Non-communicable diseases: a multifactorial field of research

Chronic conditions like cancer, diabetes, Alzheimer's disease and heart disease affect millions of people. The one thing they have in common is that they cannot be pinned down to any single cause. They are a product of people's personal stories in terms of their genetics, diet, environment, infection history, and microbiota. In order to improve prevention and treatment, it is vital to understand their causes.

What is a non-communicable disease?

Behind this seemingly technical term lies a simple concept: they are diseases that "cannot be caught". Unlike influenza or COVID-19, they cannot be contracted through contact with a sick person. They gradually become established, often over a period spanning several years. 
 

The most well-known examples include:

• cancer: breast cancer, prostate cancer, lung cancer, etc.;
• cardiovascular disease, including strokes and heart attacks;
• diabetes;
• chronic respiratory diseases such as asthma;
• neurodegenerative diseases such as Alzheimer's and Parkinson's disease;
• neurodevelopmental disorders such as autism.
   

The figures for these conditions are staggering. In Europe, one in every six people dies of one of these diseases before the age of 70. In France, cancer and cardiovascular disease account for over half of all deaths every year. According to WHO, almost one in two people worldwide could be suffering from asthma or allergies by 2050. 
 

The incidence of autoimmune and inflammatory diseases (Crohn's disease, multiple sclerosis, etc.), neurodegenerative diseases and metabolic disorders (type 1 and 2 diabetes, etc.), and some types of cancer has risen dramatically, including in young people. In France, almost 5 million people are affected by an autoimmune disease. Type 1 diabetes incidence has significantly risen among the under 20s in recent years, and some types of cancer are beginning to affect teens and young adults (aged 15 to 39). 

Our goal is to elucidate, understand and ultimately curb mechanisms that disrupt physiological balance and promote the development of these conditions in humans.

Why we are all at risk of developing non-communicable diseases 

Tackling infectious diseases involves seeking out a culprit, whether that be a virus or bacterium. However, when it comes to non-communicable or inflammatory diseases, there is no single culprit. This is why they are so complex.
These diseases develop based on a combination of factors specific to each individual:

• our genes: some people are biologically more vulnerable than others;
• our diet and lifestyle;
• our environment: pollution, stress, exposure to chemicals; 
• our infection history: an infection can leave traces that remain hidden for years but eventually have consequences; 
• our microbiota: the billions of microorganisms that live in and on us affect our immunity, digestion and even our brain.

To put it plainly, we are not all equal when it comes to these diseases. Age, sex, genetics, and social and geographic environment all determine who is most likely to contract a disease, when this will occur, and how severe it will be. A better understanding of these individual pathways is essential for steering medicine toward a more preventive, predictive and personalized approach.
 

The Institut Pasteur's response to this global public health challenge

Although complex, these diseases should not be viewed as inevitable. The Institut Pasteur has made non-communicable and inflammatory diseases one of its key strategic priorities under the Pasteur 2030 Plan.
We have set ourselves the clear goal of improving the prevention and treatment of these diseases by unraveling disruptions to our body's balance that allow them to take hold. 
We are exceptionally well equipped to face these challenges due to the extensive expertise available within our 12 scientific departments in areas such as immunology, microbiology, neuroscience, genetics, cellular biology, bioinformatics and artificial intelligence. This unique multidisciplinary configuration represents a key strength helping us understand the multifactorial aspect of these diseases.
 

Our research is focused on four key areas:

• The physiology of barrier tissues such as the gut, lungs, skin and brain: how do these organs respond to attacks and how can their reparative capability be restored?
• The host as a metaorganism: our body is home to billions of useful microbes and therefore the constant interactions between the host (ourselves or our bodies) and its microbiota need to be explored. Around forty teams are investigating this area through our Integrative Microbiome Program (IM2P).
• Infections and chronic diseases: deciphering the long-term consequences of acute infections including long COVID.
• Individual pathways: taking account of biological diversity (age, sex, genetics, diet, environment) to personalize prevention and treatment.
  The Institut Pasteur is also recognized for its scientific leadership in autism and neurodevelopmental disorders, exploring their biological basis, from genetics to brain-microbiota interactions, to develop novel therapeutic avenues. 

Cancer, microbiota, allergies... constant progress is being made on research

Regular advances in our understanding of diseases are being made by our scientists, including: 

• Microbial components can protect us against allergies by helping our immune systems to tolerate allergens.
• Some types of breast cancer occurring after giving birth are particularly aggressive due to a specific cellular mechanism which has now been identified.
• The gut microbiota may predict individual sensitivity to food additives.
• Smoking has a lasting effect on the immune system that can persist long after quitting.
• The discovery of crosstalk between the microbiota and brain provides new avenues helping us understand some types of neurological and mental illnesses.

Chronic diseases are on the rise. But thanks to you, so is progress in research.

Understanding why some people fall ill and others don't. Identifying early signs so steps can be taken before a disease becomes established. Paving the way for more targeted, effective and humane treatments. The Institut Pasteur is an independent foundation that is over one-third funded by public gifts and donations. Each donation allows our scientists to go further, explore new avenues and procure equipment for their laboratories.