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Wu M, Zhang X, Karunaratne S, Lee JH, Lampugnani ER, Selva KJ, Chung AW, Mueller SN, Chinnery HR, Downie LE. Intravital imaging of the human cornea reveals the differential effects of season on innate and adaptive immune cell morphodynamics. Ophthalmology 2024:S0161-6420(24)00273-2. [PMID: 38703795 DOI: 10.1016/j.ophtha.2024.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 04/19/2024] [Accepted: 04/23/2024] [Indexed: 05/06/2024] Open
Abstract
PURPOSE While the external environment has been shown to shape the systemic human immune landscape, defining the in vivo immune status of peripheral tissues has remained a technical challenge. We recently developed functional in vivo confocal microscopy (Fun-IVCM) for dynamic, longitudinal imaging of corneal immune cells in living humans. This study investigated the effect of seasonal-driven environmental factors on the density, morphology and dynamic behavior of human corneal immune cell subsets. DESIGN Longitudinal, observational clinical study. PARTICIPANTS Sixteen healthy participants (18-40 years) attended two visits in distinct seasons in Melbourne, Australia (Visit 1: Spring/Summer: November-December 2021; Visit 2: Autumn/Winter: April-June 2022). METHODS Environmental data were collected over each period. Participants underwent ocular surface examinations and corneal Fun-IVCM (Heidelberg HRT-3, Rostock Corneal Module). Volume scans (80μm) were acquired at 5.5±1.5 minute intervals, for up to five timepoints. Time-lapse videos were created to analyze corneal immune cells, comprising epithelial T cells and dendritic cells (DCs), and stromal macrophages. Tear cytokines were analyzed using multiplex bead-based immunoassay. MAIN OUTCOME MEASURES Difference in the density, morphological and dynamic parameters of corneal immune cell subsets over the study periods. RESULTS Visit 1 was characterized by higher temperature, lower humidity, and higher air particulate and pollen levels than Visit 2. Clinical ocular surface parameters, and the density of immune cell subsets were similar across visits. At Visit 1 (Spring/Summer), corneal epithelial DCs were larger and more elongated, with a lower dendrite probing speed (0.38±0.21 vs 0.68±0.33μm/min, p<0.001) relative to Visit 2; stromal macrophages were more circular and had less dynamic activity (Visit 1: 7.2±1.9 vs Visit 2: 10.3±3.7 'dancing index', p<0.001). T cell morphology and dynamics were unchanged across periods. Basal tear levels of IL-2 and CXCL10 were lower during Spring/Summer. CONCLUSION This novel study shows that the in vivo morphodynamics of innate corneal immune cells (DCs, macrophages) are modified by environmental factors, but such effects are not evident for adaptive immune cells (T cells). The cornea is a potential non-invasive, in vivo 'window' to season-dependent changes to the human immune system, with capacity to yield new insight into environmental influences on immune regulation.
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Affiliation(s)
- Mengliang Wu
- Department of Optometry and Vision Sciences, The University of Melbourne, Carlton, VIC, Australia; Department of Microbiology and Immunology, The University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Xinyuan Zhang
- Department of Optometry and Vision Sciences, The University of Melbourne, Carlton, VIC, Australia
| | - Senuri Karunaratne
- Department of Optometry and Vision Sciences, The University of Melbourne, Carlton, VIC, Australia
| | - Ji-Hyun Lee
- Department of Optometry and Vision Sciences, The University of Melbourne, Carlton, VIC, Australia
| | - Edwin R Lampugnani
- School of BioSciences, The University of Melbourne, Parkville, VIC, Australia; Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Kevin J Selva
- Department of Microbiology and Immunology, The University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Amy W Chung
- Department of Microbiology and Immunology, The University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Scott N Mueller
- Department of Microbiology and Immunology, The University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Holly R Chinnery
- Department of Optometry and Vision Sciences, The University of Melbourne, Carlton, VIC, Australia
| | - Laura E Downie
- Department of Optometry and Vision Sciences, The University of Melbourne, Carlton, VIC, Australia.
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2
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Luyten A, Bürgler A, Glick S, Kwiatkowski M, Gehrig R, Beigi M, Hartmann K, Eeftens M. Ambient pollen exposure and pollen allergy symptom severity in the EPOCHAL study. Allergy 2024. [PMID: 38659216 DOI: 10.1111/all.16130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 03/01/2024] [Accepted: 03/25/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Ambient pollen exposure causes nasal, ocular, and pulmonary symptoms in allergic individuals, but the shape of the exposure-response association is not well characterized. We evaluated this association and determined (1) whether symptom severity differs between subpopulations; (2) how the association changes over the course of the pollen season; and (3) which pollen exposure time lags affect symptoms. METHODS Adult study participants (n = 396) repeatedly scored severity of nasal, ocular, and pulmonary allergic symptoms, resulting in three composite symptom scores. We calculated hourly individually relevant pollen exposure to seven allergenic plants (alder, ash, birch, hazel, grasses, mugwort, and ragweed) considering personal sensitization and exposure time lags of up to 96 h. We fitted generalized additive mixed models, with a random personal intercept, adjusting for weather and air pollution as potential time-varying confounders. RESULTS We identified a clear nonlinear positive association between pollen exposure and ocular and nasal symptom severity in the pollen allergy group: Symptom severity increased steeply with increasing exposure initially, but attenuated beyond approximately 80 pollen/m3. We found no evidence of an exposure threshold, below which no symptoms occur. While recent pollen exposure in the last approximately 5 h affected symptoms most, associations lingered for up to 60 h. Grass pollen exposure (compared to tree pollen) and younger age (18-30 years, as opposed to 30-65 years) were both associated with higher nasal and ocular symptom severity. CONCLUSIONS The lack of a threshold and attenuated dose-response curve may have implications for pollen warning systems, which may be revised to include multiday pollen concentrations in the future.
