Cedar and cypress pollen counts are associated with the prevalence of allergic diseases in Japanese schoolchildren

JACQLQ subjective symptom questionnaire score and clinical test results for patients with allergic conjunctival disease

We investigated the relationship between subjective symptoms and objective findings in patients with allergic conjunctival diseases (ACD) and test results for tear total IgE (t-tIgE), conjunctival eosinophils (c-Eo), serum total IgE (s-tIgE), serum-antigen specific IgE (s-sIgE), and serum eosinophils (s-Eo). Subjective symptoms and objective findings of patients with ACD were evaluated using Japanese Allergic Conjunctival Disease Quality of Life Questionnaire (JACQLQ), which described disability score and emotional score written by patient and clinical findings score written by ophthalmologist. We investigated the relationship between questionnaire scores and laboratory data for t-tIgE, c-Eo, s-tIgE, s-sIgE, and s-Eo. Scores of impediments to life and of moods were highest in vernal keratoconjunctivitis among ACD. Cases with positive pollen-sIgE showed significantly more nasal symptom score than those with negative pollen-sIgE (P < 0.05). Cases with positive t-tIgE or c-Eo showed significantly more objective symptoms' JACQLQ score than those with negative t-tIgE or c-Eo (P < 0.05), respectively. Cases positive for house dust/mite-sIgE, showed significantly more objective symptoms' JACQLQ score than those without for house dust/mite-sIgE (P < 0.05). These results indicate that ACD could be analyzed more accurately by the combination of JACQLQ and laboratory data.

Rhinitis in Japanese students - associations with window pane condensation, recent indoor painting, wooden home and dog allergen at school

We studied risk factors for rhinitis in Japanese homes and schools. A questionnaire was sent to students in four schools (12-15 y age), 1048 (99.2%) participated. Crowdedness and furry pet allergens were measured in their classrooms. Household environment data was collected by a questionnaire. Risk factors were identified by multi-level logistic regression with mutual adjustment. The prevalence of current rhinitis was 60.3%, current rhinoconjunctivitis 24.4% and weekly rhinitis 29.5%. Window condensation (AORs1.69-1.90) and indoor painting (AORs1.72-1.76) at home were associated with rhinitis. The association between painting and rhinitis was stronger in girls (interaction p = 0.002) and in wooden homes (interaction p = 0.05). Dog allergen (Can f 1) in classroom air was associated with rhinitis (p = 0.04). In conclusion, window pane condensation and indoor painting can be household risk factors for rhinitis and dog allergen may be a risk factor in Japanese schools. Girls can be more sensitive to emissions from indoor paint than boys.

Association of asthma exacerbations with paper mulberry (Broussenetia papyrifera) pollen in Islamabad: An observational study

Background

Although the role of airborne plant pollen in causing allergic rhinitis has been established, the association of concentrations of paper mulberry (Broussenetia papyrifera) pollens in the air and incidence of asthma exacerbations has not, despite an observed increase in the number of asthma patients attending physician clinics and hospital Accident and Emergency (A&E) Departments during the paper mulberry pollen season. We aimed to assess the association between paper mulberry pollen concentrations (typically peaking in March each year) and asthma exacerbations in the city of Islamabad.

Methods

We used three approaches to investigate the correlation of paper mulberry pollen concentration with asthma exacerbations: A retrospective analysis of historical records (2000-2019) of asthma exacerbations of patients from the Allergy and Asthma Institute, Pakistan (n = 284), an analysis of daily nebulisations in patients attending the A&E Department of the Pakistan Institute of Medical Sciences (March 2020 to July 2021), a prospective peak expiratory flow rate (PEFR) diary from participants (n = 40) with or without asthma and with or without paper mulberry sensitisation. We examined associations between pollen data and asthma exacerbations using Pearson correlation.

Results

We found a strong positive correlation between mean paper mulberry pollen counts and clinical records of asthma exacerbations in patients sensitised to paper mulberry (Pearson correlation coefficient (r) = 0.86; P < 0.001), but not in non-sensitised patients (r = 0.32; P = 0.3). There was a moderate positive correlation between monthly nebulisation counts and pollen counts (r = 0.56; P = 0.03), and a strong negative correlation between percent predicted PEFR and pollen counts in sensitised asthma patients (r = -0.72, P < 0.001). However, these correlations were of low magnitude in the non-sensitised asthma (r = -0.16; P < 0.001) and sensitised non-asthma (r = -0.28; P < 0.001) groups.

