Prevalence and risk factors of allergic rhinitis and cedar pollinosis among Japanese men

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

BACKGROUND

The 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.

METHODS

This 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.

RESULTS

Of 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).

CONCLUSIONS

Our 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.

Investigation of the allergens in 2,316 children with allergic rhinitis from Guangdong, China

Allergic rhinitis (AR) is one of the popular childhood diseases, bringing physical and metal burdens to the children and their families. The study was performed to detect common allergens eliciting AR in children, to investigate the prevalence of allergens in different age and gender cohorts, and to provide a reliable basis for clinical prevention and treatment of AR during childhood. We measured serum-specific IgE and performed inhalant and ingestion allergen examinations in 2,316 children with AR, in collaboration with BioSciTec GmbH. The prevalence of different allergens was determined according to gender, age, severity, and season. Among the 2,316 AR cases, the top five inhalant allergens were Dermatophagoides pteronyssinus (1,674 cases, 72.3%), Dermatophagoides farinae (1,520 cases, 65.6%), Blomia tropicalis (1,477 cases, 63.8%), Cockroach (602 cases, 26.0%), and Dog hair (602 cases, 26.0%). The top five ingestive allergens were Milk (1,111 cases, 48.0%), Egg white (543 cases, 23.4%), Shrimp/Crab (425 cases, 18.4%), Beef/Mutton (422 cases, 18.2%), and Egg yold (329 cases, 14.2%). AR severity analyses showed that 50.9% (1,180 cases) of D. pteronyssinus allergies were above level three, 47.9% (1,109 cases) of D. farinae allergies were above level three, only 23.3% (539 cases) of B. tropicalis allergies were level three, and B. tropicalis allergies were mainly of level 2. Other AR-inducing allergens mainly produced level one or two reactions. Regarding ingestion allergens, 7.9% (183 cases) of milk allergies and 4.7% (108 cases) of Shrimp/Crab allergies were above level three, and other allergens induced AR mainly of level one or two. The study investigated the major allergens eliciting AR in children from Guangdong, China, assessed the prevalence and severity among cohorts regarding age, gender, and season, and produced essential information on childhood AR, laying important references for AR prevention and treatment in the future.

Clinical Manifestations of Allergic Rhinitis by Age and Gender: A 12-Year Single-Center Study

OBJECTIVES

Currently, epidemiological data on allergic rhinitis collected through the skin prick test are scarce. Moreover, the relationship of age and sex to allergic rhinitis is not comprehensively understood. This study aimed to characterize allergic rhinitis and the associated clinical manifestations by age and sex.

METHODS

We retrospectively investigated data from 2883 patients who visited a single university hospital for rhinitis symptoms between January 2003 and December 2014. Of these 2883 patients, 1964 who underwent a skin prick test with 11 standardized allergen extracts and completed a nasal symptom questionnaire were enrolled. The clinical characteristics of allergen sensitization and nasal symptoms were analyzed by sex and age distribution.

RESULTS

The prevalence of allergen sensitization progressively decreased with age after peaking at between 20 and 29 years. The sensitization rate was higher in males than in females (P = .046). The sensitization rate to house dust mites decreased with age, while sensitization to mugwort and ragweed increased. Six allergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae, mugwort, trees, ragweed, and cats) were sufficient to identify >96% of patients with allergen sensitization. Nasal obstruction tended to decrease with age and was more prevalent in males (P = .002) than in females, while rhinorrhea (P = .007) and itching (P = .013) were more prevalent in females. Total nasal symptom scores did not differ by sex.

CONCLUSIONS

The clinical characteristics of allergic rhinitis, including allergen-sensitization patterns and related symptoms, varied by age and sex. Six common allergens could be sufficient to generate a cost-effective tool to identify allergic rhinitis.

Cedar Pollinosis and Mortality: A Population-Based Prospective Cohort Study in Japan

BACKGROUND

Cedar pollinosis is one of the most prevalent forms of seasonal allergic reaction in Japan. Only one prospective study has examined the association between cedar pollinosis and mortality. Using a symptom-based questionnaire on cedar pollinosis, we investigated the association of cedar pollinosis with all-cause and cause-specific mortality.

