forced vital capacity (FVC) decreased, consistent with previous studies linking altitude exposure to pulmonary interstitial changes.
- Exhaled nitric oxide (FeNO), an inflammation marker, did not significantly change.
Skin Parameters and Allergen Exposure
- Skin hydration decreased while roughness and pH levels increased.
- Despite reduced allergen exposure at high altitude (e.g., house dust mites do not survive above 1500m), symptoms did not improve significantly within the short timeframe.
- ECP levels, an inflammation marker, decreased initially but rose again, potentially reflecting skin aggravation.
Quality of Life and Itch Intensity
- Unlike the AURA study, which found improvements in quality of life, no significant differences were observed in this study.
- Itch-related questionnaire scores did not show notable changes, possibly due to the short exposure period and lack of additional therapeutic interventions.
Discussion
The study highlights the potential benefits of moderate-altitude exposure for patients with asthma but suggests that atopic eczema symptoms may require a longer adaptation period for significant improvement. While reduced allergen exposure and climatic conditions are expected to aid symptom relief, the short duration of this study may have limited its impact on skin-related conditions.
Conclusion
This pilot study demonstrates that moderate-altitude exposure can have positive effects on lung function in asthma patients but may not provide immediate benefits for skin conditions like atopic eczema. Future studies with longer observation periods are recommended to determine the long-term impact of altitude therapy on atopic diseases.
References
- Buters J et al. (Unpublished observations)
- AURA Study [11]
- Additional studies on altitude effects on pulmonary and skin conditions [6, 13-25]