Pollen Season Research Articles

The Effect of Glasgow Prognostic Score And Systemic Inflammatory Index On Mortality In Patients With Postoperative Pneumonia

The Effect of Glasgow Prognostic Score And Systemic Inflammatory Index On Mortality In Patients With Postoperative Pneumonia

Air Pollen Monitoring in a Specific Region as a Part of the Pollinosis Prevention

Background: The prevalence and severity of allergic diseases, including pollinosis, are increasing worldwide. Hay fever develops due to the complex interaction of genes and manifests itself due to exogenous factors. The main environmental etiology of allergy is plant pollen. Continuous study and analysis of the air pollen spectrum constitute the basis of air monitoring and are important in developing preventive measures for allergic diseases. Objective: To perform an air pollen monitoring in Kr snodar and to assess the treatment of patients with pollinosis in various cities and districts of the Krasnodar Region according to the Krasnodar Regional Allergy Center data. Materials and methods: We retrospectively analyzed the patients seeking medical care due to allergy in the Krasnodar Region using the statistical data obtained in 2022 from the Krasnodar Regional Allergy Center. We assessed the effects of air pollen pollution according to the data of air pollen monitoring in Krasnodar during the main activity of herbaceous plants’ taxa (from April 1, 2022 to October 31, 2022). We used AeRobiology and Microsoft Excel 2010 tools for data processing and development of the main parameters of the pollen season. Results: According to the Krasnodar Regional Allergy Center data, there were 37,212 people diagnosed with J45.0, J46 and 20,012 people diagnosed with J30.1-30.4 in 2022. We identified 8 allergenic taxa of herbaceous plants in the Krasnodar air. We found that the total seasonal pollen concentration increased by an average of 1.8 in 2022 compared to previous monitoring periods in 2018-2021. Conclusions: Comparative assessment of the prevalence of pollinosis and the air pollen monitoring are important for effective medical care.

Phenology as a tool to gain more insights into the grass pollen season

Abstract Background Grass pollen allergy is the most common pollen allergy in the world. The grass family (Poaceae) consists of many genera and species of allergenic importance, but all share a uniform pollen grain morphology. Phenology is the key to discriminate different taxa. Methodology PubMed was used as the search engine. The publications found were selected based on their relevance and summarized. Results Studies with this focus are still rare. The composition of grass genera and species varies largely from region to region. Some taxa play a more important role in terms of pollen release and allergenicity than others. Conclusion Phenological routines need deep botanical knowledge and are time-consuming. Nonetheless, they should be integrated into studies on the grass pollen season since they allow a more precise understanding.

Impact of meteorological parameters and air pollutants on airborne concentration of Betula pollen and Bet v 1 allergen

The intensity of birch pollen season is expressed by seasonal pollen integral (SPIn, the sum of the mean daily pollen concentration during the birch pollination period) and the amount of Bet v 1 allergen released per birch pollen grain expressed by pollen allergen potency (PAP). Betula pollen and Bet v 1 allergen were simultaneously measured in the air of Bratislava from 2019 to 2022 by using two Burkard traps (Hirst-type and cyclone) in order to evaluate the causes of the seasonal variation in the SPIn and PAP levels. The highest SPIn (19,975 pollen/m3) was observed in 2022 and the lowest one (1484 pollen/m3) in 2021. The average daily PAP level (4.0 pg Bet v 1/pollen) was highest in 2019 and lowest (2.5 pg Bet v 1/pollen) in 2020. We found that seasonal variation in SPIn was associated mainly with the changes in environmental conditions during the pre-season period, whereas the year-to-year variation in PAP levels was attributed to environmental conditions during both pre- and in-season periods. Our results indicate that rainy weather in June 2020 and cold overcast weather in January‒February 2021 resulted in low SPIn in 2021. On the other hand, dry weather in June 2021 and warm weather in January‒February 2022 resulted in high SPIn in 2022. The low average daily PAP level in 2020 was associated with (1) low levels of gaseous air pollutants in March, when the ripening of pollen takes place; (2) an earlier start of the birch main pollen season (MPS); and (3) dry weather during the MPS. On the other hand, high PAP level in 2019 was associated with higher levels of air pollutants in March and during the MPS.

