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Dramburg S, Grittner U, Potapova E, Travaglini A, Tripodi S, Arasi S, Pelosi S, Acar Şahin A, Aggelidis X, Barbalace A, Bourgoin A, Bregu B, Brighetti MA, Caeiro E, Caglayan Sozmen S, Caminiti L, Charpin D, Couto M, Delgado L, Di Rienzo Businco A, Dimier C, Dimou MV, Fonseca JA, Goksel O, Hernandez D, Hernandez Toro CJ, Hoffmann TM, Jang DT, Kalpaklioglu F, Lame B, Llusar R, Makris M, Mazon A, Mesonjesi E, Nieto A, Öztürk AB, Pahus L, Pajno G, Panasiti I, Papadopoulos NG, Pellegrini E, Pereira AM, Pereira M, Pinar NM, Priftanji A, Psarros F, Sackesen C, Sfika I, Suarez J, Thibaudon M, Uguz U, Verdier V, Villella V, Xepapadaki P, Yazici D, Matricardi PM. Heterogeneity of sensitization profiles and clinical phenotypes among patients with seasonal allergic rhinitis in Southern European countries-The @IT.2020 multicenter study. Allergy 2024; 79:908-923. [PMID: 38311961 DOI: 10.1111/all.16029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 11/30/2023] [Accepted: 12/04/2023] [Indexed: 02/06/2024]
Abstract
BACKGROUND Pollen allergy poses a significant health and economic burden in Europe. Disease patterns are relatively homogeneous within Central and Northern European countries. However, no study broadly assessed the features of seasonal allergic rhinitis (SAR) across different Southern European countries with a standardized approach. OBJECTIVE To describe sensitization profiles and clinical phenotypes of pollen allergic patients in nine Southern European cities with a uniform methodological approach. METHODS Within the @IT.2020 multicenter observational study, pediatric and adult patients suffering from SAR were recruited in nine urban study centers located in seven countries. Clinical questionnaires, skin prick tests (SPT) and specific IgE (sIgE) tests with a customized multiplex assay (Euroimmun Labordiagnostika, Lübeck, Germany) were performed. RESULTS Three hundred forty-eight children (mean age 13.1 years, SD: 2.4 years) and 467 adults (mean age 35.7 years SD: 10.0 years) with a predominantly moderate to severe, persistent phenotype of SAR were recruited. Grass pollen major allergenic molecules (Phl p 1 and/or Phl p 5) ranged among the top three sensitizers in all study centers. Sensitization profiles were very heterogeneous, considering that patients in Rome were highly poly-sensitized (sIgE to 3.8 major allergenic molecules per patient), while mono-sensitization was prominent and heterogeneous in other cities, such as Marseille (sIgE to Cup a 1: n = 55/80, 68.8%) and Messina (sIgE to Par j 2: n = 47/82, 57.3%). Co-sensitization to perennial allergens, as well as allergic comorbidities also broadly varied between study centers. CONCLUSIONS In Southern European countries, pollen allergy is heterogeneous in terms of sensitization profiles and clinical manifestations. Despite the complexity, a unique molecular, multiplex, and customized in-vitro IgE test detected relevant sensitization in all study centers. Nevertheless, this geographical diversity in pollen allergic patients imposes localized clinical guidelines and study protocols for clinical trials of SAR in this climatically complex region.
