Seasonal Hay Fever Research Articles

Effect of antihistamine-releasing contact lenses on ocular symptoms and treatment behavior in patients with seasonal allergic conjunctivitis: A retrospective study

PurposeThis study aimed to compare subjective allergic conjunctivitis symptoms and anti-allergic eye drop use patterns between antihistamine-releasing contact lens users and daily disposable soft contact lens users during Japan's hay fever season. MethodsThis web-based retrospective cohort study included daily disposable soft contact lens or antihistamine-releasing contact lens users with a history of seasonal allergic conjunctivitis who regularly used daily disposable soft contact lenses since the previous year. The total ocular symptom score (range 0–20) based on 5-item questionnaire scores and time from the start of the hay fever season to the initiation of anti-allergic eye drop treatment were compared between antihistamine-releasing contact lens users and daily disposable soft contact lens users. ResultsThe study included 24 participants: 17 using daily disposable soft contact lenses and 7 using antihistamine-releasing contact lenses. Antihistamine-releasing contact lens users experienced a greater reduction in total ocular symptom score from 2021 to 2022 compared with daily disposable soft contact lens users (mean total ocular symptom score [standard deviation]: daily disposable soft contact lens: −0.65 [1.4], antihistamine-releasing contact lens: −4.7 [3.6]; n = 24; Mann–Whitney U test, P = 0.010). Fourteen daily disposable soft contact lens users and five antihistamine-releasing contact lens users eventually required anti-allergic eye drops. Kaplan–Meier analysis revealed a significant delay in the initiation of anti-allergic eye drop treatment among those using antihistamine-releasing contact lenses compared with those using daily disposable soft contact lenses (median days, daily disposable soft contact lenses: 19 days, antihistamine-releasing contact lens: 57 days; n = 24; log-rank test, P = 0.045). ConclusionsAntihistamine-releasing contact lenses can potentially mitigate worsening ocular allergic responses during the hay fever season when used appropriately as a preventive measure.

Influenza season influence on outcome of new nodules in the NELSON study

We evaluated the impact of the influenza season on outcome of new lung nodules in a LDCT lung cancer screening trial population. NELSON-trial participants with ≥ 1 new nodule detected in screening rounds two and three were included. Outcome (resolution or persistence) of new nodules detected per season was calculated and compared. Winter (influenza season) was defined as 1st October to 31st March, and compared to the summer (hay-fever season), 1st April to 30th September. Overall, 820 new nodules were reported in 529 participants. Of the total new nodules, 482 (59%) were reported during winter. When considering the outcome of all new nodules, there was no statistically significant association between summer and resolving nodules (OR 1.07 [CI 1.00–1.15], p = 0.066), also when looking at the largest nodule per participant (OR 1.37 [CI 0.95–1.98], p = 0.094). Similarly, there was no statistically significant association between season and screen detected cancers (OR 0.47 [CI 0.18–1.23], p = 0.123). To conclude, in this lung cancer screening population, there was no statistically significant association between influenza season and outcome of new lung nodules. Hence, we recommend new nodule management strategy is not influenced by the season in which the nodule is detected.

Individual multidisciplinary clinical phenotypes of nasal and ocular symptoms in hay fever: Crowdsourced cross-sectional study using AllerSearch

BackgroundMultidisciplinary efforts to prospectively collect and analyze symptoms of hay fever are limited. We aimed to identify the characteristics of nasal and ocular symptoms of hay fever, using the AllerSearch smartphone application. MethodsThis mobile health-based prospective observational study using the AllerSearch smartphone application was conducted between February 1, 2018, and May 1, 2020. Individuals who downloaded AllerSearch from Japan and provided comprehensive self-assessments (including 17 items related to quality of life [QoL]-related items) were included. The characteristics and risk factors for allergic rhinitis (AR) and allergic conjunctivitis (AC) were identified using hierarchical heat maps and multivariate logistic regression. ResultsOf the 9041 participants with hay fever, 58.8% had AR and AC, 22.2% had AR, and 5.7% had AC. The AR–AC comorbid cohort showed worse symptoms of hay fever and QoL scores than the other cohorts. Factors (odds ratio, 95% confidence interval) associated with AR–AC included a lower age (0.98, 0.97–0.98), female sex (1.31, 1.19–1.45), liver disease (1.58, 1.26–2.35), dry eye disease (1.45, 1.30–1.63), unknown dry eye disease status (1.46, 1.31–1.62), contact lens use discontinuation during the hay fever season (1.69, 1.28–2.23), and bedroom flooring material other than hardwood, carpet, tatami, or vinyl (1.91, 1.16–3.14). ConclusionsAnalysis of medical big data for hay fever performed using a mobile health app helped identify risk factors and characteristics of AC, AR, and AR–AC. Phenotyping of highly variable symptoms of hay fever, such as nasal and ocular symptoms, can facilitate better-quality clinical care.

