GLOBAL INCREASE IN ALLERGIC DISEASES

The prevalence of allergic diseases has increased dramatically since the mid 20th century, with asthma, allergic rhinitis, atopic dermatitis, and food allergies affecting one quarter of individuals in developed regions. This rapid increase cannot be attributed solely to genetic predisposition; rather, environmental changes play a central role. Allergic diseases result from the interaction between genes, environment, epigenetics, and the microbiota. Simultaneously, global warming, extended pollen seasons, changing pollen content, reduced biodiversity, and urbanized lifestyles diminish microbial diversity and weaken immune tolerance. The exposome framework highlights the cumulative impact of air pollution, indus-trial chemicals, microplastics, processed diets, and climate change, all of which compromise epithelial barrier integrity and skew immune responses toward chronic type 2 (T2) inflammation. The epithelial barrier hypothesis links environmental pollutants and toxicants to mucosal disruption, facilitating aller-gen penetration and innate immune activation. Epigenetic modifications, including DNA methylation and histone changes, further mediate long term susceptibility, and microbiota derived metabolites part-ly shape these processes. Clinically, strengthening epithelial barriers, leveraging microbiota targeted or epigenetic therapies are key. Approaches to preventing the rise in allergic diseases require not only individual treatment but also planet health focused, multidisciplinary, environmentally compatible strategies. At the societal level, adopting preventive strategies such as biodiversity restoration and nature based public health policies is essential for prevention. The continuous rise in allergic diseases reflects complex gene environment epigenome interactions and requires personalized and environmen-tally focused interventions for effective prevention and management. The targeted approach is not only to treat the symptoms of diseases but also to repair the epithelial barrier, support immune tolerance, and reduce environmental exposures. Future research will focus on epigenetics based exposome studies and microbiota based therapies. Key interventions include the “from avoidance to tolerance” approach, encouraging contact with nature, controlled allergen exposure, green spaces in urban planning, emis-sion control and biodiversity restoration, supporting early microbial contact in childhood, and avoiding unnecessary antibiotic use.