Allergenic pollen and pollen allergy in Europe

Prediction of the birch pollen season characteristics in Cracow, Poland using an 18-year data series

The aim of the study was to construct the model forecasting the birch pollen season characteristics in Cracow on the basis of an 18-year data series. The study was performed using the volumetric method (Lanzoni/Burkard trap). The 98/95 % method was used to calculate the pollen season. The Spearman's correlation test was applied to find the relationship between the meteorological parameters and pollen season characteristics. To construct the predictive model, the backward stepwise multiple regression analysis was used including the multi-collinearity of variables. The predictive models best fitted the pollen season start and end, especially models containing two independent variables. The peak concentration value was predicted with the higher prediction error. Also the accuracy of the models predicting the pollen season characteristics in 2009 was higher in comparison with 2010. Both, the multi-variable model and one-variable model for the beginning of the pollen season included air temperature during the last 10 days of February, while the multi-variable model also included humidity at the beginning of April. The models forecasting the end of the pollen season were based on temperature in March-April, while the peak day was predicted using the temperature during the last 10 days of March.

Development of a regional-scale pollen emission and transport modeling framework for investigating the impact of climate change on allergic airway disease

Exposure to bioaerosol allergens such as pollen can cause exacerbations of allergenic airway disease (AAD) in sensitive populations, and thus cause serious public health problems. Assessing these health impacts by linking the airborne pollen levels, concentrations of respirable allergenic material, and human allergenic response under current and future climate conditions is a key step toward developing preventive and adaptive actions. To that end, a regional-scale pollen emission and transport modeling framework was developed that treats allergenic pollens as non-reactive tracers within the WRF/CMAQ air-quality modeling system. The Simulator of the Timing and Magnitude of Pollen Season (STaMPS) model was used to generate a daily pollen pool that can then be emitted into the atmosphere by wind. The STaMPS is driven by species-specific meteorological (temperature and/or precipitation) threshold conditions and is designed to be flexible with respect to its representation of vegetation species and plant functional types (PFTs). The hourly pollen emission flux was parameterized by considering the pollen pool, friction velocity, and wind threshold values. The dry deposition velocity of each species of pollen was estimated based on pollen grain size and density. An evaluation of the pollen modeling framework was conducted for southern California for the period from March to June 2010. This period coincided with observations by the University of Southern California's Children's Health Study (CHS), which included O₃, PM_2.5, and pollen count, as well as measurements of exhaled nitric oxide in study participants. Two nesting domains with horizontal resolutions of 12 km and 4 km were constructed, and six representative allergenic pollen genera were included: birch tree, walnut tree, mulberry tree, olive tree, oak tree, and brome grasses. Under the current parameterization scheme, the modeling framework tends to underestimate walnut and peak oak pollen concentrations, and tends to overestimate grass pollen concentrations. The model shows reasonable agreement with observed birch, olive, and mulberry tree pollen concentrations. Sensitivity studies suggest that the estimation of the pollen pool is a major source of uncertainty for simulated pollen concentrations. Achieving agreement between emission modeling and observed pattern of pollen releases is the key for successful pollen concentration simulations.

Climate change, air pollution and extreme events leading to increasing prevalence of allergic respiratory diseases

The prevalence of asthma and allergic diseases has increased dramatically during the past few decades not only in industrialized countries. Urban air pollution from motor vehicles has been indicated as one of the major risk factors responsible for this increase.Although genetic factors are important in the development of asthma and allergic diseases, the rising trend can be explained only in changes occurred in the environment. Despite some differences in the air pollution profile and decreasing trends of some key air pollutants, air quality is an important concern for public health in the cities throughout the world.Due to climate change, air pollution patterns are changing in several urbanized areas of the world, with a significant effect on respiratory health.The observational evidence indicates that recent regional changes in climate, particularly temperature increases, have already affected a diverse set of physical and biological systems in many parts of the world. Associations between thunderstorms and asthma morbidity in pollinosis subjects have been also identified in multiple locations around the world.Allergens patterns are also changing in response to climate change and air pollution can modify the allergenic potential of pollens especially in presence of specific weather conditions.The underlying mechanisms of all these interactions are not well known yet. The consequences on health vary from decreases in lung function to allergic diseases, new onset of diseases, and exacerbation of chronic respiratory diseases.Factor clouding the issue is that laboratory evaluations do not reflect what happens during natural exposition, when atmospheric pollution mixtures in polluted cities are inhaled. In addition, it is important to recall that an individual's response to pollution exposure depends on the source and components of air pollution, as well as meteorological conditions. Indeed, some air pollution-related incidents with asthma aggravation do not depend only on the increased production of air pollution, but rather on atmospheric factors that favour the accumulation of air pollutants at ground level.Considering these aspects governments worldwide and international organizations such as the World Health Organization and the European Union are facing a growing problem of the respiratory effects induced by gaseous and particulate pollutants arising from motor vehicle emissions.

The biodiversity hypothesis and allergic disease: world allergy organization position statement

Biodiversity loss and climate change secondary to human activities are now being associated with various adverse health effects. However, less attention is being paid to the effects of biodiversity loss on environmental and commensal (indigenous) microbiotas. Metagenomic and other studies of healthy and diseased individuals reveal that reduced biodiversity and alterations in the composition of the gut and skin microbiota are associated with various inflammatory conditions, including asthma, allergic and inflammatory bowel diseases (IBD), type1 diabetes, and obesity. Altered indigenous microbiota and the general microbial deprivation characterizing the lifestyle of urban people in affluent countries appear to be risk factors for immune dysregulation and impaired tolerance. The risk is further enhanced by physical inactivity and a western diet poor in fresh fruit and vegetables, which may act in synergy with dysbiosis of the gut flora. Studies of immigrants moving from non-affluent to affluent regions indicate that tolerance mechanisms can rapidly become impaired in microbe-poor environments. The data on microbial deprivation and immune dysfunction as they relate to biodiversity loss are evaluated in this Statement of World Allergy Organization (WAO). We propose that biodiversity, the variability among living organisms from all sources are closely related, at both the macro- and micro-levels. Loss of the macrodiversity is associated with shrinking of the microdiversity, which is associated with alterations of the indigenous microbiota. Data on behavioural means to induce tolerance are outlined and a proposal made for a Global Allergy Plan to prevent and reduce the global allergy burden for affected individuals and the societies in which they live.

A numerical model of birch pollen emission and dispersion in the atmosphere. Model evaluation and sensitivity analysis

An evaluation of performance of the System for Integrated modeLling of Atmospheric coMposition (SILAM) in application to birch pollen dispersion is presented. The system is described in a companion paper whereas the current study evaluates the model sensitivity to details of the pollen emission module parameterisation and to the meteorological input data. The most important parameters are highlighted. The reference year considered for the analysis is 2006. It is shown that the model is capable of predicting about two-thirds of allergenic alerts, with the odds ratio exceeding 12 for the best setup. Several other statistics corroborate with these estimations. Low-pollen concentration days are also predicted correctly in more than two-thirds of cases. The model experiences certain difficulties only with intermediate pollen concentrations. It is demonstrated that the most important input parameter is the near-surface temperature, the bias of which can easily jeopardise the results. The model sensitivity to random fluctuations of temperature is much lower. Other parameters important at various stages of pollen development, release, and dispersion are precipitation and ambient humidity, as well as wind direction.

