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

Letty A De Weger,Thijs Beerthuizen,Jacob K Sont,Jeannette M Gast‐Strookman,Ingrid Terreehorst,Dirk T Van Der Plas,Pieter S Hiemstra

doi:10.1186/2045-7022-1-18

Letty A De Weger, Thijs Beerthuizen + Show 5 more

Open Access

https://doi.org/10.1186/2045-7022-1-18

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Abstract

BackgroundFor the development of forecasts for seasonal allergic rhinitis symptoms, it is essential to understand the relationship between grass pollen concentrations and the symptoms of grass pollen allergic patients.ObjectiveThe aim of this study was to delineate this relationship between seasonal allergic rhinitis symptoms and grass pollen concentrations in the Netherlands.MethodsGrass pollen allergic patients (n = 80 [2007] - 84 [2008]) were enrolled into the study. They were asked to enter their seasonal allergic rhinitis symptoms (runny nose, sneezing, blocked nose, post nasal drip, and eye symptoms) daily on a scale from 0 to 3 to the study centre either by short message service (SMS) or by internet from May-July 2007 and April-July 2008. Daily pollen counts were used to define the early and the late grass pollen season as the period 'before and during' respectively 'after' the first grass pollen peak (more than 150 pollen/m3).ResultsAt similar grass pollen concentrations, the daily mean of the individual maximum symptom scores reported in the early season were higher as compared to that reported in the late season [differences of -0.41 (2007) and -0.30 (2008)]. This difference could not be explained by medication use by the patients nor by co-sensitization to birch.ConclusionsWe conclude that seasonal allergic rhinitis symptoms at similar grass pollen concentrations are more severe in the early flowering season as compared to those in the late flowering season. This finding is not only relevant for development of forecasts for seasonal allergic rhinitis symptoms but also for understanding symptom development and planning and analysis of clinical studies.

Highlights

For the development of forecasts for seasonal allergic rhinitis symptoms, it is essential to understand the relationship between grass pollen concentrations and the symptoms of grass pollen allergic patients
We conclude that seasonal allergic rhinitis symptoms at similar grass pollen concentrations are more severe in the early flowering season as compared to those in the late flowering season
All participants were subjected to: (i) screening of their medical history; (ii) performance of skin prick tests with pollen, house dust mite (Dermatophagoides pteronyssinus and D. farinae), dog and cat; and (iii) a general physical examination and a nasal examination to exclude the existence of nasal pathology interfering with the scoring of seasonal allergic rhinitis symptoms

Summary

Introduction

For the development of forecasts for seasonal allergic rhinitis symptoms, it is essential to understand the relationship between grass pollen concentrations and the symptoms of grass pollen allergic patients. Allergic rhinitis is amongst the most common chronic diseases of the world It results from IgE-mediated inflammation after allergen exposure of the nasal mucosa and includes symptoms such as rhinorrhea, nasal obstruction, nasal itching and sneezing [1]. The majority of these patients (70-80%) report ocular symptoms [2]. It should be noted that in most of these intervention studies a selected patient population is studied with more severe seasonal allergic rhinitis

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