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Gilles S, Akdis C, Lauener R, Schmid-Grendelmeier P, Bieber T, Schäppi G, Traidl-Hoffmann C. The role of environmental factors in allergy: A critical reappraisal. Exp Dermatol 2018; 27:1193-1200. [PMID: 30099779 DOI: 10.1111/exd.13769] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 07/26/2018] [Accepted: 08/07/2018] [Indexed: 12/12/2022]
Abstract
Allergies are usually referred to as type I hypersensitivity reactions against innocuous environmental antigens, characterized by a Th2/IgE-dominated inflammation. They can manifest themselves in various organs, such as skin, gastrointestinal and respiratory tract, and comprise diseases as diverse as allergic rhinitis and conjunctivitis, bronchial asthma, oral allergy syndrome, food allergy, urticaria and atopic eczema, but also anaphylactic shock. Within the last decades, there was a significant global increase in allergy prevalence, which has been mostly attributed to changes in environment and lifestyle. But which, among all factors discussed, are the most relevant, and what are the mechanisms by which these factors promote or prevent the development of allergic diseases? To answer this, it is necessary to go back to the two key questions that have occupied allergy researchers for the last decades: Firstly, what makes an allergen an allergen? Secondly, why are more and more individuals affected? Within the last decade, we have made considerable progress in answering these questions. This review gives an overview over scientific progress in the field, summarizes latest findings and points out future prospective and research needs.
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Affiliation(s)
- Stefanie Gilles
- Chair and Institute of Environmental Medicine, UNIKA-T, Technical University of Munich, Augsburg, Germany
| | - Cezmi Akdis
- Swiss Institute of Allergy and Asthma Research, University of Zürich, Davos, Switzerland.,Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Roger Lauener
- Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland.,Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland
| | - Peter Schmid-Grendelmeier
- Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland.,Allergy Unit, Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland
| | - Thomas Bieber
- Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland.,Department of Dermatology and Allergy, University of Bonn, Bonn, Germany
| | - Georg Schäppi
- Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland.,Hochgebirgsklinik Davos, Davos-Wolfgang, Switzerland
| | - Claudia Traidl-Hoffmann
- Chair and Institute of Environmental Medicine, UNIKA-T, Technical University of Munich, Augsburg, Germany.,Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
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Obersteiner A, Gilles S, Frank U, Beck I, Häring F, Ernst D, Rothballer M, Hartmann A, Traidl-Hoffmann C, Schmid M. Pollen-Associated Microbiome Correlates with Pollution Parameters and the Allergenicity of Pollen. PLoS One 2016; 11:e0149545. [PMID: 26910418 PMCID: PMC4765992 DOI: 10.1371/journal.pone.0149545] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 02/02/2016] [Indexed: 12/11/2022] Open
Abstract
Pollen allergies have been rapidly increasing over the last decades. Many allergenic proteins and non-allergenic adjuvant compounds of pollen are involved in the plant defense against environmental or microbial stress. The first aim of this study was to analyze and compare the colonizing microbes on allergenic pollen. The second aim was to investigate detectable correlations between pollen microbiota and parameters of air pollution or pollen allergenicity. To reach these aims, bacterial and fungal DNA was isolated from pollen samples of timothy grass (Phleum pratense, n = 20) and birch trees (Betula pendula, n = 55). With this isolated DNA, a terminal restriction fragment length polymorphism analysis was performed. One result was that the microbial diversity on birch tree and timothy grass pollen samples (Shannon/Simpson diversity indices) was partly significantly correlated to allergenicity parameters (Bet v 1/Phl p 5, pollen-associated lipid mediators). Furthermore, the microbial diversity on birch pollen samples was correlated to on-site air pollution (nitrogen dioxide (NO2), ammonia (NH3), and ozone (O3)). What is more, a significant negative correlation was observed between the microbial diversity on birch pollen and the measured NO2 concentrations on the corresponding trees. Our results showed that the microbial composition of pollen was correlated to environmental exposure parameters alongside with a differential expression of allergen and pollen-associated lipid mediators. This might translate into altered allergenicity of pollen due to environmental and microbial stress.