Climate change impact on the olive pollen season in Mediterranean areas of Italy: air quality in late spring from an allergenic point of view

Recent studies have shown that there are many effects of climate change on aeroallergens, and thus on allergic diseases in humans. In the Mediterranean region, despite the importance of the olive tree for production, there is high allergenicity of olive pollen and related risks to human health. Aerobiological sampling techniques can be used to analyse the pollinosis phenomenon through determination of mean daily pollen concentrations per cubic metre of air. The present study was carried out from 1999 to 2008 in 16 olive-growing areas in Italy, to update the information on the pollinosis characteristics of Olea europaea in the study areas. The analysis of the average flowering season over the study period highlights a temporal scaling of pollen in the atmosphere that depends on the different climatic characteristics. This is mainly dependent on temperature, and in part, determined by latitude. Generally, the levels of O. europaea pollen in the atmosphere are higher from mid-April to the end of June, with the period of greatest risk to human health due to this olive pollen in this area currently limited primarily to the last 10 days of May. However, the pollen season can move, depending on the climate scenario considered, and data here can be used to determine potential time shifts in pollinosis that might cause more precocious asthma and allergy problems. The allergy season for this type of pollen might be significantly precocious in future decades (20-30 days earlier in the year), which will impact on the severity and duration of allergies attributable to olive tree pollen.

Airborne pollen of allergenic herb species in Toledo (Spain)

This study analysed airborne pollen counts for allergenic herb taxa in Toledo (central Spain), a major tourist city receiving over 2 million visitors per year, located in the region of Castilla-La Mancha. The taxa selected were Chenopodiaceae-Amaranthaceae, Plantago, Poaceae and Urticaceae, all of which produce allergenic pollen giving rise to serious symptoms in pollen-allergy sufferers. Aerobiological data were recorded over a 6-year period (2005 to 2010) using the sampling and analysis procedures recommended by the Spanish Aerobiology Network. The abundance and the temporal (annual, daily and intradiurnal) distribution of these pollen types were analysed, and the influence of weather-related factors on airborne pollen counts was assessed. Pollen from herbaceous species accounted for 20.9% of total airborne pollen in Toledo, the largest contributor being Poaceae, with 8.5% of the total pollen count; this family was also the leading cause of respiratory allergies. Examination of intradiurnal variation revealed three distinct distribution patterns: (1) peak daily counts for Chenopodiaceae-Amaranthaceae and Plantago were recorded during the hottest part of the day, i.e. from 1400 to 1600 hours; (2) Urticaceae displayed two peaks (1400-1600 and 2200 hours); and (3) Poaceae counts remained fairly stable throughout the day. Two main risk periods were identified for allergies: spring, with allergies caused by Urticaceae, Plantago and Poaceae pollen, and summer, due to Chenopodiaceae-Amaranthaceae pollen.

Prevalence and real clinical impact of Cupressus sempervirens and Juniperus communis sensitisations in Tuscan "Maremma", Italy

OBJECTIVE

The aim was to evaluate the impact of Cupressus sempervirens (Cs) and Juniperus communis (Jc) sensitisations in "Maremma" in southern Tuscany.

METHODS

811 consecutive outpatients (357 F - 57.86%; age: 36.9 ± 16.6) with suspected allergic respiratory symptoms underwent skin prick tests (SPT) for common allergens and for Cs and Jc.

RESULTS

SPT resulted negative in 295 (36.37%) subjects. A Cs/Jc sensitisation was found in 294 (36.25%): 289 (98.3%) were sensitised to Cs whereas 198 (67.34%) to Jc. There was a co-sensitisation between Cs and Jc in 193 (65.6%) subjects. Cs/Jc mono-sensitisation was found in 39 (13.6%) subjects. A higher number (p<0.0001) of Cs/Jc sensitised subjects reported winter (131-44.55%) and spring (124-42.2%) symptoms compared to Cs/Jc non-sensitised and non-allergic subjects. Most Cs/Jc sensitised subjects reported rhinitis and conjunctivitis (p<0.0001), whereas only few reported coughing and asthma (p<0.01). The most frequent co-sensitisation was with grass, olive and other trees in Cs/Jc subjects (p<0.001). Those who reported winter symptoms, likely influenced by Cupressaceae, rhinitis was the main symptom whereas asthma was less frequent. Cs/Jc sensitisation resulted to be a risk factor (OR: 1.73 [CI95% 1.18-2.55]) for rhinitis whereas the probability of being asthmatic was reduced (OR: 0.62 [CI95% 0.44-0.85]).

CONCLUSION

The prevalence of Cs/Jc sensitisation is about 36% in "Maremma". However, only in 44% of the patients, Cs/Jc seem to cause typical winter symptoms. Rhinitis is the predominant symptom, whereas asthma is less frequent. Testing Cupressaceae sensitisation using Jc pollen extract, rather than Cs, may result to be less sensitive.

Reactions of airway epithelial cells to birch pollen grains previously exposed to in situ atmospheric Pb concentrations: a preliminary assay of allergenicity

A growing body of evidence suggests that interactions between pollen grains and environmental pollutants, especially air pollutants, could be of critical importance with regard to the increase in allergic responses observed in the past decades. Using birch pollen grains (BPG), a major allergy source in European countries, and lead (Pb), a highly toxic metal trace element (MTE) present in urban areas, the immune response of human epithelial cells exposed to BPG or to Pb-associated BPG was compared. The cellular response after exposure either to BPG, BPG exposed to 30 mg/L of Pb (BPG-30), or BPG exposed to 60 mg/L of Pb (BPG-60) was evaluated after two time lapses (2 and 6 h) by measuring mRNA levels of four mediators, including two inflammatory (interleukin-8 and interleukin-6) and two allergic (interleukin-5 [IL-5] and interleukin-13) cytokines. After 2 h of exposure, significant upregulation of the IL-5 gene was observed after exposure to BPG-60 in comparison with exposure to BPG and BPG-30 (N (IL-5) = 1.9, Mann-Whitney test, p = 0.003). After 6 h of exposure, significant upregulation of the IL-5 gene was observed after exposure to BPG-30 with N (IL-5) = 1.8 and to BPG-60 with N (IL-5) = 2.3 (Mann-Whitney test, p = 0.0029) in comparison with exposure to BPG. This first attempt to investigate the influence of pollution by MTE on pollen grain showed a dose-time-dependent increase in IL-5 gene expression after exposure to BPG combined to Pb.

Association of allergic asthma emergency room visits with the main biological and chemical air pollutants

Joint effect of biological (pollen) and chemical air pollutants on asthma emergency room (ER) visits was analyzed for Szeged region of Southern Hungary. Our database of a nine-year period (1999-2007) includes daily number of asthma emergency room (ER) visits, and daily mean concentrations of CO, PM(10), NO, NO(2), O(3) and SO(2), furthermore two pollen variables (Ambrosia and total pollen excluding Ambrosia), as well. The analysis was performed for ER visits of asthma bronchiale using two age groups (adults and the elderly) of males and females for three seasons. Factor analysis was performed in order to clarify the relative importance of the pollutant variables affecting asthma ER visits. Asthma ER visits denote notably stronger associations with the pollutants in adult male than in adult female patients both for the pollen season of Ambrosia and the pollen-free season. Furthermore, adults are substantially more sensitive to severe asthma attack than the elderly for the season of total pollen excluding Ambrosia pollen. The joint effect of the chemical and pollen variables is the highest for the asthma ER cases in the pollen season of Ambrosia, basically due to the extra impact of the total pollen excluding Ambrosia pollen and partly due to Ambrosia pollen. A nonparametric regression technique was applied to discriminate between events of ER visit-no ER visit using pollen and chemical pollutants as explaining variables. Based on multiple correlations, the strongest relationships between ER visits and pollutants are observed during the pollen-free season. The elderly group with asthma bronchiale is characterized by weaker relationships between ER visits and pollutants compared to adults. Ratio of the number of correct decisions on the events of ER visit-no ER visit is lowest for the season of total pollen excluding Ambrosia pollen. Otherwise, similar conclusions hold as those received by multiple correlations.

