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Zain A, Yeo I, Wong L, Shek LP. Climate change from the Asia-Pacific perspective: What an allergist needs to know and do. Pediatr Allergy Immunol 2024; 35:e14216. [PMID: 39137244 DOI: 10.1111/pai.14216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 07/29/2024] [Accepted: 07/31/2024] [Indexed: 08/15/2024]
Abstract
Allergic diseases such as asthma, atopic dermatitis, and food allergies are a burgeoning health challenge in the Asia-Pacific region. Compounding this, the region has become increasingly susceptible to the impacts of climate change. The region has weathered extreme precipitation, intense heat waves, and dust storms over the recent decades. While the effects of environmental and genetic factors on allergic diseases are well understood, prevailing gaps in understanding the complex interactions between climate change and these factors remain. We aim to provide insights into the various pathways by which climate change influences allergic diseases in the Asia-Pacific population. We outline practical steps that allergists can take to reduce the carbon footprint of their practice on both a systemic and patient-specific level. We recommend that allergists optimize disease control to reduce the resources required for each patient's care, which contributes to reducing greenhouse gas emissions. We encourage the responsible prescription of metered dose inhalers by promoting the switch to dry powder inhalers for certain patients, at each clinician's discretion. We also recommend the utilization of virtual consultations to reduce patient travel while ensuring that evidence-based guidelines for rational allergy management are closely adhered to. Finally, eliminating unnecessary testing and medications will also reduce greenhouse gas emissions in many areas of medical care.
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Affiliation(s)
- Amanda Zain
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
- Centre for Sustainable Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Inez Yeo
- Centre for Sustainable Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Lydia Wong
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
| | - Lynette P Shek
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore, Singapore
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2
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Kallen EJJ, Revers A, Fernández-Rivas M, Asero R, Ballmer-Weber B, Barreales L, Belohlavkova S, de Blay F, Clausen M, Dubakiene R, Ebisawa M, Fernández-Perez C, Fritsche P, Fukutomi Y, Gislason D, Hoffmann-Sommergruber K, Jedrzejczak-Czechowicz M, Knulst AC, Kowalski ML, Kralimarkova T, Lidholm J, Metzler C, Mills ENC, Papadopoulos NG, Popov TA, Purohit A, Reig I, Seneviratne SL, Sinaniotis A, Takei M, Versteeg SA, Vassilopoulou AE, Vieths S, Welsing PMJ, Zwinderman AH, Le TM, Van Ree R. A European-Japanese study on peach allergy: IgE to Pru p 7 associates with severity. Allergy 2023; 78:2497-2509. [PMID: 37334557 DOI: 10.1111/all.15783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 04/28/2023] [Accepted: 05/05/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND Pru p 3 and Pru p 7 have been implicated as risk factors for severe peach allergy. This study aimed to establish sensitization patterns to five peach components across Europe and in Japan, to explore their relation to pollen and foods and to predict symptom severity. METHODS In twelve European (EuroPrevall project) and one Japanese outpatient clinic, a standardized clinical evaluation was conducted in 1231 patients who reported symptoms to peach and/or were sensitized to peach. Specific IgE against Pru p 1, 2, 3, 4 and 7 and against Cup s 7 was measured in 474 of them. Univariable and multivariable Lasso regression was applied to identify combinations of parameters predicting severity. RESULTS Sensitization to Pru p 3 dominated in Southern Europe but was also quite common in Northern and Central Europe. Sensitization to Pru p 7 was low and variable in the European centers but very dominant in Japan. Severity could be predicted by a model combining age of onset of peach allergy, probable mugwort, Parietaria pollen and latex allergy, and sensitization to Japanese cedar pollen, Pru p 4 and Pru p 7 which resulted in an AUC of 0.73 (95% CI 0.73-0.74). Pru p 3 tended to be a risk factor in South Europe only. CONCLUSIONS Pru p 7 was confirmed as a significant risk factor for severe peach allergy in Europe and Japan. Combining outcomes from clinical and demographic background with serology resulted in a model that could better predict severity than CRD alone.