Effects of a Probiotic Formulation on Seasonal Allergic Rhinitis in Adults-A Randomized Double-Blind Placebo-Controlled Trial: The Probiotics for Hay Fever Trial.

BackgroundSeasonal-allergic-rhinitis (hay fever) affects approximately 4.6 million (20%) Australians each year. Hay fever manifests as runny/blocked nose and often itchy/sore/swollen eyes, with symptoms greatly impacting the quality of life. Rescue medications such as antihistamines are often needed to restore function, but they may trigger some other unwanted side effects. Probiotics have shown promise to reduce hay fever symptoms.ObjectiveIn this randomized double-blind placebo-controlled 12-week trial, we aimed to assess the tolerability and efficacy of the probiotic formula “NC-Seasonal-Biotic” on symptoms, quality-of-life, and immunological and microbial factors.MethodsAdults, who had previously suffered from hay fever symptoms, were screened for eligibility and randomly allocated to probiotic or placebo trial powder. Treatment effectiveness was assessed by questionnaires, daily total-nasal-symptom-score, and weekly rhinoconjunctivitis quality-of-life questionnaire. Secondary outcome measures included immunological parameters such as T-cell immunity (Th1/Th2 ratio) and the stool-microbiome analysis. Tolerability was assessed weekly by the gastrointestinal symptom scale.ResultsRecruitment and follow-up were challenging around the 2020/2021 hay fever season in Melbourne, Australia, due to the harsh COVID-19 restrictions and extended lockdowns. Out of the 82 adults enrolled in this study, 75% participated (n = 60), and half (n = 40) completed the 10–12-week intervention period. In the intention-to-treat analysis, no significant differences in hay fever symptoms were apparent between the groups, while quality-of-life trended toward greater improvement in the active group. Intention-to-treat analysis was confounded due to a third of all participants not completing the full 10–12-week-intervention period. Subgroup analyses of the participants (n = 40) completing the full 10–12-week study period revealed a significantly greater reduction in symptoms in the active group compared with the placebo group, including runny nose (p = 0.04) and itchy eyes (p = 0.01). Furthermore, the active group reported significant improvements in the quality-of-life, including more functionality during the day (p = 0.05), better sleep (p = 0.005), less fatigue (p = 0.04), less thirst (p = 0.007), and less irritability (p = 0.007). Immunological parameters, measured by T-helper cell ratio (Th1/Th2), improved significantly in the active group compared with the placebo group. Most microbial changes were not statistically different between the groups. The trial powder was generally well tolerated.ConclusionOur study suggests the probiotic formula “NC-Seasonal-Biotic,” taken for 10–12 weeks, as effective in reducing hay fever symptoms, such as runny nose and itchy eyes, and improved the quality-of-life and immunological parameters while being well tolerated.Clinical Trial Registration[www.ClinicalTrials.gov], identifier [ACTRN126200 01078943].