IgE reactivity patterns in patients with allergic rhinoconjunctivitis to ragweed and mugwort pollens

BACKGROUND

Differential diagnosis between ragweed and mugwort pollen allergy represents a large clinical problem in areas where both plants are present. The aim of this study was to investigate ragweed- and mugwort-sensitized patients to identify specific IgE reactivity profiles. Results were correlated to clinical findings such as medical history and health-related quality of life (HRQL).

METHODS

Seventy-four patients with allergic rhinoconjunctivitis between July and October were examined and underwent in vivo tests (skin-prick test [SPT] and nasal provocation). Sera were evaluated for IgE reactivity to mugwort and ragweed pollen extracts, major (Art v 1; Amb a 1) and minor (profilin and calcium-binding protein) allergens. HRQL was evaluated using a standardized questionnaire.

RESULTS

Seventy-one patients revealed positive SPT reactivity against mugwort and 60 patients against ragweed extracts. Of these patients, 74 revealed IgE antibodies against mugwort extracts, whereas anti-Art v 1 antibodies were detectable in 50 individuals. Fifty-five patients showed IgE antibodies against natural ragweed extracts; anti-Amb v 1 antibodies were detected in six cases only. Using standardized clinical history and HRQL questionnaires we were not able to detect any differences within different reactivity patterns.

CONCLUSION

Within the investigated population of 74 weed-allergic patients the prevalence of true mugwort and ragweed sensitization can be calculated as 68 and 8%. High prevalence of ragweed sensitization when testing with full extracts can be explained by cross-reactivity between other weeds, e.g., mugwort rather than cosensitization. Differences in medical history and HRQL between different reactivity patterns were not detectable.

Characterization of a Par j 1/Par j 2 mutant hybrid with reduced allergenicity for immunotherapy of Parietaria allergy

BACKGROUND

Parietaria pollen is one of the major cause of pollinosis in the southern Europe. Specific immunotherapy is the only treatment able to modify the natural outcome of the disease restoring a normal immunity against allergens.

METHODS

We designed a recombinant molecule (PjEDloop1) comprised of genetic-engineered variants of the major allergens of the Parietaria pollen (Par j 2/Par j 1). Purity and chemical-physical properties of the derivative were analysed by RP-HPLC chromatography and Photon Correlation Spectroscopy. Immunological activity was evaluated by means of Western blotting, ELISA inhibition and PBMC proliferation assay in 10 Parietaria allergic patients. Basophil activation was studied in six subjects. The immunogenicity of the hybrid was studied looking at the immune responses induced in a mouse model of sensitization.

RESULTS

The PjEDloop1 hybrid was produced as a purified recombinant protein with high stability in solution. Western blot, ELISA inhibition and basophil activation test showed that the PjEDloop1 displays a remarkable reduced IgE binding and anaphylactic activity. CD3 reactivity was conserved in all patients. Mice immunization with the rPjEDloop1 induced antibodies and T cell responses comparable to that obtained by the wild type allergens. Such antibodies shared the specificities to rPar j 1 and rPar j 2 with human IgE antibodies.

CONCLUSION

Our results demonstrated that a mutant hybrid expressing genetically engineered forms of the major P. judaica allergens displayed reduced allergenicity and retained T cell reactivity for the induction of protective antibodies in vaccination approaches for the treatment of Parietaria pollinosis.

Bronchoalveolar lavage fluid exosomes contribute to cytokine and leukotriene production in allergic asthma

BACKGROUND

Leukotrienes (LTs) are potent pro-inflammatory mediators involved in asthma. Exosomes, nanosized vesicles released from various cells, can stimulate or down-regulate immune responses, depending on the state and nature of the originating cell. We have recently shown an altered exosome profile in bronchoalveolar lavage fluid (BALF) of patients with sarcoidosis, but their role in asthma is unknown. Our aims were to investigate whether exosomes from BALF have LT biosynthetic capacity and to explore phenotypic and functional characteristics of BALF exosomes in asthma.

METHODS

Bronchoalveolar lavage fluid exosomes were collected from healthy individuals (n = 13) and patients with mild allergic asthma to birch pollen (n = 12) before and after birch allergen provocation. Exosomes were characterized by flow cytometry and Western blot. Their capacity to induce IL-8 and LT production in the human bronchial epithelial cell (BEC) line 16HB14o- was measured by ELISA and reverse-phase HPLC, respectively.

RESULTS

Compared to BALF exosomes from healthy individuals, BALF exosomes from asthmatics displayed higher levels of exosome-associated markers, such as the tetraspanins CD63 and CD81 and the scavenger receptor CD36. No major differences were observed between BALF exosomes from before and after allergen provocation. Furthermore, we show that BALF exosomes contain enzymes for LT biosynthesis. The effect of exosomes to promote LTC(4) and IL-8 release in BEC was significantly increased for exosomes from asthmatics, and the CysLT(1) receptor antagonist Montelukast reduced exosome-induced IL-8 secretion.

CONCLUSIONS

Bronchoalveolar lavage fluid exosomes from asthmatic and healthy individuals exhibit distinct phenotypes and functions. BALF exosomes from asthmatics might contribute to subclinical inflammation by increasing cytokine and LTC(4) generation in airway epithelium.

Multiphase chemical kinetics of the nitration of aerosolized protein by ozone and nitrogen dioxide

Proteins contained in pollen and other biological particles are nitrated by ozone and nitrogen dioxide in polluted air. The nitration can enhance the allergenic potential of proteins, which may contribute to the increasing prevalence of allergic diseases. The reactive uptake of NO(2) by aerosolized protein (bovine serum albumin) was investigated in an aerosol flow tube using the short-lived radioactive tracer (13)N. In the absence of O(3), the NO(2) uptake coefficient was below detection limit (γ(NO2) < 10(-6)), but with 20-160 ppb O(3) γ(NO2) increased from ~10(-6) to ~10(-4). Using the kinetic multilayer model of surface and bulk chemistry (KM-SUB), the observed time and concentration dependence can be well reproduced by a multiphase chemical mechanism involving ozone-generated reactive oxygen intermediates (ROIs), but not by NO(3) radicals formed in the gas phase. Product studies show the formation of protein dimers, suggesting that the ROIs are phenoxy radical derivatives of the amino acid tyrosine (tyrosyl radicals) which are also involved in physiological protein nitration processes. Our results imply that proteins on the surface of aerosol particles undergo rapid nitration in polluted air, while the rate of nitration in bulk material may be low depending on phase state and surface-to-volume ratio.

