Allergenic pollen and pollen allergy in Europe

Pollen Allergy in a Changing Planetary Environment

Airborne pollens are one of the common causative and triggering agents of respiratory allergy in a changing planetary environment. A growing number of people worldwide are contracting allergic diseases caused by pollens. The seasonal variations in pollens have occurred everywhere and the sensitization rate to pollens has increased in children as well as in adults. Moreover, allergenic plants, such as ragweed and Japanese hop, grow in soil damaged by human’s activities and deforestation with air pollution. It is impossible to avoid plants that cause allergies, because pollens can travel many kilometers in the breeze or wind. Hence, it is essential to survey and forecast pollens for the management of pollen allergy. Weather conditions may alter pollen concentrations. A number of studies have shown that increases in CO₂ concentration and atmospheric temperature raise pollen concentration. Hence most of the studies on the impact of climate change on aeroallergens must include the amount and allergenicity of pollens. It is yet unknown whether complex interactions with pollens, meteorological variables, and air pollutants in the changing environment. Considering the effect of climate change on the long-term trends in pollen levels and emerging viral infection, it is crucial to forecast and eliminate the associated risk for human health in future and take appropriate measures to reduce it.

Combating data incompetence in pollen images detection and classification for pollinosis prevention

Automatic pollen images recognition is crucial for pollinosis symptoms prevention and treatment. The problem of pollen recognition can be efficiently solved using deep learning, however neural networks require tens of thousands of images to generalize. At the same time, the existing open pollen images datasets are very small. In this paper, we present a novel open pollen dataset annotated for both detection and classification tasks. Based on our dataset we study learning from a small data using different state-of-the-art approaches. For the detection task we propose to use our new Bayesian RetinaNet network, which models aleatoric uncertainty. We compare it with the baseline RetinaNet and demonstrate that our model allows for higher detection precision. For the classification task we compare the impact of pre-training on the synthetic images from generative adversarial networks (GANs) and metric-based few-shot learning. Namely, we pre-trained our small convolutional neural network and Siamese neural network classifiers on synthetic pollen images generated by two GANs: StyleGAN and Self-attention GAN. The best classifier is the convolutional neural network pre-trained on StyleGAN images. Our best models achieved 96.3% of mean average precision for the detection task and 97.7% of F1 measure for the classification task on 13 pollen plant species. We have implemented the best models in our pollen recognition web service, which is available for palynologists on request.

Are Markers of Allergic Inflammation in Grass Pollen Allergy Influenced by H1 Antihistamines?

Soluble intercellular adhesion molecule-1 (ICAM-1) and soluble vascular adhesion molecule-1 (VCAM-1) play important roles in allergic rhinitis (AR). Treatment with H1 antihistamines improves AR symptoms and in vitro reduces the levels of adhesion molecules. The aim of the study was to evaluate serum levels of ICAM-1 and VCAM-1 in patients with AR to grass pollen and their response to different H1 antihistamines.

MATERIAL AND METHODS

A total of 50 patients with grass pollen AR were clinically and biologically evaluated. ICAM-1 and VCAM-1 serum levels were evaluated during pollen season before and after treatment with levocetirizine and desloratadine through the ELISA method.

RESULTS

ICAM-1, VCAM-1, eosinophils, and total IgE were elevated in patients with AR, compared with healthy subjects. Both antihistamines improved specific symptoms of AR and increased patients' quality of life during pollen season after one month of treatment. H1 antihistamines reduced VCAM-1, ICAM-1, and total IgE after one-month treatment but not significantly. Patients with increased baseline values tend to remain with increased values after one-month AH1 treatment.

CONCLUSIONS

ICAM-1 and sVCAM-1 levels are higher in patients with grass pollen-induced AR than healthy controls during pollen exposure. Their serum levels tend to remain at high values during pollen season despite antihistaminic therapy.

Relative abundance of saccharides, free amino acids, and other compounds in specific pollen species for source profiling of atmospheric aerosol

Though studies in bioaerosols are being conducted with increasing frequency over the past decade, the total breadth of knowledge on bioaerosols and their role in atmospheric processes is still minimal. In order to better characterize the chemical composition of fresh biological aerosol for purposes of source apportionment and tracing in the atmosphere, several plant pollen species were selected for detailed chemical analyses. For this purpose, different pollen species were purchased and collected around Reno, Nevada, USA, for further extraction and detailed chemical analysis. These species included aspen, corn, pecan, ragweed, eastern cottonwood, paper mulberry, rabbitbrush, bitterbrush, lodgepole pine, and Jeffrey pine. Saccharides, free amino acids, and various other polar compounds (e.g., anhydrosugars and resin acids) were quantitatively analyzed using gas chromatography and ultra-high performance liquid chromatography coupled with mass spectrometry techniques (GC-MS and UPLC-MS), with the purpose to identify differences and nuances in chemical composition of specific pollen species. The saccharides β-d-fructose, α-d-glucose, and β-d-glucose were ubiquitously found across all pollen samples (10), and sucrose was found in five samples. d-galactose was also found in pine species. Total saccharides were 4.0 to 29% of total dry weight across all samples. Total free amino acids were 0.29% to 15% of total dry weight across all samples, with the most common amino acid being proline. Chemical profiles (including both saccharides and amino acids) of surface-deposited aerosol in the Lake Tahoe area correlated most closely with pine pollen than other analyzed pollen species, indicating that chemical profiles of pollen can be used to infer its contribution to local aerosols.

Sensitization Profiles of Timothy Grass Pollen in Northern China

Purpose

Grass pollen is an important cause of IgE-mediated allergy in countries worldwide, especially within Europe. However, there has been no research on grass pollen allergy in northern China. We aimed to determine the status of grass pollen allergy and the sensitization patterns to Phleum pratense (P. pratense) in northern China.

Patients and Methods

Pollen data were collected for three geographic areas (Beijing, Shenmu, Shizuishan) in northern China. The study enrolled 101 patients (62 men; age range, 1–64 years; median age, 10 years) who had allergic rhinoconjunctivitis and/or asthma during the grass pollen season and positive skin prick test results positive to P. pratense. Serum-specific IgE (sIgE) against Phl p 1, Phl p 2, Phl p 5, Phl p 6, Phl p 7, Phl p 12 was measured by ImmunoCAP.

Results

The pollen season of P. pratense was from June to September in Beijing, May to September in Shenmu and July to August in Shizuishan. P. pratense pollen accounted for 2–3% of the annual pollen index of total pollen counts. Among 101 patients with positive skin prick test results to P. pratense, 72% had detectable sIgE to P. pratense. Phl p 12 was the most frequently recognized component (45%), followed by Phl p 1 (22%), Phl p 5 (14%), Phl p 6 (8%) and Phl p 7 (3%). No patients had sIgE to Phl p 2. Ten sensitization patterns to the six components were observed. High rate of sIgE to Phl p 12 was positively correlated with co-sensitization to weed or tree pollen.

Conclusion

Considering the pollen concentration, P. pratense was a minor pollen allergen in northern China and its pollen season overlapped with that of weed pollen. IgE sensitization to P. pratense was likely to be induced by cross-reactivity between grass pollen allergy and weed/tree pollen allergy.

Comparison of the characterization of allergenic protein 3 (Pla a3) released from Platanus pollen grains collected in Shanghai during the spring of 2019 and 2020

Due to the COVID-19 pandemic in early 2020, large-scale industrial production has been stagnant and reduced, the urban air quality has been greatly improved. It provided an excellent opportunity to explore the effects of air pollutants on the sensitization of pollen allergen proteins in the environment. Platanus pollen grains sampled in the spring of 2019 and 2020 were used for detailed characterization and analysis. Scanning electron microscopy, Fourier transform infrared, X-ray spectroscopy (XPS), trypan blue staining, and western blot analysis were employed to characterize Platanus pollen protein released from pollen grains. Our data showed that the viability of the pollen grains in 2019 was lower compared that in 2020, and the pollen grains collected in 2019 had a higher absorption peak of protein functional groups. The XPS spectra assay result demonstrated that the binding energy of the high-resolution components had not variation on the surface of pollen grains, but relative content of nitrogen and peptide chain in the pollen grains sampled in 2019 were higher than in 2020. These results suggested that more protein in the pollen grains was released onto the surface of pollen grains. In addition, western blot assay showed that the expression of Pla a3 protein in pollen grains sampled in 2019 was significantly higher than that in 2020, revealing that air pollutants could enhance the expression of Pla a3 proteins in Platanus pollen.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10453-021-09731-6.