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Affiliation(s)
- S Dramburg
- Department of Pediatric Respiratory Care, Immunology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - U Grittner
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - E Potapova
- Department of Pediatric Respiratory Care, Immunology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - A Travaglini
- Department of Biology, Tor Vergata University, Rome, Italy
- Italian Aerobiology Monitoring Network - Italian Aerobiology Association, Rome, Italy
| | - S Tripodi
- Pediatric Allergy Unit, Sandro Pertini Hospital, Rome, Italy
- Allergolology Service, Policlinico Casilino, Rome, Italy
| | - S Arasi
- Department of Pediatric Respiratory Care, Immunology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Pediatric Allergology Unit, Department of Pediatric Medicine, Bambino Gesù Children's Research Hospital (IRCCS), Rome, Italy
| | | | - A Acar Şahin
- Department of Biology, Faculty of Science, Ankara University, Ankara, Turkey
| | - X Aggelidis
- Allergy Unit, 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, University Hospital "Attikon", Athens, Greece
| | - A Barbalace
- Allergy Unit, Department of Pediatrics, University of Messina, Messina, Italy
| | - A Bourgoin
- Department of Pneumonology and Allergy, La Timone Hospital, APHM, Aix-Marseille University, Marseille, France
| | - B Bregu
- Department of Allergology and Clinical Immunology, UHC Mother Teresa, Medical University Tirana, Tirana, Albania
| | - M A Brighetti
- Department of Biology, Tor Vergata University, Rome, Italy
| | - E Caeiro
- MED- Mediterranean Institute for Agriculture, Environment and Development, Institute for Advanced Studies and Research, University of Évora, Évora, Portugal
- Portuguese Society of Allergology and Clinical Immunology, Lisbon, Portugal
| | | | - L Caminiti
- Allergy Unit, Department of Pediatrics, University of Messina, Messina, Italy
| | - D Charpin
- Department of Pneumonology and Allergy, La Timone Hospital, APHM, Aix-Marseille University, Marseille, France
| | - M Couto
- Immunoallergology, Hospital CUF Trindade, Porto, Portugal
| | - L Delgado
- Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, Porto, Portugal
- Allergy Unit, Instituto & Hospital CUF Porto, Porto, Portugal
| | | | - C Dimier
- Department of Pneumonology and Allergy, La Timone Hospital, APHM, Aix-Marseille University, Marseille, France
| | - M V Dimou
- Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece
| | - J A Fonseca
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, Porto, Portugal
- Allergy Unit, Instituto & Hospital CUF Porto, Porto, Portugal
- MEDCIDS-Department of Community Medicine, Information, and Health Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
| | - O Goksel
- Department of Pulmonary Medicine, Division of Immunology, Allergy and Asthma. Faculty of Medicine, Ege University, Izmir, Turkey
| | - D Hernandez
- Department of Allergy, Health Research Institute Hospital La Fe, Valencia, Spain
| | - C J Hernandez Toro
- Department of Pediatric Respiratory Care, Immunology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - T M Hoffmann
- Department of Pediatric Respiratory Care, Immunology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - D T Jang
- Pediatric Allergy and Pneumology Unit, Children's Hospital La Fe; Health Research Institute La Fe, Valencia, Spain
| | - F Kalpaklioglu
- Department of Immunology and Allergic Diseases, Kırıkkale University School of Medicine, Kırıkkale, Turkey
| | - B Lame
- Department of Allergology and Clinical Immunology, UHC Mother Teresa, Medical University Tirana, Tirana, Albania
| | - R Llusar
- Pediatric Allergy and Pneumology Unit, Children's Hospital La Fe; Health Research Institute La Fe, Valencia, Spain
| | - M Makris