Global warming and allergy in Asia Minor

The earth is warming, and it is warming quickly. Epidemiological studies have demonstrated that global warming is correlated with the frequency of pollen-induced respiratory allergy and allergic diseases. There is a body of evidence suggesting that the prevalence of allergic diseases induced by pollens is increasing in developed countries, a trend that is also evident in the Mediterranean area. Because of its mild winters and sunny days with dry summers, the Mediterranean area is different from the areas of central and northern Europe. Classical examples of allergenic pollen-producing plants of the Mediterranean climate include Parietaria, Olea and Cupressaceae. Asia Minor is a Mediterranean region that connects Asia and Europe, and it includes considerable coastal areas. Gramineae pollens are the major cause of seasonal allergic rhinitis in Asia Minor, affecting 1.3-6.4 % of the population, in accordance with other European regions. This article emphasizes the importance of global climate change and anticipated increases in the prevalence and severity of allergic disease in Asia Minor, mediated through worsening air pollution and altered local and regional pollen production, from an otolaryngologic perspective.

Specific IgE response to different grass pollen allergen components in children undergoing sublingual immunotherapy

Background

Grass pollen is a major cause of respiratory allergy worldwide and contain a number of allergens, some of theme (Phl p 1, Phl p 2, Phl p 5, and Phl 6 from Phleum pratense, and their homologous in other grasses) are known as major allergens. The administration of grass pollen extracts by immunotherapy generally induces an initial rise in specific immunoglobulin E (sIgE) production followed by a progressive decline during the treatment. Some studies reported that immunotherapy is able to induce a de novo sensitisation to allergen component previously unrecognized.

Methods

We investigated in 30 children (19 males and 11 females, mean age 11.3 years), 19 treated with sublingual immunotherapy (SLIT) by a 5-grass extract and 11 untreated, the sIgE and sIgG4 response to the different allergen components.

Results

Significant increases (p < 0.001) were detected for Phl p 1, Phl p 2, Phl p 5, and Phl p 6, while sIgE levels induced in response to Phl p 7 and Phl p 12 were low or absent at baseline and unchanged following SLIT treatment; no new sensitisation was detected. As to IgG4, significant increases were found for Phl p2 and Phl p 5, while the increase for Phl p 12 was not significant. In the control group, no significant increase in sIgE for any single allergen component was found.

Conclusions

These findings confirm that the initial phase of SLIT with a grass pollen extract enhances the sIgE synthesis and show that the sIgE response concerns the same allergen components which induce IgE reactivity during natural exposure.

Detection of Phl p 1, Phl p 5, Phl p 7 and Phl p 12 specific IgE antibodies in the sera of children and adult patients allergic to Phleum pollen

BACKGROUND

Grasses belong to major sources of inhaled allergens. The knowledge of particular molecules responsible for hypersensitivity is of crucial importance for better understanding of individual differences among single allergic subjects and allergic populations living in various world-areas.

METHODS

Specific-IgE-antibodies against Phl p 1, Phl p 5, Phl p 7, Phl p 12 were detected in a group of 130 Phleum-allergic-subjects (82 children, 48 adults).

RESULTS

Phl p 1 antibodies were detected in most pediatric and adult patients, however, the children were associated with higher RAST classes more often. Anti-Phl p 5-antibodies were found more frequently in adults. An increase was observed in the number of pediatric patients reacting to Phl p 7 and Phl p 12. There were no differences in concentrations of specific-IgE against Phl p 5, Phl p 7 and Phl p 12 depending on age. Almost 10% of allergic children produced antibodies directed exclusively against minor allergens or did not produce specific-IgE-antibodies against tested molecules. Part of the patients reacted to profilin and calcium-binding protein originating from only one source (Phl p 12/Bet v 2 and Phl p 7/Bet v 4).

CONCLUSIONS

Antibodies against Phl p 1 and Phl p 5 can be used as a marker of allergy to grasses in adult patients. Children reacted exclusively to minor allergens more frequently than adults. Prolonged allergen exposure is evidently necessary to induce sensitization to Phl p 5. A high level of homology between profilins and calcium-binding proteins enables only one allergen to be used for diagnostic purposes but a possibility of a reaction to species-bound epitopes should be taken into account.

Treatment of seasonal allergic rhinoconjunctivitis with a once-daily SQ-standardized grass allergy immunotherapy tablet

OBJECTIVES

Specific immunotherapy with the grass allergy immunotherapy tablet (AIT) has been developed as an effective, well tolerated, and convenient treatment for grass pollen induced seasonal allergic rhinoconjunctivitis (ARC). Six phase II/III randomized, placebo-controlled trials with the duration of a single grass pollen season of treatment using the SQ-standardized grass AIT, Grazax (Phleum pratense, 75,000 SQ-T/2,800 BAU, ALK, Denmark), have been published previously. This review compares results from these trials.

METHODS

As outcome measures and methods of assessing them were similar across the trials, we have summarized the main efficacy findings (Total Combined Score [TCS], average daily rhinoconjunctivitis symptom and medication scores, percentage of well days, quality of life scores) during a single season of treatment with grass AIT in adults and children with seasonal ARC.

RESULTS

The results of the European and North American trials were similar. Compared with the placebo group, who received symptomatic medications only, treatment with grass AIT resulted in fewer rhinoconjunctivitis symptoms, a lower intake of symptomatic medication, better patient self-rated quality of life and a greater percentage of well days during the entire grass pollen season. The data indicate that grass AIT treatment is equally effective in adults and children; the measured effect varies with pollen exposure, but is comparable across regions and continents, with a consistent difference compared with placebo in TCS that was above 20% for all trials. Local adverse events were experienced by the majority of patients. These reactions were generally mild to moderate in severity and transient in duration. Systemic adverse events were rare.

CONCLUSIONS

This review confirms SQ-standardized grass AIT as a suitable therapeutic option for seasonal use in patients aged 5 years or older with grass pollen induced ARC.

The use of geostatistics in the study of floral phenology of Vulpia geniculata (L.) link

Traditionally phenology studies have been focused on changes through time, but there exist many instances in ecological research where it is necessary to interpolate among spatially stratified samples. The combined use of Geographical Information Systems (GIS) and Geostatistics can be an essential tool for spatial analysis in phenological studies. Geostatistics are a family of statistics that describe correlations through space/time and they can be used for both quantifying spatial correlation and interpolating unsampled points. In the present work, estimations based upon Geostatistics and GIS mapping have enabled the construction of spatial models that reflect phenological evolution of Vulpia geniculata (L.) Link throughout the study area during sampling season. Ten sampling points, scattered throughout the city and low mountains in the "Sierra de Córdoba" were chosen to carry out the weekly phenological monitoring during flowering season. The phenological data were interpolated by applying the traditional geostatitical method of Kriging, which was used to elaborate weekly estimations of V. geniculata phenology in unsampled areas. Finally, the application of Geostatistics and GIS to create phenological maps could be an essential complement in pollen aerobiological studies, given the increased interest in obtaining automatic aerobiological forecasting maps.

Changes to airborne pollen counts across Europe

A progressive global increase in the burden of allergic diseases has affected the industrialized world over the last half century and has been reported in the literature. The clinical evidence reveals a general increase in both incidence and prevalence of respiratory diseases, such as allergic rhinitis (common hay fever) and asthma. Such phenomena may be related not only to air pollution and changes in lifestyle, but also to an actual increase in airborne quantities of allergenic pollen. Experimental enhancements of carbon dioxide (CO[Formula: see text]) have demonstrated changes in pollen amount and allergenicity, but this has rarely been shown in the wider environment. The present analysis of a continental-scale pollen data set reveals an increasing trend in the yearly amount of airborne pollen for many taxa in Europe, which is more pronounced in urban than semi-rural/rural areas. Climate change may contribute to these changes, however increased temperatures do not appear to be a major influencing factor. Instead, we suggest the anthropogenic rise of atmospheric CO[Formula: see text] levels may be influential.