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Affiliation(s)
- Axel Luyten
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Alexandra Bürgler
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Sarah Glick
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Marek Kwiatkowski
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Regula Gehrig
- Federal Office of Meteorology and Climatology MeteoSwiss, Zurich, Switzerland
| | - Minaya Beigi
- Division of Allergy, Department of Dermatology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Karin Hartmann
- Division of Allergy, Department of Dermatology, University Hospital Basel and University of Basel, Basel, Switzerland
- Department of Biomedicine, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Marloes Eeftens
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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3
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Tegart LJ, Schiro G, Dickinson JL, Green BJ, Barberán A, Marthick JR, Bissett A, Johnston FH, Jones PJ. Decrypting seasonal patterns of key pollen taxa in cool temperate Australia: A multi-barcode metabarcoding analysis. ENVIRONMENTAL RESEARCH 2024; 243:117808. [PMID: 38043901 DOI: 10.1016/j.envres.2023.117808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/23/2023] [Accepted: 11/27/2023] [Indexed: 12/05/2023]
Abstract
Pollen allergies pose a considerable global public health concern. Allergy risk can vary significantly within plant families, yet some key pollen allergens can only be identified to family level by current optical methods. Pollen information with greater taxonomic resolution is therefore required to best support allergy prevention and self-management. We used environmental DNA (eDNA) metabarcoding to deepen taxonomic insights into the seasonal composition of airborne pollen in cool temperate Australia, a region with high rates of allergic respiratory disease. In Hobart, Tasmania, we collected routine weekly air samples from December 2018 until October 2020 and sequenced the internal transcribed spacer 2 (ITS2) and chloroplastic tRNA-Leucine tRNA-Phenylalanine intergenic spacer (trnL-trnF) regions in order to address the following questions: a) What is the genus-level diversity of known and potential aeroallergens in Hobart, in particular, in the families Poaceae, Cupressaceae and Myrtaceae? b) How do the atmospheric concentrations of these taxa change over time, and c) Does trnL-trnF enhance resolution of biodiversity when used in addition to ITS2? Our results suggest that individuals in the region are exposed to temperate grasses including Poa and Bromus in the peak grass pollen season, however low levels of exposure to the subtropical grass Cynodon may occur in autumn and winter. Within Cupressaceae, both metabarcodes showed that exposure is predominantly to pollen from the introduced genera Cupressus and Juniperus. Only ITS2 detected the native genus, Callitris. Both metabarcodes detected Eucalyptus as the major Myrtaceae genus, with trnL-trnF exhibiting primer bias for this family. These findings help refine our understanding of allergy triggers in Tasmania and highlight the utility of multiple metabarcodes in aerobiome studies.
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Affiliation(s)
- Lachlan J Tegart
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia.
| | - Gabriele Schiro
- Department of Environmental Science, University of Arizona, Tucson, AZ, 85721, United States.
| | - Joanne L Dickinson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia.
| | - Brett J Green
- Office of the Director, Health Effects Laboratory Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV, 26505, United States.
| | - Albert Barberán
- Department of Environmental Science, University of Arizona, Tucson, AZ, 85721, United States.
| | - James R Marthick
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia.
| | - Andrew Bissett
- Commonwealth Scientific and Industrial Research Organisation, Hobart, TAS, Australia.
| | - Fay H Johnston
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia; Public Health Services, Department of Health, Hobart, TAS, 7000, Australia.
| | - Penelope J Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia.
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4
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Yin Z, Ouyang Y, Dang B, Zhang L. Pollen grading prediction scale for patients with Artemisia pollen allergy in China: A 3-day moving predictive model. Clin Transl Allergy 2023; 13:e12280. [PMID: 37488741 PMCID: PMC10332133 DOI: 10.1002/clt2.12280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 03/13/2023] [Accepted: 06/23/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Artemisia pollen is the most prevalent outdoor aeroallergen causing respiratory allergies in Beijing, China. Pollen allergen concentrations have a direct impact on the quality of life of those suffering from allergies. Artemisia pollen deposition grading predictions can provide early warning for the protection and treatment of patients as well as provide a scientific basis for allergen specific clinical immunotherapy. OBJECTIVE To develop a model of Artemisia pollen grading to predict development in patients with pollen allergy. METHODS Artemisia pollen data from four pollen monitoring stations in Beijing as well as the number of Artemisia pollen allergen serum specific immunoglobulin E positive cases in Beijing Tongren Hospital from 2014 to 2016 were used to develop a statistical model of pollen deposition and provide optimised threshold values. RESULTS A logarithmic correlation existed between the number of patients with Artemisia pollen allergy and Artemisia pollen deposition, and the average pollen deposition for three consecutive days was most correlated with the number of allergic patients. Based on the threshold of the number of patients and the characteristics of Artemisia pollen, a five-stage pollen deposition grading model was developed to predict the degree of pollen allergy. CONCLUSIONS Graded prediction of pollen deposition may help pollen allergic populations benefit from preventive interventions before onset.
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Affiliation(s)
- Zhaoyin Yin
- Institute of Urban Meteorology, China Meteorological Administration, Beijing, China
- Beijing Meteorological Service Center, Beijing, China
| | - Yuhui Ouyang
- Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
- Research Unit of Diagnosis and Treatment of Chronic Nasal Diseases, Chinese Academy of Medical Sciences, Beijing, China
| | - Bing Dang
- Beijing Municipal Climate Center, Beijing, China
| | - Luo Zhang
- Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
- Research Unit of Diagnosis and Treatment of Chronic Nasal Diseases, Chinese Academy of Medical Sciences, Beijing, China
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5
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Idrose NS, Lodge CJ, Peters RL, Douglass JA, Koplin JJ, Lowe AJ, Perrett KP, Tang MLK, Newbigin EJ, Abramson MJ, Erbas B, Vicendese D, Dharmage SC. The role of short-term grass pollen exposure in food skin-prick test reactivity, food allergy, and eczema flares in children. Pediatr Allergy Immunol 2022; 33:e13862. [PMID: 36282135 PMCID: PMC9828461 DOI: 10.1111/pai.13862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 07/13/2022] [Accepted: 09/20/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND While the relationship between pollen and respiratory allergies is well-documented, the role of short-term pollen exposure in food allergy and eczema flares has not previously been explored. We aimed to investigate these associations in a population-based sample of children. METHODS We investigated 1- (n = 1108) and 6-year-old (n = 675) children in the grass pollen season from the HealthNuts cohort. Grass pollen concentrations were considered on the day of testing (lag 0), up to three days before (lag 1-lag 3) and cumulatively (lag 0-3). Associations between grass pollen and food skin-prick test reactivity (SPT ≥ 2 mm at age 1 year and ≥ 3 mm at age 6 years), eczema flares, challenge-confirmed food allergy, reaction threshold to oral food challenges (OFC), and serum food-specific IgE levels were analyzed using either logistic or quantile regression models. Atopy and family history of allergic disease were considered as potent effect modifiers. RESULTS Grass pollen at lag 0-3 (every 20 grains/m3 increase) was associated with an up to 1.2-fold increased odds of food SPT reactivity and eczema flares in 6-year-olds. In 1-year-olds, the associations were only observed for peanut in those with a family history of food allergy. Increasing grass pollen concentrations were associated with a lower reaction threshold to OFC and higher serum IgE levels in peanut-allergic 1-year-olds only. CONCLUSION Increasing grass pollen concentration was associated with increased risk of food SPT reactivity and eczema flares in children. The associations in peanut-allergic infants may be related to immune activation and/or peanut and grass pollen cross-reactivity leading to a lower reaction threshold.