- Allergy Unit, 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, University Hospital "Attikon", Athens, Greece
| | - A Mazon
- Pediatric Allergy and Pneumology Unit, Children's Hospital La Fe; Health Research Institute La Fe, Valencia, Spain
| | - E Mesonjesi
- Department of Allergology and Clinical Immunology, UHC Mother Teresa, Medical University Tirana, Tirana, Albania
| | - A Nieto
- Pediatric Allergy and Pneumology Unit, Children's Hospital La Fe; Health Research Institute La Fe, Valencia, Spain
| | - A B Öztürk
- Division of Allergy and Immunology, Department of Pulmonary Medicine, Arel University, School of Medicine, Istanbul, Turkey
| | - L Pahus
- Aix Marseille Univ, APHM, INSERM CIC 1409, INSERM U1263, INRA 1260 (C2VN), Marseille, France
| | - G Pajno
- Allergy Unit, Department of Pediatrics, University of Messina, Messina, Italy
| | - I Panasiti
- Allergy Unit, Department of Pediatrics, University of Messina, Messina, Italy
| | - N G Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece
- Division of Infection, Immunity & Respiratory Medicine, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK
| | - E Pellegrini
- Department of Reggio Calabria, ARPA - Regional Agency for Environmental Protection, Calabria, Italy
| | - A M Pereira
- Allergy Unit, Instituto & Hospital CUF Porto, Porto, Portugal
- MEDCIDS-Department of Community Medicine, Information, and Health Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
| | - M Pereira
- Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, Porto, Portugal
| | - N M Pinar
- Department of Biology, Faculty of Science, Ankara University, Ankara, Turkey
| | - A Priftanji
- Department of Allergology and Clinical Immunology, UHC Mother Teresa, Medical University Tirana, Tirana, Albania
| | - F Psarros
- Allergy Department, Athens Naval Hospital, Athens, Greece
| | - C Sackesen
- Division of Pediatric Allergy, Koç University School of Medicine, Istanbul, Turkey
| | - I Sfika
- Pediatric Allergy Unit, Sandro Pertini Hospital, Rome, Italy
| | - J Suarez
- Department of Biology of Organisms and Systems, Area of Botany, University of Oviedo, Oviedo, Spain
| | - M Thibaudon
- Réseau National de Surveillance Aérobiologique, Brussieu, France
| | - U Uguz
- Department of Biology, Faculty of Science, Ege University, Izmir, Turkey
| | - V Verdier
- Department of Pneumonology and Allergy, La Timone Hospital, APHM, Aix-Marseille University, Marseille, France
| | - V Villella
- Pediatric Allergy Unit, Sandro Pertini Hospital, Rome, Italy
| | - P Xepapadaki
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - D Yazici
- Cellular and Molecular Medicine, KUTTAM, Graduate School of Health Sciences, Koç University, Istanbul, Turkey
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - P M Matricardi
- Department of Pediatric Respiratory Care, Immunology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Lipp T, Acar Şahin A, Aggelidis X, Arasi S, Barbalace A, Bourgoin A, Bregu B, Brighetti MA, Caeiro E, Caglayan Sozmen S, Caminiti L, Charpin D, Couto M, Delgado L, Di Rienzo Businco A, Dimier C, Dimou MV, Fonseca JA, Goksel O, Guvensen A, Hernandez D, Hoffmann TM, Jang DT, Kalpaklioglu F, Lame B, Llusar R, Makris MP, Mazon A, Mesonjesi E, Nieto A, Öztürk A, Pahus L, Pajno GB, Panasiti I, Papadopoulos NG, Pellegrini E, Pelosi S, Pereira AM, Pereira M, Pinar M, Potapova E, Priftanji A, Psarros F, Sackesen C, Sfika I, Suarez J, Thibaudon M, Travaglini A, Tripodi S, Verdier V, Villella V, Xepapadaki P, Yazici D, Matricardi PM, Dramburg S. Heterogeneity of pollen food allergy syndrome in seven Southern European countries: The @IT.2020 multicenter study. Allergy 2021; 76:3041-3052. [PMID: 33492738 DOI: 10.1111/all.14742] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 11/17/2020] [Accepted: 11/25/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Pollen