METHODS

Data came from the Takayama Study, which recruited residents aged ≥35 years in 1992 from Takayama city in Gifu Prefecture, Japan. The current study used information on cedar pollinosis that was obtained from the second survey in 2002. A total of 12,471 persons who were 45-80 years old and had no history of cancer, coronary heart disease, or stroke responded to a questionnaire asking about four symptoms related to cedar pollinosis. Mortality and migration data were obtained throughout the follow-up period up to March 2013. Cox proportional hazard models were used to examine the relation between cedar pollinosis and mortality.

RESULTS

A total of 1,276 persons died during follow-up period. Among these, there were 504 neoplasm, 278 cardiovascular, and 181 respiratory deaths. After adjusting for potential confounders, cedar pollinosis was associated with significantly lower all-cause mortality (hazard ratio [HR] 0.79; 95% confidence interval [CI], 0.65-0.95) and respiratory mortality (HR 0.38; 95% CI, 0.18-0.82). There was no significant association between cedar pollinosis and mortality due to neoplasm or cardiovascular disease.

CONCLUSIONS

We found an inverse association between cedar pollinosis and the risk of all-cause and respiratory mortality. Further research is needed to elucidate the association between cedar pollinosis and mortality.

Morphofunctional analysis of antigen uptake mechanisms following sublingual immunotherapy with beads in mice

Background

Recently, sublingual immunotherapy (SLIT) has been used as a safe and efficient method for the treatment of and immunization against asthma and various allergies. However, the routes of antigen/allergen (particulate antigen) uptake through the mucosa of the oral cavity remain incompletely understood, as do the roles of sex and age in the process. For this purpose, to elucidate the mechanism and efficacy of SLIT among different sexes and ages, microbeads were dripped into the sublingual region to mimic particulate antigen uptake by the sublingual mucosa.

Methods

Twenty microliters of either phosphate buffered saline (PBS) or fluorescently labelled microbeads (latex and silica beads) were placed under the tongue of both male and female C57BL/6 mice at young (3 months) and old (6 months) ages. The lower jaw was examined 30 min after administration, and beads were detected with a fluorescence stereomicroscope. Morphological observations of the mucosa of the fluorescent areas were made with a scanning electron microscope (SEM) and an all-in-one light fluorescence microscope (LM). Fluorescence intensity was compared between both sexes and ages.

Results

Stereomicroscopic observation revealed fluorescent illuminations in three compartments of the sublingual mucosa: the sublingual caruncles (SC), the oral rostral mucosa (OR) and the buccal mucosa (BM). Interestingly, the fluorescence intensity tended to be higher among females than among males in the SC region in particular. However, there were no significant age-related differences. SEM and LM revealed beads in the lumina of both mandibular ducts and sublingual ducts (Sd). Additionally, the apical cytoplasm of some Sd cells contained silica beads. However, there was no specification in the OR mucosa or BM.

Conclusions

This study reveals the major role Sd plays in local immunity via the antigen uptake mechanisms. Furthermore, our data suggest that the efficacy of SLIT in humans could be affected by sex.

Allergic Rhinitis: Mechanisms and Treatment

The prevalence of allergic rhinitis (AR) has been estimated at 10% to 40%, and its economic burden is substantial. AR patients develop specific immunoglobulin E (IgE) antibody responses to indoor and outdoor environmental allergens with exposure over time. These specific IgE antibodies bind to high-affinity IgE receptors on mast cells and basophils. Key outcome measures of therapeutic interventions include rhinitis symptom control, rescue medication requirements, and quality-of-life measures. A comprehensive multiple modality treatment plan customized to the individual patient can optimize outcomes.

Prevalence and diversity of allergic rhinitis in regions of the world beyond Europe and North America

BACKGROUND

There is comparatively little information in the public domain on the diversity in prevalence and triggers/factors associated with allergic rhinitis (AR) or allergic rhinoconjunctivitis (AR/C) in countries beyond western-Europe and North America.

OBJECTIVE

To review the prevalence and the sensitizing agents/triggers and factors associated with AR/C in several countries in Africa, the Asia-Pacific region, Australia, Eastern Europe, Latin America, Middle East and Turkey.

METHODS

Articles published in English in peer-reviewed journals were assessed and selected for further review, following an extensive literature search using the Medline database.