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Affiliation(s)
- Nur Sabrina Idrose
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, Carlton, Victoria, Australia.,Centre for Food and Allergy Research (CFAR), Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Caroline J Lodge
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, Carlton, Victoria, Australia
| | - Rachel L Peters
- Centre for Food and Allergy Research (CFAR), Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Pediatrics, The University of Melbourne, Victoria, Australia
| | - Jo A Douglass
- Department of Clinical Immunology and Allergy, Royal Melbourne Hospital, Parkville, Victoria, Australia.,Department of Medicine, University of Melbourne, Victoria, Australia
| | - Jennifer J Koplin
- Centre for Food and Allergy Research (CFAR), Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Pediatrics, The University of Melbourne, Victoria, Australia
| | - Adrian J Lowe
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, Carlton, Victoria, Australia.,Centre for Food and Allergy Research (CFAR), Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Kirsten P Perrett
- Centre for Food and Allergy Research (CFAR), Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Pediatrics, The University of Melbourne, Victoria, Australia.,Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Mimi L K Tang
- Centre for Food and Allergy Research (CFAR), Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Pediatrics, The University of Melbourne, Victoria, Australia.,Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Ed J Newbigin
- School of Biosciences, The University of Melbourne, Victoria, Australia
| | - Michael J Abramson
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Don Vicendese
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, Carlton, Victoria, Australia.,Department of Mathematics and Statistics, La Trobe University, Bundoora, Victoria, Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, Carlton, Victoria, Australia.,Centre for Food and Allergy Research (CFAR), Murdoch Children's Research Institute, Parkville, Victoria, Australia
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6
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Hughes KM, Price D, Suphioglu C. Importance of allergen–environment interactions in epidemic thunderstorm asthma. Ther Adv Respir Dis 2022; 16:17534666221099733. [PMID: 35603956 PMCID: PMC9134402 DOI: 10.1177/17534666221099733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Australia is home to one of the highest rates of allergic rhinitis
worldwide. Commonly known as ‘hay fever’, this chronic condition
affects up to 30% of the population and is characterised by
sensitisation to pollen and fungal spores. Exposure to these
aeroallergens has been strongly associated with causing allergic
reactions and worsening asthma symptoms. Over the last few decades,
incidences of respiratory admissions have risen due to the increased
atmospheric concentration of airborne allergens. The fragmentation and
dispersion of these allergens is aided by environmental factors like
rainfall, temperature and interactions with atmospheric aerosols.
Extreme weather parameters, which continue to become more frequent due
to the impacts of climate change, have greatly fluctuated allergen
concentrations and led to epidemic thunderstorm asthma (ETSA) events
that have left hundreds, if not thousands, struggling to breathe.
While a link exists between airborne allergens, weather and
respiratory admissions, the underlying factors that influence these
epidemics remain unknown. It is important we understand the potential
threat these events pose on our susceptible populations and ensure our
health infrastructure is prepared for the next epidemic.
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Affiliation(s)
- Kira Morgan Hughes
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences, Faculty of Science, Engineering and Built Environment, Deakin University, Burwood, VIC, Australia
- Deakin AIRwatch Pollen and Spore Counting and Forecasting Facility, Deakin University, Melbourne, VIC, Australia
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Waurn Ponds, VIC, Australia
| | - Dwan Price
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences, Faculty of Science, Engineering and Built Environment, Deakin University, Burwood, VIC, Australia
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences, Faculty of Science, Engineering and Built Environment, Deakin University, Waurn Ponds, VIC, Australia
- Deakin AIRwatch Pollen and Spore Counting and Forecasting Facility, Deakin University, Melbourne, VIC, Australia
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Waurn Ponds, VIC, Australia
- COVID-19 Response, Department of Health, Melbourne, VIC, Australia
| | - Cenk Suphioglu
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences, Faculty of Science, Engineering and Built Environment, Deakin University, Burwood, VIC, Australia
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences, Faculty of Science, Engineering and Built Environment, Deakin University, Waurn Ponds, VIC, Australia
- Deakin AIRwatch Pollen and Spore Counting and Forecasting Facility, Deakin University, Melbourne, VIC, Australia
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Waurn Ponds Campus, 75 Pidgons Road, Geelong, VIC 3216, Australia
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7
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Idrose NS, Vicendese D, Peters RL, Koplin JJ, Douglass JA, Walters EH, Perret JL, Lowe AJ, Tang MLK, Newbigin EJ, Erbas B, Lodge CJ, Dharmage SC. Children With Food Allergy Are at Risk of Lower Lung Function on High-Pollen Days. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:2144-2153.e10. [PMID: 35398553 DOI: 10.1016/j.jaip.2022.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 03/02/2022] [Accepted: 03/18/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND Grass pollen exposure is a risk factor for childhood asthma hospital attendances. However, its short-term influence on lung function, especially among those with other allergic conditions, has been less well-studied. OBJECTIVE To investigate this association in a population-based sample of children. METHODS Within the HealthNuts cohort, 641 children performed spirometry during the grass pollen season. Grass pollen concentration was considered on the day of testing (lag 0), up to 3 days before (lag 1-lag 3), and cumulatively (lag 0-3). We used linear regression to assess the relevant associations and examined potential interactions with current asthma, hay fever or eczema, and food allergy. RESULTS Associations were observed only in children with allergic disease (P value for interaction ≤ 0.1). In children with food allergy, grass pollen concentration was associated with a lower ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC) and lower mid-forced expiratory flows (FEF25%-75%) at all lags (eg, at lag 2, FEV1/FVC z-score = -0.50 [95% CI -0.80 to -0.20] and FEF25%--75% z-score = -0.40 [-0.60 to -0.04] per 20 grains/m3 pollen increase), and increased bronchodilator responsiveness (BDR) at lag 2 and lag 3 (eg, at lag 2, BDR = (31 [95% CI -0.005 to 62] mL). In children with current asthma, increasing grass pollen concentration was associated with lower FEF25%-75% and increased BDR, whereas children with current hay fever or eczema had increased BDR only. CONCLUSIONS A proactive approach needs to be enforced to manage susceptible children, especially those with food allergy, before high-grass pollen days.