Aerobiological modeling I: A review of predictive models

The present work is the first of two reviews on applied modeling in the field of aerobiology. The aerobiological predictive models for pollen and fungal spores, usually defined as predictive statistical models, will, amongst other objectives, forecast airborne particles' concentration or dynamical behavior of the particles. These models can be classified into Observation Based Models (OBM), Phenological Based Models (PHM), or OTher Models (OTM). The aim of this review is to show, analyze and discuss the different predictive models used in pollen and spore aerobiological studies. The analysis was performed on published electronic scientific articles from 1998 to 2016 related to the type of model, the taxa and the modelled parameters. From a total of 503 studies, 55.5% used OBM (44.8% on pollen and 10.7% on fungal spores), 38.5% PHM (all on pollen) and 6% OTM (5.4% on pollen and 0.6% on fungal spores). OBM have been used with high frequency to forecast concentration. The most frequent model of OBM was linear regression (18.5% out of 503) on pollen and artificial neural networks (4.6%) on fungal spores. In the PHM, the principal use was to characterize the main pollen season (flowering season) based on the model of growth degree days. Finally, OTM have been used to estimate concentrations at unmonitored areas. Olea (14,5%) on pollen and Alternaria (4,8%) on fungal spores were the taxa most frequently modelled. Daily concentration was the most modelled parameter by OBM (25.2%) and season start day by PHM (35.6%). The PHM approaches include greater model diversity and use fewer independent variables than OBM. In addition, PHM show to be easier to apply than OBM; however, the wide range of criteria to define the parameters to use in PHM (e.g.: pollination start day) makes that each model is used with a lesser frequency than other models.

Isotype-specific binding patterns of serum antibodies to multiple conformational epitopes of Bet v 1

BACKGROUND

Birch pollen is an important elicitor of respiratory allergy. The major allergen, Bet v 1, binds IgE exclusively via conformational epitopes.

OBJECTIVE

To identify Bet v 1-specific epitope repertoires of IgE and IgG from birch pollen-allergic and non-allergic subjects.

METHODS

Chimeric proteins were created by grafting individual epitope-sized, contiguous surface patches of Bet v 1 onto a non-allergenic structural homologue and expressed in Escherichia coli. Binding of IgE, IgG1 and IgG4 from sera of 30 birch pollen-allergic and 11 non-allergic subjects to Bet v 1, 13 chimeric proteins and four bacterial Bet v 1 homologues were measured by ELISA. The proportion of epitope-specific in total Bet v 1-specific IgE and the cross-reactivity of Bet v 1-specific IgE with bacterial homologues were determined by competitive ELISA.

RESULTS

Thirteen soluble, correctly folded chimeric proteins were produced. IgE from 27/30 birch pollen-allergic patients bound to 1-12 chimeric proteins (median 4.0) with patient-specific patterns. Three chimeras binding IgE from the majority of sera were identified, whose pgrafted patches overlapped with previously published epitopes. Patterns of IgG1 and IgG4 binding to the chimeric proteins did not correspond to the binding patterns of IgE. Sera of 19/30 birch pollen-allergic patients contained low amounts of IgE to bacterial homologues. Bacterial proteins were able to partially inhibit IgE binding to Bet v 1.

CONCLUSION

Epitopes recognized by Bet v 1-specific antibodies from birch pollen-allergic patients are specific to each patient and differ between IgE, IgG1 and IgG4.

Seasonal variation in the allergenic potency of airborne grass pollen in Bratislava (Slovakia) urban environment

The Phl p 5 allergen of the plant species Phleum pratense is considered one of the most crucial grass pollen allergenic molecules inducing respiratory allergies. In this study, we evaluated seasonal variation in the concentration of both grass pollen and Phl p 5 allergens as well as the ratio allergen/pollen (pollen potency) in the air of Bratislava during two consecutive years, 2019-2020. These 2 years differed in terms of air pollution, as COVID-19 lockdown in spring 2020 considerably improved air quality in the study area. Air samples were collected using a Hirst-type sampler for pollen detection and the cyclone sampler for aeroallergen detection. In 2020, we observed 80.3% higher seasonal pollen integral, probably associated with the longer pollen season duration, however, 43.6% lower mean daily pollen potency than in 2019. The mean daily pollen value was 37.5% higher in 2020 than in the previous year, while the mean daily allergen value was 14.9% lower in 2020. To evaluate the relationship between the amount of pollen or allergen in the air and selected meteorological factors and air pollution parameters, we used multiple regression analysis. Regarding weather factors, precipitation and relative humidity were significantly associated with pollen and/or allergen concentration, though these associations were negative. Atmospheric pollutants, especially CO, NO₂ and O₃ were significantly associated with pollen and/or allergen levels. The associations with CO and O₃ were positive, while the association with NO₂ was negative. Our results indicate that for grasses, an air pollutant that has a significant positive relationship to the ratio of allergen/pollen is nitrogen dioxide.

Establishing the twig method for investigations on pollen characteristics of allergenic tree species

The twig method in climate chambers has been shown to successfully work as a proxy for outdoor manipulations in various experimental setups. This study was conducted to further establish this method for the investigation of allergenic pollen from tree species (hazel, alder, and birch). Direct comparison under outdoor conditions revealed that the cut twigs compared to donor trees were similar in the timing of flowering and the amount of pollen produced. Cut twigs were able to flower in climate chambers and produced a sufficient amount of pollen for subsequent laboratory analysis. The addition of different plant or tissue fertilizers in the irrigation of the twigs did not have any influence; rather, the regular exchange of water and the usage of fungicide were sufficient for reaching the stage of flowering. In the experimental setup, the twigs were cut in different intervals before the actual flowering and were put under warming conditions in the climate chamber. An impact of warming on the timing of flowering/pollen characteristics could be seen for the investigated species. Therefore, the twig method is well applicable for experimental settings in pollen research simulating, e.g., accelerated warming under climate change.

Buccal and Sublingual Vaccines: A Review on Oral Mucosal Immunization and Delivery Systems

Currently, most vaccines available on the market are for parental use; however, this may not be the best option on several occasions. Mucosal routes of administration such as intranasal, sublingual, and buccal generate great interest due to the benefits they offer. These range from increasing patient compliance to inducing a more effective immune response than that achieved through conventional routes. Due to the activation of the common mucosal immune system, it is possible to generate an effective systemic and local immune response, which is not achieved through parenteral administration. Protection against pathogens that use mucosal entry routes is provided by an effective induction of mucosal immunity. Mucosal delivery systems are being developed, such as films and microneedles, which have proven to be effective, safe, and easy to administer. These systems have multiple advantages over commonly used injections, which are simple to manufacture, stable at room temperature, painless for the patient since they do not require puncture. Therefore, these delivery systems do not require to be administered by medical personnel; in fact, they could be self-administered.

