Peak Pollen Research Articles

The interaction of environment and genetic diversity within meadows of the seagrass Posidonia australis (Posidoniaceae)

Understanding the extent and impact of factors influencing the levels and structur- ing of genetic diversity within natural populations is a key objective of ecological genetics. For marine angiosperms, variation in abiotic environmental factors at the local scale can have a major influence on levels of clonality and spatial genetic structure, and thus influence mating systems, sexual reproduction, and recruitment. Identifying the key drivers of genetic structuring is critical for genetic management of ecological restoration success, especially in systems where the nature and extent of clonality is highly variable. Here, we quantify clonality and patterns of genetic structure in the temperate Australian seagrass Posidonia australis. We examine the loca- tion of meadows in relation to water movement and prevailing winds to assess their relative influence on local spatial genetic structuring. Measures of genetic diversity, assessed with 7 polymorphic microsatellite loci, were highly variable across 13 meadows sampled within and around a natural embayment on the west coast of Australia. The overall structure of P. australis meadows across this region is best explained as one of 'chaotic' genetic patchiness, with signifi- cant differentiation among most meadows (pairwise FST values), high levels of genetic diversity in meadows that are in more open waters, and lower genetic diversity at inshore sites facing strong prevailing winds at the time of seed dispersal or that have little water movement. A strong isolation by distance relationship within the embayment is consistent with prevailing winds (which create surface currents) at the time of peak pollen and seed release, strongly influencing dispersal direction.

The effect of component-resolved diagnosis on specific immunotherapy prescription in children with hay fever

Sensitization to profilins and other cross-reacting molecules might hinder proper specific immunotherapy (SIT) prescription in polysensitized patients with pollen-related allergic rhinitis (AR). In these patients, component-resolved diagnosis (CRD) might modify SIT prescription by improving the identification of the disease-eliciting pollen sources. We sought to measure the effect of CRD on SIT prescription in children with pollen-related AR. Children (n = 651) with moderate-to-severe pollen-related AR were recruited between May 2009 and June 2011 in 16 Italian outpatient clinics. Skin prick test (SPT) reactivity to grass, cypress, olive, mugwort, pellitory, and/or Betulaceae pollen was considered clinically relevant if symptoms occurred during the corresponding peak pollen season. IgE sensitization to Phl p 1, Phl p 5, Bet v 1, Cup a 1, Art v 1, Ole e 1, Par j 2, and Phl p 12 (profilin) was measured by using ImmunoCAP. SIT prescription was modeled on SPT responses first and then remodeled considering also CRD according to GA(2)LEN-European Academy of Allergology and Clinical Immunology guidelines and the opinions of 14 pediatric allergists. No IgE to the respective major allergens was detected in significant proportions of patients with supposed clinically relevant sensitization to mugwort (45/65 [69%]), Betulaceae (146/252 [60%]), pellitory (78/257 [30%]), olive (111/390 [28%]), cypress (28/184 [15%]), and grass (56/568 [10%]). IgE to profilins, polcalcins, or both could justify 173 (37%) of 464 of these SPT reactions. After CRD, the SPT-based decision on SIT prescription or composition was changed in 277 (42%) of 651 or 315 (48%) of 651 children according to the European or American approach, respectively, and in 305 (47%) of 651 children according to the opinion of the 14 local pediatric allergists. In children with pollen-related AR, applying CRD leads to changes in a large proportion of SIT prescriptions as opposed to relying on clinical history and SPT alone. The hypothesis that CRD-guided prescription improves SIT efficacy deserves to be tested.