Supplementation of Dihomo-γ-Linolenic Acid for Pollen-Induced Allergic Symptoms in Healthy Subjects: A Randomized, Double-Blinded, Placebo-Controlled Trial.

Dihomo-γ-linolenic acid (DGLA) is an n-6 polyunsaturated fatty acid that has been shown to have anti-inflammatory and anti-allergic effects in mice and cell study. To date, however, no human intervention study has examined the effects of DGLA. Therefore, we investigated the effects of DGLA on pollen-induced allergic symptoms in healthy adults. We performed a randomized, double-blind, placebo-controlled, parallel-group study comprising healthy Japanese men and women. Each subject received four 250 mg capsules providing 314 mg DGLA/day (DGLA group, n = 18) or olive oil (placebo group, n = 15) for 15 weeks. The primary outcomes, classification of the severity of allergic rhinitis symptoms (CSARS), and the Japanese Rhino-conjunctivitis Quality of Life Questionnaire (JRQLQ) served as symptom scores during the pollen season. In the DGLA group, the cedar pollen associated symptoms of sneezing and a blocked nose in the CSARS were significantly lower than those in the placebo group (p < 0.05, p < 0.01, respectively). Significant trends were observed the symptoms of runny nose in the CSARS and total symptom score (TSS) in the JRQLQ for cedar pollen (p < 0.1). To our knowledge, this is the first study to report the effects of DGLA in humans, and the results suggest that DGLA is effective in reducing allergic symptoms caused by pollen.

Alnus Airborne Pollen Trends during the Last 26 Years for Improving Machine Learning-Based Forecasting Methods

Black alder (Alnus glutinosa (L.) Gaertn.) is a species of tree widespread along Europe and belongs to mixed hardwood forests. In urban environments, the tree is usually located along watercourses, as is the case in the city of Ourense. This taxon belongs to the betulaceae family, so it has a high allergenic potential in sensitive people. Due to the high allergenic capacity of this pollen type and the increase in global temperature produced by climate change, which induces a greater allergenicity, the present study proposes the implementation of a Machine Learning (ML) model capable of accurately predicting high-risk periods for allergies among sensitive people. The study was carried out in the city of Ourense for 28 years and pollen data were collected by means of the Hirst trap model Lanzoni VPPS-2000. During the same period, meteorological data were obtained from the meteorological station of METEOGALICIA in Ourense. We observed that Alnus airborne pollen was present in the study area during winter months, mainly in January and February. We found statistically significant trends for the end of the main pollen season with a lag trend of 0.68 days per year, and an increase in the annual pollen integral of 112 pollen grains per year and approximately 12 pollen grains/m3 per year during the pollen peak. A Spearman correlation test was carried out in order to select the variables for the ML model. The best ML model was Random Forest, which was able to detect those days with medium and high labels.

Prolonging the period of allergenic burden: late-flowering grasses and local peculiarities

Summary Background The grass pollen season is characterized by a particularly long duration, covering the months May to July in Europe but can vary depending on the altitude and geographical location. Methods Three grass species whose flowering period takes place late in the season are discussed in detail: Phragmites australis (common reed), Miscanthus spp. (silvergrass), and Zea mays (maize). Results Phragmites australis flowers between August and September and provides significant pollen concentrations at sites with large reed populations. Miscanthus spp. flowers from August to October and is found as an ornamental plant in urban areas and as a crop plant in rural areas. Zea mays flowers from July to October and can cause discomfort especially in the vicinity of cornfields. Discussion Phenological observations are an important part of aerobiological routine work to gain insights into regional peculiarities like late-flowering grasses, which play a role in prolonging the duration of the grass pollen season.