Pollen Counts in Slavonski Brod, Croatia During the Pollination Period 2008 to 2010

Hay fever or pollinosis is the allergic reaction of the human body to allergic pollen grains and is a seasonal phenomenon. Pollen concentrations depend on the climate, geographic features, and vegetation. Trees, grass, and weed pollinosis is frequent in Croatia, common ragweed (Ambrosia artemisifolia L.) pollinosis in particular. Continuous monitoring of pollen air concentrations can provide timely information to the general public and can help sensitised patients and their physicians to prevent or alleviate allergic reactions. This is the task of health ecology services such as our Public Health Institute of the Brod-Posavina County. This article reports pollen concentrations in Slavonski Brod measured in March 2008 to November 2008, March 2009 to October 2009, and April 2010 to October 2010 and discusses the increasing exposure to ragweed and ways to control it.

In vitro exposure of Acer negundo pollen to atmospheric levels of SO₂ and NO₂: effects on allergenicity and germination

In the last years, a rising trend of pollen allergies in urban areas has been attributed to atmospheric pollution. In this work, we investigated the effects of SO(2) and NO(2) on the protein content, allergenicity, and germination rate of Acer negundo pollen. A novel environmental chamber was assembled to exposure pollen samples with SO(2) or NO(2) at two different levels: just below and two times the atmospheric hour-limit value acceptable for human health protection in Europe. Results showed that protein content was lower in SO(2)-exposed pollen samples and slightly higher in NO(2)-exposed pollen compared to the control sample. No different polypeptide profiles were revealed by SDS-PAGE between exposed and nonexposed pollen, but the immunodetection assays indicated higher IgE recognition by all sera of sensitized patients to Acer negundo pollen extracts in all exposed samples in comparison to the nonexposed samples. A decrease in the germination rate of exposed in contrast to nonexposed pollen was verified, which was more pronounced for NO(2)-exposed samples. Our results indicated that in urban areas, concentrations of SO(2) and NO(2) below the limits established for human protection can indirectly aggravate pollen allergy on predisposed individuals and affect plant reproduction.

The association between daily outpatient visits for allergic rhinitis and pollen levels in Beijing

To investigate the effects of aerosol pollen on human health, we carried out a time-series analysis of daily general practitioner consultations for allergic rhinitis (AR) in Beijing. The objective of this study was to assess the possible effects of pollen on clinic visits for allergic rhinitis in Beijing during the pollen season. We found a strong association between the concentration of pollen in ambient air and the number of consultations for allergic rhinitis. Females had significantly more outpatient visits than males when the levels of pollen increased. Young people (20-60 years old) had had significantly more outpatient visits than older people (over 60 years old) when the levels of pollen increased. After adjusting for air pollutants, the relative risks of pollen on daily number of outpatient for AR were increased.

Oral administration of allergen extracts from mugwort pollen desensitizes specific allergen-induced allergy in mice

Clinically, sublingual immunotherapy (SLIT) using allergen extracts effectively alleviates the symptoms of allergic rhinitis and asthma. We hypothesized that oral administration of a high-dose of allergen extracts imitates SLIT, which may prevent IgE-related responses in allergic diseases. In the present study, we investigated the effects of oral administration of allergen extracts from mugwort pollen (MP) on allergen-induced inflammation and airway hyperresponsiveness (AHR) in an allergic mouse model. After administration of MPdrop containing Art v 1 and Art v 4 extracts derived from MP specifically in MP-sensitized mice, the effects of MPdrop on AHR, inflammatory cell accumulation, cytokine production in the bronchoalveolar lavage fluid and lung tissue, and serum IgE and IgG levels were investigated. The results indicated that MPdrop not only prevented the AHR in response to methacholine in a dose-dependent manner but also significantly reduced the total serum and allergen-specific IgE levels. All of the maximal effects were achieved at a dose of 100μg/(kgd) and were comparable to the effects of dexamethasone at a dose of 0.5mg/(kgd). Furthermore, oral administration of MPdrop dose-dependently elevated allergen-specific serum IgG2a levels, reduced total and allergen-specific IgE levels and normalized the imbalance between the Th1 cytokine IL-12 and Th2 cytokines IL-4 and IL-5. Finally, oral administration of MPdrop significantly reduced goblet cell hyperplasia and eosinophilia in the MP-sensitized allergic mouse model. These data suggest that MPdrop effectively improves specific allergen-induced inflammation and AHR in MP-sensitized and -challenged mice and provides the rationale for clinical use of MPdrop in the specific allergen-induced asthma.

Difference in symptom severity between early and late grass pollen season in patients with seasonal allergic rhinitis

BACKGROUND

For the development of forecasts for seasonal allergic rhinitis symptoms, it is essential to understand the relationship between grass pollen concentrations and the symptoms of grass pollen allergic patients.

OBJECTIVE

The aim of this study was to delineate this relationship between seasonal allergic rhinitis symptoms and grass pollen concentrations in the Netherlands.

METHODS

Grass pollen allergic patients (n = 80 [2007] - 84 [2008]) were enrolled into the study. They were asked to enter their seasonal allergic rhinitis symptoms (runny nose, sneezing, blocked nose, post nasal drip, and eye symptoms) daily on a scale from 0 to 3 to the study centre either by short message service (SMS) or by internet from May-July 2007 and April-July 2008. Daily pollen counts were used to define the early and the late grass pollen season as the period 'before and during' respectively 'after' the first grass pollen peak (more than 150 pollen/m3).

RESULTS

At similar grass pollen concentrations, the daily mean of the individual maximum symptom scores reported in the early season were higher as compared to that reported in the late season [differences of -0.41 (2007) and -0.30 (2008)]. This difference could not be explained by medication use by the patients nor by co-sensitization to birch.

CONCLUSIONS

We conclude that seasonal allergic rhinitis symptoms at similar grass pollen concentrations are more severe in the early flowering season as compared to those in the late flowering season. This finding is not only relevant for development of forecasts for seasonal allergic rhinitis symptoms but also for understanding symptom development and planning and analysis of clinical studies.

Impact of meteorological variation on hospital visits of patients with tree pollen allergy

Background

Climate change could affect allergic diseases, especially due to pollen. However, there has been no epidemiologic study to demonstrate the relationship between meteorological factors, pollen, and allergic patients. We aimed to investigate the association between meteorological variations and hospital visits of patients with tree pollen allergy.

Methods

The study subjects were adult patients who received skin prick tests between April and July from 1999 to 2008. We reviewed the medical records for the test results of 4,715 patients. Patients with tree pollen allergy were defined as those sensitized to more than 1 of 12 tree pollen allergens. We used monthly means of airborne tree pollen counts and meteorological factors: maximum/average/minimum temperature, relative humidity, and precipitation. We analyzed the correlations between meteorological variations, tree pollen counts, and the patient numbers. Multivariable logistic regression analyses were used to investigate the associations between meteorological factors and hospital visits of patients.