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Affiliation(s)
- Andrea Obersteiner
- Research Unit Microbe-Plant Interactions, Helmholtz Zentrum München—German Research Centre for Environmental Health (GmbH), Neuherberg, Germany
| | - Stefanie Gilles
- Institute of Environmental Medicine, UNIKA-T, Technische Universität München, Augsburg, Germany
- CK Care, Christine-Kühne-Center for Allergy Research and Education, Davos, Switzerland
| | - Ulrike Frank
- Institute of Biochemical Plant Pathology, Helmholtz Zentrum München–German Research Centre for Environmental Health (GmbH), Neuherberg, Germany
| | - Isabelle Beck
- Institute of Environmental Medicine, UNIKA-T, Technische Universität München, Augsburg, Germany
| | - Franziska Häring
- Institute of Environmental Medicine, UNIKA-T, Technische Universität München, Augsburg, Germany
| | - Dietrich Ernst
- Institute of Biochemical Plant Pathology, Helmholtz Zentrum München–German Research Centre for Environmental Health (GmbH), Neuherberg, Germany
| | - Michael Rothballer
- Research Unit Microbe-Plant Interactions, Helmholtz Zentrum München—German Research Centre for Environmental Health (GmbH), Neuherberg, Germany
| | - Anton Hartmann
- Research Unit Microbe-Plant Interactions, Helmholtz Zentrum München—German Research Centre for Environmental Health (GmbH), Neuherberg, Germany
| | - Claudia Traidl-Hoffmann
- Institute of Environmental Medicine, UNIKA-T, Technische Universität München, Augsburg, Germany
- CK Care, Christine-Kühne-Center for Allergy Research and Education, Davos, Switzerland
| | - Michael Schmid
- Research Unit Microbe-Plant Interactions, Helmholtz Zentrum München—German Research Centre for Environmental Health (GmbH), Neuherberg, Germany
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Barber D, Díaz-Perales A, Villalba M, Chivato T. Challenges for allergy diagnosis in regions with complex pollen exposures. Curr Allergy Asthma Rep 2015; 15:496. [PMID: 25504260 DOI: 10.1007/s11882-014-0496-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Over the past few decades, significant scientific progress has influenced clinical allergy practice. The biological standardization of extracts was followed by the massive identification and characterization of new allergens and their progressive use as diagnostic tools including allergen micro arrays that facilitate the simultaneous testing of more than 100 allergen components. Specific diagnosis is the basis of allergy practice and is always aiming to select the best therapeutic or avoidance intervention. As a consequence, redundant or irrelevant information might be adding unnecessary cost and complexity to daily clinical practice. A rational use of the different diagnostic alternatives would allow a significant improvement in the diagnosis and treatment of allergic patients, especially for those residing in complex pollen exposure areas.