Diurnal pattern of Poaceae and Betula pollen flight in Central Europe

In Central Europe the most common allergies are provoked by grass or birch pollen allergens. We determined the intra-daily behavior of airborne pollen grains of grasses (Poaceae) and birch (Betula ssp.) in Central Europe, based on data obtained from a network of automatic pollen monitors over Europe (www.pollenscience.eu). Our aim was to determine the time of day when the lowest concentrations occur, to provide allergic individuals the optimal time to ventilate their homes. The study was carried out in three Central European capitals, Berlin (Germany), Paris-Saclay (France), and Luxembourg (Luxembourg), as well as in eight stations in Germany (Altötting, Feucht, Garmisch-Partenkirchen, Hof, Marktheidenfeld, Mindelheim, Munich and Viechtach). The diurnal rhythm of these eleven locations was analyzed for either the complete, first week, peak week, peak day and last week of the pollen season. The data studied were reported as pollen/m3 measured in 3 h periods. Stations were classified as city, semi-populated or countryside areas using land-use and population density criteria.Grass pollen has a more pronounced diurnal rhythm than birch pollen concentrations. A significant difference was observed when comparing day (6–21 h) versus night (21–6 h) for all stations. No difference was detected between city and countryside for both pollen types, although for Poaceae a longer period of maximum concentrations was observed in big cities and higher day/night-time differences were registered in the countryside (6.4) than in cities (3.0). The highest pollen concentrations were observed between 9 and 18 h for grass, but the rhythm was less pronounced for birch pollen. For allergic individuals who want to bring in fresh air in their homes, we recommend opening windows after 21 h, but even better early in the morning between 6 and 9 h before pollinations (re)starts.

Clinical efficacy in one-year treatment with Artemisia annua-SLIT drops in monosensitized and polysensitized individuals

PurposeSeasonal allergic rhinoconjunctivitis (SARC) caused by Artemisia seriously affects patients' quality of life in northern China. This study aimed to estimate further the efficacy and safety of a one-year course of Artemisia annua-sublingual immunotherapy (SLIT) on SARC patients. Materials and methodsThis was an open-label, randomized, controlled, single-centre study involving 150 SARC patients induced by Artemisia, randomized to SLIT group (n = 75, SLIT along with pharmacotherapy) or control group (n = 75, pharmacotherapy only). According to the skin prick test (SPT) results, the SLIT group was divided into monosensitized and polysensitized groups to analyze the influence of sensitization status on the efficacy of Artemisia annua-SLIT. The clinical indicators of this study were total rhinoconjunctivitis symptom score (TRSS), total medication score (TMS), combined scores of medication and rhinoconjunctivitis symptom (CSMRS), and score of visual analog scale (VAS). Safety was evaluated by the occurrence of adverse events (AEs). Daily administration of the drops was recorded in diaries by the patients. ResultsAfter nearly one year of treatment and follow-ups, there was a significant decline in TRSS, TMS, CSMRS, and VAS from the baseline scores in the SLIT group (p < 0.001). However, as pollen counts increased in 2022, indicators above in the control group increased significantly during the peak pollen phase (PPP) in 2022 grass pollen season (GPS) compared to the baseline. Meanwhile, we found no significant difference in TRSS, TMS, CSMRS, and VAS between the monosensitized and polysensitized groups (p > 0.05). Moreover, the result indicated that the clinical improvement in TRSS, TMS, CSMRS, and VAS was still observed in polysensitized patients who were allergic to Artemisia pollen and sensitized to house dust mite (HDM) (n = 15) in PPP of 2022, compared to the baseline value (p < 0.001). ConclusionArtemisia annua-SLIT was proven effective, tolerable and safe in patients with SARC after nearly one year of treatment, whether monosensitization or polysensitization.

Birch-induced allergic rhinitis: Results of exposure during nasal allergen challenge, environmental chamber, and pollen season

BackgroundPollen variation can affect field study data quality. Nasal allergen challenge (NAC) is considered the gold standard for evaluating allergic rhinitis, while environmental exposure chambers (EECs) are mainly used in phase 2 drug development studies. We aimed to study birch-induced allergic rhinitis under 3 different conditions. MethodsThis study included 30 participants allergic to birch pollen, based on birch skin prick test, specific immunoglobulin E (IgE), and positive NAC. Participants were exposed to placebo twice, followed by 2 consecutive 4-h birch airborne exposures, repeated on 2 occasions to evaluate reproducibility and priming effect. Nasal response was defined as total corrected nasal symptom score (ΔTNSS) ≥ 5 during NAC and EEC. The primary end-point was to measure TNSS during the last 2 h of first allergen exposure. TNSS was also analyzed during natural exposure. ResultsThe dose most commonly yielding positive TNSS during NAC was 175.2 ng/200 μL. Eighteen participants experienced ΔTNSS ≥5 during the last 2 h of the first exposure, whereas 21 had positive responses at all 4 exposures. Mean ΔTNSS was 1 with placebo versus 6 with birch. Exposures were reproducible, with no observed priming effect. Airborne Bet v 1 was 25 ng/m3, while the pollen measurement was 279/m3 during pollen season. TNSS reached 5 in 67.9% of participants during peak pollen season. ConclusionEEC outcomes were similar to those obtained with NAC and natural exposure, suggesting the usefulness of EEC in allergic rhinitis studies. The primary end-point was reached, as 60% of participants experienced nasal responses.