RESULTS

This review demonstrated that prevalence of AR and AR/C in these regions has predominantly been investigated in children; with studies indicating wide inter- and intra-regional variations ranging from 2.9% AR and 3.8% AR/C in 10-18-years-old children from one region in Turkey to 54.1% AR and 39.2% AR/C in 13-14-years-old children in one region in Nigeria. Moreover, the prevalence of AR and AR/C has increased markedly over the last decade particularly in some of the more affluent African countries, China-Taiwan and several Middle East countries, likely as a consequence of improved living standards leading to increased exposure to multiple traditional and non-traditional sensitizing agents and risk factors similar to those noted in western-Europe and North America.

CONCLUSIONS AND CLINICAL RELEVANCE

Our findings suggest that the greater diversity in prevalence of AR or AR/C in populations in these regions is in contrast to the lower diversity of AR or AR/C in the 'western populations (USA and Europe), which tend to be more uniform. This review provides a comprehensive database of the important allergens and triggers which are likely to influence the prevalence of allergic rhinitis in these diverse regions, where the prevalence of allergic rhinitis is increasing and its adverse impact on the quality of life of affected individuals is increasingly recognised.

Presenteeism in college students: reliability and validity of the Presenteeism Scale for Students

OBJECTIVE

Presenteeism is the impaired work performance due to health problems. We aimed to develop a Presenteeism Scale for Students (PSS), and to reveal the existence of presenteeism among students.

METHODS

Students (n = 5,701) in 4 national universities in Japan were recruited via the school-based health examination. Moreover, 122 students participated in a 2-week interval test-retest to examine the reliability and criterion-related validity of the PSS.

RESULTS

Of the students, 59.2% indicated some health problems. Allergy was most prevalent health problems, affecting 35.7% of the whole students. Students with emotional problems had higher degree of presenteeism than those with the other problems. The Cronbach's α of the work impairment score of the PSS was 0.90. The Spearman's coefficient for the test-retest score was 0.80 (P < 0.001). Regarding criterion-related validity, Spearman's coefficient between the work impairment score of the PSS and summary score of the SF-36 was -0.60 (P < 0.001).

CONCLUSIONS

These findings suggest that the PSS can be expected to be useful for assessment of students with presenteeism. Furthermore, we found that the majority of students have some health problems, and proposed that the issue of presenteeism on campus should be addressed.

Two thirds of forest walkers with Japanese cedar pollinosis visit forests even during the pollen season

BACKGROUND

The most common type of pollinosis in Japan is Japanese cedar pollinosis (JCP). While forest walking is a common form of recreation for Japanese people, it has been unclear whether forest walkers with JCP still choose to visit forested areas during the pollen season or whether they avoid those areas, and as such, the aim of this study was to investigate this question.

METHODS

The study participants were all healthy men and women volunteers aged 20 years or over who visited the Tokyo University Forest in Chiba during 4 different days. The survey was conducted using self-administered questionnaires.

RESULTS

The number of available responses was 498. Of these, 112 participants who experienced JCP were included in the analysis. Seventy-three participants (65.2%) responded that they visit forests even during the pollen season. The association between forest walking choices during the pollen season and self-rated levels of pollinosis symptoms was not statistically significant (Cramer's V = 0.13, p = 0.47). As many as 60% of the participants who reported serious symptom levels responded that they visit forested areas even during the pollen season.

CONCLUSIONS

These results revealed that two thirds of forest walkers who had experienced JCP visited forests even during the pollen season. This indicates the further need for public service announcements informing people with JCP that the risk of pollen exposure and subsequent JCP reaction is increased by visiting forested areas during the pollen season.

Analysis of the comorbidity of bronchial asthma and allergic rhinitis by questionnaire in 10,009 patients

BACKGROUND

Bronchial asthma (BA) and allergic rhinitis (AR) are thought to share a common pathogenesis. However, reports concerning the comorbidity of the two diseases in a large-scaled population are rare in Japan. In the present study, we performed an analysis on the two diseases using questionnaires that addressed the diagnosis, symptoms and period of occurrence in more than 10,000 patients with BA or AR.

METHODS

Patients with BA (adult: n = 2,781, childhood: n = 3,283) and AR (n = 3,945) were enrolled in the present study during the 3 months from August 1, 2006 to October 31, 2006.

RESULTS

Sixty one percent of the patients with adult BA showed symptoms of AR. Among them, 68% of the patients were diagnosed with AR. Among the patients with childhood BA, 68% showed AR symptoms and 60% were diagnosed with AR. On the other hand, 49% of AR patients showed BA symptoms and 35% of them were diagnosed with BA. The symptoms of both BA and AR in the BA and AR patients were frequent in two seasons, March and April, and September and October. In addition, BA and AR symptoms often co-occurred in the patients with BA and AR.