Association between first airborne cedar pollen level peak and pollinosis symptom onset: a web-based survey

Cedar pollinosis in Japan affects nearly 25 % of Japanese citizens. To develop a treatment for cedar pollinosis, it is necessary to understand the relationship between the time of its occurrence and the amount of airborne cedar pollen. In the spring of 2009, we conducted daily Internet-based epidemiologic surveys, which included 1453 individuals. We examined the relationship between initial date of onset of pollinosis symptoms and daily amount of airborne cedar pollen to which subjects were exposed. Approximately 35.2 % of the subjects experienced the onset of pollinosis during a one-week interval in which the middle day coincided with the peak pollen count. The odds ratio for this one-week time interval was 4.03 (95 % confidence interval: 3.34–4.86). The predicted date of the cedar pollen peak can be used to determine the appropriate date for initiation of self-medication with anti-allergy drugs and thus avoid development of sustained and severe pollinosis.

Beneficial Effects of Citrus Juice Fermented with Lactobacillus plantarum YIT 0132 on Japanese Cedar Pollinosis.

Recently, the prevalence of allergies in Japan has been increasing. Certain types of fruit juice and lactic acid bacteria are known to alleviate allergic symptoms. Therefore, we examined whether citrus juice fermented by a specific lactic acid bacteria can improve the symptoms of Japanese cedar pollinosis (JCPsis). Lactobacillus plantarum YIT 0132 (LP0132) was selected based on its high proliferative activity in citrus juice and anti-inflammatory interleukin-10-inducing activity. Dietary administration of heat-killed LP0132 cells or citrus juice fermented with LP0132 was found to significantly suppress nasal rubbing in a JCPsis mouse model, indicating relief of allergy symptoms. To evaluate the effects of LP0132-fermented citrus juice on pollinosis symptoms and quality of life (QOL) in humans with JCPsis, a single-blind, placebo-controlled, parallel-group clinical trial was conducted. The participants were 42 adults with JCPsis. They ingested 100 mL of sterilized LP0132-fermented citrus juice (active group) or unfermented citrus juice (placebo group) once daily for 8 weeks. Immediately after the pollen peak when allergy symptoms and QOL loss were most severe, itchy eyes, itchy skin, and QOL loss by JCPsis were alleviated in the active group compared with the placebo group. At 10 weeks after starting the intervention, increased the levels of blood eosinophils were significantly suppressed in the active group compared with the placebo group. We conclude that continuous ingestion of citrus juice fermented with LP0132 may help alleviate the allergy symptoms and impaired QOL caused by JCPsis.

Beneficial Effects of Citrus Juice Fermented with Lactobacillus plantarum YIT 0132 on Japanese Cedar Pollinosis

Recently, the prevalence of allergies in Japan has been increasing. Certain types of fruit juice and lactic acid bacteria are known to alleviate allergic symptoms. Therefore, we examined whether citrus juice fermented by a specific lactic acid bacteria can improve the symptoms of Japanese cedar pollinosis (JCPsis). Lactobacillus plantarum YIT 0132 (LP0132) was selected based on its high proliferative activity in citrus juice and anti-inflammatory interleukin-10-inducing activity. Dietary administration of heat-killed LP0132 cells or citrus juice fermented with LP0132 was found to significantly suppress nasal rubbing in a JCPsis mouse model, indicating relief of allergy symptoms. To evaluate the effects of LP0132-fermented citrus juice on pollinosis symptoms and quality of life (QOL) in humans with JCPsis, a single-blind, placebo-controlled, parallel-group clinical trial was conducted. The participants were 42 adults with JCPsis. They ingested 100 mL of sterilized LP0132-fermented citrus juice (active group) or unfermented citrus juice (placebo group) once daily for 8 weeks. Immediately after the pollen peak when allergy symptoms and QOL loss were most severe, itchy eyes, itchy skin, and QOL loss by JCPsis were alleviated in the active group compared with the placebo group. At 10 weeks after starting the intervention, increased the levels of blood eosinophils were significantly suppressed in the active group compared with the placebo group. We conclude that continuous ingestion of citrus juice fermented with LP0132 may help alleviate the allergy symptoms and impaired QOL caused by JCPsis.