Seasonal Hydrodynamic Forecasts of INM-CM5 Model for Estimation of the Start of the Birch Pollen Season

The experimental seasonal forecasts of the INM-CM5 climate model were used as input data for the temperature-time phenological model of birch dusting. Within the framework of the joint model, a test technology was developed for seasonal forecasting of the timing of the beginning of birch dusting in the European territory of Russia. Verification of this technology on seasonal retrospective forecasts of the INM-CM5 model (1991–2019) showed an adequate reproduction of the birch dusting start dates calculated for the same period according to the ERA5 reanalysis. The mean systematic errors are ±2 days, and the spatial correlation coefficients are above +0.84. The forecasts of the date of dusting start in 2022, calculated from the experimental operational seasonal forecasts of the INM-CM5 model with a monthly lead-time and with a zero lead-time, are also evaluated. It is shown that the errors in forecasting the beginning of dusting are ±5–10 days, and the forecasts with a one-month lead-time have fewer errors. The obtained results allow us to conclude that the seasonal forecast of the surface temperature of the INM-CM5 model can be used as input information for the temperature-time phenological model for the operational forecast of the timing of the start of birch dusting in the European territory of Russia.

Short-course subcutaneous treatment with PQ Grass strongly improves symptom and medication scores in grass allergy.

A modified grass allergen subcutaneous immunotherapy (SCIT) product with MicroCrystalline Tyrosine and monophosphoryl lipid-A as an adjuvant system (Grass MATA MPL [PQ Grass]) is being developed as short-course treatment of grass-pollen allergic rhinitis (SAR) and/or rhinoconjunctivitis. We sought to evaluate the combined symptom and medication score (CSMS) of the optimized cumulative dose of 27,600 standardized units (SU) PQ Grass in a field setting prior to embarking on a pivotal Phase III trial. In this exploratory, randomized, double-blind, placebo-controlled trial subjects were enrolled across 14 sites (Germany and the United States of America). Six pre-seasonal subcutaneous injections of PQ Grass (using conventional or extended regimens) or placebo were administered to 119 subjects (aged 18-65 years) with moderate-to-severe SAR with or without asthma that was well-controlled. The primary efficacy endpoint was CSMS during peak grass pollen season (GPS). Secondary endpoints included Rhinoconjunctivitis Quality of Life Questionnaire standardized (RQLQ-S) and allergen-specific IgG4 response. The mean CSMS compared to placebo was 33.1% (p = .0325) and 39.5% (p = .0112) for the conventional and extended regimens, respectively. An increase in IgG4 was shown for both regimens (p < .01) as well as an improvement in total RQLQ-S for the extended regimen (mean change -0.72, p = .02). Both regimens were well-tolerated. This trial demonstrated a clinically relevant and statistically significant efficacy response to PQ Grass. Unprecedented effect sizes were reached for grass allergy of up to ≈40% compared to placebo for CSMS after only six PQ Grass injections. Both PQ Grass regimens were considered equally safe and well-tolerated. Based on enhanced efficacy profile extended regime will be progressed to the pivotal Phase III trial.

