Long-Term Pollen Monitoring in the Benelux: Evaluation of Allergenic Pollen Levels and Temporal Variations of Pollen Seasons

Current and Future Effects of Climate Change on Airborne Allergens

PURPOSE OF REVIEW

Delineation of the impact of elevated carbon dioxide and concomitant global warming on airborne allergens is performed.

RECENT FINDINGS

European tree pollen trends in general showed earlier start and end dates and increased total pollen release, with some differences both in locale and among species. Earlier flowering was also seen with grasses and weeds. In the case of some boreal trees, flowering was delayed due to a pre-seasonal requirement for necessary accumulated chilling temperature to achieve bud-set. Anthropogenic climate change induced rise in temperature and CO2 levels has resulted in demonstrable increases in aeroallergens. This has been most dramatic in tree pollen annual load, but also seen with grasses and weeds. Collected data is greatest for the Northern Hemisphere, especially the European continent, with supporting data from North America and Australia.

Long-term pollen season trends of Fraxinus (ash), Quercus (oak) and Ambrosia artemisiifolia (ragweed) as indicators of anthropogenic climate change impact

The ongoing climatic change, together with atmospheric pollution, influences the timing, duration and intensity of pollen seasons of some allergenic plant taxa. To study these influences, we correlated the trends in the pollen season characteristics of both woody (Fraxinus, Quercus) and herbaceous (Ambrosia) taxa from two pollen monitoring stations in Slovakia with the trends in meteorological factors and air pollutants during the last two decades. In woody species, the increased temperature during the formation of flower buds in summer and autumn led to an earlier onset and intensification of next year's pollen season, especially in Quercus. The increase of relative air humidity and precipitation during this time also had a positive influence on the intensity of the pollen season of trees. The pollen season of the invasive herbaceous species Ambrosia artemisiifolia was prolonged by increased temperature and humidity during the summer and autumn of the same year, which extended the blooming period and delayed the end of the pollen season. From the studied air pollutants, only three were found to correlate with the intensity of the pollen season of the studied taxa, CO - positively and SO2 and NO2 - negatively. It is important to study these long-term trends since they not only give us valuable insight into the response of plants to changing conditions but also enable the prognosis of the exacerbations of pollen-related allergenic diseases.

Projections of the start of the airborne pollen season in Barcelona (NE Iberian Peninsula) over the 21st century

The effects of global warming are numerous and recent studies reveal that they can affect the timing of pollination. Temperature is the meteorological variable that presents a clearer relationship with the start of the pollination season of most of the observed airborne pollen taxa. In Catalonia, in the last fifty years, the average annual air temperature has increased by +0.23 °C/decade, and the local warming has been slightly higher than the one on a global scale. Projections point to an increase in temperature in the coming decades, which would be more marked towards the middle of the century. To analyse the effect of the increase in temperature due to global warming on the starting date of pollen season in Barcelona, a forecasting model has been applied to a set of projected future temperatures estimated by the European RESCCUE project. This model, largely used in the literature, is based on determining the thermal needs of the plant for the pollen season to begin. The model calibration to obtain the initial parameters has been made by using 20 years of pollen data (2000-2019), and the model effectiveness has subsequently been tested through an internal evaluation over the period of the calibration and an external evaluation on 4 years not included in the calibration (2020-2023). The mean bias error in the internal calibration ranged between -0.4 and - 0.6 days, and between +0.5 and - 8.3 in the external one, depending on the taxon. The results of the application of the model to the temperature projections over the 21st century point to a progressive advancement in the pollination dates of several pollen types abundant in the city, allergenic most of them. These advances ranged, at the end of the century, between 15 and 27 days, depending on the climate model, for the scenario of the highest concentrations (RCP8.5) and between 7 and 12 days for the emissions stabilization scenario (RCP4.5).

The effects of the COVID-19 pandemic on PICU admissions for severe asthma exacerbations: A single-center experience

BACKGROUND

The incidence of severe asthma exacerbations (SAE) requiring a pediatric intensive care unit (PICU) admission during the coronavirus disease 2019 (COVID-19) pandemic (and its association with public restrictions) is largely unknown. We examined the trend of SAE requiring PICU admission before, during, and after COVID-19 restrictions in Amsterdam, the Netherlands, and its relationship with features such as environmental triggers and changes in COVID-19 restriction measures.

METHODS

In this single-center, retrospective cohort study, all PICU admissions of children aged ≥2 years for severe asthma at the Amsterdam UMC between 2018 and 2022 were included. The concentrations of ambient fine particulate matter (PM2.5 ) and pollen were obtained from official monitoring stations.

RESULTS

Between January 2018 and December 2022, 228 children were admitted to the PICU of the Amsterdam UMC for SAE. While we observed a decrease in admissions during periods of more stringent restriction, there was an increase in the PICU admission rate for SAE in some periods following the lifting of restrictions. In particular, following the COVID-19 restrictions in 2021, we observed a peak incidence of admissions from August to November, which was higher than any other peak during the indicated years. No association with air pollution or pollen was observed.

CONCLUSION

We hypothesize that an increase in clinically diagnosed viral infections after lockdown periods was the reason for the altered incidence of SAE at the PICU in late 2021, rather than air pollution and pollen concentrations.