'Benifuuki' Green Tea Containing O-Methylated Catechin Reduces Symptoms of Japanese Cedar Pollinosis: A Randomized, Double- Blind, Placebo-Controlled Trial

Methylated catechin, one of the active ingredients in green tea, has been reported to ameliorate allergic reactions. We evaluated the efficacy of 'Benifuuki' green tea, which contains O-methylated epigallocatechin-3-O-[3-O-methyl] gallate (O-methylated EGCG), in alleviating Japanese cedar pollinosis (JCP). The study was a double-blind, randomized, placebo-controlled trial. The subjects with JCP were randomly assigned to drink 700 ml of 'Benifuuki' green tea containing O-methylated EGCG or 'Yabukita' green tea (not containing O-methylated EGCG) as a placebo every day from December 2007 through March 2008, which includes the pollen season. The primary outcome was the area under the curve (AUC) of symptom scores during the peak pollen season. Fifty-one adults with JCP participated in the study. Twenty-six subjects were assigned to 'Benifuuki' and 25 to 'Yabukita'. The AUC of symptom score during the peak pollen season in the 'Benifuuki' group was significantly smaller than in the 'Yabukita' group for each of runny nose, itchy eyes, tearing, total nasal symptom score, total ocular symptom score, nasal symptom-medication score and ocular symptom-medication score. The total QOL-related questionnaire score for one week in the peak pollen season was significantly better in the 'Benifuuki' group. Increase in the peripheral eosinophil count in response to pollen exposure was suppressed in the 'Benifuuki' group. No adverse events were reported in either group. 'Benifuuki' green tea containing a large amount of O-methylated EGCG reduced the symptoms of JCP and has potential as a complementary/alternative medicine for treating seasonal allergic rhinitis.

The correlation between allergy sensitization rate in pediatric and aerobiological study for airborne pollen in Busan for 15 years

Purpose: Airborne pollen is the most common causative agents of allergic disease. Since 2000, there isn``t no more report about airborne pollen in Busan. This study is that pollen in one area of Busan was collected to investigate species, particle counts, seasonal distribution, and of its correlation with reactivity to skin prick test in children during 1998-2012. Methods: Rotorod sampler was installed on the rooftop of St. Mary Hospital in Busan. A 24-hour sampling of airborne allergens over a fifteen-year period was conducted 6 days/wk from January 1, 1998 to December 31, 2012. After staining they were identified, counted and recorded with the weather in Busan. Results: Major pollens collected were Pine, Alder, Oak, Juniperus, Humulus. The pollen season is relatively short and the pollen dispersed mainly during the period from March to May in case of tree pollen, from April to September in case of grass pollen and from August to October in case of weed pollen. Total annual pollen count ranged from 36,412 grains/m3 (2002) to 1,342 grains/m3 (2006). The peak pollen season was seen for spring and autumn, especially in May and September during 1998-2012. In skin prick tests, birch was the highest sensitization rate (15.1%), followed by alder (14.7%), hazel (14.1%) in the tree for 15 years. And in weed, mugwort and ragweed were the highest sensitization rate (10.6%, 10.3%), followed by humulus (5.5%) for 15 years, but since 2008, was increased. Conclusion: Analysis of pollens sampled in the atmosphere of Busan, Korea, for a 15-year period identified 24 species of pollens with seasonal variation of some clinically important pollen load. Analysis of data, it showed that alder and birch are main allergen in spring for 15 years, and in 1998-2008, ragweed and artemisia was main allergen in fall, since 2009, followed by humulus. (Allergy Asthma Respir Dis 2014;2:38-47)

The weak effects of climatic change on Plantago pollen concentration: 17 years of monitoring in Northwestern Spain