Influence of environmental drivers on allergy to pollen grains in a case study in Spain (Madrid): meteorological factors, pollutants, and airborne concentration of aeroallergens

The aim of this study was to compare airborne levels of Phl p 1 and Phl p 5, with Poaceae pollen concentrations inside and outside of the pollen season, and to evaluate their association with symptoms in grass allergic patients and the influence of climate and pollution. The Hirst and the Burkard Cyclone samplers were used for pollen and allergen quantification, respectively. The sampling period ran from 23 March 2009 to 27 July 2010. Twenty-three patients with seasonal allergic asthma and rhinitis used an electronic symptom card. The aerosol was extracted and quantified for Phl p 1 and Phl p 5 content. Descriptive statistics, non-parametric paired contrast of Wilcoxon, Spearman's correlations, and a categorical principal component analysis (CatPCA) were carried out. Significant variations in pollen, aeroallergen levels, pollen allergen potency, and symptoms score were observed in this study. Phl p 5 pollen allergen potency was higher at the beginning of the 2010 grass pollen season. Presence of Phl p 1 outside the pollen season with positive O₃ correlation was clinically relevant. 45.5% of the variance was explained by two dimensions in the CatPCA analysis, showing the symptom relationships dissociated in two dimensions. In the first one, the more important relationship was with grass pollen grains concentration and Phl p 5 and to a lesser extent with Phl p 1 and levels of NO₂ and O₃, and in the second dimension, symptoms were associated with humidity and SO₂. Clinically relevant out-season Phl p 1 was found with a positive O₃ correlation. The effect of climate and pollution may have contributed to the higher seasonal allergic rhinitis symptom score recorded in 2009.

A systematic review of the effects of temperature and precipitation on pollen concentrations and season timing, and implications for human health

Climate and weather directly impact plant phenology, affecting airborne pollen. The objective of this systematic review is to examine the impacts of meteorological variables on airborne pollen concentrations and pollen season timing. Using PRISMA methodology, we reviewed literature that assessed whether there was a relationship between local temperature and precipitation and measured airborne pollen. The search strategy included terms related to pollen, trends or measurements, and season timing. For inclusion, studies must have conducted a correlation analysis of at least 5 years of airborne pollen data to local meteorological data and report quantitative results. Data from peer-reviewed articles were extracted on the correlations between seven pollen indicators (main pollen season start date, end date, peak date, and length, annual pollen integral, average daily pollen concentration, and peak pollen concentration), and two meteorological variables (temperature and precipitation). Ninety-three articles were included in the analysis out of 9,679 articles screened. Overall, warmer temperatures correlated with earlier and longer pollen seasons and higher pollen concentrations. Precipitation had varying effects on pollen concentration and pollen season timing indicators. Increased precipitation may have a short-term effect causing low pollen concentrations potentially due to "wash out" effect. Long-term effects of precipitation varied for trees and weeds and had a positive correlation with grass pollen levels. With increases in temperature due to climate change, pollen seasons for some taxa in some regions may start earlier, last longer, and be more intense, which may be associated with adverse health impacts, as pollen exposure has well-known health effects in sensitized individuals.

Long-term pollen trends and associations between pollen phenology and seasonal climate in Atlanta, Georgia (1992-2018)

BACKGROUND

Previous research has revealed that airborne pollen concentrations and phenology in allergenic plants are changing. In addition, variations in seasonal climate are known to affect pollen phenology in trees, weeds, and grasses.

OBJECTIVE

To investigate localized trends in pollen concentrations and pollen phenology over time and the effect of seasonal climate variations.

METHODS

We used daily pollen count concentrations from a National Allergy Bureau pollen counting station located in metropolitan Atlanta, Georgia, for 13 allergenic taxa. To evaluate long-term trends over time, we developed linear regression models for 6 pollen measures. To evaluate the effect of seasonal climate on phenology, we developed regression models using seasonal climate measures as independent variables and pollen measures as dependent variables.

RESULTS

For several tree pollen taxa, pollen concentrations increased over time, including oak and juniper pollen. In multiple species, pollen seasons trended toward an earlier release throughout the 27-year period. Variations in seasonal climate did have an effect on pollen counts and the timing of pollen release but varied by taxa. Generally, warmer spring temperatures were associated with an earlier pollen release. In addition, increased precipitation from the preceding fall was associated with increased pollen concentration in the spring months.

CONCLUSION

Allergenic pollen concentrations for several types of pollen are increasing and trending toward an earlier pollen release in Atlanta, Georgia. Warmer temperatures preceding the pollen season were associated with the earlier pollen release.

Heterogeneity of pollen food allergy syndrome in seven Southern European countries: The @IT.2020 multicenter study

BACKGROUND

Pollen food allergy syndrome (PFAS) is a frequently underdiagnosed disease due to diverse triggers, clinical presentations, and test results. This is especially relevant in geographic areas with a broad spectrum of pollen sensitization, such as Southern Europe.

OBJECTIVES

To elucidate similarities and differences of PFAS in nine Southern European centers and identify associated characteristics and unique markers of PFAS.

METHODS

As part of the @IT.2020 Multicenter Study, 815 patients with seasonal allergic rhinitis (SAR), aged 10-60 years, were recruited in seven countries. They completed questionnaires regarding SAR, comorbidities, family history, and PFAS, and underwent skin prick testing (SPT) and serum IgE testing.

RESULTS

Of the 815 patients, 167 (20.5%) reported PFAS reactions. Most commonly, eliciting foods were kiwi (58, 34.7%), peach (43, 25.7%), and melon (26, 15.6%). Reported reactions were mostly local (216/319, 67.7%), occurring within 5 min of contact with elicitors (209/319, 65.5%). Associated characteristics included positive IgE to at least one panallergen (profilin, PR-10, or nsLTP) (p = 0.007), maternal PFAS (OR: 3.716, p = 0.026), and asthma (OR: 1.752, p = 0.073). Between centers, heterogeneity in prevalence (Marseille: 7.5% vs. Rome: 41.4%, p < 0.001) and of clinical characteristics was apparent. Cypress played a limited role, with only 1/22 SPT mono-sensitized patients reporting a food reaction (p < 0.073).

CONCLUSIONS

PFAS is a frequent comorbidity in Southern European SAR patients. Significant heterogeneity of clinical characteristics in PFAS patients among the centers was observed and may be related to the different pollen sensitization patterns in each geographic area. IgE to panallergen(s), maternal PFAS, and asthma could be PFAS-associated characteristics.

Earlier Flowering of Betula pendula Roth in Augsburg, Germany, Due to Higher Temperature, NO2 and Urbanity, and Relationship with Betula spp. Pollen Season

Flowering and pollen seasons are sensitive to environmental variability and are considered climate change indicators. However, it has not been concluded to what extent flowering phenology is indeed reflected in airborne pollen season locally. The aim of this study was to investigate, for the commonly represented in temperate climates and with highly allergenic pollen Betula pendula Roth, the responsiveness of flowering to different environmental regimes and also to check for commensurate changes in the respective pollen seasons. The region of Augsburg, Bavaria, Germany, was initially screened for birch trees, which were geolocated at a radius of 25 km. Random trees across the city were then investigated during three full flowering years, 2015–2017. Flowering observations were made 3–7 times a week, from flower differentiation to flower desiccation, in a total of 43 plant individuals. Data were regressed against meteorological parameters and air pollutant levels in an attempt to identify the driving factors of flowering onset and offset. Flowering dates were compared with dates of the related airborne pollen seasons per taxon; airborne pollen monitoring took place daily using a Hirst-type volumetric sampler. The salient finding was that flowering occurred earlier during warmer years; it also started earlier at locations with higher urbanity, and peaked and ended earlier at sites with higher NO₂ concentrations. Airborne pollen season of Betula spp. frequently did not coincide locally with the flowering period of Betula pendula: while flowering and pollen season were synchronized particularly in their onset, local flowering phenology alone could explain only 57.3% of the pollen season variability. This raises questions about the relationship between flowering times and airborne pollen seasons and on the rather underestimated role of the long-distance transport of pollen.

Validity of Skin Prick Test to Bermuda Grass in a desert environment

Background and aim:

Skin prick test (SPT) with a wheal diameter of >3 mm, generally accepted as a positive, is most commonly use diagnostic tool for Allergic rhinitis. Aim was to validate wheal size of Skin Prick Test for the Bermuda grass, in desert environment, with positive Bermuda grass Nasal challenge in same environment.

