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The course of plane pollen season in Bialystok, Bydgoszcz, Drawsko Pomorskie, Olsztyn, Opole, Szczecin, Warsaw and in Zielona Gora in the year 2018 was presented. Measurements were performed by the volumetric method (Lanzoni or Burkard pollen sampler). Pollen season was defined as the period in which 98% of the annual total catch occurred. In most of the cities, the plane pollen season in 2018 started in the second decade of April. The highest airborne concentration of 87 pollen grains/m3 was noted in Zielona Gora on the April 28th and in Opole (85 pollen grains/m3) on the April 29th. The high pollen count of plane has a local character resulting from the number of trees in cities. The highest risk of pollen allergy associated with the presence of airborne plane pollen was found in Zielona Gora, Opole, Warsaw and Szczecin.

The study compares the hazel pollen seasons in Szczecin, Drawsko Pomorskie, Bydgoszcz, Zielona Gora, Wroclaw, Opole, Sosnowiec, Cracow, Piotrkow Trybunalski, Warsaw, Lublin, Olsztyn and Bialystok in 2018. The investigations were carried out using the volumetric method. The hazel pollen season began between 24th January and 7th March. Maximum daily pollen concentrations were noted earliest on 3rd March and latest on 4th April. The greatest risk of allergies caused by the presence of airborne hazel pollen was observed in Lublin. Based on phenological observations of hazel pollen emission, it was found that pollen release also occurred on frosty days with high sunshine hours.

This paper presents the course of pollen season of birch in Bialystok, Bydgoszcz, Drawsko Pomorskie, Koszalin, Olsztyn and Szczecin in 2017. Measurements were performed by the volumetric method (Burkard and Lanzoni pollen samplers). Pollen season was defined as the period in which 95% of the annual total catch occurred. Seasonal Pollen Index (SPI) was estimated as the annual sum of daily average pollen concentrations. Birch pollen season started first in Szczecin, on the 1st of April, lasted till the 9th of May and was the longest one in northern Poland. The highest recorded airborne concentration of 1575 pollen grains/m3 was noted in Olsztyn on 10th of April. The maximum values of seasonal pollen count occurred between 9th and 10th of April in all monitoring sites. Birch pollen season of 2017 was much less intense than the one of 2016.

There is a large selection of bronchial challenge tests. The most commonly employed tests involve provocation with methacholine, histamine, exercise, a hypertonic saline solution, or mannitol. The first two mentioned tests use pharmacological substances acting directly on bronchial smooth muscles causing constriction and increased blood vessel permeability. The remaining tests are considered as indirect stimuli, which by osmotic mechanisms lead to release of endogenous mediators responsible for quick obturation of the respiratory tract. Studies in recent years concerning direct tests have shown interpretation discrepancies when using approved methods and tools to carry out the tests. Bronchial challenge tests with mannitol, which have greater specificity for asthma, are increasingly being promoted. However, negative results of these tests are frequently encountered in patients with well-controlled asthma which is not the case in tests involving methacholine.

The paper presents the course of pollen season of plantain in Bialystok, Bydgoszcz, Drawsko Pomorskie, Cracow, Lublin, Olsztyn, Opole, Piotrkow Trybunalski, Sosnowiec, Szczecin, Warsaw, Wroclaw and Zielona Gora in 2018. Measurements were performed by the volumetric method (Burkard and Lanzoni pollen samplers). Pollen season was defined as the period in which 98% of the annual total catch occurred. The plantain pollen season started in the first decade of May and lasted until the end of September. Despite such a long pollen season in Poland, only in some cities there are days with an average concentration exceeding 10 P/m3. Significant differences were observed in annual sum values. The highest values were recorded in Lublin (400 grains) and Zielona Gora (308 grains), and the lowest in Drawsko Pomorskie (160 grains) and Olsztyn (184 grains). The value of annual average in 2018 was usually lower than in the previous years.

Introduction There are many potential factors that can modulate bronchial reactivity, including exposure to allergens, viral infections, and medications. The aim of this study was to analyze the effect of grass pollination intensity on the bronchial reactivity in seasonal allergic rhinitis (SAR) patients subjected to subcutaneous allergenic immunotherapy (SCIT). Material and methods This study, performed between 2005 and 2008, included 41 patients with confirmed sensitivity to grass pollens and predominating symptoms of SAR, randomly assigned to desensitization by pre-seasonal or maintenance SCIT. Bronchial provocation challenge with histamine was performed before the onset of immunotherapy, and repeated three times after each pollen season covered by this study. Bronchial reactivity was analyzed with regard to grass pollination intensity in 2005–2008 (air concentration of grass pollen grains, seasonal number of days when air concentration of grass pollen reached at least 20 or 50 grains per 1 m3). Results After 3 years of SCIT, a significant decrease in bronchial responsiveness was observed in the analyzed group as confirmed by an increase in PC20 FEV1 histamine values (p = 0.001). An inverse tendency was observed after 2 years of SCIT, however. This second year of SCIT corresponded to the 2007 season, when a significantly higher number of days with at least 50 grains of pollen per 1 m3 of air was recorded. Conclusions Fluctuations in pollination intensity observed during consecutive years of immunotherapy can influence bronchial reactivity in patients subjected to SCIT (ISRCTN Register: ISRCTN 86562422).