CONCLUSIONS

Comorbidity of BA and AR was high in both populations of BA and AR. The symptoms of both BA and AR co-occurred on both a daily and seasonal basis. These results suggested that BA and AR share a common immuno-pathogenesis in the airway and need to be treated as a single airway disease.

Characterization of pollen dispersion in the neighborhood of Tokyo, Japan in the spring of 2005 and 2006

The behavior of Japanese cedar (Cryptomeria japonica) and Japanese cypress (Chamaecyparis obtusa) pollens in an urban area was examined through the measurements of the dispersion characteristics at the various sampling locations in both outdoor and indoor environments. Airborne pollens were counted continuously for three months during the Japanese cedar pollen and Japanese cypress seasons in 2005 and 2006 by the use of Durham's pollen trap method in and around Tokyo, Japan. The dispersion of pollens at the rooftop of Kyoritsu Women's University was observed to be at extremely high levels in 2005 compared with previously reported results during the past two decades. As for Japanese cedar pollen, the maximum level was observed as 440 counts cm(-2) day(-1) on 18 March 2005. Japanese cypress pollen dispersed in that area in the latter period was compared with the Japanese cedar pollen dispersions. The maximum dispersion level was observed to be 351 counts cm(-2) day(-1) on 7 April 2005. Total accumulated dispersions of Japanese cedar and Japanese cypress pollens were 5,552 and 1,552 counts cm(-2) for the three months (Feb., Mar. and Apr.) in 2005, respectively. However, the dispersion of both pollens in 2006 was very low. The total accumulated dispersions of Japanese cedar and Japanese cypress pollens were 421 and 98 counts cm(-2) for three months (Feb., Mar. and Apr.) in 2006, respectively. Moreover, the pollen deposition on a walking person in an urban area showed that the pollen counts on feet were observed to be extremely high compared with the ones on the shoulder, back and legs. These findings suggested that pollen fell on the surface of the paved road at first, rebounded to the ambient air and was deposited on the residents again. Furthermore, the regional distribution of the total pollen dispersion in the South Kanto area was characterized on 15-16 March 2005 and on 14-15 March 2006. Although the pollen levels in 2005 were much higher than in 2006, it was commonly observed that higher pollen counts existed in the outlying areas. That is, the pollen counts in an urban area were confirmed to be at a lower level. As for the indoor dispersion of pollens, two cases were evaluated. At the lobby of the main building of Kyoritsu Women's University, the averaged ratio of the indoor to the outdoor pollen count is 4.1%. Another case was at the hospital building of a medical school. The pollen dispersion in the indoor environment was also observed to be low. It was concluded that the indoor pollen would be mainly carried from the outer environment by the movement of air.

Helicobacter pylori infection and allergic diseases: epidemiological study in Japanese university students

BACKGROUND AND AIM

A negative association between Helicobacter pylori infection and allergic diseases has not been consistent. The aim of this study was to examine the association between allergic diseases and H. pylori infection in Japan.

METHODS

Newly enrolled university students completed health survey questionnaires regarding general health and the presence of allergic diseases. Helicobacter pylori status was determined by the presence of serum H. pylori IgG and the presence of allergic manifestations was confirmed by interview.

RESULTS

A total of 1953 students had a routine health survey; H. pylori status was determined in 777 including 369 with allergic diseases and 408 controls. The reported frequency of allergic rhinoconjunctivitis, atopic dermatitis, urticaria, bronchial asthma and mixed diseases was 29.0%, 11.1%, 2.0%, 0.9% and 5.0%, respectively. Helicobacter pylori infection was diagnosed less frequently in the allergic group compared with controls (11.4% vs 17.6%, P = 0.015). Helicobacter pylori infection was less frequent in men with allergic diseases (OR 0.49, 95% CI 0.27-0.89).

CONCLUSION

Allergic diseases are frequent in young Japanese adults and are negatively associated with H. pylori infection especially in men.