Conclusions

Our three approaches to analysis all showed an association between high paper mulberry pollen concentration in Islamabad and asthma exacerbations. Predicting pollen peaks could enable alerts and mobilise strategies to proactively manage these peaks of asthma exacerbations.

TFOS Lifestyle Report: Impact of environmental conditions on the ocular surface

Environmental risk factors that have an impact on the ocular surface were reviewed and associations with age and sex, race/ethnicity, geographical area, seasonality, prevalence and possible interactions between risk factors are reviewed. Environmental factors can be (a) climate-related: temperature, humidity, wind speed, altitude, dew point, ultraviolet light, and allergen or (b) outdoor and indoor pollution: gases, particulate matter, and other sources of airborne pollutants. Temperature affects ocular surface homeostasis directly and indirectly, precipitating ocular surface diseases and/or symptoms, including trachoma. Humidity is negatively associated with dry eye disease. There is little data on wind speed and dewpoint. High altitude and ultraviolet light exposure are associated with pterygium, ocular surface degenerations and neoplastic disease. Pollution is associated with dry eye disease and conjunctivitis. Primary Sjögren syndrome is associated with exposure to chemical solvents. Living within a potential zone of active volcanic eruption is associated with eye irritation. Indoor pollution, "sick" building or house can also be associated with eye irritation. Most ocular surface conditions are multifactorial, and several environmental factors may contribute to specific diseases. A systematic review was conducted to answer the following research question: "What are the associations between outdoor environment pollution and signs or symptoms of dry eye disease in humans?" Dry eye disease is associated with air pollution (from NO2) and soil pollution (from chromium), but not from air pollution from CO or PM10. Future research should adequately account for confounders, follow up over time, and report results separately for ocular surface findings, including signs and symptoms.

Use of Ketotifen Fumarate-Eluting Daily Disposable Soft Contact Lens in Management of Ocular Allergy: Literature Review and Report of Two Cases

We present two cases in which the drug-eluting daily disposable soft contact lens (DDSCL) Acuvue® Theravision^TM with Ketotifen (Johnson & Johnson Vision Care, Inc., Jacksonville, Florida, USA) (ATK), which contains the anti-allergic drug ketotifen fumarate, alleviated ocular allergic symptoms. Case 1 was a 57-year-old woman with a history of allergic conjunctivitis in the spring and fall. In the summer and winter, the patient used frequent replacement soft contact lenses, but in the allergy seasons, she used DDSCLs in combination with anti-allergic eye drops. She agreed to start wearing ATK lenses from before the next fall season. The lenses suppressed her allergic signs and symptoms, and she felt comfortable wearing them and continued their use throughout the season. Her symptoms were suppressed, providing her comforts that enabled uses of the CLs for some time. She successfully used the lenses again from the beginning of the next spring season. Case 2 was a 31-year-old woman with a history of cedar pollinosis. The patient previously used DDSCLs and was prescribed ATK lenses at her regular clinic. About one month later, she was referred to our department. With ATK lenses, she did not experience any subjective symptoms during the pollinosis season. At a subsequent visit, hyperemia had decreased compared with the initial visit. In these two cases, the use of ATK lenses from before until the end of both the spring and fall allergy seasons suppressed the symptoms of allergic conjunctivitis, allowing the patients to continue to wear contact lenses.

Is Pollen Production of Birch Controlled by Genetics and Local Conditions?

Intraspecific genetic variation might limit the relevance of environmental factors on plant traits. For example, the interaction between genetics and (a-)biotic factors regulating pollen production are still poorly understood. In this study, we investigated pollen production of 28 birch (Betula pendula Roth) individuals in the years 2019−2021. We sampled catkins of eleven groups of genetically identical trees, which were partially topped, but of the same age and located in a seed plantation in southern Germany characterized by similar microclimatic conditions. Furthermore, we monitored environmental factors such as air temperature, characterized air quality (NO2, NOx and O3), and assessed potential solar radiation. We especially checked for differences between years as well as between and within clones and assessed the synchronicity of years with high/low pollen production. We present a robust mean for the pollen production of Betula pendula (1.66 million pollen grains per catkin). Our findings show temporal (H(2) = 46.29, p < 0.001) and clonal variations (H(4) = 21.44, p < 0.001) in pollen production. We conclude that synchronized high or low pollen production is not utterly site-specific and, in addition, not strictly dependent on genotypes. We suggest that appropriate clone selection based on application (seed plantation, urban planting) might be advantageous and encourage a long-term monitoring.

