Abstract

Background: In Japan, pollen counts increased between 1977 and 1987, including three peaks (1978- 1980, 1982, 1984-1986) coinciding with triphasic Kawasaki disease (KD) outbreaks. Epidemiological findings have been then extensively accumulated that KD and related specific intractable diseases such as systemic vasculitis, collagen diseases, inflammatory bowel diseases, idiopathic dilated cardiomyopathy and further various cancers may be correlated to pollen exposure (PE). Methods and results: To elucidate the effects of PE on outbreaks of neurological intractable diseases (NIDs), we evaluated the annual occurrence of disorders in relation to pollen counts using data from a national database. Specifically, we evaluated the occurrence of Parkinson disease (PD), amyotrophic lateral sclerosis (ALS), Myasthenia Gravis (MG), multiple sclerosis (MS), spinocerebellar degeneration (SCD), Huntington’s disease (HUNTG), Shy-Drager syndrome, moyamoya disease and CreutzfeldtJakob disease (CJD). During 1975–2014, the 1984-86 peak of pollen scatter was the earliest big peak with which simultaneous increase in occurrence of PD, ALS, MG, MS, SCD and HUNTG coincided. Furthermore, simultaneous outbreaks of each NID coincided with subsequent ten peaks of pollen scatter till 2014. Our results showed statistically significant correlations for PD, ALS, MG, MS and SCD between the annual number of newly registered patients (nRPs) in the patient-registry year and annual pollen levels in the same patient-registry year. Significant correlations were also shown between the number of nRPs in the patient-registry year and annual pollen levels measured 3 years (PD), 6 years (PD, MG, MS, MMD), 9 years (PD, MS, MMD, CJD), 14 years (PD, CJD), and 16 years MG, MS, HUNTG and MMD before the patient-registry year. Conclusion: We assume that cumulative effects of PE during a decade or more before the diagnosis of NIDs might possibly trigger onset of NIDs when cumulative effects of PE as environmental stress overwhelmed immunoreactive threshold.

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