food allergy syndrome (PFAS) is a frequently underdiagnosed disease due to diverse triggers, clinical presentations, and test results. This is especially relevant in geographic areas with a broad spectrum of pollen sensitization, such as Southern Europe. OBJECTIVES To elucidate similarities and differences of PFAS in nine Southern European centers and identify associated characteristics and unique markers of PFAS. METHODS As part of the @IT.2020 Multicenter Study, 815 patients with seasonal allergic rhinitis (SAR), aged 10-60 years, were recruited in seven countries. They completed questionnaires regarding SAR, comorbidities, family history, and PFAS, and underwent skin prick testing (SPT) and serum IgE testing. RESULTS Of the 815 patients, 167 (20.5%) reported PFAS reactions. Most commonly, eliciting foods were kiwi (58, 34.7%), peach (43, 25.7%), and melon (26, 15.6%). Reported reactions were mostly local (216/319, 67.7%), occurring within 5 min of contact with elicitors (209/319, 65.5%). Associated characteristics included positive IgE to at least one panallergen (profilin, PR-10, or nsLTP) (p = 0.007), maternal PFAS (OR: 3.716, p = 0.026), and asthma (OR: 1.752, p = 0.073). Between centers, heterogeneity in prevalence (Marseille: 7.5% vs. Rome: 41.4%, p < 0.001) and of clinical characteristics was apparent. Cypress played a limited role, with only 1/22 SPT mono-sensitized patients reporting a food reaction (p < 0.073). CONCLUSIONS PFAS is a frequent comorbidity in Southern European SAR patients. Significant heterogeneity of clinical characteristics in PFAS patients among the centers was observed and may be related to the different pollen sensitization patterns in each geographic area. IgE to panallergen(s), maternal PFAS, and asthma could be PFAS-associated characteristics.
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Affiliation(s)
- Theresa Lipp
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine Charité – Universitätsmedizin Berlin Berlin Germany
| | - Aydan Acar Şahin
- Department of Biology Faculty of Science Ankara University Ankara Turkey
| | - Xenophon Aggelidis
- Allergy Unit, 2nd Department of Dermatology and Venereology National and Kapodistrian University of AthensUniversity Hospital "Attikon" Athens Greece
| | - Stefania Arasi
- Pediatric Allergology Unit Department of Pediatric Medicine Bambino Gesù Children's Research Hospital (IRCCS) Rome Italy
| | - Andrea Barbalace
- Department of Pediatrics‐Allergy Unit University of Messina Messina Italy
| | - Anne Bourgoin
- Department of Pneumonology and Allergy La Timone HospitalAPHMAix‐Marseille University Marseille France
| | - Blerina Bregu
- Department of Allergology and Clinical Immunology UHC Mother TeresaMedical University Tirana Tirana Albania
| | | | - Elsa Caeiro
- MED‐Mediterranean Institute for Agriculture, Environment and Development Institute for Advanced Studies and Research University of Évora Évora Portugal
- Portuguese Society of Allergology and Clinical Immunology Lisbon Portugal
| | - Sule Caglayan Sozmen
- Department of Pediatric Allergy and Immunology Okan University Faculty of Medicine Istanbul Turkey
| | - Lucia Caminiti
- Department of Pediatrics‐Allergy Unit University of Messina Messina Italy
| | - Denis Charpin
- Department of Pneumonology and Allergy La Timone HospitalAPHMAix‐Marseille University Marseille France
| | - Mariana Couto
- Department of Immunoallergology CUF Decobertas HospitalJosé de Mello Saúde Porto Portugal
| | - Luís Delgado
- Basic and Clinical Immunology Unit Department of Pathology Faculty of Medicine University of Porto Porto Portugal
- CINTESIS Center for Health Technology and Services Research Porto Portugal
- Allergy Unit Instituto & Hospital CUF Porto Porto Portugal
| | | | - Claire Dimier