Plantago L. species are very common in nitrified areas such as roadsides and their pollen is a major cause of pollinosis in temperate regions. In this study, we sampled airborne pollen grains in the city of León (NW, Spain) from January 1995 to December 2011, by using a Burkard® 7-day-recording trap. The percentage of Plantago pollen compared to the total pollen count ranged from 11% (1997) to 3% (2006) in the period under study. Peak pollen concentrations were recorded in May and June. Our 17-year analysis failed to disclose significant changes in the seasonal trend of plantain pollen concentration. In addition, there were no important changes in the start dates of pollen release and the meteorological parameters analyzed did not show significant variations in their usual trends. We analyzed the influence of several meteorological parameters on Plantago pollen concentration to explain the differences in pollen concentration trends during the study. Our results show that temperature, sun hours, evaporation, and relative humidity are the meteorological parameters best correlated to the behavior of Plantago pollen grains. In general, the years with low pollen concentrations correspond to the years with less precipitation or higher temperatures. We calculated the approximate Plantago flowering dates using the cumulative sum of daily maximum temperatures and compared them with the real bloom dates. The differences obtained were 4 days in 2009, 3 days in 2010, and 1 day in 2011 considering the complete period of pollination.

Environmental behaviour of airborne Amaranthaceae pollen in the southern part of the Iberian Peninsula, and its role in future climate scenarios

The Amaranthaceae family includes a number of species which, through a series of specific adaptations, thrive in salty soils, arid environments and altered human settlements. Their ability to tolerate high temperatures favours summer flowering, giving rise to the widespread involvement of Amaranthaceae pollen grains in summer allergies, both in Mediterranean Europe and in areas with arid climates. This study analysed a 21-year set of historical airborne Amaranthaceae pollen records for an area located in the southern part of the Iberian Peninsula, in order to chart species' environmental reaction to changing climate conditions which occurred in the last decades. Airborne pollen data were collected from January 1991 to December 2011 using a Hirst-type volumetric impact sampler. Results showed that Amaranthaceae pollen remained in the atmosphere for over 6months along the year, from early spring until early autumn. The annual Pollen Index ranged from barely 200 grains to almost 2000 grains, and was strongly influenced by rainfall during the flowering period, which prompted the development of new individuals and thus an increase in pollen production. A trend was noted towards increasingly early pollen peak dates; peaks were recorded in August–September in years with summer rainfall, but as early as May–June in years when over 50% of annual rainfall was recorded in the months prior to flowering. The gradual decline in the annual Pollen Index over later years is attributable not only to growing urbanisation of the area but also to a change in rainfall distribution pattern. High maximum temperatures in spring were also directly related to the peak date and the Pollen Index. This ability to adapt to changeable and occasionally stressful and restrictive, environmental conditions places Amaranthaceae at a competitive advantage with respect to other species sharing the same ecological niche. An increased presence of Amaranthaceae is likely to have a greater impact on future scenarios for pollen allergy diseases associated with climate change.

Do specialized flowers promote reproductive isolation? Realized pollination accuracy of three sympatric Pedicularis species

Interest in pollinator-mediated evolutionary divergence of flower phenotype and speciation in plants has been at the core of plant evolutionary studies since Darwin. Specialized pollination is predicted to lead to reproductive isolation and promote speciation among sympatric species by promoting partitioning of (1) the species of pollinators used, (2) when pollinators are used, or (3) the sites of pollen placement. Here this last mechanism is investigated by observing the pollination accuracy of sympatric Pedicularis species (Orobanchacae). Pollinator behaviour was observed on three species of Pedicularis (P. densispica, P. tricolor and P. dichotoma) in the Hengduan Mountains, south-west China. Using fluorescent powder and dyed pollen, the accuracy was assessed of stigma contact with, and pollen deposition on, pollinating bumble-bees, respectively. All three species of Pedicularis were pollinated by bumble-bees. It was found that the adaptive accuracy of female function was much higher than that of male function in all three flower species. Although peak pollen deposition corresponded to the optimal location on the pollinator (i.e. the site of stigma contact) for each species, substantial amounts of pollen were scattered over much of the bees' bodies. The Pedicularis species studied in the eastern Himalayan region did not conform with Grant's 'Pedicularis Model' of mechanical reproductive isolation. The specialized flowers of this diverse group of plants seem unlikely to have increased the potential for reproductive isolation or influenced rates of speciation. It is suggested instead that the extreme species richness of the Pedicularis clade was generated in other ways and that specialized flowers and substantial pollination accuracy evolved as a response to selection generated by the diversity of co-occurring congeners.