Individual characteristics and associated factors of hay fever: A large-scale mHealth study using AllerSearch

BackgroundThe prevalence of hay fever, a multifactorial allergic disease, is increasing. Identifying individual characteristics and associated factors of hay fever is essential for predictive, preventive, personalized, and participatory (P4) medicine. This study aimed to identify individual characteristics and associated factors of hay fever using an iPhone application AllerSearch. MethodsThis large-scale mobile health-based cross-sectional study was conducted between February 2018 and May 2020. Individuals who downloaded AllerSearch in Japan and provided a comprehensive self-assessment (general characteristics, medical history, lifestyle habits, and hay fever symptoms [score range 0–36]) were included. Associated factors of hay fever (vs. non-hay fever) and severe hay fever symptoms were identified using multivariate logistic and linear regression analyses, respectively. ResultsOf the included 11,284 individuals, 9041 had hay fever. Factors associated with hay fever (odds ratio) included age (0.98), female sex (1.33), atopic dermatitis (1.40), history of dry eye diagnosis (1.36), discontinuation of contact lens use during hay fever season (3.34), frequent bowel movements (1.03), and less sleep duration (0.91). The factors associated with severe hay fever symptoms among individuals with hay fever (coefficient) included age (−0.104), female sex (1.329), history of respiratory disease (1.539), history of dry eye diagnosis (0.824), tomato allergy (1.346), discontinuation of contact lens use during hay fever season (1.479), smoking habit (0.614), and having a pet (0.303). ConclusionsOur large-scale mobile health-based study using AllerSearch elucidated distinct hay fever presentation patterns, characteristics, and factors associated with hay fever. Our study establishes the groundwork for effective individualized interventions for P4 medicine.

Seasonal prevalence and characteristics of low-dose CT detected lung nodules in a general Dutch population

We investigated whether presence and characteristics of lung nodules in the general population using low-dose computed tomography (LDCT) varied by season. Imaging in Lifelines (ImaLife) study participants who underwent chest LDCT-scanning between October 2018 and October 2019 were included in this sub-study. Hay fever season (summer) was defined as 1st April to 30th September and Influenza season (winter) as 1st October to 31st March. All lung nodules with volume of ≥ 30 mm3 (approximately 3 mm in diameter) were registered. In total, 2496 lung nodules were found in 1312 (38%) of the 3456 included participants (nodules per participant ranging from 1 to 21, median 1). In summer, 711 (54%) participants had 1 or more lung nodule(s) compared to 601 (46%) participants in winter (p = 0.002). Of the spherical, perifissural and left-upper-lobe nodules, relatively more were detected in winter, whereas of the polygonal-, irregular-shaped and centrally-calcified nodules, relatively more were detected in summer. Various seasonal diseases with inflammation as underlying pathophysiology may influence presence and characteristics of lung nodules. Further investigation into underlying pathophysiology using short-term LDCT follow-up could help optimize the management strategy for CT-detected lung nodules in clinical practice.

The evolution of IgE-mediated type I hypersensitivity and its immunological value.

The allergic phenotype manifests itself in a spectrum of troublesome to life-threatening diseases, from seasonal hay fever, through the food allergies, atopic eczema, asthma, to anaphylaxis. Allergy, that is an overreaction to allergen in hypersensitive individuals, results from the production of IgE, mast cell and basophil sensitisation and degranulation, requiring a range of medications to manage the conditions. Yet it is highly likely that allergy evolved for a purpose and that allergic diseases are accidental consequences of an insufficiently regulated immune response. This article presents a viewpoint from which to restore the immunological reputation of the allergic phenotype. We consider the evolutionary origins of potential allergens, toxins and parasites, and how they might have influenced early-mammal species in existence when IgE first developed. We conclude that the allergic phenotype has likely saved the lives of many more mammals than have ever died from allergy, so justifying the positive role of IgE in our evolution.

William Frankland: the “grandfather of allergy”

Photo credit: Imperial College London William Frankland (“Bill”), the British clinical allergist who transformed global understanding of allergies, has died aged 108. He developed the pollen count in order to...

Diversity of Grasses as Producers of Atmospheric Aerosol Pollen Component

The article provides the results of a study dealing with pollen release into the atmosphere by 23 species from 21 genera of the Poaceae Barnh family. The species under investigation are the dominant ones in natural plant communities and are used as components in turf plant ^communities and belong to the group of ornamental grasses. Their pollen causes seasonal hay fever (allergic rhinitis), which accounts for the interest in the regularities of its drift. The drift distance is determined by the particles sedimentation velocity and depends on the number of pollen grains they include. The study estimates the cluster composition of pollen particles released into the atmosphere. All species under consideration massively form clusters consisting of two or more grains. Their share was 11,1-50,8%, the share of pollen grains in them was – 21.9-84,0%.

