Allergy to cypress and olive pollen: Clinical phenotypes and allergen recognition

BACKGROUND AND OBJECTIVES

Cypress and olive pollen are the most prevalent sensitizer trees in the Mediterranean area. Some patients exhibit a dual sensitization which has not been well documented yet. To identify the allergens involved in the dual cypress and olive allergy (C+O) and study the relationship between phenotype and allergen sensitization.

METHODS

C+O patients were selected. Monosensitized subjects to olive or cypress were used as reference. Specific IgE to whole extracts and purified allergens from olive and cypress were performed. Immunoblotting was done to analyze IgG and IgE-binding using olive polyclonal antibodies and patients' sera, respectively. Mutual immunoblotting inhibition of olive and cypress extracts, and inhibition of cypress extract immunoblotting with olive allergens were performed. Multiple correspondence analysis and hierarchical cluster classifications were conducted to analyze the relationships between C+O clinical presentation (symptoms, seasonality) and allergen profile.

RESULTS

C+O patients were clustered in 4 phenotypes. The most frequent one (58.4%) was rhinoconjunctivitis in winter (February) and spring (May), with asthma in 38% of subjects. Ole e 1 and Cup s 1 were the major allergens. Homologous proteins to Ole e 1, Ole e 9 and Ole e 11 in cypress pollen were identified and these olive allergens inhibit IgE-binding to cypress extract.

CONCLUSIONS

The exclusive C+O allergy results from co-sensitization to Cup s 1 and Ole e 1, and to cross-reactivity due to Ole e 1-like, Ole e 9-like and Ole e 11-like allergens not described previously, and translates into 4 clinical phenotypes of winter and/or spring or perennial rhinoconjunctivitis with and without asthma.

Selection and characterization of DNA aptamers for highly selective recognition of the major allergen of olive pollen Ole e 1

In this study, single-stranded DNA aptamers with binding affinity to Ole e 1, the major allergen of olive pollen, were selected using systematic evolution of ligands by exponential enrichment (SELEX) method. Binding of the aptamers was firstly established by enzyme-linked oligonucleotide assay (ELONA) and aptaprecipitation assays. Additionally, aptamer-modified monolithic capillary chromatography was used in order to evaluate the recognition of this allergenic protein against other non-target proteins. The results indicated that AptOle1#6 was the aptamer that provided the highest affinity for Ole e 1. The selected aptamer showed good selective recognition of this protein, being not able to retain other non-target proteins (HSA, cyt c, and other pollen protein such as Ole e 9). The feasibility of the affinity monolithic column was demonstrated by selective recognition of Ole e 1 in an allergy skin test. The stability and reproducibility of this monolithic column was suitable, with relative standard deviations (RSDs) in retention times and peak area values of 7.8 and 9.3%, respectively (column-to-column reproducibility). This is the first study that describes the design of an efficient DNA aptamer for this relevant allergen.

Assessment of heterogeneity of two cultivars of Olea europaea based on the study of their Ole e 1 protein content

Olive pollen is one of the main causes of allergic disease in the Mediterranean area. Ten different proteins with allergenic activity have been described in olive pollen, with major allergen Ole e 1. Olea europaea L. may cause allergenic effects of different severity depending on the Ole e 1 content of cultivars. In this paper, we aimed to assess the heterogeneity of two olive cultivars concerning concentrations of the major allergen Ole e 1 during a period of 2 years. Pollens from two most common olive cultivars, known as "Gemlik" and "Celebi," were analyzed on regular basis. Ole e 1 amounts were measured by double-sandwich enzyme-linked immunosorbent assay (ELISA). The results were expressed as μg of Ole e 1 per μg of total freeze-dried extract. Comparisons of Ole e 1 levels were made both between individual trees and between cultivars. It was analyzed the influence of some meteorological parameters on pollen counts/allergenic content on a local scale, for 2 years. Pollen sampling was carried out continuously for 2 years, using a Hirst-type volumetric trap. "Gemlik" had the higher value (mean ± standard deviation) of Ole e 1 content (2.44 ±0.70 and 1.87 ±1.03 μg/μg, respectively) when compared to "Celebi" (2.16 ±0.86 and 0.20 ±0.30 μg/μg, respectively) in the years 2013 and 2015. In our research, daily variations were observed in pollen samples of two olive cultivars and even different trees of the same cultivar. Furthermore, during certain sampling days, discrepancies between airborne pollen counts and Ole e 1 concentrations were detected for both cultivars. It was found that meteorological changes, especially temperature and precipitation fluctuations, could affect airborne pollen and Ole e 1 allergen levels in the atmosphere. Therefore, pollen samples of different O. europaea cultivars demonstrated great differences in Ole e 1 content. We believe that these findings were a result of alternate bearing behavior modulated by meteorological factors.

