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            <r:String xml:lang="sv">PARSIFAL - mätningar och prover</r:String>
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      <r:Content xml:lang="sv">Både ärftliga och miljörelaterade faktorer påverkar risken att barn insjuknar i lung- och allergirelaterade sjukdomar, men hur dessa faktorer påverkar debutålder och prognos är föga studerat. Likaså är det okänt vilka faktorer som avgör om dessa sjukdomar går tillbaka under barnaåren, om de förblir av lindrig art eller förvärras. En sammanhållen databas där livsstil och allergisjukdom studeras från födseln till och med tonåren saknas både nationellt och internationellt.

Infrastrukturens användning: från 1994 till 1996 föddes drygt 4000 barn i vissa på förhand utvalda områden i Stockholms län. Dessa har följts med upprepade frågeformulär och undersökningar inom ramen för det s.k. BAMSE-projektet (0, 1, 2, 4, 8, 12, 16 och 24 år). Därtill genomfördes BAMSE covid-19 uppföljningsstudien som startade i augusti 2020 och där syftet är att undersöka riskfaktorer för covid-19 och långsiktiga hälsokonsekvenser bland unga vuxna. I ett nytt projekt planerar vi även att studera hur allergisjukdom påverkar introduktionen i yrkeslivet. Vi kommer att inhämta information om yrkesrelaterade faktorer från LISA-registret och MiDAS-registret för studiedeltagare som inte avböjt att information om dem samlas in från nationella och regionala register.

En större databas på mer än 6000 variabler innehållande all insamlad information har succesivt byggts upp. Ett omfattande nationellt och internationellt forskningssamarbete är etablerat kring miljö och genetik i relation till utveckling av lung- och allergisjukdomar inom ramen för projektet. 

Med data från det insamlade materialet har utvecklingen av allergisjukdomar beskrivits liksom riskfaktorer för allergisjukdomar samt konsekvenser på livskvalitén av sådana sjukdomar. Mer än 300 vetenskapliga artiklar har publicerats, 42 doktorsavhandlingar och en licentiatavhandling har lagts fram. Fortlöpande sker ett omfattande arbete med att utveckla databasen genom att lägga in och utvärdera insamlade data, arbeta med beskrivningar av enskilda och sammansatta variabler som används av de olika forskargrupperna, samt utveckla den epidemiologiskt/statistiska analystekniken. Med hjälp av epidemiologassistenter och statistiker säkerställs en hög kvalitet i de dataset som används av olika forskargrupper.

Nya möjligheter till forskning: Mer än 30 seniora forskare inom KI, nationellt utanför KI samt internationellt samarbetar med projektet. Projektet ingår i europasamarbete där ett flertal kohorter ingår för att erhålla tillräcklig statistisk teststyrka. Data på mer än 30 000 barn finns i den gemensamma europeiska databasen där BAMSE således bidrar med data på 4000 barn. Ett flertal områden kan beforskas, men huvudvikt kommer att ligga på lung- och allergisjukdomar, miljö och genetik. Stora ansträngningar görs för att databasen ska bli allmänt känd och tillgänglig för forskare. BAMSE-databasens struktur finns bl.a. tillgänglig via internet på tre sajter.

Betydelse: Genom sin populationsbaserade rekrytering, upprepade uppföljningar med insamlande av biologiskt material under hela barndomen och upp i tonåren, litet bortfall, mer än 6 000 variabler, europeiskt samarbete och uppbyggnad av gemensam databas på mer än 30 000 barn, så föreligger det utmärkta möjligheter till världsledande forskning med syfte att förebygga lung- och allergisjukdomar samt att minska bördan för redan drabbade.

Syfte: Syftet med projektet är att studera riskfaktorer och hur miljö, livsstil och arv påverkar utveckling av astma och allergi. Under projektets gång har syftet utökats till att också inkludera andra vanliga folksjukdomar såsom kronisk obstruktiv lungsjukdom, övervikt och hjärt-kärlsjukdom.</r:Content>
      <r:Content xml:lang="en">Both hereditary and environmental factors influence the risk of children developing lung- and allergy-related diseases, but how these factors affect the age of onset and prognosis has been little studied. Similarly, it is unknown which factors determine whether these diseases regress during childhood, remain mild, or worsen. A unified database that tracks lifestyle and allergic diseases from birth through adolescence is lacking both nationally and internationally.

Use of the infrastructure: From 1994 to 1996, over 4,000 children were born in pre-selected areas of Stockholm County. These children have been followed with repeated questionnaires and examinations as part of the BAMSE project (at ages 0, 1, 2, 4, 8, 12, 16, and 24 years). Additionally, the BAMSE COVID-19 follow-up study, initiated in August 2020, aims to investigate risk factors for COVID-19 and the long-term health consequences among young adults. In a new project, we also plan to study how allergic diseases affect the introduction to working life. We will collect information on work-related factors from the LISA register and the MiDAS register for study participants who have not declined to allow their information to be collected from national and regional registers.

A large database with more than 6,000 variables containing all collected information has been gradually built up. A comprehensive national and international research collaboration has been established around environment and genetics in relation to the development of lung and allergic diseases within the framework of the project.

With data from the collected material, the development of allergic diseases has been described, as well as risk factors for allergic diseases and the consequences for quality of life due to such diseases. More than 300 scientific articles have been published, 42 doctoral dissertations and one licentiate thesis have been presented. Ongoing extensive work is being done to develop the database by adding and evaluating collected data, working with descriptions of individual and composite variables used by the various research groups, and developing epidemiological/statistical analysis techniques. With the help of epidemiology assistants and statisticians, high quality in the datasets used by different research groups is ensured.

New research opportunities: More than 30 senior researchers within KI, nationally outside KI, and internationally collaborate with the project. The project is part of a European collaboration involving several cohorts to achieve sufficient statistical power. Data on more than 30,000 children are included in the joint European database, to which BAMSE contributes data on 4,000 children. Several areas can be researched, but the main focus will be on lung and allergic diseases, environment, and genetics. Significant efforts are being made to make the database well-known and accessible to researchers. The structure of the BAMSE database is available on the internet across three sites.

Significance: Due to its population-based recruitment, repeated follow-ups with the collection of biological material throughout childhood and adolescence, low attrition, more than 6,000 variables, European collaboration, and the establishment of a joint database of more than 30,000 children, there are excellent opportunities for world-leading research aimed at preventing lung and allergic diseases and reducing the burden for those already affected.

Aim: The aim of the project is to study risk factors and how environment, lifestyle, and heredity influence the development of asthma and allergies. During the course of the project, the aim has expanded to also include other common public health diseases such as chronic obstructive pulmonary disease, obesity, and cardiovascular disease.</r:Content>
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