Results

The minimum temperature in March was significantly and positively correlated with tree pollen counts in March/April and patient numbers from April through July. Pollen counts in March/April were also correlated with patient numbers from April through July. After adjusting for confounders, including air pollutants, there was a positive association between the minimum temperature in March and hospital visits of patients with tree pollen allergy from April to July(odds ratio, 1.14; 95% CI 1.03 to 1.25).

Conclusions

Higher temperatures could increase tree pollen counts, affecting the symptoms of patients with tree pollen allergy, thereby increasing the number of patients visiting hospitals.

Identification of european allergy patterns to the allergen families PR-10, LTP, and profilin from Rosaceae fruits

High fruit intakes are associated with significant health benefits but fruit allergy sufferers may be discouraged from eating fruit due to the symptoms they experience. Knowledge about allergens involved in fruit allergy and the frequent cross-reactions to other allergens is essential to (a) design the best strategy for fruit allergy testing (b) prescribe optimal avoidance diets, and (c) design technological solutions for development of hypoallergenic fruits. The objective of this review was to investigate whether some characteristic disease entities could be identified in Europe for allergy to Rosaceae fruits. Five allergy patterns were found involving the allergen families PR-10, LTP, and profilin. In the Western Mediterranean area allergies to Rosaceae fruits are caused by monosensitization to LTP, monosensitization to profilin, or co-sensitization to both these allergens. On the contrary, monosensitization to PR-10 and, to a lesser degree, co-sensitization to profilin and PR-10 is dominant in Northern and Central Europe. LTP sensitization is present both in pollinosis and non-pollinosis patients and is associated with peach allergy in particular. The disease pattern for patients sensitized to profilin is characterized by several concomitant allergies including grass and other pollens, Rosaceae and non-Rosaceae fruits. Finally, PR-10 sensitization is primarily associated to concomitant birch pollen and apple allergy.

Thirty-year survey on airborne pollen concentrations in Genoa, Italy: relationship with sensitizations, meteorological data, and air pollution

BACKGROUND

Pollen allergy represents a relevant health issue. Betulaceae sensitization significantly increased in Genoa, Italy, in the last decades. This study investigated possible relationships among pollen count, meteorological changes, air pollution, and sensitizations in this city during a 30-year period.

METHODS

Betulaceae, Urticaceae, Gramineae, and Oleaceae pollen counts were measured from 1981 to 2010 in Genoa. Sensitization to these pollens was also considered in large populations of allergic patients. Meteorological parameters and pollutants were also measured in the same area.

RESULTS

Betulaceae sensitization increased over time. All pollen species significantly increased over this time. Pollen season advanced for Betulaceae and Urticaceae. Only Urticaceae season significantly increased. Temperature increased while rainfall decreased over the time. Pollutants significantly decreased. There were some relationships between pollen changes and climatic and air pollution parameters.

CONCLUSION

This 30-year study conducted in an urbanized area provided evidence that Betulaceae sensitization significantly increased, pollen load significantly augmented, and climate and air pollution changed with a possible influence on pollen release.

Bet v 1-like pollen allergens of multiple Fagales species can sensitize atopic individuals

BACKGROUND

In the temperate climate zone of the Northern hemisphere, Fagales pollen allergy represents the main cause of winter/spring pollinosis. Among Fagales trees, pollen allergies are strongly associated within the Betulaceae and the Fagaceae families. It is widely accepted that Fagales pollen allergies are initiated by sensitization against Bet v 1, the birch pollen major allergen, although evidence is accumulating that the allergenic activity of some Bet v 1-like molecules has been underestimated.

OBJECTIVE

To investigate the allergenic potential of the clinically most important Fagales pollen allergens from birch, alder, hazel, hornbeam, hop-hornbeam, oak, beech and chestnut.

METHODS

To obtain the full spectrum of allergens, the three previously unavailable members of the Bet v 1-family, hop-hornbeam Ost c 1, chestnut Cas s 1 and beech Fag s 1, were identified in the respective pollen extracts, cloned and produced as recombinant proteins in E. coli. Together with recombinant Bet v 1, Aln g 1, Car b 1, Cor a 1 and Que a 1, the molecules were characterized physicochemically, mediator release assays were performed and IgE cross-reactivity was evaluated by ELISA and Immuno Solid-phase Allergen Chip (ISAC) IgE inhibition assays.

RESULTS

All allergens showed the typical Bet v 1-like secondary structure elements, and they were all able to bind serum IgE from Fagales allergic donors. Strong IgE binding was observed for Betuloideae and Coryloideae allergens, however, cross-reactivity between the two subfamilies was limited as explored by inhibition experiments. In contrast, IgE binding to members of the Fagaceae could be strongly inhibited by serum pre-incubation with allergens of the Betuloideae subfamily.

CONCLUSIONS AND CLINICAL RELEVANCE

The data suggest that Bet v 1-like allergens of the Betuloideae and Coryloideae subfamily might have the potential to induce IgE antibodies with different specificities, while allergic reactions towards Fagaceae allergens are the result of IgE cross-reactivity.

A review of non-pharmacological and pharmacological management of seasonal and perennial allergic conjunctivitis

Allergic eye disease encompasses a group of hypersensitivity disorders which primarily affect the conjunctiva and its prevalence is increasing. It is estimated to affect 8% of patients attending optometric practice but is poorly managed and rarely involves ophthalmic assessment. Seasonal allergic conjunctivitis (SAC) is the most common form of allergic eye disease (90%), followed by perennial allergic conjunctivitis (PAC; 5%). Both are type 1 IgE mediated hypersensitivity reactions where mast cells play an important role in pathophysiology. The signs and symptoms are similar but SAC occurs periodically whereas PAC occurs year round. Despite being a relatively mild condition, the effects on the quality of life can be profound and therefore they demand attention. Primary management of SAC and PAC involves avoidance strategies depending on the responsible allergen(s) to prevent the hypersensitivity reaction. Cooled tear supplements and cold compresses may help bring relief. Pharmacological agents may become necessary as it is not possible to completely avoid the allergen(s). There are a wide range of anti-allergic medications available, such as mast cell stabilisers, antihistamines and dual-action agents. Severe cases refractory to conventional treatment require anti-inflammatories, immunomodulators or immunotherapy. Additional qualifications are required to gain access to these medications, but entry-level optometrists must offer advice and supportive therapy. Based on current evidence, the efficacy of anti-allergic medications appears equivocal so prescribing should relate to patient preference, dosing and cost. More studies with standardised methodologies are necessary elicit the most effective anti-allergic medications but those with dual-actions are likely to be first line agents.

The pollen season dynamics and the relationship among some season parameters (start, end, annual total, season phases) in Kraków, Poland, 1991-2008

The dynamics of 15 taxa pollen seasons in Kraków, in 1991-2008 was monitored using a Burkard volumetric spore trap of the Hirst design. The highest daily pollen concentrations were achieved in the first half of May, and they were caused mainly by Betula and Pinus pollen. The second period of the high concentrations took place from the middle of July to the end of August (mainly Urtica pollen). Tree pollen seasons were shorter (18-24 days) in comparison with the most herbaceous pollen seasons (73-89 days), except at Artemisia and Ambrosia seasons (30 and 24 days, respectively). The season phases (percentyles) of the spring and late-summer taxa were the most variable in the consecutive years. The highest annual sums were noted for Urtica, Poaceae (herbaceous pollen seasons) and for Betula, Pinus, Alnus (tree pollen seasons), and the highest variability of annual totals was stated for Urtica, Populus, Fraxinus and the lowest for Ambrosia, Corylus, Poaceae. For the plants that pollinate in the middle of the pollen season (Quercus, Pinus and Rumex), the date of the season start seems not to be related to the season end, while for late pollen seasons, especially for Ambrosia and Artemisia, the statistically negative correlation between the start and the end season dates was found. Additionally, for the most studied taxa, the increase in annual pollen totals was observed. The presented results could be useful for the allergological practice and general botanical knowledge.