Practical issues of using emollients for the prevention of exacerbations of atopic dermatitis during the flowering season: expert resolution

In February 2023, a meeting of the Council of Experts was held, attended by leading specialists in the fields of allergology, pediatrics and dermatology. The working group discussed the problem of sensitization to pollen allergens in patients with atopic dermatitis (AD) and exacerbation of the disease during the pollination season of plants, as well as the formation of epicutaneous sensitization through a damaged epidermal barrier. The experts comprehensively considered the criteria that a modern emollient used for the care of AD patients' skin should meet, discussed the role of moisturizers in preventing seasonal exacerbations of AD based on previously conducted research, and developed unified recommendations on the principles of managing this type of patients. Suggestions were made for further informational and organizational measures aimed at expanding the knowledge of patients and medical specialists about the problem of epicutaneous sensitization to aeroallergens in AD patients, their role in the development of seasonal exacerbations of AD, and the possibility of their prevention using modern emollients.

Efficacy and safety of Artemisia annua sublingual immunotherapy in patients with seasonal allergic rhinoconjunctivitis over two pollen seasons.

This study investigates the efficacy and safety of sublingual immunotherapy (SLIT) with A. annua allergens in patients with seasonal allergic rhinoconjunctivitis over two pollen seasons. Seventy patients with moderate-severe seasonal allergic rhinoconjunctivitis were divided evenly into the SLIT and control groups. The SLIT last from 3months before the summer-autumn pollen season in 2021 till the end of the summer-autumn pollen season in 2022. The daily individual symptom score, total rhinoconjunctivitis symptom score (dTRSS), total medication score (dTMS), combined score of medication and rhinoconjunctivitis symptom (dCSMRS), visual analog scale (VAS) score, and adverse events (AEs) were evaluated. The average pollen concentration in 2022 was twice that previous two-year during the pollen season. Fifty-six patients completed treatments (SLIT group: 29, control group: 27). Compared with baseline, the individual symptoms, dTRSS, dTMS, dCSMRS, and VAS scores of SLIT group declined in 2021. After 16months of SLIT, all efficacy indexes in 2022 were still lower than baseline and equivalent to those in 2021. In control group, the efficacy indexes in 2022 were higher than that in 2020 and 2021. The efficacy indexes of SLIT group were lower than those of control group in 2021 and 2022. SLIT is effective for both mono- and poly-sensitized patients. AEs incidence in SLIT group was 82.7% without severe AEs. The A. annua-SLIT can obtain efficacy and safety over two pollen seasons for patients with moderate-severe seasonal allergic rhinoconjunctivitis.

Trends and future projections of Olea flowering in the western Mediterranean: The example of the Alentejo region (Portugal)

Olives are one of the most economically relevant crops in the Mediterranean area but this region is experiencing a strong warming due to climate change. Therefore, it would be of great interest to estimate the possible implications of climate change on olive flowering timing by modelling its thermal requirements, and aerobiological records have proved to be a useful tool for monitoring regional olive phenology. Recently, a new phenological modelling framework has been developed called PhenoFlex. It has shown excellent results in estimating the thermal requirements of fruit trees. However, this framework has not previously been applied to olive trees or tested using aerobiological data, which could present greater spatial distribution than in situ phenological observations. This study has a threefold aim: i) to detect the trends in the main pollen season start date of Olea during the past 25 years in a western Mediterranean region (Alentejo, Portugal); ii) to evaluate the applicability of the PhenoFlex modelling framework to olive aerobiological data, and iii) to use the modelled parameter estimates to evaluate the influence of projected future climate change scenarios on Olea flowering regional onset dates. Our results showed that global warming had not produced any significant trend in the olive flowering onset dates until the present time, and they are not expected to do so in the near future, either. A temperature increase during winter was observed that is delaying the fulfilment of the Olea chilling requirements, but this is compensated for by a reduction in the forcing period due to higher temperatures observed during spring. However, our study points out a significant increase in the interannual variability of flowering onset dates, which could compromise fruit development and adversely affect the yield, raising uncertainty in olive fruit production in the near future.

Six-Food Elimination Diet Is Less Effective During Pollen Season in Adults With Eosinophilic Esophagitis Sensitized to Pollens.