- Department of Pneumonology and Allergy La Timone HospitalAPHMAix‐Marseille University Marseille France
| | - Maria V. Dimou
- Allergy Department 2nd Pediatric Clinic Athens General Children's Hospital “P&A Kyriakou”University of Athens Athens Greece
| | - João A. Fonseca
- CINTESIS Center for Health Technology and Services Research Porto Portugal
- Allergy Unit Instituto & Hospital CUF Porto Porto Portugal
- MEDCIDS‐Department of Community Medicine, Information, and Health Sciences Faculty of Medicine University of Porto Porto Portugal
| | - Ozlem Goksel
- Department of Pulmonary Medicine Division of Immunology, Allergy and Asthma Faculty of Medicine Ege University Izmir Turkey
| | - Aykut Guvensen
- Department of Biology Faculty of Science Ege University Izmir Turkey
| | - Dolores Hernandez
- Department of Allergy Health Research Institute Hospital La Fe Valencia Spain
| | - Tara Maria Hoffmann
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine Charité – Universitätsmedizin Berlin Berlin Germany
| | - Dah Tay Jang
- Pediatric Allergy and Pneumology Unit Children's Hospital La Fe Health Research Institute La Fe Valencia Spain
| | - Fusun Kalpaklioglu
- Department of Immunology and Allergic Diseases Kırıkkale University School of Medicine Ankara Turkey
| | - Blerta Lame
- Department of Allergology and Clinical Immunology UHC Mother TeresaMedical University Tirana Tirana Albania
| | - Ruth Llusar
- Pediatric Allergy and Pneumology Unit Children's Hospital La Fe Health Research Institute La Fe Valencia Spain
| | - Michael P. Makris
- Allergy Unit, 2nd Department of Dermatology and Venereology National and Kapodistrian University of AthensUniversity Hospital "Attikon" Athens Greece
| | - Angel Mazon
- Pediatric Allergy and Pneumology Unit Children's Hospital La Fe Health Research Institute La Fe Valencia Spain
| | - Eris Mesonjesi
- Department of Allergology and Clinical Immunology UHC Mother TeresaMedical University Tirana Tirana Albania
| | - Antonio Nieto
- Pediatric Allergy and Pneumology Unit Children's Hospital La Fe Health Research Institute La Fe Valencia Spain
| | - Ayse Öztürk
- Department of Pulmonary Medicine Division of Allergy and Immunology Koç University, School of Medicine Istanbul Turkey
| | - Laurie Pahus
- Department of Pneumonology and Allergy North HospitalAPHMAix‐Marseille University Marseille France
| | | | - Ilenia Panasiti
- Department of Pediatrics‐Allergy Unit University of Messina Messina Italy
| | - Nikolaos G. Papadopoulos
- Allergy Department 2nd Pediatric Clinic Athens General Children's Hospital “P&A Kyriakou”University of Athens Athens Greece
- Division of Infection, Immunity & Respiratory Medicine Royal Manchester Children's HospitalUniversity of Manchester Manchester UK
| | - Elisabetta Pellegrini
- Department of Reggio Calabria ARPA‐Regional Agency for Environmental Protection Calabria Italy
| | | | - Ana M. Pereira
- CINTESIS Center for Health Technology and Services Research Porto Portugal
- Allergy Unit Instituto & Hospital CUF Porto Porto Portugal
- MEDCIDS‐Department of Community Medicine, Information, and Health Sciences Faculty of Medicine University of Porto Porto Portugal
| | - Mariana Pereira
- CINTESIS Center for Health Technology and Services Research Porto Portugal
- Allergy Unit Instituto & Hospital CUF Porto Porto Portugal
| | - Munevver Pinar
- Department of Biology Faculty of Science Ankara University Ankara Turkey
| | - Ekaterina Potapova
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine Charité – Universitätsmedizin Berlin Berlin Germany
| | - Alfred Priftanji
- Department of Allergology and Clinical Immunology UHC Mother TeresaMedical University Tirana Tirana Albania
| | - Fotis Psarros
- Allergy Department Athens Naval Hospital Athens Greece
| | - Cansin Sackesen
- Division of Pediatric Allergy Koç University School of Medicine Istanbul Turkey