The effect of the meteorological factors on the Alnus pollen season in Lublin (Poland)

Alder pollen seasons and the effect of meteorological conditions on daily average pollen counts in the air of Lublin (Poland) were analysed. Alnus pollen grains reach very high concentrations in the atmosphere of this city during the early spring period and the parameters of pollen seasons were very different in the particular years studied. The pollen season lasted on average one month. The highest variation was observed for the peak value and the Seasonal Pollen Index (SPI). The pollen seasons, which started later, had shorter duration. Peak daily average pollen counts and SPI value were higher during the shorter seasons. Similarities in the stages of pollen seasons designated by the percentage method depended on the start date of the pollen season. Season parameters were mainly correlated with thermal conditions at the beginning of the year. Regression analysis was used to predict certain characteristics of the alder pollen season. The highest level of explanation of the variation in Alnus pollen season start and peak dates was obtained in the model using mean temperature in February. The obtained regression models may predict 82% of the variation in the pollen season start date, 73% of the variation in the duration, and 62% in the peak date.

Immunotherapy Safety: What Have We Learned from Surveillance Surveys?

Subcutaneous allergen immunotherapy (SCIT) is beneficial for the treatment of allergic rhinitis, asthma, and in preventing stinging insect anaphylaxis, but is not without risks. Four retrospective surveillance surveys and one on-going national prospective study have attempted to characterize the incidence and risk factors for fatal and non-fatal SCIT reactions. These studies have contributed significantly to currently recommended SCIT safety guidelines. Recent surveillance studies indicate stable SR rates, and a possible decline in the incidence of fatal reactions since the implementation of evidence-based safety guidelines. This review will provide a detailed summary of the evidence from surveillance studies for risk factors associated with SCIT reactions, including: uncontrolled asthma, prior systemic reactions, dosing during peak pollen seasons, epinephrine being delayed or not given, dosing or administration errors, inadequate waiting times, reactions occurring more than 30 min after injections, injections given in medically unsupervised settings, concomitant beta-blocker and angiotensin-converting enzyme inhibitor (ACEi) use, and accelerated build-up regimens.

The pollen counts as bioindicator of meteorological trends and tool for assessing the status of endangered species: the case of Artemisia in Sierra Nevada (Spain)

This study sought to analyse the effects of climate change on Artemisia species growing in Sierra Nevada, a high mountain range in the south-east of the Iberian Peninsula, using pollen counts as a bioindicator. The study also examined the impact of Recovery Programmes implemented for the most endangered of these species. Analysis of historical Artemisia pollen-data series from 1992 to 2011 showed that flowering took place between late July and late September, but the trend towards higher summer temperatures detected over the series as a whole appeared to have delayed the start of flowering and brought forward the end of flowering, thus prompting a shortening of the season. A trend was also observed towards a delayed peak pollen period, together with a significant decline in the Annual Pollen Index, which was significantly influenced by rainfall over the months immediately prior to flowering. Recovery Programmes implemented for three species—Artemisia granatensis, A. alba subsp. nevadensis and A. umbelliformis—involved conservation measures including direct seeding and planting of seedlings. From the outset, these programmes led to a recovery of the Pollen Index, especially when using germinated seedlings, which adapted better than seeds to environmental conditions. In conclusion, pollen records proved to be a useful tool for assessing the status of endangered species.

AAAAI and ACAAI surveillance study of subcutaneous immunotherapy, Year 3: what practices modify the risk of systemic reactions?