Associations between sensitisation to allergens and allergic diseases: a hospital-based case-control study in China

OBJECTIVES

To assess the associations of sensitisation to common allergens with atopic dermatitis, allergic rhinitis and allergic asthma in adults.

DESIGN

Case-control study.

SETTING

Data were collected from the First Affiliated Hospital of Harbin Medical University in Harbin, China.

PARTICIPANTS

Cases were 5111 patients with physician-diagnosed atopic dermatitis (n=2631), allergic asthma (n=1320) and allergic rhinitis (n=1160) recruited from the department of allergy from March 2009 to December 2017. Controls were 2576 healthy adults who underwent physical examination at the same hospital during the same period.

MAIN OUTCOME MEASURES

Specific IgE levels to 16 common food, indoor and outdoor allergens were assessed in all participants. Adjusted ORs and 95% CIs for the association between allergen sensitisation and allergic diseases were estimated using multivariate logistic regression.

RESULTS

The prevalence of allergen sensitisation was higher in patients with atopic dermatitis (indoor=17.14%, outdoor=12.85%, food=21.44%), allergic rhinitis (indoor=23.18%, outdoor=26.81%, food=8.94%) and allergic asthma (indoor=24.65%, outdoor=16.46%, food=14.31%) compared with controls (indoor=11.03%, outdoor=6.84%, food=5.83%). After adjustment for potential confounding variables, there was a dose-response relevance between the levels of allergen-specific IgE and allergic diseases (p trend <0.0001). The number of allergens to which a patient was sensitised increased the risk of allergic diseases (atopic dermatitis: highest adjusted OR=4.28, 95% CI 2.57 to 7.11; allergic rhinitis: highest adjusted OR=13.00, 95% CI 3.76 to 45.00; allergic asthma: OR=2.37, 95% CI 1.67 to 3.37).

CONCLUSION

There was a dose-response relevance between levels of allergen-specific IgE and allergic diseases' prevalence, and multiple sensitisations increased the risk of allergic diseases. This study provides evidence for the prophylaxis of allergic diseases.

Effects of a Cloth Panel Containing a Specific Ore Powder on Patients with Chamaecyparis obtusa (Cypress) Pollen Allergy

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.

Development and application of a method to classify airborne pollen taxa concentration using light scattering data

Although automated pollen monitoring networks using laser optics are well-established in Japan, it is thought that these methods cannot distinguish between pollen counts when evaluating various pollen taxa. However, a method for distinguishing the pollen counts of two pollen taxa was recently developed. In this study, we applied such a method to field evaluate the data of the two main allergens in Japan, Chamaecyparis obtusa and Cryptomeria japonica. We showed that the method can distinguish between the pollen counts of these two species even when they are simultaneously present in the atmosphere. This result indicates that a method for automated and simple two pollen taxa monitoring with high spatial density can be developed using the existing pollen network.

Short-term exposure to pollen and the risk of allergic and asthmatic manifestations: a systematic review and meta-analysis

BACKGROUND

Several studies have assessed effects of short-term exposure to pollen on allergic and asthmatic manifestations. The evidence is inconclusive, and no meta-analysis has been published.

OBJECTIVE

To synthesise the evidence on the relations between short-term pollen exposure and the risk of allergic and asthmatic manifestations.

METHODS

We performed a systematic literature search of PubMed and Scopus databases up to the end of August 2018. In addition, we reviewed the reference lists of relevant articles. Two authors independently evaluated the eligible articles and extracted relevant information in a structured form. We calculated summary effect estimates (EE) based on the study-specific ORs and regression coefficients (β) by applying both fixed-effects and random-effects models.