Methods:

In 53 adults, mean age 33.43 ± 9.36 years, both gender (females: 33.96%), SPT positive on Bermuda grass with cut off wheal longest diameter of 3 mm, Bermuda grass nasal challenge test (bgNCT) was carried out. Response was assessed subjectively (scored) and objectively (PNIF). Safety profile was assessed by PEF measurement.

Results:

Mean weal size of SPT (mm) was bigger in bgNCT positive patients (n=47; 88.68%) 8 [4, 15] vs 5 [3, 6] (p<0.0001). ROC analysis showed Bermuda Grass SPT at the threshold of >6.5mm enabled identification of Bermuda challenge with sensitivity of 82.98% and specificity of 100.0% (area under the curve 0.9326, standard error 0.03528; 95% confidence interval (CI): 0.8635 to 1.002; p=0.0006203).

Conclusions:

A SPT wheal size ≥6.5mm might be considered as an appropriate wheal size for confirming Bermuda grass allergy in adults with SAR, avoiding the demanding, time consuming and often unavailable bgNCT, especially in patients eligible for allergen immunotherapy. In these patients, bgNCT is recommended if SPT wheal size is <6.5 mm. (www.actabiomedica.it)

Allergenic risk assessment of urban parks: Towards a standard index

Allergenicity indices are a powerful tool to assess the health hazard posed by urban parks to pollen allergic subjects. Nonetheless, only few indices have been developed and applied to urban vegetation in the last decade, and they were never compared nor standardised over the same dataset. To address this issue, in this paper the two best-known allergenicity indices, the Urban Green Zones Allergenicity Index (I_UGZA) and the Specific Allergenicity Index (SAI), have been calculated for the same park (the Botanical Garden of Bologna), collecting vegetation data through both systematic sampling and arboreal census. The results obtained with the two data collection methods were comparable for both indices, indicating systematic sampling as a reliable approximation of the total census. Besides, the allergenic risk resulted moderate to high according to SAI, and very low according to I_UGZA. Since SAI does not consider the total volume of the vegetation, it was deemed less reliable than I_UGZA in evaluating the allergenicity of an enclosed green space.

Pollen forecasting and its relevance in pollen allergen avoidance

Pollinosis and allergic asthma are respiratory diseases of global relevance, heavily affecting the quality of life of allergic subjects. Since there is not a decisive cure yet, pollen allergic subjects need to avoid exposure to high pollen allergens concentrations. For this purpose, pollen forecasting is an essential tool that needs to be reliable and easily accessible. While forecasting methods are rapidly evolving towards more complex statistical and physical models, the use of simple and traditional methods is still preferred in routine predictions. In this review, we summarise and explain the main parameters considered when forecasting pollen, and classify the different forecasting methods in two groups: observation-based and process-based. Finally, we compare these approaches based on their usefulness to allergic patients, and discuss possible future developments of the field.

Patient needs and benefits of sublingual immunotherapy for grass pollen-induced allergic rhinitis: an observational study

Aim: Clinical efficacy of sublingual immunotherapy for grass pollen-induced allergic rhinitis (AR) needs to translate into patient benefit. Patients & methods: Patients received Oralair (Stallergenes, Antony, France) in real-life medical practice. Patient-relevant treatment benefits were measured with the AR-specific Patient Benefit Index. Subgroups were analyzed regarding distinct patient characteristics. Results: Data of 883 patients (children, adolescents, and adults) were analyzed. The highest-ranked patient needs referred to having less AR-symptoms, being able to go outdoors, and being free in the choice of leisure activities. Most patients (89.2-94.6%) attained at least minimally relevant benefit. All subgroups reported relevant benefits, with significantly higher scores in some subgroups. Conclusion: Treatment with Oralair was associated with considerable patient-relevant benefit in all age groups.

Does airborne pollen influence COVID-19 outbreak?

The fast spread of SARS-CoV-2 presented a worldwide challenge to public health, economy, and educational system, affecting wellbeing of human society. With high transmission rates, there are increasing evidences of COVID-19 spread via bioaerosols from an infected person. The current review was conducted to examine airborne pollen impact on COVID-19 transmission and to identify the major gaps for post-pandemic research. The study used all key terms to identify revenant literature and observation were collated for the current research. Based on existing literature, there is a potential association between pollen bioaerosols and COVID-19. There are few studies focusing the impact of airborne pollen on SARS-CoV-2, which could be useful to advance future research. Allergic rhinitis and asthma patients were found to have pre-modified immune activation, which could help to provide protection against COVID-19. However, does airborne pollen acts as a potent carrier for SARS-CoV-2 transport, dispersal and its proliferation still require multidisciplinary research. Further, a clear conclusion cannot be drawn due to limited evidence and hence more research is needed to show how pollen bioaerosols could affect virus survivals. The small but growing literature review focuses on searching for every possible answer to provide additional security layers to overcome near future corona-like infectious diseases.

Seasonal Variation in miR-328-3p and let-7d-3p Are Associated With Seasonal Allergies and Asthma Symptoms in Children

OBJECTIVE

MicroRNAs (miRs) are small non-coding RNA molecules of around 18-22 nucleotides that are key regulators of many biologic processes, particularly inflammation. The purpose of this study was to determine the association of circulating miRs from asthmatic children with seasonal variation in allergic inflammation and asthma symptoms.

METHODS

We used available small RNA sequencing on blood serum from 398 children with mild-to-moderate asthma from the Childhood Asthma Management Program. We used seasonal asthma symptom data at the study baseline and allergen affection status from baseline skin prick tests as primary outcomes. We identified differentially expressed (DE) miRs between pairs of seasons using DESeq2. Regression analysis was used to identify associations between allergy status to specific seasonal allergens and DE miRs in 4 seasons and between seasonal asthma symptom data and DE miRs. We performed pathway enrichment analysis for target genes of the DE miRs using DAVID.

RESULTS

After quality control, 398 samples underwent differential analysis between the 4 seasons. We found 52 unique miRs from a total of 81 DE miRs across seasons. Further investigation of the association between these miRs and sensitization to seasonal allergens using skin prick tests revealed that 26 unique miRs from a total of 38 miRs were significantly associated with a same-season allergen. Comparison between seasonal asthma symptom data revealed that 2 of these 26 miRs also had significant associations with asthma symptoms in the same seasons: miR-328-3p (P < 0.03) and let-7d-3p (P < 0.05). Enrichment analysis showed that the most enriched pathway clusters were Rap1, Ras, and MAPK signaling pathways.

CONCLUSION

Our results show seasonal variation in miR-328-3p and let-7d-3p are significantly associated with seasonal asthma symptoms and seasonal allergies. These indicate a potentially protective role for let-7d-3p and a deleterious role for miR-328-3p in asthmatics sensitized to mulberry. Further work will determine whether these miRs are drivers or results of the allergic response.

Novel antibody cocktail targeting Bet v 1 rapidly and sustainably treats birch allergy symptoms in a phase 1 study

BACKGROUND

The efficacy of an allergen-specific IgG cocktail to treat cat allergy suggests that allergen-specific IgG may be a major protective mechanism elicited by allergen immunotherapy.

OBJECTIVES

Extending these findings, we tested a Bet v 1-specific antibody cocktail in birch-allergic subjects.

METHODS

This was a phase 1, randomized, double-blind, study with 2 parts. Part A administered ascending doses of the Bet v 1-specific antibody cocktail REGN5713/14/15 (150-900 mg) in 32 healthy adults. Part B administered a single subcutaneous 900-mg dose or placebo in 64 birch-allergic subjects. Total nasal symptom score response to titrated birch extract nasal allergen challenge and skin prick test (SPT) with birch and alder allergen were assessed at screening and days 8, 29, 57, and 113 (SPT only); basophil activation tests (n = 26) were conducted.