ObjectiveTo define the incidence of and clinical practices associated with subcutaneous immunotherapy (SCIT)–related systemic reactions (SRs). MethodsFrom 2008-2011, American Academy of Allergy, Asthma & Immunology and American College of Allergy, Asthma & Immunology members completed an annual survey of SCIT-related SRs of varying severity (with grade 1 indicating mild; grade 2, moderate; and grade 3, severe anaphylaxis). From 2010-2011 (year 3) data were collected regarding SCIT-related procedures, including screening of patients with asthma, dose adjustment during peak pollen seasons, build-up regimens (conventional, cluster, or rush), and premedication. ResultsNo fatal reactions were directly or indirectly reported from 2008-2011. The SR rates were similar for all 3 years (0.1% of injection visits; 83% of practices), as were severity grades. On average, for all 3 years, there were 7.1 grade 1, 2.6 grade 2, and 0.4 grade 3 SRs per 10,000 injection visits. Screening for worsening asthma symptoms was highly prevalent (86% always screened). Practices that always reduced doses during peak pollen season were significantly less likely to report grade 2 or 3 SRs (44% vs 65%; P = .04). Cluster and rush build-up were associated with significantly more SRs (P < .001). Practices that premedicated were significantly more likely to report grade 2 and 3 SRs (P < .01). ConclusionFatal reactions to SCIT appear to be declining, possibly related to almost universal screening of asthmatic patients. Adjusting doses during the pollen season may be associated with decreased risk for severe SRs. Cluster and rush immunotherapy were associated with increased risk for SRs. Premedication by practices reporting SRs likely reflects past experience with SRs.

Impact of 2003 heat waves on aerobiological indices of allergenic herbaceous family pollen season in Tuscany (Italy)

The aim of this study was to assess the current aerobiological situation and to investigate the influence of the hot and dry summer 2003 on pollen season (onset, end and duration of the pollen season, peak pollen day and value, total seasonal amount of pollen grains) of herbaceous family as Poaceae, Urticaceae and Compositeae. Heat wave of 2003 influenced the phenology of the main pollen families in Tuscany: the high temperatures occurred during 2003 affected pollen season of different family with different responses. This study confirms the role that the climate has on the flora species and in particular on herbaceous species phenology and the high variability of the pollination among different places, during extreme events. In general, high spring temperature induces an advance of the flowering period and a release of higher pollen quantity of Urticaceae and Poaceae; however, exceptional weather conditions (i.e., summer 2003) could exert an opposite effect, resulting in an impairment of flowering of Urticaceae during autumn. Compositeae species produced a low amount of pollen in 2003, even if the peak value was higher than the average in some stations.

Classification of Allergic Rhinitis: What is Most Suitable in Korea?

Classification of Allergic Rhinitis: What is Most Suitable in Korea?

Forecasting the Poaceae pollen season in eastern Poland

The aim of the present study was to develop forecast models for the grass pollen season by using regression analyses to predict such characteristics as onset, duration and peak pollen concentration (values and timing). The study shows a negative correlation between seasonal pollen index (SPI) and season duration as well as strong correlations between some features of the pollen season and meteorological data. The forecasting models may predict 86–98% of the variation in pollen onset and duration of the pollen season. Less satisfactory results were obtained for the peak date and peak value. The best prediction was obtained for the season duration. The mean minimum temperature of March and cloud cover in the first 10-day period of May were the best variables for forecasting the start of the grass pollen season in Lublin. The rainfall in May was the most important factor to determine season duration. When the developed models are applied for pollen season forecasting, it is possible to predict the season onset and duration with an accuracy of up to one or two days.