RESULTS

26 studies met the a priori eligibility criteria, and 12 of them provided sufficient information for the meta-analysis. The summary EE related to 10 grains per m³ increase in pollen exposure showed an 1% increase (EE 1.01, 95% CI 1.00 to 1.02) in the risk of lower respiratory symptoms and a 2% increase (EE 1.02, 95% CI 1.01 to 1.03) in the risk of any allergic or asthmatic symptom. Correspondingly, the risk of upper respiratory symptoms and ocular symptoms increased 7% (EE 1.07, 95% CI 1.04 to 1.09) and 11% (EE 1.11, 95% CI 1.05 to 1.17), respectively, in relation to such pollen exposure. Short-term exposure to pollen did not show any significant effect on daily lung function levels.

CONCLUSION

Our results provide new evidence that short-term pollen exposure significantly increases the risks of allergic and asthmatic symptoms.

Nationwide survey of the prevalence of wheeze, rhino-conjunctivitis, and eczema among Japanese children in 2015

BACKGROUND

Global surveys and cohort studies have been conducted to evaluate the prevalence of allergic disease in childhood, but only a few nationwide surveys have been conducted in Japan. We aimed to report the prevalence of childhood allergic disease in Japan and determine the prevalence distribution by sex and prefecture.

METHODS

In 2015, we conducted a school-based questionnaire survey using the Japanese version of the International Study of Asthma and Allergies in Childhood questionnaire among two age groups: primary school students (PS, 6-8 years old) and middle school students (MS, 13-15 years old). The schools were randomly selected from each prefecture.

RESULTS

Valid responses were obtained from 42,582 PS and 36,638 MS. Among PS and MS, the prevalence of wheeze was 10.2% and 8.2%, that of allergic rhino-conjunctivitis was 18.7% and 26.7%, and that of eczema was 14.6% and 9.7%, respectively. In terms of sex, the prevalence of wheeze and rhino-conjunctivitis was higher in male PS while that of rhino-conjunctivitis and eczema was higher in female MS. In terms of prefecture, there was a two-fold difference in the prevalence of wheeze and eczema and a four-fold difference in the prevalence of rhino-conjunctivitis, with each disease showing different distribution patterns.

CONCLUSIONS

We demonstrated the prevalence of allergic disease among PS and MS in 2015. The prevalence tended to be higher in male PS and female MS. Each disease exhibited different prevalence ranges and distributions. Identifying the factors behind these differences is a topic for future research.

Prevalence of allergic rhinitis and asthma in Poland in relation to pollen counts

Introduction

Despite the known role of pollen allergens in causing allergy symptoms in sensitized individuals, there are few publications investigating the relationship between pollen exposure in different regions and the prevalence of inhalant allergy.

Aim

To assess the association between the prevalence of allergic rhinitis and asthma and the degree of exposure to pollen in various regions of Poland.

Material and methods

Completed questionnaires of 9,443 subjects living in four urban centres (Wroclaw, Katowice, Warsaw, Bialystok), collected within part of the ECAP project, were analyzed. Children aged 6–7 (n = 2,278), adolescents aged 13–14 (n = 2,418), and adults aged 20–44 (n = 4,747) constituted 24.2%, 25.6% and 50.3% of the respondents, respectively. The clinical part (including skin prick tests, an assay of Timothy grass-specific IgE), was attended by 24% of the respondents. Data from 6-year pollen monitoring served to characterize birch and grass pollen seasons.

Results

We found insignificant negative associations between the duration of birch pollen season and the prevalence of declared allergic rhinitis and asthma during the season across all age groups. There were insignificant inverse associations between the number of days with above-threshold and high grass pollen concentrations, total grass pollen count and the prevalence of declared allergic rhinitis and asthma during the season across all age groups. Associations noted in the clinical part were also non-significant; however, these trends were not uniform across the age groups.

Conclusions

Our findings do not confirm the hypothesis of a positive association between pollen exposure and the prevalence of allergic rhinitis and asthma.