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Affiliation(s)
- N Sabrina Idrose
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Melbourne, Victoria, Australia; Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia
| | - Don Vicendese
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Melbourne, Victoria, Australia; Department of Mathematics and Statistics, La Trobe University, Bundoora, Victoria, Australia
| | - Rachel L Peters
- Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia; Department of Pediatrics, The University of Melbourne, Parkville, Melbourne, Victoria, Australia
| | - Jennifer J Koplin
- Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia; Department of Pediatrics, The University of Melbourne, Parkville, Melbourne, Victoria, Australia
| | - Jo A Douglass
- Department of Clinical Immunology and Allergy, Royal Melbourne Hospital, Parkville, Melbourne, Victoria, Australia; Department of Medicine, University of Melbourne, Parkville, Melbourne, Victoria, Australia
| | - E Haydn Walters
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Melbourne, Victoria, Australia; Department of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Jennifer L Perret
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Melbourne, Victoria, Australia
| | - Adrian J Lowe
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Melbourne, Victoria, Australia; Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia
| | - Mimi L K Tang
- Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia; Department of Pediatrics, The University of Melbourne, Parkville, Melbourne, Victoria, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Ed J Newbigin
- School of BioSciences, The University of Melbourne, Parkville, Melbourne, Victoria, Australia
| | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Caroline J Lodge
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Melbourne, Victoria, Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Melbourne, Victoria, Australia; Centre for Food and Allergy Research, Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia.
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8
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Al-Mukhtar O, Vogrin S, Lampugnani ER, Noaman S, Dinh DT, Brennan AL, Reid C, Lefkovits J, Cox N, Stub D, Chan W. Temporal Changes in Pollen Concentration Predict Short-Term Clinical Outcomes in Acute Coronary Syndromes. J Am Heart Assoc 2022; 11:e023036. [PMID: 35289185 PMCID: PMC9075470 DOI: 10.1161/jaha.121.023036] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background Atmospheric changes in pollen concentration may affect human health by triggering various allergic processes. We sought to assess if changes in pollen concentrations were associated with different acute coronary syndrome (ACS) subtype presentations and short-term clinical outcomes. Methods and Results We analyzed data in consecutive patients presenting with ACS (unstable angina, non-ST-segment-elevation myocardial infarction, and ST-segment-elevation myocardial infarction) treated with percutaneous coronary intervention between January 2014 and December 2017 and enrolled in the VCOR (Victorian Cardiac Outcomes Registry). Baseline characteristics were compared among patients exposed to different grass and total pollen concentrations. The primary outcome was occurrence of ACS subtypes and 30-day major adverse cardiac and cerebrovascular events (composite of mortality, myocardial infarction, stent thrombosis, target vessel revascularization, or stroke). Of 15 379 patients, 7122 (46.3%) presented with ST-segment-elevation myocardial infarction, 6781 (44.1%) with non-ST-segment-elevation myocardial infarction, and 1476 (9.6%) with unstable angina. The mean age was 62.5 years, with men comprising 76% of patients. No association was observed between daily or seasonal grass and total pollen concentrations with the frequency of ACS subtype presentation. However, grass and total pollen concentrations in the preceding days (2-day average for grass pollen and 7-day average for total pollen) correlated with in-hospital mortality (odds ratio [OR], 2.17 [95% CI, 1.12-4.21]; P=0.021 and OR, 2.78 [95% CI, 1.00-7.74]; P=0.05), respectively, with a trend of 2-day grass pollen for 30-day major adverse cardiac and cerebrovascular events (OR, 1.50 [95% CI, 0.97-2.32]; P=0.066). Conclusions Increased pollen concentrations were not associated with differential ACS subtype presentation but were significantly related to in-hospital mortality following percutaneous coronary intervention, underscoring a potential biologic link between pollen exposure and clinical outcomes.