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Affiliation(s)
- Domingo Barber
- Institute for Applied Molecular Medicine (IMMA) School of Medicine, Universidad CEU San Pablo, 28668, Madrid, Spain,
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Ihler F, Canis M. Ragweed-induced allergic rhinoconjunctivitis: current and emerging treatment options. J Asthma Allergy 2015; 8:15-24. [PMID: 25733916 PMCID: PMC4337734 DOI: 10.2147/jaa.s47789] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Ragweed (Ambrosia spp.) is an annually flowering plant whose pollen bears high allergenic potential. Ragweed-induced allergic rhinoconjunctivitis has long been seen as a major immunologic condition in Northern America with high exposure and sensitization rates in the general population. The invasive occurrence of ragweed (A. artemisiifolia) poses an increasing challenge to public health in Europe and Asia as well. Possible explanations for its worldwide spread are climate change and urbanization, as well as pollen transport over long distances by globalized traffic and winds. Due to the increasing disease burden worldwide, and to the lack of a current and comprehensive overview, this study aims to review the current and emerging treatment options for ragweed-induced rhinoconjunctivitis. Sound clinical evidence is present for the symptomatic treatment of ragweed-induced allergic rhinoconjunctivitis with oral third-generation H1-antihistamines and leukotriene antagonists. The topical application of glucocorticoids has also been efficient in randomized controlled clinical trials. Combined approaches employing multiple agents are common. The mainstay of causal treatment to date, especially in Northern America, is subcutaneous immunotherapy with the focus on the major allergen, Amb a 1. Beyond this, growing evidence from several geographical regions documents the benefit of sublingual immunotherapy. Future treatment options promise more specific symptomatic treatment and fewer side effects during causal therapy. Novel antihistamines for symptomatic treatment are aimed at the histamine H3-receptor. New adjuvants with toll-like receptor 4 activity or the application of the monoclonal anti-immunoglobulin E antibody, omalizumab, are supposed to enhance conventional immunotherapy. An approach targeting toll-like receptor 9 by synthetic cytosine phosphate–guanosine oligodeoxynucleotides promises a new treatment paradigm that aims to modulate the immune response, but it has yet to be proven in clinical trials.
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Affiliation(s)
- Friedrich Ihler
- Department of Otorhinolaryngology, University Medical Center Göttingen, Göttingen, Germany
| | - Martin Canis
- Department of Otorhinolaryngology, University Medical Center Göttingen, Göttingen, Germany
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Stemeseder T, Hemmer W, Hawranek T, Gadermaier G. Marker allergens of weed pollen - basic considerations and diagnostic benefits in the clinical routine: Part 16 of the Series Molecular Allergology. ALLERGO JOURNAL INTERNATIONAL 2014; 23:274-280. [PMID: 26120538 PMCID: PMC4479474 DOI: 10.1007/s40629-014-0033-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 08/25/2014] [Indexed: 10/28/2022]
Abstract
The term weed is referring to plants used as culinary herbs and medicinal plants as well as ecologically adaptive and invasive segetal plants. In Europe, pollen of ragweed, mugwort, English plantain and pellitory are the main elicitors of weed pollen allergies. Presently, 35 weed pollen allergens have been identified. The most relevant belong to the protein families of pectate lyases, defensin-like proteins, non-specific lipid transfer proteins, and Ole e 1-like proteins. The sensitization frequency depends on geographic regions and might affect more than 50 % of pollen allergic patients in distinct regions. Due to overlapping flowering seasons, similar habitats, polysensitizations and cross-reactive (pan)-allergens, it is difficult to diagnose genuine weed pollen sensitization using pollen extracts. Marker allergens for component-resolved diagnostics are available for the important weed pollen. These are Amb a 1 (ragweed), Art v 1 (mugwort), Pla l 1 (English plantain) and Par j 2 (pellitory). Molecule-based approaches can be used to identify the primary sensitizer and thus enable selection of the appropriate weed pollen extracts for allergen immunotherapy.
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Affiliation(s)
- Teresa Stemeseder
- />Department of Molecular Biology, University of Salzburg, Salzburg, Austria
| | | | - Thomas Hawranek
- />Department of Dermatology, Paracelsus Private Medical University Salzburg, Salzburg, Österreich
| | - Gabriele Gadermaier
- />Department of Molecular Biology, University of Salzburg, Salzburg, Austria
- />Christian Doppler Laboratory for Biosimilar Characterization, University of Salzburg, Salzburg, Austria
- />Christian Doppler Laboratory for Biosimilar Characterization Department of Molecular Biology, University of Salzburg, Hellbrunnerstraße 34, 5020 Salzburg, Austria
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Stemeseder T, Hemmer W, Hawranek T, Gadermaier G. Markerallergene von Kräuterpollen — Grundlagen und diagnostischer Nutzen im klinischen Alltag. ALLERGO JOURNAL 2014. [DOI: 10.1007/s15007-014-0718-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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