Genotypes and Haplotypes of CCR2 and CCR3 Genes in Japanese Cedar Pollinosis

Whole genome scan analyses have revealed that the chromosomal region 3p21.3, which contains a gene cluster of the CC chemokine receptor, is possibly critical for the pathogenesis of allergic inflammation. Japanese cedar pollinosis is mediated by a type I allergy and induces seasonal rhinitis and conjunctivitis in humans as the most common form of hay fever in spring in Japan, although the candidate genes for cedar pollinosis remain to be elucidated. We sequenced CCR1, CCR2, CCR3, CCR5, and CCXCR1 using the PCR restriction fragment length polymorphism method in subjects with cedar pollinosis and controls. We found 8 polymorphisms of A111G, Arg127Cys and Arg252Gln in CCXCR1, T885C in CCR1, Val64Ile and T780C in CCR2, T51C in CCR3 and Arg223Gln in CCR5. The transmission disequilibrium test using 60 children with pollinosis and their parents and an association study using unrelated adult subjects (151 patients and 157 controls) showed a significant association of 64Ile in CCR2 and 51C in CCR3 with cedar pollinosis. The frequency of haplotype 64Ile/780C/51C in pollinosis was significantly higher than in controls. Our results suggest that CCR2 and CCR3 genes are candidate genes for Japanese cedar pollinosis.

Case-control study of medical history and idiopathic pulmonary fibrosis in Japan

OBJECTIVES

A few epidemiological studies have indicated that a patient's past medical history may contribute to the risk of developing idiopathic pulmonary fibrosis (IPF). A relationship between a history of selected disorders and the risk of IPF was assessed in a multicentre hospital-based case-control study in Japan.

METHODOLOGY

Included in the study were 104 patients of IPF, aged 40 years or over, who had been diagnosed within the previous 2 years, in accordance with the most recent criteria. Control subjects, aged 40 years or over, consisted of 56 hospitalized patients diagnosed as having acute bacterial pneumonia and four outpatients with the common cold. Adjustment was made for age, gender, region, pack-years of smoking, employment status, occupational exposure and BMI.

RESULTS

Medical histories of hypertension, hyperlipidaemia, coronary heart disease, diabetes mellitus, hepatitis C virus infection, tuberculosis, asthma, atopic dermatitis and allergic rhinitis were not statistically significantly associated with the risk of IPF, although cases were more likely to have suffered from allergic rhinitis and less likely to have been asthmatics than control subjects. Having a child with a history of allergic rhinitis, but not of asthma or atopic dermatitis, was significantly related to an increased risk of IPF.

CONCLUSIONS

These findings suggest that a genetic predisposition to allergic rhinitis may be associated with an increased risk of IPF.

Association of Single Nucleotide Polymorphisms in the Eosinophil Peroxidase Gene with Japanese Cedar Pollinosis

BACKGROUND

Japanese cedar pollinosis is the most common form of hay fever in spring in Japan. We have previously demonstrated that single nucleotide polymorphism Pro358Leu of exon 7 in the eosinophil peroxidase (EPO) gene is associated with cedar pollinosis, although the association has not been confirmed by analysis of the whole gene in a different population.

METHODS

We sequenced all exons of the EPO gene in 60 children with pollinosis and their parents using the PCR-restriction fragment length polymorphism method.

RESULTS

We found 8 polymorphisms, Ile40Met, Gln122His, Arg202Arg (A660G), Asn303Asn (C909T), Arg326Pro, Arg326His, Pro358Leu, and Asn572Ty, in the EPO gene. As a result of the transmission disequilibrium test, we recognized significant transmissions of 202Arg (660G) in exon 6 in addition to 358Leu of exon 7 in the EPO gene of affected children.

CONCLUSIONS

Our results might indicate that polymorphisms of the EPO gene are associated with Japanese cedar pollinosis.

Increase in serum levels of autoantibodies after attack of seasonal allergic rhinitis in patients with Graves' disease

BACKGROUND

The prevalence of allergic disease is increasing worldwide, but its influence on the clinical course of autoimmune diseases is unknown.

OBJECTIVE

The purpose of this study was to assess the effect of seasonal allergic rhinitis on the clinical course of Graves' disease, which has been considered a Th2-dominant autoimmune disease.

METHODS

Ten patients with Graves' disease, who were considered to be in a state of remission or near remission, were serially examined for 18 months starting from August. Five of them had seasonal allergic rhinitis due to Japanese cedar pollen, and the remaining patients had no such allergic disorders. Peripheral eosinophil counts, serum concentrations of cedar-pollen-specific IgE, anti-TSH-receptor antibody, anti-thyroid-peroxidase antibody and antithyroglobulin antibody were assessed at 2- to 4-month intervals. Serum thyroid hormones and TSH levels were also measured to evaluate disease activity.