| | - Ifigenia Sfika
- Pediatric Allergy Unit Sandro Pertini Hospital Rome Italy
| | - Javier Suarez
- Department of Biology of Organisms and Systems Area of Botany University of Oviedo Oviedo Spain
| | | | - Alessandro Travaglini
- Department of Biology Tor Vergata University Rome Italy
- Italian Aerobiology Monitoring Network‐Italian Aerobiology Association Rome Italy
| | - Salvatore Tripodi
- Pediatric Allergy Unit Sandro Pertini Hospital Rome Italy
- Allergolology Service Policlinico Casilino Rome Italy
| | - Valentine Verdier
- Department of Pneumonology and Allergy La Timone HospitalAPHMAix‐Marseille University Marseille France
| | | | - Paraskevi Xepapadaki
- Allergy Department 2nd Pediatric Clinic National and Kapodistrian University of Athens Athens Greece
| | - Duygu Yazici
- Cellular and Molecular Medicine KUTTAM Graduate School of Health Sciences Koç University Istanbul Turkey
| | - Paolo M. Matricardi
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine Charité – Universitätsmedizin Berlin Berlin Germany
| | - Stephanie Dramburg
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine Charité – Universitätsmedizin Berlin Berlin Germany
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Hoffmann TM, Acar Şahin A, Aggelidis X, Arasi S, Barbalace A, Bourgoin A, Bregu B, Brighetti MA, Caeiro E, Caglayan Sozmen S, Caminiti L, Charpin D, Couto M, Delgado L, Di Rienzo Businco A, Dimier C, Dimou MV, Fonseca JA, Goksel O, Guvensen A, Hernandez D, Jang DT, Kalpaklioglu F, Lame B, Llusar R, Makris MP, Mazon A, Mesonjesi E, Nieto A, Öztürk A, Pahus L, Pajno GB, Panasiti I, Panetta V, Papadopoulos NG, Pellegrini E, Pelosi S, Pereira AM, Pereira M, Pinar M, Pfaar O, Potapova E, Priftanji A, Psarros F, Sackesen C, Sfika I, Suarez J, Thibaudon M, Travaglini A, Tripodi S, Verdier V, Villella V, Xepapadaki P, Yazici D, Matricardi PM, Dramburg S. "Whole" vs. "fragmented" approach to EAACI pollen season definitions: A multicenter study in six Southern European cities. Allergy 2020; 75:1659-1671. [PMID: 31833579 DOI: 10.1111/all.14153] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 10/08/2019] [Accepted: 10/29/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND The adequate definition of pollen seasons is essential to facilitate a correct diagnosis, treatment choice, and outcome assessment in patients with seasonal allergic rhinitis. A position paper by the European Academy of Allergy and Clinical Immunology (EAACI) proposed season definitions for Northern and Middle Europe. OBJECTIVE To test the pollen season definitions proposed by EAACI in six Mediterranean cities for seven pollen taxa. METHODS As part of the @IT.2020 multi-center study, pollen counts for Poaceae, Oleaceae, Fagales, Cupressaceae, Urticaceae (Parietaria spp.), and Compositae (Ambrosia spp., Artemisia spp.) were collected from January 1 to December 31, 2018. Based on these data, pollen seasons were identified according to EAACI criteria. A unified monitoring period for patients in AIT trials was created and assessed for feasibility. RESULTS The analysis revealed a great heterogeneity between the different locations in terms of pattern and length of the examined pollen seasons. Further, we found a fragmentation of pollen seasons in several segments (max. 8) separated by periods of low pollen counts (intercurrent periods). Potential monitoring periods included often many recording days with low pollen exposure (max. 341 days). CONCLUSION The Mediterranean climate leads to challenging pollen exposure times. Monitoring periods for AIT trials based on existing definitions may include many intermittent days with low pollen concentrations. Therefore, it is necessary to find an adapted pollen season definition as individual solution for each pollen and geographical area.