The aim of the study was to compare the pollen season of oak in the cities of Bialystok, Bydgoszcz, Cracow, Katowice, Piotrkow Trybunalski, Lublin, Olsztyn, Opole, Szczecin, Warsaw, Wroclaw and Zielona Gora in 2017. Measurements were performed by the volumetric method (Hirst type pollen sampler). Seasonal Pollen Index (SPI) was estimated as the sum of daily average pollen concentrations in the given season. Pollen season was defined as the period in which 98% of the annual total catch occurred. The pollen season of oak started first in Szczecin, on the 1st April, and lasted till the end of May. At the latest pollen season ended in Olsztyn on the 1st June. However, in the most of other cities the season lasted till the end of May. The differences of pollen seasons duration were considerables from 28 to 56 days. The highest, record airborne concentration of 342 pollen grains/m3 was noted in Warsaw on the 17th May. The maximum values of seasonal pollen count occurred between of 11th and 20th May. The highest oak pollen allergen hazard occurred in 2017 in Piotrkow Trybunalski, Lublin and Warsaw.

The aim of this study was to compare the usefulness of mannitol provocation test to that of classical histamine challenge in children with PC(20)FEV(1) histamine lower than 4 mg/ml.Twenty-two adolescent patients (mean age of 15.4 ± 4.1 years) with established asthma (PC(20)FEV(1) histamine below 4 mg/ml) were included in this study. Bronchial challenge with mannitol was performed 1-2 days after the test with histamine.The fraction of positive results of mannitol test was markedly lower when compared with the histamine challenge (72.7% vs. 100%, p = .015). The test was discontinued in one case due to severe coughing after inhalation of 315 mg of mannitol. Coughing during inhalation of dry mannitol powder occurred in most patients, although drinking water after subsequent doses alleviated this symptom in nearly all of them. Of note, triboelectrification of the inhaler and capsules was observed during the administration of consecutive mannitol doses, markedly hindering the delivery of this provoking agent. The relative decrease in FEV(1) resulting from bronchial provocation was significantly lower following mannitol delivery when compared with the histamine test (70.3% vs. 81.6% of resting value, p.001). Significant correlation was not observed between the values of PC(20)FEV(1) histamine and PD(15)FEV(1) mannitol levels.Bronchial challenge with mannitol can be used as a screening test in everyday practice, but one cannot exclude bronchial hyperresponsiveness based on its negative results. Moreover, its usefulness is limited by the influence of static on the delivery of sequential mannitol doses and coughing which can be often associated with mannitol inhalation.

Long-term oral corticosteroid (OCS) therapy and related adverse events are associated with a significant burden on patients and healthcare resources.This subgroup analysis of a randomized, open-label, parallel-group study evaluated the OCS-sparing effect of omalizumab (OMA) added to optimized asthma therapy (OAT), compared with OAT alone. Patients (12-75 years) with severe allergic asthma, uncontrolled despite GINA 2004 Step 4 therapy, received OMA or OAT for 32 weeks. The change from baseline in OCS use by Week 32 in patients requiring maintenance OCS at baseline was assessed in terms of percent OCS dose change and numbers of patients with reduced/stopped or maintained/increased OCS.Eighty-two patients were receiving maintenance OCS at baseline (OMA/OAT n = 59, OAT n = 23). Change from baseline in mean maintenance OCS dose at Week 32 was significantly greater in the OMA/OAT group compared with the OAT group (-45% vs. + 18.3%, p = 0.002). In the OMA/OAT group, 37 patients (62.7%) reduced/stopped OCS use at Week 32, compared with seven patients (30.4%) receiving OAT (p = 0.013). Improvements in other efficacy outcomes were seen at Week 32 in the OMA/OAT group, irrespective of OCS use. An investigator global evaluation of treatment effectiveness at Week 16 was an effective predictor of persistent treatment response at 32 weeks for the majority of OMA/OAT patients (93%), also irrespective of OCS use.In this open-label study of patients with severe allergic asthma, OMA/OAT therapy reduced maintenance OCS use, compared with OAT alone. Improvements in efficacy measures were observed in the OMA/OAT group, irrespective of OCS change. CLINICALTRIALS.GOV IDENTIFIER: NCT00264849.