RESULTS

All patients with pollinosis had attacks of allergic rhinitis caused by cedar pollen in early March. Subsequently, peripheral eosinophil counts, pollen-specific IgE activity and serum levels of anti-thyroid-peroxidase and antithyroglobulin autoantibodies markedly increased. Serum levels of anti-TSH-receptor antibody increased in 3 patients in association with an increase in serum thyroid hormones but were always negative in 2 patients. The control patients without pollinosis showed no consistent change of these parameters.

CONCLUSIONS

Seasonal allergic rhinitis aggravated the clinical course of Graves' disease and induced an increase in serum antithyroid autoantibody concentrations as well as an increase in pollen-specific IgE concentration. These data suggest that environmental antigens induce not only local allergic reactions, but also stimulate thyroid immune reactions toward Th2 proliferation, and finally aggravate Th2-dependent autoimmune thyroid disease.

Ecological association of water hardness with prevalence of childhood atopic dermatitis in a Japanese urban area

The prevalence of symptoms of atopic eczema among Japanese children aged 6-7 years is the second highest in 56 countries. Reasons for such a high prevalence are unknown. This ecological study examined whether the positive association of water hardness with atopic dermatitis among British primary-school children also exists in Japan. Study subjects were 458,284 of 489,725 children, aged 6-12 years, in 1,016 public elementary schools in Osaka Prefecture with 44 municipalities. The study used data on water hardness and chlorine content of the water supply; prevalence of atopic dermatitis diagnosed by physicians and episodes of wheezing reported by the parents; and potential confounding factors by socioeconomic and health care status per municipality. The prevalence of atopic eczema was significantly higher in the highest water hardness category than that in the lowest (24.4% [n=2,288/9,362] and 22.9% [n=77,408/33,8267], respectively; adjusted odds ratio 1.12, 95% confidence interval 1.06-1.18; P<0.0001 for trend). A significant and slightly J-shaped relationship between chlorine content of the water supply and prevalence of atopic dermatitis was observed after adjustment for confounding factors. There were no apparent associations of water hardness and chlorine content of the water supply with prevalence of wheeze. Water hardness may increase the risk of atopic dermatitis among elementary-school children in Japan, as well as in the United Kingdom.

High contribution contrast between the genes of eosinophil peroxidase and IL-4 receptor α-chain in Japanese cedar pollinosis

BACKGROUND

Japanese cedar pollinosis is the most common form of hayfever in Japan in spring and has remarkably increased since 1960.

OBJECTIVE

We sought to clarify the candidate genes for cedar pollinosis using a case-control study.

METHODS

After diagnosing 351 subjects on the basis of an intradermal test, nasal provocation test, and questionnaire regarding nasal and conjunctival symptoms, we determined the blood-specific IgE values and genotypes of eosinophil peroxidase (EPO) and interleukin-4 receptor alpha-chain (IL4RA) in 145 patients with pollinosis and 206 healthy subjects, including 75 healthy subjects with higher specific IgE values.

RESULTS

We found significant differences in the frequencies of Pro358Leu in EPO and of Ile50Val and Glu375Ala in IL4RA between patients and healthy subjects. There was a significantly higher frequency of 358Leu in EPO in patients than in healthy subjects showing a higher specific IgE value. In contrast, we recognized significant changes in the prevalence of Ile50Val and Glu375Ala in IL4RA in healthy subjects with a normal IgE value compared with those in healthy subjects with a higher specific IgE value. The relationship between EPO polymorphisms and the onset of symptoms was exactly opposite that for IL4RA.

CONCLUSIONS

These results suggest that Pro358Leu in EPO is strongly involved in the development of cedar pollinosis. Ile50Val and Glu375Ala in IL4RA seem to be related to cedar pollen sensitization. Subjects with Ile50 or Glu375 might develop cedar pollinosis with increased exposure to cedar pollen.

Epidemiology of Japanese cedar pollinosis throughout Japan

BACKGROUND

Japanese cedar pollinosis (JCP) is a common disease posing a major public health problem in Japan. For health care policy planning and development of new treatment modalities, investigation of the accurate prevalence and current status of JCP nationwide is imperative.