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Affiliation(s)
- Tara Maria Hoffmann
- Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine Charité Universitätsmedizin Berlin Berlin Germany
| | - Aydan Acar Şahin
- Department of Biology Faculty of Science Ankara University Ankara Turkey
| | - Xenophon Aggelidis
- Allergy Unit 2 Department of Dermatology and Venereology National and Kapodistrian University of Athens University Hospital "Attikon" Athens Greece
| | - Stefania Arasi
- Pediatric Allergology Unit Department of Pediatric Medicine Bambino Gesù Children´s research Hospital (IRCCS) Rome Italy
| | - Andrea Barbalace
- Department of Pediatrics‐ Allergy Unit University of Messina Messina Italy
| | - Anne Bourgoin
- Department of Pneumonology and Allergy La Timone Hospital APHM Aix‐Marseille University Marseille France
- Hospital APHM Aix‐Marseille University Marseille France
| | - Blerina Bregu
- Department of Allergology and Clinical Immunology UHC Mother Teresa Medical University Tirana Tirana Albania
| | | | - Elsa Caeiro
- MED ‐ Mediterranean Institute for Agriculture, Environment and Development Institute for Advanced Studies and Research University of Évora Évora Portugal
- Portuguese Society of Allergology and Clinical Immunology Lisbon Portugal
| | - Sule Caglayan Sozmen
- Department of Pediatric Allergy and Immunology Okan University Faculty of Medicine Istanbul Turkey
| | - Lucia Caminiti
- Department of Pediatrics‐ Allergy Unit University of Messina Messina Italy
| | - Denis Charpin
- Department of Pneumonology and Allergy La Timone Hospital APHM Aix‐Marseille University Marseille France
- Hospital APHM Aix‐Marseille University Marseille France
| | - Mariana Couto
- Immunoallergology José de Mello Saúde Porto Portugal
| | - Luís Delgado
- Basic and Clinical Immunology Unit Department of Pathology Faculty of Medicine University of Porto Porto Portugal
- CINTESIS Center for Health Technology and Services Research Bologna Portugal
- Allergy Unit Instituto & Hospital CUF Porto Porto Portugal
| | | | - Claire Dimier
- Department of Pneumonology and Allergy La Timone Hospital APHM Aix‐Marseille University Marseille France
- Hospital APHM Aix‐Marseille University Marseille France
| | - Maria V. Dimou
- Allergy Department 2nd Pediatric Clinic Athens General Children's Hospital "P&A Kyriakou" University of Athens Athens Greece
| | - João A. Fonseca
- CINTESIS Center for Health Technology and Services Research Bologna Portugal
- Allergy Unit Instituto & Hospital CUF Porto Porto Portugal
- MEDCIDS‐Department of Community Medicine, Information, and Health Sciences Faculty of Medicine University of Porto Porto Portugal
| | - Ozlem Goksel
- Department of Pulmonary Medicine Division of Immunology, Allergy and Asthma Faculty of Medicine Ege University Izmir Turkey
| | - Aykut Guvensen
- Department of Biology Faculty of Science Ege University Izmir Turkey
| | - Dolores Hernandez
- Service of Allergy Hospital La Fe; Health Research Institute La Fe Valencia Spain
| | - Dah Tay Jang
- Pediatric Allergy and Pneumology Unit Children's Hospital La Fe; Health Research Institute La Fe Valencia Spain
| | - Fusun Kalpaklioglu
- Department of Chest Diseases Division of Immunology and Allergic Diseases Kırıkkale University School of Medicine Kırıkkale Turkey
| | - Blerta Lame
- Department of Allergology and Clinical Immunology UHC Mother Teresa Medical University Tirana Tirana Albania
| | - Ruth Llusar
- Pediatric Allergy and Pneumology Unit Children's Hospital La Fe; Health Research Institute La Fe Valencia Spain
| | - Michael P. Makris
- Allergy Unit 2 Department of Dermatology and Venereology National and Kapodistrian University of Athens University Hospital "Attikon" Athens Greece
| | - Angel Mazon