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Affiliation(s)
- E J J Kallen
- Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - A Revers
- Epidemiology and Data Science (EDS), Amsterdam University Medical Center location University of Amsterdam, Amsterdam, The Netherlands
| | - M Fernández-Rivas
- Department of Allergy, Hospital Clinico San Carlos, Universidad Complutense, IdISSC, ARADyAL, Madrid, Spain
| | - R Asero
- Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Italy
| | - B Ballmer-Weber
- Allergy Unit, Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland
- Faculty of Medicine, University of Zürich, Zürich, Switzerland
- Clinic for Dermatology and Allergology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - L Barreales
- Department of Allergy, Hospital Clinico San Carlos, Universidad Complutense, IdISSC, ARADyAL, Madrid, Spain
| | - S Belohlavkova
- Medical Faculty Pilsen, Charles University Prague, Prague, Czech Republic
| | - F de Blay
- Allergy Division, Chest Disease Department, Strasbourg University Hospital, Strasbourg, France
| | - M Clausen
- Landspitali University Hospital, University of Iceland, Faculty of Medicine, Reykjavik, Iceland
| | - R Dubakiene
- Clinic of Chest diseases, Allergology and Immunology Institute of Clinic al Medicine Medical Faculty Vilnius University, Vilnius, Lithuania
| | - M Ebisawa
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Kanagawa, Japan
| | - C Fernández-Perez
- Servicio de Medicina Preventiva, Area De Santiago de Compostela y Barbanza, Instituto de Investigación Sanitaria de Santiago (IDIS) A Coruña, Santiago, Spain
| | - P Fritsche
- Allergy Unit, Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland
| | - Y Fukutomi
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Kanagawa, Japan
| | - D Gislason
- Landspitali University Hospital, University of Iceland, Faculty of Medicine, Reykjavik, Iceland
| | - K Hoffmann-Sommergruber
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - M Jedrzejczak-Czechowicz
- Department of Immunology and Allergy, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - A C Knulst
- Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - M L Kowalski
- Department of Immunology and Allergy, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - T Kralimarkova
- Clinic of Occupational Diseases, University Hospital Sv. Ivan Rilski, Sofia, Bulgaria
| | - J Lidholm
- Thermo Fisher Scientific, Uppsala, Sweden
| | - C Metzler
- Allergy Unit, Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland
| | - E N C Mills
- Division of Infection, Immunity and Respiratory Medicine, Manchester Institute of Biotechnology & Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK
| | - N G Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
| | - T A Popov
- Clinic of Occupational Diseases, University Hospital Sv. Ivan Rilski, Sofia, Bulgaria
| | - A Purohit
- Allergy Division, Chest Disease Department, Strasbourg University Hospital, Strasbourg, France
| | - I Reig
- Allergist and Pediatrician, Nápoles y Sicilia Health Center, Valencia, Spain
| | - S L Seneviratne
- Institute of Immunity and Transplantation, University College London, London, UK
| | - A Sinaniotis
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
| | - M Takei
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Kanagawa, Japan
| | - S A Versteeg
- Department of Experimental Immunology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - A E Vassilopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - S Vieths
- Paul-Ehrlich-Institut, Federal Institute for Vaccines and Biomedicines, Langen, Germany
| | - P M J Welsing
- Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - A H Zwinderman
- Epidemiology and Data Science (EDS), Amsterdam University Medical Center location University of Amsterdam, Amsterdam, The Netherlands
| | - T M Le
- Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - R Van Ree
- Departments of Experimental Immunology and of Otorhinolaryngology, Amsterdam University Medical Center, Amsterdam, The Netherlands
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Goyal A, Ravindra K, Mor S. Occupational exposure to airborne pollen and associated health risks among gardeners: a perception-based survey. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:70084-70098. [PMID: 35583755 DOI: 10.1007/s11356-022-20595-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
Airborne pollen are considered a major trigger of respiratory diseases that causes morbidity and subsequently affects a person's quality of life (QOL). Outdoor workers, such as gardeners, florists, etc., are at greater risk of allergies due to continuous exposure to the high concentration of allergens. The current study aims to assess the associated health risks among gardeners due to occupational exposure to airborne pollen. A semi-structured questionnaire-based survey was conducted among gardeners (496) in Chandigarh, covering their socio-demographic status, occupational and environmental history, and respiratory and other health-related problems. Out of 496 respondents from 26 gardens in the city, 72.58% fall under the category of plantsman (mali), followed by 15.72% of grass cutters and 3.02% of headmali/supervisor. The majority of gardeners were males (95.76%) and a maximum number of respondents were in the age group of 29-38 years (27.41%). Among all, 4.2%, 3.6%, and 3.2% of respondents perceived the problem of shortness of breath and breathing problems. At the same time, 3.2% of respondents perceived that their breathing is never wholly satisfactory and surprisingly, all of them are plantsman (mali). Moreover, 18.9% of the respondents covered their faces with a cloth and only 0.5% of the respondents wore both spectacles and covered their faces with a cloth. Out of all respondents, 6.5% reported irritation in the eyes without wearing any personal protective device. The results show that a large proportion of gardeners are illiterate and unaware of occupational hazards and pollen allergies in their workplaces. Moreover, the regulatory authorities conduct no formal health awareness and training/education sessions to minimize the exposure and associate risk. The findings of the study will aid in a better understanding of the working conditions and health status of occupational gardeners, as well as the development of appropriate methods to improve their working conditions.