RESULTS

Single-dose REGN5713/14/15 significantly reduced total nasal symptom score following birch nasal allergen challenge relative to baseline. Differences in total nasal symptom score areas under the curve (0-1 hour) for subjects treated with REGN5713/14/15 versus those given placebo (day 8: -1.17, P = .001; day 29: -1.18, P = .001; day 57: -0.85, P = .024) and titration SPT with birch difference in area under the curve of mean wheal diameters for subjects treated with REGN5713/14/15 versus placebo (all P < .001) were sustained for ≥2 months; similar results were observed with alder SPT. REGN5713/14/15 was well tolerated. Basophil responsiveness to birch-related allergens was significantly decreased in subjects treated with REGN5713/14/15 versus those given placebo on days 8, 57, and 113 (all P < .01).

CONCLUSIONS

Single-dose REGN5713/14/15 was well tolerated and provided a rapid (1 week) and durable (2 months) reduction in allergic symptoms after birch allergen nasal allergen challenge, potentially offering a new paradigm for the treatment of birch allergy symptoms.

Monitoring techniques for pollen allergy risk assessment

Understanding airborne pollen allergens trends is of great importance for the high prevalence and the socio-economic impact that pollen-related respiratory diseases have on a global scale. Pursuing this aim, aeropalynology evolved as a broad and complex field, that requires multidisciplinary knowledge covering the molecular identity of pollen allergens, the nature of allergen-bearing particles (pollen grains, pollen sub-particles, and small airborne particles), and the distribution of their sources. To estimate the health hazard that urban vegetation and atmospheric pollen concentrations pose to allergic subjects, it is pivotal to develop efficient and rapid monitoring systems and reliable allergic risk indices. Here, we review different pollen allergens monitoring approaches, classifying them into I) vegetation-based, II) pollen-based, and III) allergen-based, and underlining their advantages and limits. Finally, we discuss the outstanding issues and directions for future research that will further clarify our understanding of pollen aeroallergens dynamics and allergen avoidance strategies.

Characterization of allergenicity of Platanus pollen allergen a 3 (Pla a 3) after exposure to NO2 and O3

Pollen allergens, widely present in the atmosphere, are the main cause of seasonal respiratory diseases that affect millions of people worldwide. Although previous studies have reported that nitrogen dioxide (NO₂) and ozone (O₃) promote pollen allergy, the specific biological processes and underlying mechanisms remain less understood. In this study, Platanus pollen grains were exposed to gaseous pollutants (NO₂ and O₃). We employed environmental electron microscopy, flow cytometry, western blot assay, enzyme-linked immunoassay, ultraviolet absorption spectrometry, circular dichroism, and protein mass spectrometry to characterise the subpollen particles (SPPs) released from pollen grains. Furthermore, we determined the immunogenicity and pathogenicity induced by Platanus pollen allergen a 3 (Pla a 3). Our results demonstrated that NO₂ and O₃ could damage the pollen cell membranes in SPPs and increase the amount of Pla a 3 allergen released into the atmosphere. Additionally, NO₂ and O₃ altered the structure of Pla a3 protein through nitrification and oxidation, which not only enhanced the immunogenicity of allergens but also increased the stability of the protein. In vivo analysis using an animal model indicated that NO₂ and O₃ greatly aggravated pollen-induced pneumonia. Thus, our study provides guidance for the prevention of pollen allergic diseases.

Development of a solid-supported cysteinyl probe for the isolation of electrophiles from plant pollen extracts

Recent research showed that plant secondary metabolites in pollen may exacerbate the protein-mediated allergic reaction in pollen allergy. It was found that allergenic pollen from various plant families contain significant amounts of electrophiles which may covalently bind to nucleophilic groups of proteins, such as thiol moieties. Electrophiles in pollen of the Asteraceae species are typically sesquiterpene lactones, but the nature of electrophilic metabolites in allergenic pollen of other plant families is unknown. We developed a solid-supported cysteinyl probe in order to selectively extract physiologically relevant electrophiles from pollen extracts, and to enable their subsequent characterization by on-line and off-line spectroscopic analysis. The validity of this approach was evaluated with a selection of structurally different model compounds and with a spiked model extract.

Neural networks for increased accuracy of allergenic pollen monitoring

Monitoring of airborne pollen concentrations provides an important source of information for the globally increasing number of hay fever patients. Airborne pollen is traditionally counted under the microscope, but with the latest developments in image recognition methods, automating this process has become feasible. A challenge that persists, however, is that many pollen grains cannot be distinguished beyond the genus or family level using a microscope. Here, we assess the use of Convolutional Neural Networks (CNNs) to increase taxonomic accuracy for airborne pollen. As a case study we use the nettle family (Urticaceae), which contains two main genera (Urtica and Parietaria) common in European landscapes which pollen cannot be separated by trained specialists. While pollen from Urtica species has very low allergenic relevance, pollen from several species of Parietaria is severely allergenic. We collect pollen from both fresh as well as from herbarium specimens and use these without the often used acetolysis step to train the CNN model. The models show that unacetolyzed Urticaceae pollen grains can be distinguished with > 98% accuracy. We then apply our model on before unseen Urticaceae pollen collected from aerobiological samples and show that the genera can be confidently distinguished, despite the more challenging input images that are often overlain by debris. Our method can also be applied to other pollen families in the future and will thus help to make allergenic pollen monitoring more specific.

Strong variations in urban allergenicity riskscapes due to poor knowledge of tree pollen allergenic potential

Exposure to allergenic tree pollen is an increasing environmental health issue in urban areas. However, reliable, well-documented, peer-reviewed data on the allergenicity of pollen from common tree species in urban environments are lacking. Using the concept of 'riskscape', we present and discuss evidence on how different tree pollen allergenicity datasets shape the risk for pollen-allergy sufferers in five cities with different urban forests and population densities: Barcelona, Montreal, New York City, Paris, and Vancouver. We also evaluate how tree diversity can modify the allergenic risk of urban forests. We show that estimates of pollen exposure risk range from 1 to 74% for trees considered to be highly allergenic in the same city. This variation results from differences in the pollen allergenicity datasets, which become more pronounced when a city's canopy is dominated by only a few species and genera. In an increasingly urbanized world, diverse urban forests offer a potentially safer strategy aimed at diluting sources of allergenic pollen until better allergenicity data is developed. Our findings highlight an urgent need for a science-based approach to guide public health and urban forest planning.

Towards a model of wet deposition of bioaerosols: The raindrop size role

Bioaerosols play a major role in the plant life of ecosystems. In addition, they have a profound impact on human health, since they may cause lung diseases or allergies. The key objective of this study is to assess the below cloud scavenging effect of rainfall on pollen concentration. The analysis is based on a sampling carried out in León, Spain, between 2015 and 2018. The rainfall variables and the pollen concentrations have been obtained with a disdrometer and a volumetric Hirst type spore-trap, respectively. In order to evaluate the scavenging, three parameters have been calculated: scavenging efficiency (through the concentration-weighted average (%ΔC)), the scavenging coefficient (λ) and the percentage of events with a decrease in pollen concentration (%ES) also called events with effective scavenging. 71% of rain events presented an effective scavenging that affected all types of pollen. The %ΔC mean value of total pollen was 24 ± 18% (positive values indicate an effective scavenging) and the types of pollen with the highest values were Castanea and Cupressaceae (71 and 40%, respectively). A linear model (R² = 0.94) to estimate the pollen concentration after rain was built with variables such as pollen concentration before rain and other variables from a weather station and a disdrometer. Furthermore, we have shown the possibility of knowing in real time the probable Cupressaceae pollen concentration, from the initial pollen concentration and the physical parameters of rain (such as raindrop size, rain intensity or volume swept by raindrops in their falling path).