Simulated environmental criticalities affect transglutaminase of Malus and Corylus pollens having different allergenic potential

Increases in temperature and air pollution influence pollen allergenicity, which is responsible for the dramatic raise in respiratory allergies. To clarify possible underlying mechanisms, an anemophilous pollen (hazel, Corylus avellana), known to be allergenic, and an entomophilous one (apple, Malus domestica), the allergenicity of which was not known, were analysed. The presence also in apple pollen of known fruit allergens and their immunorecognition by serum of an allergic patient were preliminary ascertained, resulting also apple pollen potentially allergenic. Pollens were subjected to simulated stressful conditions, provided by changes in temperature, humidity, and copper and acid rain pollution. In the two pollens exposed to environmental criticalities, viability and germination were negatively affected and different transglutaminase (TGase) gel bands were differently immunodetected with the polyclonal antibody AtPng1p. The enzyme activity increased under stressful treatments and, along with its products, was found to be released outside the pollen with externalisation of TGase being predominant in C. avellana, whose grain presents a different cell wall composition with respect to that of M. domestica. A recombinant plant TGase (AtPng1p) stimulated the secreted phospholipase A(2) (sPLA(2)) activity, that in vivo is present in human mucosa and is involved in inflammation. Similarly, stressed pollen, hazel pollen being the most efficient, stimulated to very different extent sPLA(2) activity and putrescine conjugation to sPLA(2). We propose that externalised pollen TGase could be one of the mediators of pollen allergenicity, especially under environmental stress induced by climate changes.

Pollen proteases compromise the airway epithelial barrier through degradation of transmembrane adhesion proteins and lung bioactive peptides

BACKGROUND

Allergic disorders, such as seasonal rhinitis and asthma, are increasing causes of morbidity worldwide and often result from exposure to airborne pollen. Pollen allergy has a remarkable clinical impact all over Europe. In fact, epidemiological longitudinal studies confirm that pollen species usually considered with low allergenic potential became more recently responsible for intense allergic reactions. In this study, we aimed to characterize major pollen proteolytic activity and evaluate its contribution to the immunologic and inflammatory response to airborne allergens.

METHODS

Proteolytic activity in four pollen diffusates with distinct allergenicity, Olea europaea, Dactylis glomerata, Cupressus sempervirens and Pinus sylvestris, was evaluated through several enzymatic assays. The action of pollen proteases on the paracellular integrity of Calu-3, grown at the air-liquid interphase, was evaluated through a transepithelial permeability assay. Immunoblot and immunofluorescence experiments were performed to analyse the disruption of intercellular complexes. Degradation of bioactive peptides by pollen crude extracts was assessed by mass spectrometry.

RESULTS

All pollen diffusates were shown to have high molecular weight proteases with serine and/or aminopeptidase activity. These proteases increased Calu-3 transepithelial permeability through disruption of transmembrane adhesion proteins: occludin, claudin-1 and E-cadherin. Moreover, they were able to degrade airway bioactive peptides and were not blocked by endogenous protease inhibitors.

CONCLUSION

Pollen grains with distinct allergenic abilities release proteases that might be involved in the sensitization to a range of airborne allergens by facilitating allergen delivery across the epithelium and also contribute directly to the inflammation characteristic of allergic diseases.

Human exposure to allergenic pollens: a comparison between urban and rural areas

BACKGROUND

Pollinosis is found more frequently in urban areas than in rural environments. This could be partly related to the different types of pollen exposure in these dissimilar areas. The objective of this study was to compare the distribution of pollen in these environments across an urbanization gradient.

METHODS

Daily pollen abundances were obtained in France using Hirst-type sensors. Sampling was conducted from January to June in 2003 and 2006 in a rural area, a semi-rural area and in two urban areas, which were characterized by several urbanization criteria.

RESULTS

Total allergenic pollen abundance was higher in rural and semi-rural areas than in urban areas irrespective of the sampling year. Multivariate analyses showed that pollen exposures differed according to the type of area and were strongly explained by the urbanization gradient. Grass, ash, birch, alder, hornbeam, hazel and plantain pollen quantities exceeded the allergy threshold more often in rural settings than in urban areas. In urban areas, only plane pollen quantities exceeded the allergy threshold more often than in rural areas.

CONCLUSIONS

Allergenic pollen exposure is higher in rural areas than in urban areas, and the most abundant pollen in each area did not originated from the same taxa. This result should be taken into account in epidemiological studies comparing allergies in rural and urban areas to adapt the panel of pollen extracts for human environmental exposure. In addition, this study highlights that some ornamental trees produce a large number of allergenic pollens and provide new sources of aeroallergens.

Climate change, migration, and allergic respiratory diseases: an update for the allergist

Local climate changes can impact on a number of factors, including air pollution, that have been shown to influence both the development and attacks of allergic respiratory diseases, and thus, they represent an important consideration for the allergist. Migration involves exposure to a new set of pollutants and allergens as well as changes in housing conditions, diet, and accessibility to medical services, all of which are likely to affect migrants' health. This review provides an update on climate change, migration, and allergy and discusses factors for consideration when making recommendations for local allergy service provision and for assessing an individual patient's environmental exposures.

On the causes of variability in amounts of airborne grass pollen in Melbourne, Australia

In Melbourne, Australia, airborne grass pollen is the predominant cause of hay fever (seasonal rhinitis) during late spring and early summer, with levels of airborne grass pollen also influencing hospital admissions for asthma. In order to improve predictions of conditions that are potentially hazardous to susceptible individuals, we have sought to better understand the causes of diurnal, intra-seasonal and inter-seasonal variability of atmospheric grass pollen concentrations (APC) by analysing grass pollen count data for Melbourne for 16 grass pollen seasons from 1991 to 2008 (except 1994 and 1995). Some of notable features identified in this analysis were that on days when either extreme (>100 pollen grains m(-3)) or high (50-100 pollen grains m(-3)) levels of grass pollen were recorded the winds were of continental origin. In contrast, on days with a low (<20 pollen grains m(-3)) concentration of grass pollen, winds were of maritime origin. On extreme and high grass pollen days, a peak in APC occurred on average around 1730 hours, probably due to a reduction in surface boundary layer turbulence. The sum of daily APC for each grass pollen season was highly correlated (r = 0.79) with spring rainfall in Melbourne for that year, with about 60% of a declining linear trend across the study period being attributable to a reduction of meat cattle and sheep (and hence grazing land) in rural areas around Melbourne. Finally, all of the ten extreme pollen events (3 days or more with APC > 100 pollen grains m(-3)) during the study period were characterised by an average downward vertical wind anomaly in the surface boundary layer over Melbourne. Together these findings form a basis for a fine resolution atmospheric general circulation model for grass pollen in Melbourne's air that can be used to predict daily (and hourly) APC. This information will be useful to those sectors of Melbourne's population that suffer from allergic problems.