The role of inhaled and swallowed aeroallergens in treatment outcomes of adult patients with eosinophilic esophagitis (EoE) is unclear. We hypothesized that the pollen season contributes to the failure of the 6-food elimination diet (SFED) in EoE. We compared outcomes of patients with EoE who underwent SFED during vs outside of the pollen season. Consecutive adult patients with EoE who underwent SFED and skin prick test (SPT) for birch and grass pollen were included. Individual pollen sensitization and pollen count data were analyzed to define whether each patient had been assessed during or outside of the pollen season after SFED. All patients had active EoE (≥15 eosinophils/high-power field) before SFED and adhered to the diet under the supervision of a dietitian. Fifty-eight patients were included, 62.0% had positive SPT for birch and/or grass, whereas 37.9% had negative SPT. Overall, SFED response was 56.9% (95% confidence interval, 44.1%-68.8%). When stratifying response according to whether the assessment had been performed during or outside of the pollen season, patients sensitized to pollens showed significantly lower response to SFED during compared with outside of the pollen season (21.4% vs 77.3%; P = 0.003). In addition, during the pollen season, patients with pollen sensitization had significantly lower response to SFED compared with those without sensitization (21.4% vs 77.8%; P = 0.01). Pollens may have a role in sustaining esophageal eosinophilia in sensitized adults with EoE despite avoidance of trigger foods. The SPT for pollens may identify patients less likely to respond to the diet during the pollen season.

Clinical efficacy and safety of coseasonal initiation of Artemisia annua sublingual immunotherapy on patients with Artemisia-induced rhinoconjunctivitis

PurposePatients with seasonal allergic rhinoconjunctivitis (SARC) might seek evaluation and treatment when symptoms appear during the pollen season. It is unclear whether coseasonal-initiated sublingual immunotherapy (SLIT) would be effective and safe for SARC. This study aims to identify the feasibility of initiating Artemisia annua SLIT during the pollen season. Materials and methodsSixty patients with Artemisia-induced SARC were equally recruited into the SLIT and control groups during the pollen season in 2021. The SLIT group was treated with standardized Artemisia annua SLIT drops using a modified dosing schedule combined with pharmacotherapy, while the control group only received pharmacotherapy. Diary cards for clinical symptoms, rescue medication use, and adverse events (AEs) were recorded during the pollen seasons. Objective measures, including average daily combined scores of medication and rhinoconjunctivitis symptoms (CSMRS), total rhinoconjunctivitis symptom score (TRSS), total medication score (TMS), and the score of visual analog scale (VAS) were calculated to evaluate the efficacy of SLIT. Safety was assessed through the occurrence and severity of AEs. ResultsIn total, 80.0 % (24/30) patients in the SLIT group and 86.67 % (26/30) patients in the control group completed the study. The severity of SARC, which was assessed by objective measures including CSMRS, TRSS, TMS, and VAS of the SLIT group and the control group, was generally at the same level during the 2021 pollen season, except for the medical consumption, which the score of TMS was slightly higher in the SLIT group. After one year of treatment, the scores of CSMRS, TRSS, and VAS in the SLIT group were significantly improved compared with the control group (all P < 0.001), and the difference in the TMS between the two groups disappeared (P > 0.05). Moreover, clinical improvement of the four objective measures was also observed in the SLIT group compared with the baseline value (P < 0.001). Overall, 9/24 patients in the SLIT group experienced mild local AEs, and two patients experienced mild systemic AEs during the SLIT period. ConclusionsThis controlled preliminary study identified that coseasonal-initiated Artemisia annua SLIT treatment for one year was generally safe and effective in improving the symptoms of SARC patients induced by Artemisia annua pollen.

Factors predicting the outcome of allergen-specific nasal provocation test in children with grass pollen allergic rhinitis.