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Affiliation(s)
- Omar Al-Mukhtar
- Department of Cardiology Western Health Melbourne Victoria Australia
| | - Sara Vogrin
- Department of Medicine Western HealthMelbourne Medical SchoolUniversity of Melbourne Melbourne Victoria Australia
| | - Edwin R Lampugnani
- School of Biosciences The University of Melbourne Melbourne Victoria Australia
| | - Samer Noaman
- Department of Cardiology Western Health Melbourne Victoria Australia.,Department of Cardiology Alfred Health Melbourne Victoria Australia
| | - Diem T Dinh
- School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia
| | - Angela L Brennan
- School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia
| | - Christopher Reid
- School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia.,NHMRC Centre of Research Excellence in Cardiovascular Outcomes Improvement Curtin University Perth Western Australia Australia
| | - Jeffrey Lefkovits
- School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia.,Department of Cardiology Royal Melbourne Hospital Melbourne Victoria Australia
| | - Nicholas Cox
- Department of Cardiology Western Health Melbourne Victoria Australia.,Department of Medicine Western HealthMelbourne Medical SchoolUniversity of Melbourne Melbourne Victoria Australia
| | - Dion Stub
- Department of Cardiology Western Health Melbourne Victoria Australia.,Department of Cardiology Alfred Health Melbourne Victoria Australia.,Baker Heart and Diabetes Institute Melbourne Victoria Australia
| | - William Chan
- Department of Cardiology Western Health Melbourne Victoria Australia.,Department of Medicine Western HealthMelbourne Medical SchoolUniversity of Melbourne Melbourne Victoria Australia.,Department of Cardiology Alfred Health Melbourne Victoria Australia.,Baker Heart and Diabetes Institute Melbourne Victoria Australia
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9
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Susanto NH, Lowe AJ, Salim A, Koplin JJ, Tang MLK, Suaini NHA, Ponsonby AL, Allen KJ, Dharmage SC, Erbas B. Associations between grass pollen exposures in utero and in early life with food allergy in 12-month-old infants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:712-722. [PMID: 32677468 DOI: 10.1080/09603123.2020.1793920] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 07/06/2020] [Indexed: 06/11/2023]
Abstract
Birth during pollen seasons may influence food allergy risk but no study has assessed pollen exposure. Using the HealthNuts population-based cohort of 5276 infants, we assessed grass pollen exposures, in utero and up to the first 6 months of life, on hen's egg, sesame and peanut allergy outcomes at 12 months. Cumulative pollen exposure in the first 7 days of life increased risk of peanut sensitization aMOR (adjusted multinomial odds ratio) = 1.21 (95% CI: 1.01-1.44). Exposure between first 4-6 months of life increased risk of hen's egg aMOR = 1.02 (95% CI: 1.004-1.04) and sensitization to all foods aMOR = 1.02 (95% CI: 1.003-1.04). Grass pollen exposure was associated with food challenge diagnosed food allergy, but only among infants with a maternal history of food allergy. Exposure to grass pollen in the intrauterine period and infancy may be important but more studies are needed to replicate these findings.
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Affiliation(s)
- Nugroho Harry Susanto
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Jakarta, Indonesia
| | - Adrian J Lowe
- Allergy and Lung Health Unit, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Agus Salim
- Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia
| | - Jennifer J Koplin
- Allergy and Lung Health Unit, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- The Murdoch Children's Research Institute, Parkville, Australia
| | - Mimi L K Tang
- The Murdoch Children's Research Institute, Parkville, Australia
- The Department of Paediatrics, University of Melbourne, Parkville, Australia
- The Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia
| | - Noor H A Suaini
- The Murdoch Children's Research Institute, Parkville, Australia
| | - Anne-Louise Ponsonby
- Allergy and Lung Health Unit, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- The Murdoch Children's Research Institute, Parkville, Australia
| | - Katrina J Allen
- The Murdoch Children's Research Institute, Parkville, Australia
- The Department of Paediatrics, University of Melbourne, Parkville, Australia
- The Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia
- The Institute of Inflammation and Repair, University of Manchester, Manchester, UK
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
- Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
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10
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van Nunen SA, Burk MB, Burton PK, Ford G, Harvey RJ, Lozynsky A, Pickford E, Rimmer JS, Smart J, Sutherland MF, Thien F, Weber HC, Zehnwirth H, Newbigin E, Katelaris CH. 5-grass-pollen SLIT effectiveness in seasonal allergic rhinitis: Impact of sensitization to subtropical grass pollen. World Allergy Organ J 2022; 15:100632. [PMID: 35280502 PMCID: PMC8873945 DOI: 10.1016/j.waojou.2022.100632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 01/24/2022] [Accepted: 01/27/2022] [Indexed: 01/08/2023] Open
Abstract
Background Temperate grass (eg, ryegrass) pollen is a major driver of seasonal allergic rhinitis (SAR) and asthma risks, including thunderstorm asthma. Data for the effectiveness of temperate grass pollen allergen immunotherapy (AIT) in SAR patients from the southern hemisphere, who are frequently polysensitized to subtropical grass pollens, are limited. The 300 IR 5-grass pollen sublingual immunotherapy tablet (300 IR 5-grass SLIT) is known to be effective in polysensitized SAR patients with primary allergy to temperate grasses, however, the influence of polysensitization to subtropical grass pollen on treatment responses has yet to be specifically addressed. Key aims of this study were to measure patient treatment satisfaction during 300 IR 5-grass SLIT treatment and evaluate how polysensitization to subtropical grass pollens affects treatment responses. Methods A prospective observational study was conducted in 63 patients (aged ≥5 years) in several temperate regions of Australia prescribed 300 IR 5-grass SLIT for SAR over 3 consecutive grass pollen seasons. Ambient levels of pollen were measured at representative sites. Patient treatment satisfaction was assessed using a QUARTIS questionnaire. Rhinoconjunctivitis Total Symptom Score (RTSS) and a Hodges-Lehmann Estimator analysis was performed to evaluate if polysensitization to subtropical grass pollen affected SAR symptom intensity changes during SLIT. Results A diagnosis of ryegrass pollen allergy was nearly universal. There were 74.6% (47/63) polysensitized to subtropical and temperate grass pollens. There were 23.8% (15/63) monosensitized to temperate grass pollens. From the first pollen season, statistically significant improvements occurred in SAR symptoms compared with baseline in both monosensitized and polysensitized patients, particularly in those polysensitized (P = 0.0297). Improvements in SAR symptoms were sustained and similar in both groups in the second and third pollen seasons, reaching 70–85% improvement (P < 0.01). Polysensitized patients from both northerly and southerly temperate regions in Australia showed similar improvements. Grass pollen counts in both regions were consistently highest during springtime. Conclusions 300 IR 5-grass SLIT is effective in a real-life setting in SAR patients in the southern hemisphere with primary allergy to temperate grass pollen and predominantly springtime grass pollen exposures. Importantly, SLIT treatment effectiveness was irrespective of the patient's polysensitization status to subtropical grass pollens.