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Affiliation(s)
- Akshi Goyal
- Department of Environment Studies, Panjab University, Chandigarh, 160014, India
| | - Khaiwal Ravindra
- Department of Community Medicine & School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India
| | - Suman Mor
- Department of Environment Studies, Panjab University, Chandigarh, 160014, India.
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Adams-Groom B, Selby K, Derrett S, Frisk CA, Pashley CH, Satchwell J, King D, McKenzie G, Neilson R. Pollen season trends as markers of climate change impact: Betula, Quercus and Poaceae. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 831:154882. [PMID: 35364159 DOI: 10.1016/j.scitotenv.2022.154882] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/19/2022] [Accepted: 03/24/2022] [Indexed: 06/14/2023]
Abstract
The incidences of respiratory allergies are at an all-time high. Pollen aeroallergens can reflect changing climate, with recent studies in Europe showing some, but not all, pollen types are increasing in severity, season duration and experiencing an earlier onset. This study aimed to identify pollen trends in the UK over the last twenty-six years for a range of pollen sites, with a focus on the key pollen types of Poaceae (grass), Betula (birch) and Quercus (oak) and to examine the relationship of these trends with meteorological factors. Betula pollen seasons show no significant trends for onset, first high day or duration but increasing pollen production in the Midlands region of the UK is being driven by warmer temperatures in the previous June and July. Quercus pollen seasons are starting earlier, due to increasing temperature and sunshine totals in April, but are not becoming more severe. The seasons are lasting longer, although no significant climate drivers for this were identified. The first high day of the Poaceae pollen season is occurring earlier in central UK regions due to an increasing trend for all temperature variables in the previous December, January, April, May and June. Severity and duration of the season show no significant trends and are spatially and temporally variable. Important changes are occurring in the UK pollen seasons that will impact on the health of respiratory allergy sufferers, with more severe Betula pollen seasons and longer Quercus pollen seasons. Most of the changes identified were caused by climate drivers of increasing temperature and sunshine total. However, Poaceae pollen seasons are neither becoming more severe nor longer. The reasons for this included a lack of change in some monthly meteorological variables, or land-use change, such as grassland being replaced by urban areas or woodland.
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Affiliation(s)
| | - Katherine Selby
- The Department of Environment and Geography, Wentworth Way, University of York, Heslington, York YO10 5NG, UK.
| | - Sally Derrett
- Department of Archaeology, University of Sheffield, Minalloy House, 10-16 Regent St, Sheffield City Centre, Sheffield, S1 3NJ, UK.
| | - Carl A Frisk
- School of Science and Environment, University of Worcester, WR2 6AJ, UK.
| | - Catherine Helen Pashley
- Aerobiology and Clinical Mycology, Department of Respiratory Sciences, Institute for Lung Health, University of Leicester, University Road, Leicester LE1 7RH, UK.
| | - Jack Satchwell
- Aerobiology and Clinical Mycology, Department of Respiratory Sciences, Institute for Lung Health, University of Leicester, University Road, Leicester LE1 7RH, UK.
| | - Dale King
- The James Hutton Institute, Dundee DD2 5DA, Scotland, UK.
| | | | - Roy Neilson
- The James Hutton Institute, Dundee DD2 5DA, Scotland, UK.