Effectiveness and safety of a glutaraldehyde-modified, L-tyrosine-adsorbed and monophosphoryl lipid A-Adjuvanted allergen immunotherapy in patients with allergic asthma sensitized to olive pollen: A retrospective, controlled real-world study

Background

Allergy to olive pollen is one of the primary causes of allergic asthma in Spain. Even though allergen immunotherapy (AIT) has shown clinical benefits in patients sensitized to different allergens, studies in asthmatic patients sensitized to olive pollen are insufficient.

Objective

To assess the effectiveness and safety of an ultra-short course of AIT with an L-tyrosine-adsorbed and monophosphoryl lipid A-adjuvanted olive pollen and olive/grass pollen extract (Pollinex Quattro®) in patients with allergic asthma in the real-world setting.

Methods

Retrospective, controlled study including patients with asthma, with and without allergic rhinitis, caused by sensitization to olive pollen from 11 centers in Spain. Patients received out-of-season (October–March) treatment with AIT in addition to their pharmacological treatment (active group) or pharmacological treatment (control group). Effectiveness variables, including unscheduled visits to the healthcare center, emergency room admissions, symptoms of asthma and rhinitis (following GEMA and ARIA classifications, respectively), and use of medication to treat asthma and rhinitis during the subsequent pollen season were compared between treatment groups.

Results

Of 131 study patients, 42 were treated with their usual asthma medication (control group) and 89 were treated with AIT (active group), either Pollinex Quattro® 100% olive pollen (n = 43, 48.3%) or 50% olive pollen/50% grass pollen (n = 46, 51.7%). Patients’ demographic and clinical characteristics were similar between groups. The mean (SD) number of unscheduled visits to a healthcare center and emergency room admissions due to allergy symptoms was 2.19 (1.40) and 0.43 (0.63) in the control group, and 1.09 (1.25) and 0.11 (0.51) in the active group (P = 0.001 and P = 0.006, respectively). Severity and control of asthma symptoms remained unchanged (P = 0.347 and P = 0.179, respectively), rhinitis type improved (P = 0.025), and severity remained unchanged in the active compared to the control group. The use of short-acting beta-agonists and inhaled corticosteroids to treat asthma symptoms decreased in the active vs. the control group (P = 0.001 and P = 0.031, respectively). Twelve (13.5%) and two (2.2%) patients in the active group experienced local adverse reactions (edema, swelling, erythema, hives, pruritus, and heat), and systemic adverse reactions (hypertensive crisis and low-grade fever) to AIT, respectively; none was serious.

Conclusion

AIT with Pollinex Quattro® specific for olive pollen and olive/grass pollens resulted in reduced visits to the healthcare center and emergency room and the use of asthma medication during the pollen season, indicating that this treatment was safe and effective in treating asthma in patients sensitized to these pollens.