Associations between sensitization to perennial/seasonal allergens and childhood asthma

Background: Childhood asthma is an important public health problem worldwide. Risk factors for asthma development include allergic sensitization and exposure to animals. Objective: To identify which (perennial or seasonal) inhalant allergens are associated with asthma and allergic rhinitis in children. Methods: This was a cross-sectional, retrospective study. We evaluated data from medical documentation of 6,000 children (aged 6 – 18 years) with diagnosed asthma and/or allergic rhinitis who had attended our allergy outpatient clinic. Into the analyses we included those subjects who had specific IgE test done during diagnostic procedures to confirm allergen sensitization. Results: We included 5,076 children in the analysis. We showed that among seasonal allergens only sensitization to timothy or birch significantly changed the prevalence of allergic rhinitis and asthma diagnosis. Of the perennial allergens, house dust mite or cat were most closely related with both allergic rhinitis and asthma. Results of ROC curve analysis showed that in atopic children the specific IgE level of seasonal allergens did not significantly change the prevalence of asthma diagnosis. Sensitization to more than one perennial allergen significantly increased the prevalence of allergic rhinitis and asthma. Conclusion: We showed that sensitization to the seasonal allergens timothy and birch as well as to the perennial allergens house dust mite and cat, is associated with asthma and allergic rhinitis in children. Our study determined the role of multiple perennial indoor allergens in the developement of allergic diseases in children. The identification of the specific allergens makes them potential targets for intervention and prevention strategies.

Airborne pollen and suicide mortality in Tokyo, 2001-2011

Prior research has indicated that pollen might be linked to suicide mortality although the few studies that have been undertaken to date have produced conflicting findings and been limited to Western settings. This study examined the association between the level of airborne pollen and suicide mortality in Tokyo, Japan in the period from 2001 to 2011. The daily number of suicide deaths was obtained from the Japanese Ministry of Health, Labour and Welfare, with pollen data being obtained from the Tokyo Metropolitan Institute of Public Health. A time-stratified case-crossover study was performed to examine the association between different levels of pollen concentration and suicide mortality. During the study period there were 5185 male and 2332 female suicides in the pollen season (February to April). For men there was no association between airborne pollen and suicide mortality. For women, compared to when there was no airborne pollen, the same-day (lag 0) pollen level of 30 to <100 grains per cm² was associated with an approximately 50% increase in the odds for suicide (e.g. 30 to <50 grains per cm²: odds ratio 1.574, 95% confidence interval 1.076-2.303, p=0.020). The estimates remained fairly stable after adjusting for air pollutants and after varying the cut-points that defined the pollen levels. Our results indicate that pollen is associated with female suicide mortality in Tokyo.

Pollen concentrations and prevalence of asthma and allergic rhinitis in Italy: Evidence from the GEIRD study

BACKGROUND

Pollen exposure has acute adverse effects on sensitized individuals. Information on the prevalence of respiratory diseases in areas with different pollen concentrations is scanty.

AIM

We performed an ecologic analysis to assess whether the prevalence of allergic rhinitis and asthma in young adults varied across areas with different pollen concentrations in Italy.

METHODS

A questionnaire on respiratory diseases was delivered to random samples of 20-44year-old subjects from six centers in 2005-2010. Data on the daily air concentrations of 7 major allergologic pollens (Poaceae, Urticaceae, Oleaceae, Cupressaceae, Coryloideae, Betula and Ambrosia) were collected for 2007-2008. Center-specific pollen exposure indicators were calculated, including the average number of days per year with pollens above the low or high concentration thresholds defined by the Italian Association of Aerobiology. Associations between pollen exposure and disease prevalence, adjusted for potential confounders, were estimated using logistic regression models with center as a random-intercept.

RESULTS

Overall, 8834 subjects (56.8%) filled in the questionnaire. Allergic rhinitis was significantly less frequent in the centers with longer periods with high concentrations of at least one (OR per 10days=0.989, 95%CI: 0.979-0.999) or at least two pollens (OR=0.974, 95%CI: 0.951-0.998); associations with the number of days with at least one (OR=0.988, 95%CI: 0.972-1.004) or at least two (OR=0.985, 95%CI: 0.970-1.001) pollens above the low thresholds were borderline significant. Asthma prevalence was not associated with pollen concentrations.

CONCLUSIONS

Our study does not support that the prevalence of allergic rhinitis and asthma is greater in centers with higher pollen concentrations. It is not clear whether the observed ecologic associations hold at the individual level.