Changes in fractional exhaled nitric oxide (FeNO) occurring after bronchial allergen challenges (BAC) are still not understood, neither are any possible associations between FeNO and forced expiratory volume in 1 sec (FEV(1)). The aim of the study was to compare the fluctuations of FeNO and FEV(1), which occur within 72 h of BAC in children sensitive to grass pollen.Seventy-four children were divided into two groups based on their medical histories and the results of skin prick tests with 10 common allergens. Individuals in whom the test yielded a positive result to at least grass pollen (Group A, n = 57), and those with negative test results against all of the allergens applied (Group B, n = 17) were subjected to BAC. FeNO was measured at a baseline and at 1, 8, 21, and 72 h after the last dose of the allergen inhalation, whereas FEV(1) was measured at a baseline, hourly for 8 h after the challenge and at 21 and 72 h thereafter.Baseline FeNO in sensitive subjects (Group A) was significantly higher than in controls of Group B. In all grass pollen-sensitive subjects, even those that were free of a bronchial response, FeNO was markedly elevated compared to its baseline values, starting from the eighth hour onward, and still increased 72 h post-BAC, whereas FEV(1) returned to a baseline at the 72nd h post-BAC. The highest increase in FeNO was registered in individuals with a dual asthmatic response.An increase in FeNO in sensitive subjects starts a few hours later than the decrease in FEV(1). Consequently, measurements of FeNO seem to be useful in long-term monitoring of the allergic reaction triggered by a specific allergen.

Introduction: Venom allergy, though rare, may seriously influence health-relat - ed quality of life (HRQoL). There is a paucity of research on HRQoL of adoles - cents and young adults with Hymenoptera venom allergy. The aim was to assess the level of HRQoL and to evaluate its independent predictors in Polish ado - lescents and young adults treated with venom immunotherapy. Material and methods: A multicenter cross-sectional study based on the Vespid Allergy Quality of Life Questionnaire (VQLQ) adapted for Polish adolescents was used. The study sample included 87 patients (14-21 years) studied at different stages of venom immunotherapy (VIT). Statistical analysis was done with mul - tivariate linear regression. Results: Anxiety level was higher in patients with 4 th grade of Mueller's classi - fication (anaphylactic shock) than in those with 3 rd grade ( B = 0.84, 95% CI = 0.07-1.61, p = 0.03). Caution increased along with an increase of anxiety of ado - lescents treated with VIT ( B = 0.54, 95% CI = 0.39-0.68, p < 0.01). Level of lim - itations increased with increasing caution of adolescents ( B = 0.63, 95% CI = 0.35-0.91, p < 0.01). Discomfort increased along with a rise of caution of patients (B = 0.38, 95% CI = 0.22-0.55, p < 0.01). Similarly, it increased with an increase of their feeling of limitations ( B = 0.37, 95% CI = 0.23-0.51, p < 0.01). The level of discomfort in adolescents treated with VIT was lower in those who were treat - ed with conventional protocol in comparison to those treated with rush or ultra- rush ones ( B = -0.47, 95% CI = -0.90 - -0.03, p = 0.04). Conclusions: Severity of anaphylactic reaction is an independent determinant of anxiety level in adolescents treated with VIT. The VIT protocol affects HRQoL of treated patients.

Concentration of nitric oxide in exhaled air (FeNO) was revealed to decrease as a result of immunotherapy. However, individuals who are exposed to environmental allergens are characterized by elevated values of FeNO. The aim of this study was to analyze the effects of subcutaneous immunotherapy (SCIT) on the dynamics of FeNO determined during consecutive pollination seasons.This study, performed between 2005 and 2008, included 41 patients with confirmed sensitivity to grass pollens and predominating symptoms of seasonal allergic rhinitis, randomly assigned to desensitization by preseasonal or maintenance SCIT. FeNO was measured prior to and during each pollen season (November-January and May-July, respectively). The results were conferred to data on grass pollination intensity in 2006-2008 (air concentration of grass pollen grains, seasonal number of days when air concentration of grass pollen reached at least 50 grains per 1 m(3)).Median content of FeNO in exhaled air was significantly higher in 2007 compared to 2006 and 2008 pollen seasons. During 2007 and 2008 pollen seasons, significant increase in FeNO was observed compared to the respective preseasonal values. Median number of days with air concentration of grass pollen ≥ 50 grains per 1 m(3) of air during 4 weeks preceding seasonal FeNO measurement was significantly higher in 2007, corresponding to higher FeNO value recorded during this pollen season. However, no significant correlation was observed between seasonal number of days with ≥ 50 grass pollen grains per 1 m(3) of air and FeNO in exhaled air (r=0.09, p=0.362).Most seasonal allergic rhinitis patients show physiological levels of FeNO prior to the pollen seasons and a marked increase in this parameter, probably proportional to pollination intensity, is observed within the seasons. ISRCTN Registry: ISRCTN86562422.