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Kumanomidou H, Kanai K, Oka A, Haruna T, Hirata Y, Makihara SI, Higaki T, Akamatsu M, Okamoto Y, Ikeda S, Okano M. Mapping naso-ocular symptom scores to EQ-5D-5L utility values in Japanese cedar pollinosis. Allergol Int 2022; 71:207-213. [PMID: 34872827 DOI: 10.1016/j.alit.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/05/2021] [Accepted: 10/30/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The total naso-ocular symptom score (TSS) is widely used as an endpoint to evaluate the severity of seasonal allergic rhinitis. However, it is not a generic preference-based measure. We sought to develop an algorithm for mapping between the TSS and health utility in Japanese cedar pollinosis (JCP). We also performed a cost-utility analysis of sublingual immunotherapy (SLIT) for JCP by using this algorithm. METHODS Patients with JCP filled out the TSS questionnaire and EQ-5D-5L simultaneously during the pollen season in 2019 and in 2020. We estimated a direct utility mapping model by regressing responses to individual TSS questions directly onto utility. The incremental cost-effectiveness ratio (ICER) of active SLIT to a placebo was determined by examining the drug expense and the estimated quality-adjusted life year (QALY) using a dataset from a double-blind placebo-controlled clinical trial. RESULTS A total of 238 records were included for analysis. The estimated utility decreased with increasing severity of rhinitis. Patients with comorbid asthma showed lower utility. A negative and significant correlation was seen between the TSS and utility in both 2019 and 2020. The estimated equations were: Y(utility) = -0.0161∗X(TSS) + 1.005 in non-asthmatic JCP patients. The ICER of active SLIT to the placebo was estimated to be 4,049,720 and 6,011,218 JPY/QALY in the first and second year, respectively. CONCLUSIONS It is possible to reasonably predict utility from the total naso-ocular symptom score by using regression models. In the estimated algorithm, pre-seasonal SLIT for JCP is cost-effective.
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Effects of a Cloth Panel Containing a Specific Ore Powder on Patients with Chamaecyparis obtusa (Cypress) Pollen Allergy. ScientificWorldJournal 2021; 2021:3924393. [PMID: 34803524 PMCID: PMC8598349 DOI: 10.1155/2021/3924393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 10/29/2021] [Indexed: 12/03/2022] Open
Abstract
Pollen allergy to Japanese cedar and cypress is a serious illness that impairs daily life and sleep, especially during pollen season. We have reported that placing a cloth panel containing a specific natural ore powder (CCSNOP) in a room may alleviate the symptoms of hay fever and may also benefit the immune system. This ore is from the Aso mountain range, a volcano on Kyushu Island in the southwestern part of Japan. The purpose of this study was to verify the effect of CCSNOP on cypress pollen. Thirty-one double-blind tests, which investigated cedar pollen allergies, were conducted from February to March 2018 and have already been reported. After this, in early April, 10 of these cases were recruited and all had CCSNOP installed in their bedrooms. Before that, various symptoms and changes in medication were recorded in a “Symptom Diary” and included a mood survey by a questionnaire, stress test using saliva amylase, changes in cypress-specific immunoglobulins IgE and IgG4 by blood sampling, and eosinophil changes. In addition, changes in 29 types of cytokines were investigated. Exposure to CCSNOP relieved symptoms and subjects decreased their intake of medication. There was no change in mood or stress, but eosinophil levels tended to decrease. Although there were no statistical changes in cypress-specific IgE or IgG4, an increase in the former and a decrease in the latter were observed in some individuals during the period of pollen dispersal. Furthermore, levels of GM-CSF and IL8 decreased significantly after use of CCSNOP. The CCSNOP was shown to be effective against cypress pollen allergy, and future investigations will be necessary to observe the long-term effects of CCSNOP.
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Denda M, Nakanishi S. Do epidermal keratinocytes have sensory and information processing systems? Exp Dermatol 2021; 31:459-474. [PMID: 34726302 DOI: 10.1111/exd.14494] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 10/26/2021] [Accepted: 10/30/2021] [Indexed: 01/22/2023]
Abstract
It was long considered that the role of epidermal keratinocytes is solely to construct a water-impermeable protective membrane, the stratum corneum, at the uppermost layer of the skin. However, in the last two decades, it has been found that keratinocytes contain multiple sensory systems that detect environmental changes, including mechanical stimuli, sound, visible radiation, electric fields, magnetic fields, temperature and chemical stimuli, and also a variety of receptor molecules associated with olfactory or taste sensation. Moreover, neurotransmitters and their receptors that play crucial roles in the brain are functionally expressed in keratinocytes. Recent studies have demonstrated that excitation of keratinocytes can induce sensory perception in the brain. Here, we review the sensory and information processing capabilities of keratinocytes. We discuss the possibility that epidermal keratinocytes might represent the earliest stage in the development of the brain during the evolution of vertebrates.
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Affiliation(s)
- Mitsuhiro Denda
- Institute for Advanced Study of Mathematical Sciences, Meiji University, Nakano-ku, Tokyo, 164-8525, Japan
| | - Shinobu Nakanishi
- Shiseido Global Innovation Center, Nishi-ku, Yokohama, 220-0011, Japan
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