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11
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Jones PJ, Koolhof IS, Wheeler AJ, Williamson GJ, Lucani C, Campbell SL, Bowman DJMS, Cooling N, Gasparrini A, Johnston FH. Characterising non-linear associations between airborne pollen counts and respiratory symptoms from the AirRater smartphone app in Tasmania, Australia: A case time series approach. ENVIRONMENTAL RESEARCH 2021; 200:111484. [PMID: 34116012 DOI: 10.1016/j.envres.2021.111484] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 05/25/2021] [Accepted: 06/02/2021] [Indexed: 06/12/2023]
Abstract
Pollen is a well-established trigger of asthma and allergic rhinitis, yet concentration-response relationships, lagged effects, and interactions with other environmental factors remain poorly understood. Smartphone technology offers an opportunity to address these challenges using large, multi-year datasets that capture individual symptoms and exposures in real time. We aimed to characterise associations between six pollen types and respiratory symptoms logged by users of the AirRater smartphone app in Tasmania, Australia. We analyzed 44,820 symptom reports logged by 2272 AirRater app users in Tasmania over four years (2015-2019). With these data we evaluated associations between daily respiratory symptoms and atmospheric pollen concentrations. We implemented Poisson regression models, using the case time series approach designed for app-sourced data. We assessed potentially non-linear and lagged associations with (a) total pollen and (b) six individual pollen taxa. We adjusted for seasonality and meteorology and tested for interactions with particulate air pollution (PM2.5). We found evidence of non-linear associations between total pollen and respiratory symptoms for up to three days following exposure. For total pollen, the same-day relative risk (RR) increased to 1.31 (95% CI: 1.26-1.37) at a concentration of 50 grains/m3 before plateauing. Associations with individual pollen taxa were also non-linear with some diversity in shapes. For all pollen taxa the same-day RR was highest. The interaction between total pollen and PM2.5 was positive, with risks associated with pollen significantly higher in the presence of high concentrations of PM2.5. Our results support a non-linear response between airborne pollen and respiratory symptoms. The association was strongest on the day of exposure and synergistic with particulate air pollution. The associations found with Dodonaea and Myrtaceae highlight the need to further investigate the role of Australian native pollen types in allergic respiratory disease.
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Affiliation(s)
- Penelope J Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia.
| | - Iain S Koolhof
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia; School of Medicine, University of Tasmania, Hobart, TAS, 7000, Australia.
| | - Amanda J Wheeler
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia; Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, 3000, Australia.
| | - Grant J Williamson
- School of Natural Sciences, University of Tasmania, Hobart, TAS, 7001, Australia.
| | - Christopher Lucani
- School of Natural Sciences, University of Tasmania, Hobart, TAS, 7001, Australia.
| | - Sharon L Campbell
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia; Public Health Services, Department of Health, Hobart, TAS, 7000, Australia.
| | - David J M S Bowman
- School of Natural Sciences, University of Tasmania, Hobart, TAS, 7001, Australia.
| | - Nick Cooling
- School of Medicine, University of Tasmania, Hobart, TAS, 7000, Australia.
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, WC1H 9SH, London, UK; Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, WC1H 9SH, London, UK; Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, WC1H 9SH, London, UK.
| | - Fay H Johnston
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia; Public Health Services, Department of Health, Hobart, TAS, 7000, Australia.
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12
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Suanno C, Aloisi I, Fernández-González D, Del Duca S. Pollen forecasting and its relevance in pollen allergen avoidance. ENVIRONMENTAL RESEARCH 2021; 200:111150. [PMID: 33894233 DOI: 10.1016/j.envres.2021.111150] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 03/26/2021] [Accepted: 04/06/2021] [Indexed: 06/12/2023]
Abstract
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.
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Affiliation(s)
- Chiara Suanno
- Department of Biological, Geological and Environmental Sciences, University of Bologna, Via Irnerio 42, 40126, Bologna, Italy
| | - Iris Aloisi
- Department of Biological, Geological and Environmental Sciences, University of Bologna, Via Irnerio 42, 40126, Bologna, Italy.
| | - Delia Fernández-González
- Institute of Atmospheric Sciences and Climate, ISAC-CNR, Via Piero Gobetti 101, 40129, Bologna, Italy; Department Biodiversity and Environmental Management, University of León, 24071, Campus Vegazana, S/n, 24007, León, Spain
| | - Stefano Del Duca
- Department of Biological, Geological and Environmental Sciences, University of Bologna, Via Irnerio 42, 40126, Bologna, Italy
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13
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AlQuran A, Batra M, Harry Susanto N, Holland AE, Davies JM, Erbas B, Lampugnani ER. Community Response to the Impact of Thunderstorm Asthma Using Smart Technology. ALLERGY & RHINOLOGY 2021; 12:21526567211010728. [PMID: 33996193 PMCID: PMC8083005 DOI: 10.1177/21526567211010728] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 11/27/2022]
Abstract
Background The most severe thunderstorm asthma (TA) event occurred in Melbourne on the 21st November 2016 and during this period, daily pollen information was available and accessible on smart devices via an App. An integrated survey within the App allows users to self-report symptoms. Objective To explore patterns of symptom survey results during the period when the TA event occurred. Methods Symptom data from the Melbourne Pollen Count and Forecast App related to asthma history, hay fever symptoms, and medication use was explored. A one-week control period before and after the event was considered. Chi-square tests and logistic regression were used to assess associations between sex, age, symptoms, and medication use. Results Of the 28,655 responses, during the 2016 pollen season, younger (18 to 40 years) males, with no hay fever and no asthma were the most single and regular responders. During the TA event for new users, sex was only significantly associated with hay fever (p = 0.008) of which 60.2% of females’ responses reported having hay fever, while 43% of males’ responses did not. Those with mild symptoms peaked during the TA event. Conclusions Many individuals completed the survey on the app for the first time during the TA event indicating the potential of digital technologies to be used as indicators of health risk among populations at risk of TA events.