Palyno-morphological characterization of selected allergenic taxa of family Poaceae from Islamabad-Pakistan using microscopic techniques

Statistics around the world show an increased risk of high allergies associated with plants. The role of allergenic pollen is now well known. The most serious allergenic diseases are asthma and rhinitis, which affect 5-30% of the population of industrialized countries. This work focuses on the exploration of allergenic grass species of Islamabad, Pakistan and use microscopic techniques to correctly identify them. This study contains 11 species of grasses which showed variations in pollen morphological features. The dominant pollen shape was prolate, prolate-spheroidal and sub oblate. The largest polar diameter was calculated for Echinochloa crus-galli (56.00 μm) while the largest equatorial diameter was found in Cenchrus ciliaris (45.00 μm). Exine ornamentation varied from Gemmate-verrucate, Scabrate-reugulate, Verrucate-reticulate, Gemmate-Scabrate, Fine-Gemmate, Gemmate-rugulate, Gemmate-reticulate, Gemmate-scabrate, Scabrate-verrucate, and Scabrate. Maximum exine thickness was found in Eleusine indica (4.90 μm) while in C. ciliaris (1.50 μm) the minimum thickness of exine was measured. In E. crus-galli (1.54 μm), the largest P to E value was measured and the smallest value was noticed in Setaria verticillata (0.86 μm). The study was performed with an aim to identify the allergenic plant species in Islamabad-Pakistan using pollen morphological studies. This study provides significant information, to arrange the pollen types within their defined classes and to discuss various pollen features for developing an allergenic pollen atlas.

Factors Affecting the Number of Pollen Grains per Male Strobilus in Japanese Cedar (Cryptomeria japonica)

Japanese cedar (Cryptomeria japonica) is the most important timber species in Japan; however, its pollen is the primary cause of pollinosis in Japan. The total number of pollen grains produced by a single tree is determined by the number of male strobili (male flowers) and the number of pollen grains per male strobilus. While the number of male strobili is a visible and well-investigated trait, little is known about the number of pollen grains per male strobilus. We hypothesized that genetic and environmental factors affect the pollen number per male strobilus and explored the factors that affect pollen production and genetic variation among clones. We counted pollen numbers of 523 male strobili from 26 clones using a cell counter method that we recently developed. Piecewise Structural Equation Modeling (pSEM) revealed that the pollen number is mostly affected by genetic variation, male strobilus weight, and pollen size. Although we collected samples from locations with different environmental conditions, statistical modeling succeeded in predicting pollen numbers for different clones sampled from branches facing different directions. Comparison of predicted pollen numbers revealed that they varied >3-fold among the 26 clones. The determination of the factors affecting pollen number and a precise evaluation of genetic variation will contribute to breeding strategies to counter pollinosis. Furthermore, the combination of our efficient counting method and statistical modeling will provide a powerful tool not only for Japanese cedar but also for other plant species.

Predicting the Olea pollen concentration with a machine learning algorithm ensemble

Air pollution in large cities produces numerous diseases and even millions of deaths annually according to the World Health Organization. Pollen exposure is related to allergic diseases, which makes its prediction a valuable tool to assess the risk level to aeroallergens. However, airborne pollen concentrations are difficult to predict due to the inherent complexity of the relationships among both biotic and environmental variables. In this work, a stochastic approach based on supervised machine learning algorithms was performed to forecast the daily Olea pollen concentrations in the Community of Madrid, central Spain, from 1993 to 2018. Firstly, individual Light Gradient Boosting Machine (LightGBM) and artificial neural network (ANN) models were applied to predict the day of the year (DOY) when the peak of the pollen season occurs, resulting the estimated average peak date 149.1 ± 9.3 and 150.1 ± 10.8 DOY for LightGBM and ANN, respectively, close to the observed value (148.8 ± 9.8). Secondly, the daily pollen concentrations during the entire pollen season have been calculated using an ensemble of two-step GAM followed by LightGBM and ANN. The results of the prediction of daily pollen concentrations showed a coefficient of determination (r²) above 0.75 (goodness of the model following cross-validation). The predictors included in the ensemble models were meteorological variables, phenological metrics, specific site-characteristics, and preceding pollen concentrations. The models are state-of-the-art in machine learning and their potential has been shown to be used and deployed to understand and to predict the pollen risk levels during the main olive pollen season.

Impact of elevated air temperature and drought on pollen characteristics of major agricultural grass species

Grass pollen allergens are known to be one of the major triggers of hay fever with an increasing number of humans affected by pollen associated health impacts. Climate change characterized by increasing air temperature and more frequent drought periods might affect plant development and pollen characteristics. In this study a one-year (2017) field experiment was conducted in Bavaria, Germany, simulating drought by excluding rain and elevated air temperature by installing a heating system to investigate their effects primarily on the allergenic potential of eight selected cultivars of the two grass species timothy and perennial ryegrass. It could be shown for timothy that especially under drought and heat conditions the allergen content is significantly lower accompanied by a decrease in pollen weight and protein content. In perennial ryegrass the response to drought and heat conditions in terms of allergen content, pollen weight, and protein content was more dependent on the respective cultivar probably due to varying requirements for their growth conditions and tolerance to drought and heat. Results support recommendations which cultivars should be grown preferentially. The optimal choice of grass species and respective cultivars under changing climate conditions should be a major key aspect for the public health sector in the future.

Symptom patterns and comparison of diagnostic methods in ragweed pollen allergy

The aim of the present study was to determine the pattern of symptoms of ragweed pollen-induced allergic disease in sensitized patients from Romania and to compare the molecular diagnosis of allergy with the skin prick test, in order to better characterize allergic patients and to guide therapy. A total of 97 subjects, including patients with ragweed pollen-induced allergic rhinoconjunctivitis with/without asthma, as well as healthy controls, were recruited prospectively in one ragweed pollen season, submitted to allergy questionnaires, skin prick tests and multiplex specific IgE (immunoglobulin E) measurement by ImmunoCAP ISAC (ImmunoCAP Immuno-Solid phase Allergy Chip) assay. A total of 83 patients were sensitized to ragweed pollen. Most patients (73%) were diagnosed with moderate-severe intermittent allergic rhinoconjunctivitis and 25% of the patients also had allergic asthma. The most common symptoms were watery rhinorrhea (91.57%), nasal obstruction (86.75%), and sneezing (85.54%). Most patients were polysensitized (62.65%), especially to other pollens, house dust mites and animal danders. Only 90% of the patients with positive skin prick test to ragweed pollen extract also had increased specific serum IgE to Amb a 1. Current options for specific molecular diagnosis of ragweed allergy are limited, as they only contain one or few of the sensitizing allergens present in ragweed pollen. An improved component-resolved diagnosis, using several ragweed pollen allergens, is required for better patient characterization and subsequent selection of an appropriate allergen immunotherapy product, thereby enabling a more personalized approach to the management of the ragweed-allergic patient.

Variability of grass pollen allergy symptoms throughout the season: Comparing symptom data profiles from the Patient's Hayfever Diary from 2014 to 2016 in Vienna (Austria)

Background

Grass pollen allergy is the most widespread pollen allergy in the world. It still remains unknown in which aspects and in which extent symptoms from grass pollen allergy differ throughout the grass pollen season, although individual sensitization profiles of persons concerned are known for a long time.

Methods

The crowd-sourced symptom data of users of the Patient's Hayfever Diary were filtered for significant positive correlated users to grass pollen from Vienna (Austria) during the respective grass pollen seasons from 2014, 2015, and 2016. These symptom data were the foundation for 3 statistical approaches in order to examine different sections of the grass pollen season defined either by grass pollen data, phenology (grass species determination in the field), or symptom data itself.

Results

Results from all 3 approaches are similar and come to the same major conclusion. The symptom peak of most users is observed in the second section of the grass pollen season (70%), followed by the first section (20%), and with the least user numbers (10%) the third section. The profiles from single users entering data for all 3 years under study are robust and show a comparable behavior from year to year.

Conclusion

Grass taxa such as Arrhenatherum, Festuca, and Lolium seem to induce the highest symptom severity in most users during the second section of the grass pollen season. Poa and Dactylis are the main triggers for the first section of the grass pollen season. The flower of Phleum und Cynodon is documented for the last section of the grass pollen season. Crowd-sourced symptom data is the prerequisite for personal pollen information to consider the individuality of grass pollen allergy sufferers. Phenological monitoring is needed to provide information on specific grass taxa of importance to allergic persons.