- Pediatric Allergy and Pneumology Unit Children's Hospital La Fe; Health Research Institute La Fe Valencia Spain
| | - Eris Mesonjesi
- Department of Allergology and Clinical Immunology UHC Mother Teresa Medical University Tirana Tirana Albania
| | - Antonio Nieto
- Pediatric Allergy and Pneumology Unit Children's Hospital La Fe; Health Research Institute La Fe Valencia Spain
| | - Ayse Öztürk
- Department of Allergy and Immunology Koç University Hospital Istanbul Turkey
| | - Laurie Pahus
- Department of Pneumonology and Allergy La Timone Hospital APHM Aix‐Marseille University Marseille France
- Hospital APHM Aix‐Marseille University Marseille France
| | | | - Ilenia Panasiti
- Department of Pediatrics‐ Allergy Unit University of Messina Messina Italy
| | - Valentina Panetta
- Biostatistics L'altrastatistica srl Consultancy & Training Rome Italy
- Division of Infection Immunity& Respiratory Medicine Royal Manchester Children's Hospital University of Manchester Manchester UK
| | - Nikolaos G. Papadopoulos
- MEDCIDS‐Department of Community Medicine, Information, and Health Sciences Faculty of Medicine University of Porto Porto Portugal
- Biostatistics L'altrastatistica srl Consultancy & Training Rome Italy
- Division of Infection Immunity& Respiratory Medicine Royal Manchester Children's Hospital University of Manchester Manchester UK
| | - Elisabetta Pellegrini
- Department of Reggio Calabria ARPACal‐ Regional Agency for Environmental Protection Messina Italy
| | | | - Ana Margarida Pereira
- CINTESIS Center for Health Technology and Services Research Bologna Portugal
- Allergy Unit Instituto & Hospital CUF Porto Porto Portugal
| | - Mariana Pereira
- CINTESIS Center for Health Technology and Services Research Bologna Portugal
- Allergy Unit Instituto & Hospital CUF Porto Porto Portugal
| | - Munevver Pinar
- Department of Biology Faculty of Science Ankara University Ankara Turkey
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery Section of Rhinology and Allergy University Hospital Marburg Phillipps‐Universität Marburg Germany
| | - Ekaterina Potapova
- Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine Charité Universitätsmedizin Berlin Berlin Germany
| | - Alfred Priftanji
- Department of Allergology and Clinical Immunology UHC Mother Teresa Medical University Tirana Tirana Albania
| | - Fotis Psarros
- Allergy Department Athens Naval Hospital Athens Greece
| | - Cansin Sackesen
- Division of Pediatric Allergy Koç University School of Medicine Istanbul Turkey
| | - Ifigenia Sfika
- Pediatric Allergy Unit Sandro Pertini Hospital Rome Italy
| | - Javier Suarez
- Department of Biology of Organisms and Systems Area of Botany University of Oviedo Oviedo Spain
| | | | - Alessandro Travaglini
- Department of Biology Tor Vergata University Rome Italy
- Italian Aerobiology Monitoring Network ‐ Italian Aerobiology Association Bologna Italy
| | - Salvatore Tripodi
- Pediatric Allergy Unit Sandro Pertini Hospital Rome Italy
- Allergology Service Policlinico Casilino Rome Italy
| | - Valentine Verdier
- Department of Pneumonology and Allergy La Timone Hospital APHM Aix‐Marseille University Marseille France
- Hospital APHM Aix‐Marseille University Marseille France
| | | | - Paraskevi Xepapadaki
- Allergy Department 2nd Pediatric Clinic National and Kapodistrian University of Athens Athens Greece
| | - Duygu Yazici
- Cellular and Molecular Medicine KUTTAM Graduate School of Health Sciences Koç University Istanbul Turkey
| | - Paolo M. Matricardi
- Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine Charité Universitätsmedizin Berlin Berlin Germany
| | - Stephanie Dramburg
- Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine Charité Universitätsmedizin Berlin Berlin Germany
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