Allergic rhinitis: assessing the triggers and treatments

As hay fever season approaches again, Hetal Dhruve explains its causes and most effective treatments

Quality of Life during the hay fever season after short-course subcutaneous immunotherapy with Lolium perenne peptides (LPP) in grass pollen related rhinoconjunctivitis: A RDBPCT

Quality of Life during the hay fever season after short-course subcutaneous immunotherapy with Lolium perenne peptides (LPP) in grass pollen related rhinoconjunctivitis: A RDBPCT

T Follicular Helper (Tfh) Cells are Activated by Natural Exposure to Pollens During the Ragweed Hay Fever Season

T Follicular Helper (Tfh) Cells are Activated by Natural Exposure to Pollens During the Ragweed Hay Fever Season

Recent Updates in Inflammatory Ocular Diseases

Inflammatory ocular diseases cover a wide spectrum of conditions and are a growing public health concern. Dry eye disease is one of the most common conditions seen by eye care practitioners. Allergic conjunctivitis is also a highly prevalent condition, especially during hay fever season. In addition to these well characterized disorders, less-common inflammatory conditions such as Sjögren’s syndrome and Stevens-Johnson syndrome also affect the eyes. Early diagnosis of these conditions is essential to optimize outcomes. In an expert interview, Bennie Jeng, Professor and Chair of the Department of Ophthalmology and Visual Sciences at the University of Maryland School of Medicine, discusses some of the latest advances in the diagnosis and treatment of inflammatory eye disorders.

Effective techniques for asthma control in hay fever season

Viv Marsh discusses how patients can be supported to manage asthma and allergic rhinitis

Asthma control in the hay fever season

People with asthma frequently also have allergic rhinitis. Seasonal factors have been implicated in asthma deaths, particularly in children and young people. Viv Marsh discusses how patients can be supported to self-manage their conditions effectively Asthma is the most common long-term respiratory disease in the UK ( Asthma UK, 2016 ), and people with asthma frequently also have seasonal allergic rhinitis or hay fever, which can affect their asthma control. Asthma can be life threatening if uncontrolled. While there are clear links between the two conditions, management must be disease- and symptom-focused. Personalised asthma action plans (PAAPs) can support patients in self-management of their asthma and can help to remind them of their seasonal triggers and management options for their symptoms.

The discovery of IgE 50 years later

In 1906, Von Pirquet1 used the term supersensitivity without immunity to describe (1) symptoms of inhalant allergy, (2) positive immediate skin test results, and (3) the fact that the results of other tests of immunity were not positive in these patients. The other tests he referred to were precipitin tests and complement fixation. Thus, he opened up the question of serum tests for supersensitivity. In 1919, Ramirez2 reported that a patient who had received a blood transfusion from a horse allergic donor became allergic to horse dander. At this point, Prausnitz and Kustner3 set out to investigate whether the serum of allergic individuals contained a factor or factors that could sensitize the skin. In 1921, they reported that the local injection of serum from a fish allergic individual, Kustner, to an individual who was only allergic to pollen, Prausnitz, would transfer specific sensitivity.3 This transfer of sensitivity came to be known as the P-K test and was used widely to study sensitivity not only to common allergens but also to extracts as diverse as those obtained from schistosomes.4,5 Furthermore, in New York, Cooke et al6 identified that there were other antibodies in the serum that increased during desensitization treatment and could block the skin-sensitizing activity. By the 1950s, it was clear that the transferred sensitivity was specific, that it could be diluted extensively, and that the skin remained locally sensitive for days if not weeks after the injection of serum.7,8 It was also already clear that the ability to sensitize the skin was lost after moderate heating of the serum.7 Several studies had also been reported on the physical properties of P-K activity. Indeed, Heimlich et al9 at Cal Tech reported on the sedimentation properties of skin-sensitizing antibodies in 1960. However, the studies before 1964 had not succeeded in defining the nature of these antibodies.

Quantitative DNA Analyses for Airborne Birch Pollen.