Pollen and Fungal Spores Evaluation in Relation to Occupants and Microclimate in Indoor Workplaces

Indoor air quality depends on many internal or external factors mutually interacting in a dynamic and complex system, which also includes indoor workplaces, where subjects are exposed to many pollutants, including biocontaminants such as pollen and fungal spores. In this context, the occupants interact actively with their environment through actions, modifying indoor environmental conditions to achieve their own thermal comfort. Actions such as opening/closing doors and windows and turning on/off air conditioning could have effects on workers’ health. The present study explored the contribution of human occupants to pollen and fungal spore levels in indoor workplaces, combining aerobiological, microclimate, and worker monitoring during summer and winter campaigns. We evaluated the overall time spent by the workers in the office, the workers’ actions regarding non-working days and working days, and non-working hours and working hours, during two campaigns of pollen and fungal spore monitoring. Our results showed that the biocontaminant values depend on many mutually interacting factors; hence, the role of all of the factors involved should be investigated. In this regard, aerobiological monitoring should be a valid tool for the management of occupational allergies, providing additional information to improve occupational health protection strategies.

The Pathogenesis and Immune Evasive Mechanisms of Equine Herpesvirus Type 1

Equine herpesvirus type 1 (EHV-1) is an alphaherpesvirus related to pseudorabies virus (PRV) and varicella-zoster virus (VZV). This virus is one of the major pathogens affecting horses worldwide. EHV-1 is responsible for respiratory disorders, abortion, neonatal foal death and equine herpes myeloencephalopathy (EHM). Over the last decade, EHV-1 has received growing attention due to the frequent outbreaks of abortions and/or EHM causing serious economical losses to the horse industry worldwide. To date, there are no effective antiviral drugs and current vaccines do not provide full protection against EHV-1-associated diseases. Therefore, there is an urgent need to gain a better understanding of the pathogenesis of EHV-1 in order to develop effective therapies. The main objective of this review is to provide state-of-the-art information on the pathogenesis of EHV-1. We also highlight recent findings on EHV-1 immune evasive strategies at the level of the upper respiratory tract, blood circulation and endothelium of target organs allowing the virus to disseminate undetected in the host. Finally, we discuss novel approaches for drug development based on our current knowledge of the pathogenesis of EHV-1.

Predicting the severity of the grass pollen season and the effect of climate change in Northwest Europe

Allergic rhinitis is an inflammation in the nose caused by overreaction of the immune system to allergens in the air. Managing allergic rhinitis symptoms is challenging and requires timely intervention. The following are major questions often posed by those with allergic rhinitis: How should I prepare for the forthcoming season? How will the season's severity develop over the years? No country yet provides clear guidance addressing these questions. We propose two previously unexplored approaches for forecasting the severity of the grass pollen season on the basis of statistical and mechanistic models. The results suggest annual severity is largely governed by preseasonal meteorological conditions. The mechanistic model suggests climate change will increase the season severity by up to 60%, in line with experimental chamber studies. These models can be used as forecasting tools for advising individuals with hay fever and health care professionals how to prepare for the grass pollen season.

Numerical modelling of birch pollen dispersion in Canada

Simulating allergenic tree pollen is important to protect sensitive population and to support bioaerosols monitoring effort. Using the regional air quality model GEM-MACH, a simulation was conducted adopting two new main hypotheses: 1) the use of vertical correlation concept to force the vertical dispersion (a method normally used in tracer data assimilation) and, 2) the use of a puff instead of a continuous pollen release. The simulation was compared with pollen observations in Montreal and with the corresponding statistical forecasts (issued daily by the Weather Network) at several locations in the province of Quebec and elsewhere. The comparison with the simulation was found satisfactory (outperform forecasts based on persistence or pollen calendar and is also superior to numerical simulation of tree pollen done elsewhere in North America). Simulation shows that, for the 2012 pollen season, the majority (88%) of the Betula pollen measured in Montreal originated from the Laurentides region. Another result of scientific importance obtained here is that Betula pollen episodes (observed or simulated birch pollen) in Montreal occur only when the average daily temperature is in the range of 10° to 18 °C. This research is considered as a first step in forecasting bioaerosols in Canada within an air quality model.

Assessment of heterogeneity of two cultivars of Olea europaea based on the study of their Ole e 1 protein content

Olive pollen is one of the main causes of allergic disease in the Mediterranean area. Ten different proteins with allergenic activity have been described in olive pollen, with major allergen Ole e 1. Olea europaea L. may cause allergenic effects of different severity depending on the Ole e 1 content of cultivars. In this paper, we aimed to assess the heterogeneity of two olive cultivars concerning concentrations of the major allergen Ole e 1 during a period of 2 years. Pollens from two most common olive cultivars, known as "Gemlik" and "Celebi," were analyzed on regular basis. Ole e 1 amounts were measured by double-sandwich enzyme-linked immunosorbent assay (ELISA). The results were expressed as μg of Ole e 1 per μg of total freeze-dried extract. Comparisons of Ole e 1 levels were made both between individual trees and between cultivars. It was analyzed the influence of some meteorological parameters on pollen counts/allergenic content on a local scale, for 2 years. Pollen sampling was carried out continuously for 2 years, using a Hirst-type volumetric trap. "Gemlik" had the higher value (mean ± standard deviation) of Ole e 1 content (2.44 ±0.70 and 1.87 ±1.03 μg/μg, respectively) when compared to "Celebi" (2.16 ±0.86 and 0.20 ±0.30 μg/μg, respectively) in the years 2013 and 2015. In our research, daily variations were observed in pollen samples of two olive cultivars and even different trees of the same cultivar. Furthermore, during certain sampling days, discrepancies between airborne pollen counts and Ole e 1 concentrations were detected for both cultivars. It was found that meteorological changes, especially temperature and precipitation fluctuations, could affect airborne pollen and Ole e 1 allergen levels in the atmosphere. Therefore, pollen samples of different O. europaea cultivars demonstrated great differences in Ole e 1 content. We believe that these findings were a result of alternate bearing behavior modulated by meteorological factors.

Incidence and remission of aeroallergen sensitization in adults in Northern Finland: 15 years longitudinal study

Studies on the longitudinal changes in sensitization to aeroallergens in adult populations are sparse. The aim was to evaluate changes in sensitization to aeroallergens [birch, timothy, cat and house dust mite (HDM)] in an unselected adult population aged from 31 to 46 years. Data were gathered from a cohort of adults (Northern Finland Birth Cohort 1966) who had been skin prick tested (SPT) with birch, timothy, cat and HDM allergens at the age of 31 years and at age 46 (n = 5484 and 5373 respectively). Data from both time points were available for 3409 participants, who made up the cohort of the longitudinal study. The overall prevalence of sensitization to any of the selected allergens was 30.3% (n = 1661) in 31-year-olds and 30.7% (n = 1649) in 46-year-olds. In general, men were more sensitized (P < 0.001) and also had more polysensitization (P < 0.001) compared to women. In longitudinal sub-population incidence of sensitization was 7.1%. Birch was the most prevalent new sensitizer, however, the difference was not statistically significant when compared to cat. We conclude that new sensitization, demonstrated by positive findings in SPT, can still occur in middle age and this should be taken into account when managing allergic manifestations in adults as sensitization can be considered the first step in developing clinical allergy.

Climate Change, Air Pollution, and Biodiversity in Asia Pacific and Impact on Respiratory Allergies

Allergic diseases are increasing globally. Air pollution, climate change, and reduced biodiversity are major threats to human health with detrimental effects on chronic noncommunicable diseases. Outdoor and indoor air pollution and climate change are increasing. Asia has experienced rapid economic growth, a deteriorating environment, and an increase in allergic diseases to epidemic proportions. Air pollutant levels in Asian countries are substantially higher than in developed countries. Moreover, industrial, traffic-related, and household biomass combustion and indoor pollutants from chemicals and tobacco are major sources of air pollutants. We highlight the major components of pollutants and their impacts on respiratory allergies.