Factors associated with the severity of childhood rhinoconjunctivitis

BACKGROUND

Allergic rhinitis is one of the most common chronic diseases in children. Although it has a large impact on the patient's quality of life, little is known about the factors associated with its severity. The aim of this study was to assess the factors associated with the severity of rhinoconjunctivitis among children in the general population.

METHODS

A survey was conducted using an online research panel in 2012. Parents were asked to answer an International Study of Asthma and Allergies in Childhood-based questionnaire to identify children with current rhinoconjunctivitis and evaluate factors associated with the severity of its symptoms. Severity was rated according to the degree of impairment caused by the symptoms in the patient's daily life.

RESULTS

Among 26,725 children aged 6-12 years old, rhinoconjunctivitis was defined in 5175 (19.4%), and of these, 688 children (13.3% of children with current rhinoconjunctivitis) presented severe symptoms. Living in areas with a high cedar and cypress pollen count and having concurrent eczema were associated with severe rhinoconjunctivitis [adjusted OR (95% CI): 1.21 (1.00-1.46) and 1.45 (1.20-1.75), respectively]. Further, a maternal history of asthma and allergic rhinitis was a significant risk factor for severe rhinoconjunctivitis [1.34 (1.04-1.74) and 1.30 (1.10-1.53), respectively]. However, living with fur-bearing animals (pets) before 1 year of age proved to be a protective factor against severe rhinoconjunctivitis [0.70 (0.52-0.94)].

CONCLUSIONS

Environmental factors such as pets and pollen, together with comorbidities and a maternal history of allergic diseases, play an important role in determining the severity of rhinoconjunctivitis.

Pollen Allergens for Molecular Diagnosis

Pollen allergens are one of the main causes of type I allergies affecting up to 30% of the population in industrialized countries. Climatic changes affect the duration and intensity of pollen seasons and may together with pollution contribute to increased incidences of respiratory allergy and asthma. Allergenic grasses, trees, and weeds often present similar habitats and flowering periods compromising clinical anamnesis. Molecule-based approaches enable distinction between genuine sensitization and clinically mostly irrelevant IgE cross-reactivity due to, e. g., panallergens or carbohydrate determinants. In addition, sensitivity as well as specificity can be improved and lead to identification of the primary sensitizing source which is particularly beneficial regarding polysensitized patients. This review gives an overview on relevant pollen allergens and their usefulness in daily practice. Appropriate allergy diagnosis is directly influencing decisions for therapeutic interventions, and thus, reliable biomarkers are pivotal when considering allergen immunotherapy in the context of precision medicine.

Sports activities enhance the prevalence of rhinitis symptoms in schoolchildren

BACKGROUND

To evaluate the association between sports activities and allergic symptoms, especially rhinitis, among schoolchildren.

METHODS

This longitudinal survey of schoolchildren collected data from questionnaires regarding allergic symptoms based on the International Study of Asthma and Allergies in Childhood (ISAAC) program and sports participation that were distributed to the parents of children at all 12 public primary schools in Ohmi-Hachiman City, Shiga Prefecture, Japan. Data were collected annually from 2011 until 2014, when the children reached 10 years of age. Blood samples were obtained in 2014, and the levels of immunoglobulin (Ig)E specific to four inhalant allergens were measured.

RESULTS

Data from 558 children were analyzed. At 10 years of age, prevalence of asthma and eczema did not differ significantly, while rhinitis was significantly higher (p = 0.009) among children who participated in sports. Prevalence of rhinitis increased as the frequency or duration of sports participation increased (p < 0.01). The prevalence of new-onset rhinitis increased significantly among 10-year-olds with increasing duration of participation in sports (p = 0.03). Among those who participated in continuous sports activities, the prevalence of rhinitis was significantly higher with prolonged eczema (p = 0.006). Sports activities did not increase sensitization to inhalant allergens.

CONCLUSION

Sports activities enhance the prevalence of rhinitis in schoolchildren. Prolonged eczema, together with sports participation, further promotes the symptoms. The mechanisms of these novel findings warrant further investigation.