Pollen counts and their relationship to meteorological factors in Ankara, Turkey during 2005-2008

Pollen plays an important role in the development and exacerbation of allergic diseases. We aimed to investigate the days with highest counts of the most allergenic pollens and to identify the meteorological factors affecting pollen counts in the atmosphere of Ankara, Turkey. Airborne pollen measurements were carried out from 2005 to 2008 with a Burkard volumetric 7-day spore trap. Microscope counts were converted into atmospheric concentrations and expressed as pollen grains/m(3). Meteorological parameters were obtained from the State Meteorological Service. All statistical analyses were done with pollen counts obtained from March to October for each year. The percentages of tree, grass and weed pollens were 72.1% (n = 24,923), 12.8% (n = 4,433) and 15.1% (n = 5,219), respectively. The Pinaceae family from tree taxa (39% to 57%) and the Chenopodiaceae/Amaranthaceae family from weed taxa, contributed the highest percentage of pollen (25% to 43%), while from the grass taxa, only the Poaceae family was detected from 2005 to 2008. Poaceae and Chenopodiaceae/Amaranthaceae families, which are the most allergenic pollens, were found in high numbers from May to August in Ankara. In multiple logistic regression analysis, wind speed (OR = 1.18, CI95% = 1.02-1.36, P = 0.023) for tree pollen, daily mean temperature (OR = 1.10, CI95% = 1.04-1.17, P = 0.001) and sunshine hours (OR = 1.15, CI95% = 1.01-1.30, P = 0.033) for grass pollen, and sunshine hours (OR = 3.79, CI95% = 1.03-13.92, P = 0.044) for weed pollen were found as significant risk factors for high pollen count. The pollen calendar and its association with meteorological factors depend mainly on daily temperature, sunshine hours and wind speed, which may help draw the attention of physicians and allergic patients to days with high pollen counts.

Allergy as an epithelial barrier disease

The objective of this review is to focus on putative modified epithelial functions related to allergy. The dysregulation of the epithelial barrier might result in the allergen uptake, which could be the primary defect in the pathogenesis of allergic reaction. We review the literature of the role of respiratory epithelium as an active barrier, how allergens are transported through it and how it senses the hostile environmental allergens and other dangerous stimuli.

Forecasting ragweed pollen characteristics with nonparametric regression methods over the most polluted areas in Europe

Nonparametric time-varying regression methods were developed to forecast daily ragweed pollen concentration, and the probability of the exceedance of a given concentration threshold 1 day ahead. Five-day and 10-day predictions of the start and end of the pollen season were also addressed with a nonparametric regression technique combining regression analysis with the method of temperature sum. Our methods were applied to three of the most polluted regions in Europe, namely Lyon (Rhône Valley, France), Legnano (Po River Plain, Italy) and Szeged (Great Plain, Hungary). For a 1-day prediction of both the daily pollen concentration and daily threshold exceedance, the order of these cities from the smallest to largest prediction errors was Legnano, Lyon, Szeged and Legnano, Szeged, Lyon, respectively. The most important predictor for each location was the pollen concentration of previous days. The second main predictor was precipitation for Lyon, and temperature for Legnano and Szeged. Wind speed should be considered for daily concentration at Legnano, and for daily pollen threshold exceedances at Lyon and Szeged. Prediction capabilities compared to the annual cycles for the start and end of the pollen season decreased from west to east. The order of the cities from the lowest to largest errors for the end of the pollen season was Lyon, Legnano, Szeged for both the 5- and 10-day predictions, while for the start of the pollen season the order was Legnano, Lyon, Szeged for 5-day predictions, and Legnano, Szeged, Lyon for 10-day predictions.

Role of pollen allergy in Taiwanese patients with allergic rhinitis

BACKGROUND/PURPOSE

Pollen allergy is believed to be less common in East Asia, Latin America, and tropical areas. The purpose of this study was to understand the role of pollen allergy in Taiwan.

METHODS

Patients with clinically diagnosed allergic rhinitis were enrolled. All subjects received a 30-item skin test panel that included perennial allergens (house dust mix, Dermatophagoides pteronyssinus, Dermatophagoides farinae, dog epithelium, cat hairs, cockroach mix, and Candida albicans) and pollen allergens (acacia, pine mix, eucalyptus, beefwood, juniper mix, willow, mulberry mix, pepper tree, cedar, Johnson grass, Bermuda grass, ragweed mix, Timothy grass, spiny pigweed, cocklebur, sage mix, sheep sorrel, dog fennel, pigweed mix, English plantain, castor bean, alfalfa, and dandelion).

RESULTS

A total of 419 patients were recruited. A total of 313 (74.7%) had a positive skin test. A total of 288 patients (68.7%) were sensitive to perennial allergens, and 11 8 patients (28.2%) were sensitive to pollen allergens. However, 93 pollen-sensitive patients were also sensitive to perennial allergens, and only 25 were sensitive to pollen allergens alone. The most common allergens were D. pteronyssinus, D. farinae, house dust mix, and cockroach, but the most common pollen allergens were spiny pigweed, Johnson grass, and sheep sorrel. All nasal symptoms tended to be more severe in patients who were sensitive to perennial allergens than in those who were sensitive to pollen allergens alone.

CONCLUSION

Most patients with allergic rhinitis in Taiwan are sensitive to perennial allergens, and pollens are a less common allergen.

Novel Strategies for the Development of a Vaccine for Parietaria Allergy

Specific immunotherapy is a well established and clinically proved strategy to cure allergic reactions. The impressive boost of knowledge derived from DNA recombinant technology applied to this field allowed the identification, cloning and expression of several clinically relevant allergens. Recombinant allergens can be easily produced in a pure and reproducible way with immunological properties comparable to natural allergens and matching the requirements of pharmaceutical companies. Parietaria pollinosis is a major health problem in the Mediterranean basin with prolonged symptoms. In this review we will discuss the rational approaches to design hypoallergenic derivatives of the major allergens of this pollen, their immunological properties and possible clinical future implications.

Effects of climatic changes and urban air pollution on the rising trends of respiratory allergy and asthma

Over the past two decades there has been increasing interest in studies regarding effects on human health of climate changes and urban air pollution. Climate change induced by anthropogenic warming of the earth's atmosphere is a daunting problem and there are several observations about the role of urbanization, with its high levels of vehicle emissions and other pollutants, and westernized lifestyle with respect to the rising frequency of respiratory allergic diseases observed in most industrialized countries.There is also evidence that asthmatic subjects are at increased risk of developing exacerbations of bronchial obstruction with exposure to gaseous (ozone, nitrogen dioxide, sulfur dioxide) and particulate inhalable components of air pollution.A change in the genetic predisposition is an unlikely cause of the increasing frequency in allergic diseases because genetic changes in a population require several generations. Consequently, environmental factors such as climate change and indoor and outdoor air pollution may contribute to explain the increasing frequency of respiratory allergy and asthma. Since concentrations of airborne allergens and air pollutants are frequently increased contemporaneously, an enhanced IgE-mediated response to aeroallergens and enhanced airway inflammation could account for the increasing frequency of allergic respiratory diseases and bronchial asthma.Scientific societies such as the European Academy of Allergy and Clinical Immunology, European Respiratory Society and the World Allergy Organization have set up committees and task forces to produce documents to focalize attention on this topic, calling for prevention measures.