Extrafine triple therapy and asthma exacerbation seasonality: TRIMARAN and TRIGGER post hoc analyses

BACKGROUND

Previous studies have shown seasonal variation in asthma exacerbations, peaking over the winter months. A single-inhaler triple therapy containing extrafine formulations of the inhaled corticosteroid (ICS) beclomethasone dipropionate (BDP), long-acting β₂-agonist formoterol fumarate (FF), and long-acting muscarinic antagonist glycopyrronium (G) is in development for asthma.

OBJECTIVE

We sought to evaluate whether calendar season impacted the relative effect of BDP/FF/G versus BDP/FF on moderate and severe asthma exacerbations.

METHODS

TRIMARAN and TRIGGER were double-blind 52-week studies comparing BDP/FF/G with BDP/FF (TRIMARAN medium-dose ICS; TRIGGER high-dose) in adults with uncontrolled asthma (Asthma Control Questionnaire-7 score ≥1.5), prebronchodilator FEV₁ less than 80% predicted, history of 1 or more asthma exacerbation, who had been receiving ICS/long-acting β₂-agonist for at least 4 weeks before entry. Moderate and severe asthma exacerbations were captured throughout each study. In these post hoc analyses, the annual moderate and severe exacerbation rate was calculated for each month, with rate ratios determined from events grouped by season.

RESULTS

In patients who received BDP/FF alone, there was a marked seasonal effect on the occurrence of asthma exacerbations, with the rate highest in the winter months. However, the addition of the long-acting muscarinic antagonist component to BDP/FF reduced this seasonal variation, especially during the winter, such that the relative effect of BDP/FF/G versus BDP/FF was greatest in the winter (significant 20.3% reduction [P = .0008]). Reductions in the other seasons ranged between 8.6% and 12.0%.

CONCLUSIONS

These post hoc analyses indicate that inhaled triple therapy with extrafine BDP/FF/G reduces seasonal peaks in moderate and severe exacerbations, and confirm the overall utility of adding long-acting muscarinic antagonist to ICS/long-acting β₂-agonist in the management of asthma.

Modelling grass pollen levels in Belgium

Biogenic aerosols such as airborne grass pollen affect the public health badly by putting additional distress on people already suffering from cardiovascular and respiratory diseases. In Belgium, daily airborne pollen concentrations are monitored offline at a few sites only, hampering the timely coverage of the country and short-term forecasts. Here we apply the Chemistry Transport Model SILAM to the Belgian territory to model the spatio-temporal airborne grass pollen levels near the surface based on bottom-up inventories of grass pollen emissions updated with the Copernicus land monitoring Service grassland map of 2015. Transport of aerosols in SILAM is driven by ECMWF ERA5 meteorological data. The emitted grass pollen amounts in SILAM are computed by the multiplication of the grass pollen source map with the release rate determined by the seasonal shape production curve during the grass flowering period. The onset and offset of this period follow a location-dependent prescribed calendar days. Here we optimize the grass pollen seasonal start and end in SILAM by comparing a 2008-2018 time series of daily airborne grass pollen concentrations from the Belgian aerobiological surveillance network with the simulations. The effect of the spatial distribution of grass pollen sources is quantified by constructing pollen source-receptor relations using model simulations with varying grass pollen emissions in five areas of the model domain as input. Up to 33% of the airborne grass pollen in one area was transport from others areas inside Belgium. Adjusting the start and end of the grass pollen season improved the model performance substantially by almost doubling the correlation with local observations. By introducing the temporal scaling of the inter-seasonal pollen amounts in the model, an additional R² increase up to 22% was obtained. Further improvements can be made by including more detailed grass pollen sources and more dynamic start and end dates of the pollen season.

Mixture Analyses of Air-sampled Pollen Extracts Can Accurately Differentiate Pollen Taxa

The daily pollen forecast provides crucial information for allergic patients to avoid exposure to specific pollen. Pollen counts are typically measured with air samplers and analyzed with microscopy by trained experts. In contrast, this study evaluated the effectiveness of identifying the component pollens using the metabolites extracted from an air-sampled pollen mixture. Ambient air-sampled pollen from Munich in 2016 and 2017 was visually identified from reference pollens and extracts were prepared. The extracts were lyophilized, rehydrated in optimal NMR buffers, and filtered to remove large proteins. NMR spectra were analyzed for pollen associated metabolites. Regression and decision-tree based algorithms using the concentration of metabolites, calculated from the NMR spectra outperformed algorithms using the NMR spectra themselves as input data for pollen identification. Categorical prediction algorithms trained for low, medium, high, and very high pollen count groups had accuracies of 74% for the tree, 82% for the grass, and 93% for the weed pollen count. Deep learning models using convolutional neural networks performed better than regression models using NMR spectral input, and were the overall best method in terms of relative error and classification accuracy (86% for tree, 89% for grass, and 93% for weed pollen count). This study demonstrates that NMR spectra of air-sampled pollen extracts can be used in an automated fashion to provide taxa and type-specific measures of the daily pollen count.

Atmospheric pollutants and their association with olive and grass aeroallergen concentrations in Córdoba (Spain)

Cumulative data indicate that pollen grains and air pollution reciprocally interact. Climate changes seem also to influence pollen allergenicity. Depending on the plant species and on the pollutant type and concentration, this interaction may modify the features and metabolism of the pollen grain. Previous results revealed a significant positive correlation between pollen and aeroallergen, even using two different samplers. However, some discrepancy days have been also detected with low pollen but high aeroallergen concentrations. The main aim of the present paper is to find how the environmental factors, and specially pollutants, could affect the amount of allergens from olive and grass airborne pollen. Pollen grains were collected by a Hirst-type volumetric spore trap. Aeroallergen was simultaneously sampled by a low-volume Cyclone Burkard sampler. Phl p 5 and Ole e 1 aeroallergen were quantified by double-sandwich ELISA test. The data related to air pollutants, pollen grains, and aeroallergens were analyzed with descriptive statistic. Spearman's correlation test was used to identify potential correlations between these variables. There is a significant positive correlation between aeroallergens and airborne pollen concentrations, in both studied pollen types, so allergen concentrations could be explained with the pollen concentration. The days with unlinked events coincide between olive and grass allergens. Nevertheless, concerning to our results, pollutants do not affect the amount of allergens per pollen. Even if diverse pollutants show an unclear relationship with the allergen concentration, this association seems to be a casual effect of the leading role of some meteorological parameters.

State of the Art: Development of a Sublingual Allergy Immunotherapy Tablet for Allergic Rhinitis in Japan

Allergic rhinitis (AR) caused by house dust mite (HDM) and Japanese cedar pollen (JCP) represents a significant, expanding health problem in Japan. Allergic symptoms often have a severe impact on the QOL such as sleep disturbance and reduced school and work performance. In addition to the classical symptoms, AR is known to be a risk factor for the development of allergic asthma, a potentially life-threatening condition. Allergy immunotherapy (AIT) is a well-documented, safe, effective treatment option for respiratory allergic disease. It has been demonstrated that AIT can provide relief from clinical symptoms and that AIT has the potential to provide long-term post-treatment effect. Although the mechanism of AIT is not fully understood, it can actively modulate protective allergen-reactive pathways of the immune system and alter the natural course of disease. Unlike pharmacotherapy, AIT addresses the basic immunological mechanisms that are responsible for the development and persistence of allergic conditions. Currently two main routes of AIT administration are commonly available, subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT). Both SCIT and SLIT are clinically effective, and SLIT is particularly well tolerated, with a lower risk of systemic allergic reactions compared with SCIT. To date, SLIT tablets have been developed for a range of different allergies including HDM and JCP and are the best-documented AIT treatment form. Here we introduce the current status of development of a SLIT tablet in Japan for AR, examine the clinical aspects and mechanism of action of AIT, and discuss the future directions of SLIT.