Extraction and quantification of Ole e 1 from atmospheric air samples: An optimized protocol

Olive pollen is the main cause of pollinosis in Mediterranean countries. The immunological analysis of Ole e 1, the major allergen of Olea europaea, has usually carried out by means of ELISA (Enzyme-Linked ImmunoSorbent Assay). However, most published works only specify the methodology related to antigen quantifications, but not the related to protein extraction. Furthermore, the results obtained are not compared with different buffers or modifications of them. The main aim of this study is to obtain an optimized and reproducible ELISA protocol for quantifications of Ole e 1 in the atmosphere. The study of Ole e 1 allergen and olive pollen in the atmosphere of Malaga (Spain) was carried out by means of an automatic multi-vial cyclonic sampler and a Hirst volumetric pollen trap, respectively. ELISA was tuned up on the basis of previously published protocols to quantify this allergen. Variations in the concentrations of capture and detection antibodies, as well as in the buffers used to carry out the extraction, were evaluated. The highest protein extraction was obtained when a modified buffer was applied. The correlation analysis between daily pollen concentrations and allergen quantifications showed highly significant values. The ELISA protocol, together with the buffer combination proposed in this work, considerably reduced the concentrations of capture and detection antibodies used for quantifying Ole e 1 in the atmosphere, allowing detect this allergen even in days in which the airborne pollen concentration was very low or null.

Analysis of airborne Olea pollen in Cartagena (Spain)

Olive cultivation is of great importance in Southern Europe but olive pollen is the leading cause of allergy in many regions where it is grown. The best preventive measure for allergic patients is to avoid exposure. Thus, aerobiological monitoring networks must supply realistic pollen classes for the different types of allergic pollen. Even though those pollen classes are defined, they do not necessarily fit local data. Altogether, they should use predictive models to assess flowering intensity in advance. In this study, the Olea pollen degree of exposure classes (OPDEC) are defined based on percentiles and a predictive model is suggested for Cartagena, Spain. 24year (1993-2016) Olea pollen counts series was used to characterize the Main Pollen Season (MPS). The aerobiological samples were processed following the methodology proposed by Hirst and developed by the Spanish Aerobiology Network. The aerobiological database was completed with the meteorological data supplied by AEMET (Spanish State Meteorological Agency). MPS evolution over time, and its relation with temperature and rainfall, has been analysed. The study showed an increase in MPS duration and the amount of Olea pollen grains collected both in MPS and the peak day. The OPDEC should fit local data to improve preventive measures. Based on the 24year series, the proposed OPDEC for Cartagena are: Low (≤10grains/m³), Medium (between 10 and 50grains/m³), High (between 51 and 100grains/m³) and Very High (≥100grains/m³). Olea pollen estimations in the MPS and in the peak day were obtained by means of three Regression Methods and climatic factors. The analysis reveals that the Bagging for Regression Trees (BRT) method is a good predictive alternative and stablishes the importance for each meteorological variable.

High-throughput screening of T7 phage display and protein microarrays as a methodological approach for the identification of IgE-reactive components

Olive pollen and yellow mustard seeds are major allergenic sources with high clinical relevance. To aid with the identification of IgE-reactive components, the development of sensitive methodological approaches is required. Here, we have combined T7 phage display and protein microarrays for the identification of allergenic peptides and mimotopes from olive pollen and mustard seeds. The identification of these allergenic sequences involved the construction and biopanning of T7 phage display libraries of mustard seeds and olive pollen using sera from allergic patients to both biological sources together with the construction of phage microarrays printed with 1536 monoclonal phages from the third/four rounds of biopanning. The screening of the phage microarrays with individual sera from allergic patients enabled the identification of 10 and 9 IgE-reactive unique amino acid sequences from olive pollen and mustard seeds, respectively. Five immunoreactive amino acid sequences displayed on phages were selected for their expression as His6-GST tag fusion proteins and validation. After immunological characterization, we assessed the IgE-reactivity of the constructs. Our results show that protein microarrays printed with T7 phages displaying peptides from allergenic sources might be used to identify allergenic components -peptides, proteins or mimotopes- through their screening with specific IgE antibodies from allergic patients.