OBJECTIVE

To ascertain the prevalence and the current status of JCP in Japan with use of a cross-sectional random sampling method.

METHODS

In a nationwide survey conducted shortly after the peak pollen season, self-evaluation questionnaire were mailed to 10,920 subjects from 390 of 3,370 places in 12 regions in Japan.

RESULTS

The response rate was 53.7%, and the usable response rate was 51.5%. The age-adjusted prevalence was 19.4%; the estimated prevalence was 13.1% after adjustment for misdiagnosis, incorrect answers, response rate, and case mix. JCP was most prevalent in the Kanto, Tokai, and Kinki areas and in working adults rather than in children or subjects ages 60 to 79 years. Total pollen count during the pollen season correlated well with the prevalence of JCP in individual regions. In subjects with JCP, nasal symptom were more severe than eye symptoms, 62.5% had severe or moderate interference with daily activities and consulted physicians, 54.1% took prescribed drugs, and 82% used some method to avoid pollen.

CONCLUSIONS

The age-adjusted prevalence of JCP was 19.4% of the Japanese population, and estimated prevalence after correction of possible biases was 13.1%. Prescribed drugs treated approximately 60% of subjects with JCP, and 80% of subjects tried self-care by avoiding pollen.

Sensitization to grass, ragweed, mugwort pollen allergens in Japanese monkeys (Macaca fuscata): preliminary report

BACKGROUND

The natural occurrence of Japanese cedar (CJ, Cryptomeria japonica) pollinosis has been reported in Japanese monkeys (Macaca fuscata). Furthermore, most of these monkeys with CJ pollinosis have immunoglobulin (Ig) E sensitization to Japanese cypress (Chamaecyparis obtusa) pollen. However, specific IgE to other pollens has not yet been reported.

OBJECTIVES

The present study was designed to investigate IgE sensitization of Japanese monkeys to grass, ragweed, and mugwort pollen.

METHODS

Serum samples from 47 monkeys as a general population in one troop were collected at random. We measured specific IgE to grass, ragweed and mugwort pollen. Next, 10 monkeys with CJ pollinosis from the same troop were also examined for their IgE sensitization to grass, ragweed, and mugwort pollen.

RESULTS

Of 47 monkeys, 13 (28%) had specific IgE to CJ pollen, 15 (32%) to grass pollen, five (11%) to ragweed pollen, and three (6%) to mugwort pollen. Furthermore, CJ pollinosis monkeys seemed to be sensitized to these pollen allergens with higher frequency; of 10 monkeys, 10 (100%) had specific IgE to CJ pollen, six (60%) to grass pollen, four (40%) to ragweed pollen, and two (20%) to mugwort pollen.

CONCLUSION

Japanese monkeys had specific IgE to grass, ragweed, and mugwort pollen in addition to CJ pollen.

IgE reactivity and cross-reactivity of Japanese monkeys (Macaca fuscata) to Japanese cedar (Cryptomeria japonica) and cypress (Chamaecyparis obtusa) pollen allergens

BACKGROUND

The natural occurrence of Japanese cedar (Cryptomeria japonica, CJ) pollinosis has been reported in Japanese monkeys (Macaca fuscata). However, the reactivity to Japanese cypress (Chamaecyparis obtusa, CO) pollen allergens in these monkeys has not yet been reported.

OBJECTIVES

The present study was designed to investigate the reactivity to CO pollen allergens in monkeys sensitized to CJ pollen allergens.

METHODS

Serum samples from 40 monkeys naturally sensitized to CJ pollen allergens were collected from four troops. We measured the specific IgE to CO pollen allergens and examined the reactivity to the allergens by intradermal test. Cross-reactivity between CJ and CO pollen allergens was examined by ELISA inhibition method. Furthermore, we examined the sensitivity to the allergens by histamine release assay from leucocytes.

RESULTS

All 40 monkeys had specific IgE to crude and purified major allergens (Cha o 1) of CO pollen. The monkeys showed a positive reaction to CO pollen allergens in the intradermal test. Allergenic cross-reactivity between Cha o 1 and Cry j 1 (a major allergen in CJ pollen) was also observed. Specific histamine release to both the major allergens was noted in two monkeys with CJ pollinosis.

CONCLUSION

Japanese monkeys sensitized to Japanese cedar pollen allergens also demonstrate reactivity to Japanese cypress pollen allergens.