Birch trees produce large amounts of highly allergenic pollen grains that are distributed by wind and impact human health by causing seasonal hay fever, pollen-related asthma, and other allergic diseases. Traditionally, pollen forecasts are based on conventional microscopic counting techniques that are labor-intensive and limited in the reliable identification of species. Molecular biological techniques provide an alternative approach that is less labor-intensive and enables identification of any species by its genetic fingerprint. A particularly promising method is quantitative Real-Time polymerase chain reaction (qPCR), which can be used to determine the number of DNA copies and thus pollen grains in air filter samples. During the birch pollination season in 2010 in Mainz, Germany, we collected air filter samples of fine (<3 μm) and coarse air particulate matter. These were analyzed by qPCR using two different primer pairs: one for a single-copy gene (BP8) and the other for a multi-copy gene (ITS). The BP8 gene was better suitable for reliable qPCR results, and the qPCR results obtained for coarse particulate matter were well correlated with the birch pollen forecasting results of the regional air quality model COSMO-ART. As expected due to the size of birch pollen grains (~23 μm), the concentration of DNA in fine particulate matter was lower than in the coarse particle fraction. For the ITS region the factor was 64, while for the single-copy gene BP8 only 51. The possible presence of so-called sub-pollen particles in the fine particle fraction is, however, interesting even in low concentrations. These particles are known to be highly allergenic, reach deep into airways and cause often severe health problems. In conclusion, the results of this exploratory study open up the possibility of predicting and quantifying the pollen concentration in the atmosphere more precisely in the future.

Common Immune-Related Exposures/Conditions and Risk of Non-Hodgkin Lymphoma: A Case-Control Study of Disease-Discordant Twin Pairs

We evaluated the association between common immune system-altering experiences and non-Hodgkin lymphoma (NHL) risk using a case-control study of 162 like-sex twin pairs discordant for NHL, identified from the International Twin Study. Information on medical history and evidence of childhood exposure to microbes was obtained by questionnaire from 1998 to 2002. Conditional logistic regression was used to estimate odds ratios and 95% confidence intervals. Intra-twin-pair agreement between twins on individual exposures was high (76%-97%). A negative association between NHL and seasonal hay fever (odds ratio (OR) = 0.28, 95% confidence interval (CI): 0.10, 0.75) and certain allergies (OR = 0.29, 95% CI: 0.13, 0.68) was observed. The number of atopic diseases was negatively associated with NHL (P for trend = 0.0003). A history of infectious mononucleosis was negatively associated with NHL risk (OR = 0.35, 95% CI: 0.14, 0.90). NHL risk was associated with more frequent childhood exposure to microbes during early life (P for trend = 0.04). No differences in association by NHL subtype were observed, although statistical power for these comparisons was low. These observations support the hypothesis that immune-related exposures, especially atopy, are associated with decreased NHL risk. Use of the within-twin-pair study design mitigates confounding by genome, family structure, and unmeasured characteristics of early childhood factors.

Helping children thrive during hay fever season

Hay fever is not just a nuisance for children but can affect their social development and educational attainment. Jane Scullion and Steve Holmes explain how to help them avoid that

The bronchial hyperactivity in children with pollinosis (834.9)

Aim of the study was to develop an easy available technique of lung function monitoring in pollinosis patients to predict the clinical course of disease both in seasonal exacerbation period and during the winter remission. Material: We studied 98 children with pollinosis aged 6‐14 years. Peak flow (PF) parameters were studied 3 times per day, namely in the morning, lunch time and in the evening, from the first of April to 30th October. Patients’ history records included hay fever symptoms and peak flow data. The curves of PF were drawn for disease monitoring and prediction. Results: Analyzing the daily changes of peak expiratory flow parameters, we estimated that in children with hay fever sensibilization to Artemisia species without evident asthma symptoms already at the second season peak expiratory flow decreased by 15‐20% and during the third season decreased further by 30% from the best parameters of the first year.Most striking in our studies was the finding that after the pollination season especially in children with disease duration more than 3 years and who did not receive the specific immunotherapy the level of changes decreased, but the type of PF curve didn’t change. In prognosis the most important was the possibility of pollen asthma appeared in most children already during the second hay fever season and was easy predictable by “bad” peak expiratory flow curves ‐ second and third type.