Tree pollen allergens-an update from a molecular perspective

It is estimated that pollen allergies affect approximately 40% of allergic individuals. In general, tree pollen allergies are mainly elicited by allergenic trees belonging to the orders Fagales, Lamiales, Proteales, and Pinales. Over 25 years ago, the gene encoding the major birch pollen allergen Bet v 1 was the first such gene to be cloned and its product characterized. Since that time, 53 tree pollen allergens have been identified and acknowledged by the WHO/IUIS allergen nomenclature subcommittee. Molecule‐based profiling of allergic sensitization has helped to elucidate the immunological connections of allergen cross‐reactivity, whereas advances in biochemistry have revealed structural and functional aspects of allergenic proteins. In this review, we provide a comprehensive overview of the present knowledge of the molecular aspects of tree pollen allergens. We analyze the geographic distribution of allergenic trees, discuss factors pivotal for allergic sensitization, and describe the role of tree pollen panallergens. Novel allergenic tree species as well as tree pollen allergens are continually being identified, making research in this field highly competitive and instrumental for clinical applications.

Relationships among indoor, outdoor, and personal airborne Japanese cedar pollen counts

Japanese cedar pollinosis (JCP) is an important illness caused by the inhalation of airborne allergenic cedar pollens, which are dispersed in the early spring throughout the Japanese islands. However, associations between pollen exposures and the prevalence or severity of allergic symptoms are largely unknown, due to a lack of understanding regarding personal pollen exposures in relation to indoor and outdoor concentrations. This study aims to examine the relationships among indoor, outdoor, and personal airborne Japanese cedar pollen counts. We conducted a 4-year monitoring campaign to quantify indoor, outdoor, and personal airborne cedar pollen counts, where the personal passive settling sampler that has been previously validated against a volumetric sampler was used to count airborne pollen grains. A total of 256 sets of indoor, outdoor, and personal samples (768 samples) were collected from 9 subjects. Medians of the seasonally-integrated indoor-to-outdoor, personal-to-outdoor, and personal-to-indoor ratios of airborne pollen counts measured for 9 subjects were 0.08, 0.10, and 1.19, respectively. A greater correlation was observed between the personal and indoor counts (r = 0.89) than between the personal and outdoor counts (r = 0.71), suggesting a potential inaccuracy in the use of outdoor counts as a basis for estimating personal exposures. The personal pollen counts differed substantially among the human subjects (49% geometric coefficient of variation), in part due to the variability in the indoor counts that have been found as major determinants of the personal pollen counts. The findings of this study highlight the need for pollen monitoring in proximity to human subjects to better understand the relationships between pollen exposures and the prevalence or severity of pollen allergy.

Allergy and asthma: Effects of the exposure to particulate matter and biological allergens

The prevalence of asthma and allergies including atopy has increased during the past decades, particularly in westernized countries. The rapid rise in the prevalence of such diseases cannot be explained by genetic factors alone. Rapid urbanization and industrialization throughout the world have increased air pollution and population exposures, so that most epidemiologic studies are focusing on possible links between air pollution and respiratory diseases. Furthermore, a growing body of evidence shows that chemical air pollution may interact with airborne allergens enhancing the risk of atopic sensitization and exacerbation of symptoms in sensitized subjects. These phenomena are supported by current in vitro and animal studies showing that the combined exposure to air pollutants and allergens may have a synergistic or additive effect on asthma and allergies, although there is an insufficient evidence about this link at the population level. Further research is needed in order to elucidate the mechanisms by which pollutants and biological allergens induce damage in exposed subjects. The abatement of the main risk factors for asthma and allergic diseases may achieve huge health benefits. Thus, it is important to raise awareness of respiratory allergies as serious chronic diseases which place a heavy burden on patients and on society as a whole.

Pectate lyase pollen allergens: sensitization profiles and cross-reactivity pattern

Background

Pollen released by allergenic members of the botanically unrelated families of Asteraceae and Cupressaceae represent potent elicitors of respiratory allergies in regions where these plants are present. As main allergen sources the Asteraceae species ragweed and mugwort, as well as the Cupressaceae species, cypress, mountain cedar, and Japanese cedar have been identified. The major allergens of all species belong to the pectate lyase enzyme family. Thus, we thought to investigate cross-reactivity pattern as well as sensitization capacities of pectate lyase pollen allergens in cohorts from distinct geographic regions.