Isolating the species element in grass pollen allergy: A review

Grass pollen is a leading cause of allergy in many countries, particularly Europe. Although many elements of grass pollen production and dispersal are quite well researched, gaps still remain around the grass species that are predominant in the air and which of those are most likely to trigger allergy. In this comprehensive review we isolate the species aspect in grass pollen allergy by exploring the interdisciplinary interdependencies between plant ecology, public health, aerobiology, reproductive phenology and molecular ecology. We further identify current research gaps and provide open ended questions and recommendations for future research in an effort to focus the research community to develop novel strategies to combat grass pollen allergy. We emphasise the role of separating temperate and subtropical grasses, identified through divergence in evolutionary history, climate adaptations and flowering times. However, allergen cross-reactivity and the degree of IgE connectivity in sufferers between the two groups remains an area of active research. The importance of future research to identify allergen homology through biomolecular similarity and the connection to species taxonomy and practical implications of this to allergenicity is further emphasised. We also discuss the relevance of eDNA and molecular ecological techniques (DNA metabarcoding, qPCR and ELISA) as important tools in quantifying the connection between the biosphere with the atmosphere. By gaining more understanding of the connection between species-specific atmospheric eDNA and flowering phenology we will further elucidate the importance of species in releasing grass pollen and allergens to the atmosphere and their individual role in grass pollen allergy.

Variation in the Concentration of Tilia spp. Pollen in the Aeroplankton of Lublin and Szczecin, Poland

Although lime trees have numerous benefits, they can pose a threat to allergy sufferers during the flowering period, as their pollen exhibits allergenic properties. This paper presents the results of 3 years of aerobiological research (2020-2022) carried out with the volumetric method in Lublin and Szczecin. A comparison of the pollen seasons in both cities revealed substantially higher concentrations of lime pollen in the air of Lublin than of Szczecin. In the individual years of the study, the maximum pollen concentrations were approximately 3-fold higher, and the annual pollen sum was about 2-3 times higher in Lublin than in Szczecin. Considerably higher lime pollen concentrations were recorded in both cities in 2020 than in the other years, which was probably associated with the 1.7-2.5 °C increase in the average temperature in April compared to the other two years. The maximum lime pollen concentrations were recorded during the last ten days of June or at the beginning of July in both Lublin and Szczecin. This period was associated with the greatest risk of pollen allergy development in sensitive subjects. The increased production of lime pollen in 2020 and in 2018-2019 with the increase in the mean temperature in April, reported in our previous study, may indicate a response of lime trees to the global warming phenomenon. Cumulative temperatures calculated for Tilia may serve as a basis for forecasting the beginning of the pollen season.

25-year retrospective longitudinal study on seasonal allergic rhinitis associations with air temperature in general practice

Due to climate change, air temperature in the Netherlands has gradually increased. Higher temperatures lead to longer pollen seasons. Possible relations between air temperature and increased impact of seasonal allergic rhinitis (SAR) in general practice have not been investigated yet. We explored trends in timing of frequent seasonal allergic rhinitis presentation to general practitioners (GPs) over 25 years and explored associations with air temperature. We performed a retrospective exploratory longitudinal study with data from our Family Medicine Network (1995-2019), including all SAR patients and their GP-encounters per week. We determined patients' GP-consultation frequency. Every year we identified seasonal periods with substantial increase in SAR related encounters: peak-periods. We determined start date and duration of the peak-period and assessed associations with air temperature in the beginning and throughout the year, respectively. The peak-period duration increased by a mean of 1.3 days (95% CI 0.23-2.45, P = 0.02) per year throughout the study period. Air temperature between February and July showed a statistically significant association with peak-period duration. We could not observe direct effects of warmer years on the start of peak-periods within distinct years (P = 0.06). SAR patients' contact frequency slightly increased by 0.01 contacts per year (95% CI 0.002-0.017, P = 0.015). These longitudinal findings may help to facilitate further research on the impact of climate change, and raise awareness of the tangible impact of climate change in general practice.

DNA metabarcoding using nrITS2 provides highly qualitative and quantitative results for airborne pollen monitoring

Airborne pollen monitoring is of global socio-economic importance as it provides information on presence and prevalence of allergenic pollen in ambient air. Traditionally, this task has been performed by microscopic investigation, but novel techniques are being developed to automate this process. Among these, DNA metabarcoding has the highest potential of increasing the taxonomic resolution, but uncertainty exists about whether the results can be used to quantify pollen abundance. In this study, it is shown that DNA metabarcoding using trnL and nrITS2 provides highly improved taxonomic resolution for pollen from aerobiological samples from the Netherlands. A total of 168 species from 143 genera and 56 plant families were detected, while using a microscope only 23 genera and 22 plant families were identified. NrITS2 produced almost double the number of OTUs and a much higher percentage of identifications to species level (80.1%) than trnL (27.6%). Furthermore, regressing relative read abundances against the relative abundances of microscopically obtained pollen concentrations showed a better correlation for nrITS2 (R2 = 0.821) than for trnL (R2 = 0.620). Using three target taxa commonly encountered in early spring and fall in the Netherlands (Alnus sp., Cupressaceae/Taxaceae and Urticaceae) the nrITS2 results showed that all three taxa were dominated by one or two species (Alnus glutinosa/incana, Taxus baccata and Urtica dioica). Highly allergenic as well as artificial hybrid species were found using nrITS2 that could not be identified using trnL or microscopic investigation (Alnus × spaethii, Cupressus arizonica, Parietaria spp.). Furthermore, perMANOVA analysis indicated spatiotemporal patterns in airborne pollen trends that could be more clearly distinguished for all taxa using nrITS2 rather than trnL. All results indicate that nrITS2 should be the preferred marker of choice for molecular airborne pollen monitoring.