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Affiliation(s)
- Ala AlQuran
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Mehak Batra
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Nugroho Harry Susanto
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,Indonesia Research Partnership on Infectious Diseases, Jakarta, Indonesia
| | - Anne E Holland
- Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne, Australia.,Department of Physiotherapy, Alfred Health, Melbourne, Australia.,Institute for Breathing and Sleep, Melbourne, Australia
| | - Janet M Davies
- School of Biomedical Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, and Office of Research, Metro North Hospital and Health Service, Brisbane Australia
| | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,Faculty of Public Health, Universitas AirLangga, Surabaya, Indonesia
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14
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Emmerson KM, Silver JD, Thatcher M, Wain A, Jones PJ, Dowdy A, Newbigin EJ, Picking BW, Choi J, Ebert E, Bannister T. Atmospheric modelling of grass pollen rupturing mechanisms for thunderstorm asthma prediction. PLoS One 2021; 16:e0249488. [PMID: 33852572 PMCID: PMC8046208 DOI: 10.1371/journal.pone.0249488] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 03/18/2021] [Indexed: 01/24/2023] Open
Abstract
The world’s most severe thunderstorm asthma event occurred in Melbourne, Australia on 21 November 2016, coinciding with the peak of the grass pollen season. The aetiological role of thunderstorms in these events is thought to cause pollen to rupture in high humidity conditions, releasing large numbers of sub-pollen particles (SPPs) with sizes very easily inhaled deep into the lungs. The humidity hypothesis was implemented into a three-dimensional atmospheric model and driven by inputs from three meteorological models. However, the mechanism could not explain how the Melbourne event occurred as relative humidity was very low throughout the atmosphere, and most available grass pollen remained within 40 m of the surface. Our tests showed humidity induced rupturing occurred frequently at other times and would likely lead to recurrent false alarms if used in a predictive capacity. We used the model to investigate a range of other possible pollen rupturing mechanisms which could have produced high concentrations of SPPs in the atmosphere during the storm. The mechanisms studied involve mechanical friction from wind gusts, electrical build up and discharge incurred during conditions of low relative humidity, and lightning strikes. Our results suggest that these mechanisms likely operated in tandem with one another, but the lightning method was the only mechanism to generate a pattern in SPPs following the path of the storm. If humidity induced rupturing cannot explain the 2016 Melbourne event, then new targeted laboratory studies of alternative pollen rupture mechanisms would be of considerable value to help constrain the parameterisation of the pollen rupturing process.
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Affiliation(s)
| | - Jeremy D. Silver
- School of Mathematics and Statistics, University of Melbourne, Parkville, Victoria, Australia
| | | | - Alan Wain
- Bureau of Meteorology, Docklands, Victoria, Australia
| | - Penelope J. Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Andrew Dowdy
- Bureau of Meteorology, Docklands, Victoria, Australia
| | | | - Beau W. Picking
- School of BioSciences, University of Melbourne, Victoria, Australia
| | - Jason Choi
- Environmental Protection Authority Victoria, Macleod, Victoria, Australia
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15
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de Weger LA, van Hal PTW, Bos B, Molster F, Mostert M, Hiemstra PS. Personalized Pollen Monitoring and Symptom Scores: A Feasibility Study in Grass Pollen Allergic Patients. FRONTIERS IN ALLERGY 2021; 2:628400. [PMID: 35387060 PMCID: PMC8974794 DOI: 10.3389/falgy.2021.628400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/15/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Pollen is a major trigger for allergic symptoms in sensitized individuals. Airborne pollen is usually monitored by Hirst type pollen samplers located at rooftop level, providing a general overview of the pollen distribution in the larger surroundings. In this feasibility study, grass pollen-sensitized subjects monitored the pollen in their direct environment using a portable pollen sampler (Pollensniffer) and scored their symptoms, to study the relation between symptom severity and personal grass pollen exposure. For comparison the symptoms were also correlated with pollen collected by the rooftop sampler. Methods: After recruitment 18 participants were screened for grass pollen specific (GP-sIgE) of which 12 were eligible. Nine participants completed the study (May, 2018). They were asked to monitor personal pollen exposure using a Pollensniffer on their way to school, work or other destination, and to score their symptoms via a mobile app on a scale from 0 to 10. Daily pollen concentrations were collected by a Hirst type sampler at rooftop level. Pollen grains were analyzed using a microscope. Results: Three of the four participants with high GP-sIgE (≥9.6 kU/l) reported high symptom scores (>4) and an analysis showed a significant correlation (CC) between eye, nose, and lung symptoms and the grass pollen counts collected by the Pollensniffer, as well as the daily grass pollen concentrations monitored by the rooftop sampler (CC≥0.54). In contrast, the participants with low GP-sIgE levels (<9.6 kU/l) reported low symptom scores (≤4) and often other sensitizations were present. For these subjects, no significant positive correlations (CC<0.3) of symptoms with either grass pollen collected by the personal or the rooftop sampler were found. Conclusion: The results of this feasibility study suggest that correlations between the severity of clinical symptoms of grass pollen allergic patients, and grass pollen counts as determined by the Pollensniffer or a rooftop sampler, is restricted to patients with high GP-sIgE levels, high symptom scores, and no relevant other sensitizations. Based on the low numbers of subjects with severe symptoms included in this feasibility study, no conclusions can be drawn on the performance of the Pollensniffer in relating symptoms and pollen exposure in comparison with the rooftop sampler. Trial Registration: The study was approved by the Committee Medical Ethics of the LUMC (approval numbers: NL63953.058.17/ P17.304).
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Affiliation(s)
- Letty A. de Weger
- Department of Pulmonology, Leiden University Medical Center, Leiden, Netherlands
- *Correspondence: Letty A. de Weger
| | - Peter Th. W. van Hal
- Department of Pulmonology, Leiden University Medical Center, Leiden, Netherlands
| | - Bernadette Bos
- Department of Pulmonology, Leiden University Medical Center, Leiden, Netherlands
| | | | - Marijke Mostert
- Leiden Centre of Applied Bioscience, University of Applied Sciences, Leiden, Netherlands
| | - Pieter S. Hiemstra
- Department of Pulmonology, Leiden University Medical Center, Leiden, Netherlands
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16
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Idrose NS, Tham RCA, Lodge CJ, Lowe AJ, Bui D, Perret JL, Vicendese D, Newbigin EJ, Tang MLK, Aldakheel FM, Waidyatillake NT, Douglass JA, Abramson MJ, Walters EH, Erbas B, Dharmage SC. Is short-term exposure to grass pollen adversely associated with lung function and airway inflammation in the community? Allergy 2021; 76:1136-1146. [PMID: 32815173 DOI: 10.1111/all.14566] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/24/2020] [Accepted: 08/06/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND The association between grass pollen exposure and early markers of asthma exacerbations such as lung function changes and increase in airway inflammation is limited. We investigated the associations between short-term grass pollen exposure and lung function and airway inflammation in a community-based sample, and whether any such associations were modified by current asthma, current hay fever, pollen sensitization, age, and other environmental factors. METHODS Cross-sectional and short-term analyses of data from the Melbourne Atopy Cohort Study (MACS) participants (n = 936). Lung function was assessed using spirometry. Airway inflammation was assessed by fractional exhaled nitric oxide (FeNO) and exhaled breath condensate pH and nitrogen oxides (NOx). Daily pollen counts were collected using a volumetric spore trap. The associations were examined by linear regression. RESULTS Higher ambient levels of grass pollen 2 days before (lag 2) were associated with lower mid-forced expiratory flow (FEF25%-75% ) and FEV1 /FVC ratio (Coef. [95% CI] = -119 [-226, -11] mL/s and -1.0 [-3.0, -0.03] %, respectively) and also 3 days before (lag 3). Increased levels of grass pollen a day before (lag 1) were associated with increased FeNO (4.35 [-0.1, 8.7] ppb) and also at lag 2. Adverse associations between pollen and multiple outcomes were greater in adults with current asthma, hay fever, and pollen sensitization. CONCLUSION Grass pollen exposure was associated with eosinophilic airway inflammation 1-2 days after exposure and airway obstruction 2-3 days after exposure. Adults and individuals with asthma, hay fever, and pollen sensitization may be at higher risk.