Methods

The clinically relevant pectate lyase pollen allergens Amb a 1, Art v 6, Cup a 1, Jun a 1, and Cry j 1 were purified from aqueous pollen extracts, and patients´ sensitization pattern of cohorts from Austria, Canada, Italy, and Japan were determined by IgE ELISA and cross-inhibition experiments. Moreover, we performed microarray experiments and established a mouse model of sensitization.

Results

In ELISA and ELISA inhibition experiments specific sensitization pattern were discovered for each geographic region, which reflected the natural allergen exposure of the patients. We found significant cross-reactivity within Asteraceae and Cupressaceae pectate lyase pollen allergens, which was however limited between the orders. Animal experiments showed that immunization with Asteraceae allergens mainly induced antibodies reactive within the order, the same was observed for the Cupressaceae allergens. Cross-reactivity between orders was minimal. Moreover, Amb a 1, Art v 6, and Cry j 1 showed in general higher immunogenicity.

Conclusion

We could cluster pectate lyase allergens in four categories, Amb a 1, Art v 6, Cup a 1/Jun a 1, and Cry j 1, respectively, at which each category has the potential to sensitize predisposed individuals. The sensitization pattern of different cohorts correlated with pollen exposure, which should be considered for future allergy diagnosis and therapy.

The impact of co-existing seasonal allergic rhinitis caused by Japanese Cedar Pollinosis (SAR-JCP) upon asthma control status

BACKGROUND

Seasonal Allergic Rhinitis Caused by Japanese Cedar Pollinosis (SAR-JCP) is a most common allergic rhinitis, affecting about 40% in Japan, but the influence from SAR-JCP upon asthma is controversial. The purpose of this study is to investigate the effect of coexistence of SAR-JCP upon control status of asthma using SACRA (Self-Assessment of Allergic Rhinitis and Asthma Questionnaire).

METHODS

The design was prospective, single-center, observational study. Asthmatic patients were classified into 3 groups, patients without rhinitis, those with perennial rhinitis or those with SAR-JCP from the results of SACRA. The control status of asthma were evaluated by Visual Analog Scale (VAS) in SACRA and Asthma Control Test (ACT) score. They were evaluated twice, from September to January (nonpollen-season) and February to April (pollen-season) and compared.

RESULTS

451 patients were enrolled and 325 cases (72%) were diagnosed as having comorbidity of rhinitis, among which 173 with only perennial rhinitis, while 152 with SAR-JCP. There was no significant difference in asthma control level measured by VAS and ACT score among 3 groups during nonpollen-season. The asthma control level measured by VAS (1.91-2.95) and ACT score (22.7-21.6) got worse during pollen-season among patients with SAR-JCP, even though 84% received treatment for rhinitis. Although it differed according to criteria, asthma control during pollen-season was impaired in 18-38% asthmatic patients with SAR-JCP.

CONCLUSION

It is possible to minimize the influence of AR on asthma control by obtaining an accurate diagnosis and providing sufficient treatment for rhinitis.

Time-dependent variation in the responses to the web-based ISAAC questionnaire

BACKGROUND

Epidemiologic studies have shown seasonal variations in responses to the written questionnaire for rhinitis symptoms.

OBJECTIVE

To evaluate whether the timing of data collection affected responses to the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire in a Web-based study.

METHODS

The Web-based ISAAC questionnaires were completed by parents with children 6 to 12 years old using an online research system. The authors conducted surveys of asthma symptoms every month for 1 year and surveys of rhinitis and eczema symptoms every season throughout 1 entire year.

RESULTS

There was a significant fluctuation in the positive responses to questions about wheezing in the past 12 months (P < .001) but not in the positive responses to questions about exercise-induced wheezing in the past 12 months and asthma ever (P = .75 and P = .15, respectively). The positive responses to questions about rhinitis and allergic rhinoconjunctivitis in the past 12 months and pollinosis ever exhibited significant seasonal variations (P = .002, P < .001, and P < .001, respectively). In contrast, there were no significant variations in positive responses regarding eczema in the past 12 months and eczema ever (P = .33 and P = .55, respectively).

CONCLUSION

There were time-dependent fluctuations in responses to the Web-based questionnaire regarding allergic symptoms. Timing of data collection should be taken into account when evaluating prevalence of asthma and rhinitis in children.