Wind dynamics' influence on south Spain airborne olive-pollen during African intrusions

Given its proximity to northern Africa, southern Spain is regularly affected by high-altitude African intrusions. This determines a well-defined wind dynamics at surface levels. Although this weather event-mainly recorded in spring and summer-coincides with the flowering season of many wind pollinated species, its potential influence on long term airborne pollen transport has been not investigated in detail. We analyse their influence on olive pollen transport at surface level in south Spain. Daily and bi-hourly olive pollen data from 2010 to 2015, recorded at two sites 150km apart, Málaga (coast) and Córdoba (inland), were analysed together with 1) air masses at 300m above ground level (m.a.g.l.), 2) surface wind direction and 3) surface wind speed over the same period. Air masses at 3000m.a.g.l. were used to identify the periods under the influence of African intrusions. The combined analysis has enabled the identification of different pollen patterns and source contributions. In Málaga, hourly pollen peaks were recorded during the early morning coinciding with the arrival of north-westerly winds (developing sea-land breezes), with a minimal impact of local pollen sources; in Córdoba, by contrast, pollen concentrations reflected the joint contribution of local and long term sources, being the maximum concentrations associated with the arrival of southerly air masses in the afternoon. These results help to understand the potential distant sources and back-trajectories of olive pollen detected. In our case pollen from sources located at the west-northwest areas in the case of Malaga, and from the south in Cordoba. These results reinforce the idea that combined studies between synoptic meteorological and aerobiological data together with different atmospheric height air masses data, offer us a better explanation and understanding of the behaviour and the potential sources of recorded airborne data in a given place.

Statistical approach to the analysis of olive long-term pollen season trends in southern Spain

Analysis of long-term airborne pollen counts makes it possible not only to chart pollen-season trends but also to track changing patterns in flowering phenology. Changes in higher plant response over a long interval are considered among the most valuable bioindicators of climate change impact. Phenological-trend models can also provide information regarding crop production and pollen-allergen emission. The interest of this information makes essential the election of the statistical analysis for time series study. We analysed trends and variations in the olive flowering season over a 30-year period (1982-2011) in southern Europe (Córdoba, Spain), focussing on: annual Pollen Index (PI); Pollen Season Start (PSS), Peak Date (PD), Pollen Season End (PSE) and Pollen Season Duration (PSD). Apart from the traditional Linear Regression analysis, a Seasonal-Trend Decomposition procedure based on Loess (STL) and an ARIMA model were performed. Linear regression results indicated a trend toward delayed PSE and earlier PSS and PD, probably influenced by the rise in temperature. These changes are provoking longer flowering periods in the study area. The use of the STL technique provided a clearer picture of phenological behaviour. Data decomposition on pollination dynamics enabled the trend toward an alternate bearing cycle to be distinguished from the influence of other stochastic fluctuations. Results pointed to show a rising trend in pollen production. With a view toward forecasting future phenological trends, ARIMA models were constructed to predict PSD, PSS and PI until 2016. Projections displayed a better goodness of fit than those derived from linear regression. Findings suggest that olive reproductive cycle is changing considerably over the last 30years due to climate change. Further conclusions are that STL improves the effectiveness of traditional linear regression in trend analysis, and ARIMA models can provide reliable trend projections for future years taking into account the internal fluctuations in time series.

From structures to diagnosis and treatment

Olive tree is one of the main allergy sources in Mediterranean countries. The identification of the allergenic repertoire from olive pollen has been essential for the development of rational strategies of standardization, diagnosis, and immunotherapy, all of them focused to increase the life quality of the patients. From its complex allergogram, twelve allergens - Ole e 1 to Ole e 12 - have been identified and characterized to date. Most of them have been cloned and produced as recombinant forms, whose availability have allowed analyzing their three-dimensional structures, mapping their T-cell and B-cell epitopes, and determining the precise allergenic profile of patients for a subsequent patient-tailored immunotherapy. Protein mutant, hypoallergenic derivatives, or recombinant fragments have been also useful experimental tools to analyze the immune recognition of allergens. To test these molecules before using them for clinic purposes, a mouse model of allergic sensitizations has been used. This model has been helpful for assaying different prophylactic approaches based on tolerance induction by intranasal administration of allergens or hypoallergens, used as free or integrated in different delivery systems, and their findings suggest a promising utilization as nasal vaccines. Exosomes - nanovesicles isolated from bronchoalveolar lavage fluid of tolerogenic mice - have shown immunomodulatory properties, being able to protect mice against sensitization to Ole e 1.