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Affiliation(s)
- Nur Sabrina Idrose
- Allergy and Lung Health Unit Melbourne School of Population and Global Health The University of Melbourne Carlton Vic. Australia
| | - Rachel C. A. Tham
- Mary MacKillop Institute for Health Research Australian Catholic University Melbourne Vic. Australia
| | - Caroline J. Lodge
- Allergy and Lung Health Unit Melbourne School of Population and Global Health The University of Melbourne Carlton Vic. Australia
| | - Adrian J. Lowe
- Allergy and Lung Health Unit Melbourne School of Population and Global Health The University of Melbourne Carlton Vic. Australia
| | - Dinh Bui
- Allergy and Lung Health Unit Melbourne School of Population and Global Health The University of Melbourne Carlton Vic. Australia
| | - Jennifer L. Perret
- Allergy and Lung Health Unit Melbourne School of Population and Global Health The University of Melbourne Carlton Vic. Australia
| | - Don Vicendese
- Allergy and Lung Health Unit Melbourne School of Population and Global Health The University of Melbourne Carlton Vic. Australia
- Department of Mathematics and Statistics La Trobe University Bundoora Vic. Australia
| | - Edward J. Newbigin
- School of BioSciences The University of Melbourne Parkville Vic. Australia
| | - Mimi L. K. Tang
- Allergy and Immunology Murdoch Children’s Research Institute Royal Children’s Hospital Melbourne Vic Australia
- Department of Pediatrics University of Melbourne Melbourne Vic. Australia
| | - Fahad M. Aldakheel
- Department of Clinical Laboratory Sciences College of Applied Medical Sciences King Saud University Riyadh Saudi Arabia
| | - Nilakshi T. Waidyatillake
- Allergy and Lung Health Unit Melbourne School of Population and Global Health The University of Melbourne Carlton Vic. Australia
| | - Jo A. Douglass
- Department of Clinical Immunology and Allergy Royal Melbourne Hospital Parkville Vic. Australia
- Department of Medicine University of Melbourne Melbourne Vic. Australia
| | - Michael J. Abramson
- School of Public Health and Preventive Medicine Monash University Melbourne Vic. Australia
| | - Eugene Haydn Walters
- Allergy and Lung Health Unit Melbourne School of Population and Global Health The University of Melbourne Carlton Vic. Australia
- School of Medicine University of Tasmania Hobart Tas Australia
| | - Bircan Erbas
- School of Psychology and Public Health La Trobe University Bundoora Vic. Australia
| | - Shyamali C. Dharmage
- Allergy and Lung Health Unit Melbourne School of Population and Global Health The University of Melbourne Carlton Vic. Australia
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17
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Silver JD, Spriggs K, Haberle SG, Katelaris CH, Newbigin EJ, Lampugnani ER. Using crowd-sourced allergic rhinitis symptom data to improve grass pollen forecasts and predict individual symptoms. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 720:137351. [PMID: 32325552 DOI: 10.1016/j.scitotenv.2020.137351] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 02/14/2020] [Accepted: 02/14/2020] [Indexed: 06/11/2023]
Abstract
Seasonal allergic rhinitis (AR), also known as hay fever, is a common respiratory condition brought on by a range of environmental triggers. Previous work has characterised the relationships between community-level AR symptoms collected using mobile apps in two Australian cities, Canberra and Melbourne, and various environmental covariates including pollen. Here, we build on these relationships by assessing the skill of models that provide a next-day forecast of an individual's risk of developing AR and that nowcast ambient grass pollen concentrations using crowd-sourced AR symptoms as a predictor. Categorical grass pollen forecasts (low/moderate/high) were made based on binning mean daily symptom scores by corresponding categories. Models for an individual's risk were constructed by forward variable selection, considering environmental, demographic, behaviour and health-related inputs, with non-linear responses permitted. Proportional-odds logistic regression was then applied with the variables selected, modelling the symptom scores on their original five-point scale. AR symptom-based estimates of today's average grass pollen concentration were more accurate than those provided by two benchmark forecasting methods using various metrics for assessing accuracy. Predictions of an individual's next-day AR symptoms rated on a five-point scale were correct in 36% of cases and within one point on this scale in 82% of cases. Both outcomes were significantly better than chance. This large-scale AR symptoms measurement program shows that crowd-sourced symptom scores can be used to predict the daily average grass pollen concentration, as well as provide a personalised AR forecast.
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Affiliation(s)
- Jeremy D Silver
- School of Earth Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Kymble Spriggs
- Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia; Department of Allergy and Immunology, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Simon G Haberle
- School of Culture, History and Language, College of Asia and the Pacific, Australian National University Canberra, Canberra, Australian Capital Territory, Australia; ARC Centre of Excellence for Australian Biodiversity and Heritage, Australian National University, Canberra, Australian Capital Territory, Australia
| | | | - Edward J Newbigin
- School of BioSciences, University of Melbourne, Parkville, Victoria, Australia
| | - Edwin R Lampugnani
- School of BioSciences, University of Melbourne, Parkville, Victoria, Australia.
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