Seasonal Specificity of Seasonal Allergens and Validation of the ARIA Classification in Korea

PurposeIn Korea, tree pollens are known to be prevalent in spring, grass pollens in summer and weed pollens in autumn. However, few studies have revealed their seasonal specificity for allergic rhinitis symptoms. An ARIA (Allergic Rhinitis and its Impact on Asthma) classification of allergic rhinitis was recently introduced and its clinical validation has not been well proved. The aim of this study was to evaluate the seasonal specificity of seasonal allergens and to validate the ARIA classification with the conventional seasonal and perennial allergic rhinitis (SAR/PAR) classification.MethodsTwo hundred twenty six patients with allergic rhinitis were included in this study. The patients were classified according to the sensitized allergens and the ARIA classifications. A questionnaire survey was performed and the data on the seasonal symptom score, the severity of symptoms and the SNOT (sinonasal outcome test)-20 score was obtained and the data was analyzed and compared between the conventional SAR/PAR classification and the ARIA classification.ResultsSeasonal pollens (tree, grass, weed) were not specific to the pollen peak season and the patients' symptoms were severe during spring and autumn regardless of the offending pollens. More than 60% of the patients with SAR showed persistent symptoms and 33% of the patients with perennial allergic rhinitis (PAR) had intermittent symptoms, showing the lack of association between the SAR/PAR/PAR+SAR classification and the ARIA classification. The ARIA classification showed better association not only with the symptomatic score, but also with the SNOT-20 score, which showed better validity than the conventional SAR/PAR classifications.ConclusionsSeasonal pollens were not specific to their season of prevalence in terms of the severity of symptoms, and the ARIA classification showed better representation of allergic symptoms and quality of life (SNOT-20 score) than did the SAR/PAR classification.

Climate sensitivity of allergenic taxa in Central Europe associated with new climate change related forces

The aim of the study was to analyse trends of the pollen season with its duration, start and end dates, as well as trends of the annual total pollen count and annual peak pollen concentration for the Szeged agglomeration in Southern Hungary. The data set covered an 11-year period (1997–2007) that included eight taxa and seven daily climate variables. Trend analysis was performed on both annual and daily bases. Trend analysis on a daily basis is a new approach that provides information on the annual cycles of the trends. To quantify the strength of the relationship between the annual cycle of the slope of a pollen concentration trend and the annual cycles of the slopes of the climate variable trends, an association measure and a multiple association measure are introduced. Individual taxa were sorted into three categories according to their climate sensitivities. These were compared with two novel climate change-related forces, namely risk potential and expansion potential due to the climate change. The total annual pollen counts indicated significant trends for 4 taxa and 3 of these 4 trends increased on a daily basis. At the same time, significant changes were detected for the pollen season characteristics of three taxa. The association measures performed well when compared to the climate change-related forces. Significant changes in pollen season characteristics were also in accordance with the risk potential and expansion potential due to the climate change. A novel procedure was applied to separate the effects of the past and current weather conditions that influence the current Ambrosia pollen concentrations. The potential effect of land use changes on pollen release of the given taxa was also discussed using the CORINE Land Cover Database.

Assessment of specific immunotherapy efficacy using a novel placebo score–based method

BackgroundIn trials of allergen immunotherapy, allergen exposure is typically assessed by pollen counts, but these may misrepresent exposure if performed remotely from multiple study centers. ObjectiveTo assess whether symptomatology in placebo-treated patients is a better measure of local allergen burden at individual centers in such trials. MethodsData from a multicenter, placebo-controlled trial of preseasonal grass pollen immunotherapy were reanalyzed to identify the 4 weeks at each center in which the placebo-treated subjects had the highest combined symptom/medication scores (CSMS). The difference in CSMS between active and placebo groups was compared during the 4 peak placebo score weeks (PlSW) and the 4 peak pollen count weeks (PoCW). ResultsThe benefit of immunotherapy over placebo in the PlSW analysis (18.5%) was greater than in the PoCW analysis (13.6%), with increased statistical significance (P = .0001, .0038, respectively). Similar improved discrimination was observed when analyzing benefits in subgroups of patients with severe symptoms, a high disease burden, and in different geographical locations. ConclusionThis novel PlSW analysis results in better discrimination of the effects of allergen immunotherapy compared with placebo and may be widely applicable in similar studies, both prospectively and retrospectively.