Nasal provocation testing (NPT) is a reference methodology to identify the culprit allergen in patients with allergic rhinitis. Selecting the right allergen for NPT is particularly difficult in poly-sensitized patients with seasonal allergic rhinitis (SAR). Predictors of NPT outcomes may facilitate the proper use of this test or even substitute it. To identify predictors of grass pollen NPT outcome from an array of clinical data, e-diary outcomes, and allergy test results in poly-sensitized pediatric patients with SAR. Poly-sensitized, SAR patients with grass pollen allergy, participating in the @IT.2020 pilot project in Rome and Pordenone (Italy), participated in a baseline (T0) visit with questionnaires, skin prick testing (SPT), and blood sampling to measure total (ImmunoCAP, TFS, Sweden) and specific IgE antibodies to grass pollen extracts and their major allergenic molecules (ESEP, Euroimmun Labordiagnostika, Germany). During the pollen season, patients filled the AllergyMonitor® e-diary app measuring their symptoms, medication intake, and allergy-related well-being via the Visual Analogue Scale (VAS). After the pollen season (T1), patients answered clinical questionnaires and underwent a nasal provocation test (NPT) with grass pollen extract. We recruited 72 patients (age 14.3 ± 2.8 years, 46 males) sensitized to grass and/or other pollens, including olive (63; 87.5%) and pellitory (49; 68.1%). Patients positive to grass pollen NPT (61; 84.7%), compared to the negative ones, had worse VAS values in the e-diary, larger SPT wheal reactions, and higher IgE levels, as well as specific activity to timothy and Bermuda grass extracts, rPhl p 5 and nCyn d 1. A positive NPT to grass pollen was predicted by an index combining the specific activity of IgE towards Phl p 5 and Cyn d 1 (AUC: 0.82; p < 0.01; best cut-off ≥7.25%, sensitivity 70.5%, specificity: 90.9%). VAS results also predicted NPT positivity, although with less precision (AUC: 0.77, p < 0.01; best cut-off ≥7, sensitivity: 60.7%, specificity: 81.8%). An index combining the specific activity of IgE to rPhl p 5 and nCyn d 1 predicted with moderate sensitivity and high specificity the outcome of a grass pollen NPT in complex, poly-sensitized pediatric patients with seasonal allergic rhinitis. Further studies are needed to improve the index sensitivity and to assess its usefulness for NPT allergen selection or as an alternative to this demanding test procedure.

L’olivier, une richesse méditerranéenne au prix d’une allergie complexe

The olive tree (Olea europea L.) is a characteristic tree of Mediterranean basin countries, responsible for the most frequent pollinosis. This pollinosis is influenced by climate change, which can anticipate flowering dates, increase the quantity of pollen produced, and the pollen season length. The occurrence of olive pollinosis mainly depends on HLA class II, IL-13 and IL-4RA genes; and environment factors, such as socioeconomic and nutritional status, physical activity and exposure to different stimuli. Among deferent categories of molecular allergens involved in olive pollinosis, Ole e 1 is the main allergen, and the presence of homology between these allergens, and those of other species from the Oleaceae family and other different taxons (Poaceae), is responsible for cross-reactions. Polysensitization is a major challenge in the diagnostic and therapeutic approach and highlights the importance of using molecular allergens in the pollinosis diagnostic. Furthermore, allergy to the olive tree has nowadays benefited from progress in specific immunotherapy, thanks in particular to the development of a strategy based on allergenic peptides as an alternative to whole olive tree pollen extracts.

Clinical response to varying pollen exposure in allergic rhinitis in children in The Netherlands

BackgroundAllergic rhinitis (AR) affects 10–15% of children. Symptoms in seasonal AR are influenced by pollen exposure. Pollen counts vary throughout the pollen season and therefore, symptom severity fluctuates. This study investigates the correlation between pollen concentration and symptom load in children with AR in The Netherlands.MethodsA secondary analysis was performed in a study determining the most effective treatment for children with seasonal AR. Symptoms were measured during three months in 2013 and 2014 using a daily symptom diary. The pollen concentration was measured with a Hirst type volumetric spore trap sampler. A correlation coefficient was calculated for the correlation between the pollen concentration and the mean daily symptom score. The study protocol was approved by the medical ethical review committee of the Erasmus MC and is incorporated in the International Clinical Trials Registry Platform (EUCTR2012-001,591–11-NL).ResultsIn 2014, the correlation coefficient for birch pollen concentration and symptom score was 0.423 (p = 0.000). The correlation coefficient for grass pollen concentration and symptom score was 0.413 (p = 0.000) and 0.655 (p = 0.000) in 2013 and 2014, respectively. A delayed correlation between the birch pollen concentration and the symptom scores was seen up to two days after the pollen measurement (0.151, p = 0.031). For grass pollen this effect lasted up to three days after the pollen measurement (0.194, p = 0.000).ConclusionWe found comparable correlations between symptom score and pollen concentration as found by EAACI. Birch and grass pollen have an elongated influence on symptom score of several days. This implies patients need to continue on demand medication longer after a measured pollen peak.