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Rationale: Most studies of the healthcare utilization impact of pollen exposure have focused on emergency department visits or hospital admissions. However, other frequent but lower cost services-phone calls and e-mails to providers and office visits-may also be affected. Objectives: The objective of our study was to estimate the impact of tree and grass pollen exposures on respiratory-related healthcare utilization across a range of medical services, including calls and e-mails to providers, nonurgent face-to-face visits, urgent and emergent care visits, and hospitalizations. Methods: We conducted a retrospective observational study of daily tree and grass pollen counts linked to electronic health records of Kaiser Permanente beneficiaries in the metropolitan Washington, DC, area for 2013-2014. Results: The proportion of Kaiser Permanente beneficiaries with respiratory-related healthcare utilization was significantly greater (for P ⩽ 0.05) given a 1 standard deviation increase in same-day pollen exposure. For tree pollen, a 1 standard deviation increase in same-day pollen exposure was associated with relative increases in utilization ranging from 1.77% (95% confidence interval [CI], 0.07-4.17%) for urgent and emergent care visits to 12.84% (95% CI, 11.02-14.65%) for provider calls/e-mails. For grass pollen exposure, a 1 standard deviation increase in same-day pollen exposure was associated with relative increases in utilization ranging from 1.42% (95% CI, 0.39-2.46) for provider face-to-face visits to 11.09% (95% CI, 9.26-12.92) for provider calls/e-mails. Conclusions: Increased pollen exposure was associated with increases in healthcare utilization across a range of services, with relatively higher increases in provider calls/e-mails and lower increases in emergent or acute care. If climate change increases intensity and geographic scope of pollen exposure as predicted and if this study's estimates of association of peak pollen exposure on healthcare utilization are generalizable, then the impact of climate change on healthcare utilization may be significant. [ABSTRACT FROM AUTHOR]

BACKGROUND Methylated derivatives of catechins have received great attention for health beneficial effects, especially antiallergic activity. However, the scarce natural abundance of methylated catechins limits further bioactive studies. The objective of this work was to investigate regiospecific methylation of the hydroxyls of (+)‐catechin through a stepwise differentiation strategy based on electronic difference between the hydroxyl groups. RESULTS: Selective methylation of the hydroxyls on different rings was realized by employing Meerwein salt as the methylation reagent. Preferential acylation of the phenolic hydroxyls on A and B rings allowed selective exposure of the aliphatic hydroxyl on C ring to methylation. The vicinal phenolic hydroxyls on B ring were preferentially methylated under mild basic condition due to the acidic properties. Methylation of the phenolic hydroxyls on A ring was achieved by sequential protection and deprotection operations. Finally, antioxidant activities of all the individual methylated (+)‐catechins were explored by 2,2′‐azino‐bis(3‐ethylbenzothiazoline‐6‐sulfonic acid) assay. CONCLUSION: Regiospecific methylation of the phenolic and aliphatic hydroxyls was systematically achieved under mild conditions. Preparation of all the individual methylated (+)‐catechins was accomplished with a greener methylation reagent: nonvolatile Meerwein salt. This work laid a solid foundation for preparation of diverse O‐methylated catechins for bioactivity studies. © 2019 Society of Chemical Industry [ABSTRACT FROM AUTHOR]

Background: Enhancing the quality and yield of protein production in heterologous expression systems is an important issue for developing new biopharmaceuticals. It has been shown that the dynamics of protein folding is influenced by codon frequencies. As codon usage frequencies are species specific, this can affect heterologous protein expression. In this respect, "codon harmonization," that is, the usage of synonymous codons with usage frequencies in the host resembling the usage frequencies in the native organism, is a promising strategy. As recombinant proteins are important tools in the area of allergy research, we investigated in this study the influence of codon harmonization on the production of the major birch pollen allergen Bet v 1.0101. Methods: To accomplish this task, parallel production of several batches of rBet v 1, BWT, together with a harmonized variant, BH, was applied. The expression yield of soluble and insoluble protein was assayed via densitometric analysis of -SDS-PAGEs for every batch. The quality of purified proteins was assessed with a variety of physicochemical methods including mass spectrometry, circular dichroism, dynamic light scattering, Fourier transform infrared spectroscopy, in vitro degradation, and 1-anilino-8-naphthalene sulfonate-binding assays. Patients' IgE reactivity was tested in enzyme-linked immunosorbent assays and rat basophil mediator release experiments. Results: No significant differences in the ligand-binding capacity and secondary structure elements, as well as, in immunological assays could be found; however, the production yield was drastically increased for BH. Conclusion: We could show that codon harmonization is a powerful method to enhance protein yields in heterologous expression systems and should be considered especially for difficult-to-express proteins. [ABSTRACT FROM AUTHOR]

Background: Google Trends (GT) searches trends of specific queries in Google, which potentially reflect the real-life epidemiology of allergic rhinitis. We compared GT terms related to ragweed pollen allergy in American and European Union countries with a known ragweed pollen season. Our aim was to assess seasonality and the terms needed to perform the GT searches and to compare these during the spring and summer pollen seasons. Methods: We examined GT queries from January 1, 2011, to January 4, 2017. We included 15 countries with a known ragweed pollen season and used the standard 5-year GT graphs. We used the GT translation for all countries and the untranslated native terms for each country. Results: The results of “pollen,” “ragweed,” and “allergy” searches differed between countries, but “ragweed” was clearly identified in 12 of the 15 countries. There was considerable heterogeneity of findings when the GT translation was used. For Croatia, Hungary, Romania, Serbia, and Slovenia, the GT translation was inappropriate. The country patterns of “pollen,” “hay fever,” and “allergy” differed in 8 of the 11 countries with identified “ragweed” queries during the spring and the summer, indicating that the perception of tree and grass pollen allergy differs from that of ragweed pollen. Conclusions: To investigate ragweed pollen allergy using GT, the term “ragweed” as a plant is required and the translation of “ragweed” in the native language needed. [ABSTRACT FROM AUTHOR]

The drivers of spatial variation in ragweed pollen concentrations, contributing to severe allergic rhinitis and asthma, are poorly quantified. We analysed the spatiotemporal variability in 16-year (1995-2010) annual total (66 stations) and annual total (2010) (162 stations) ragweed pollen counts and 8 independent variables (start, end and duration of the ragweed pollen season, maximum daily and calendar day of the maximum daily ragweed pollen counts, last frost day in spring, first frost day in fall and duration of the frost-free period) for Europe (16 years, 1995-2010) as a function of geographical coordinates. Then annual total pollen counts, annual daily peak pollen counts and date of this peak were regressed against frost-related variables, daily mean temperatures and daily precipitation amounts. To achieve this, we assembled the largest ragweed pollen data set to date for Europe. The dependence of the annual total ragweed pollen counts and the eight independent variables against geographical coordinates clearly distinguishes the three highly infected areas: the Pannonian Plain, Western Lombardy and the Rhône-Alpes region. All the eight variables are sensitive to longitude through its temperature dependence. They are also sensitive to altitude, due to the progressively colder climate with increasing altitude. Both annual total pollen counts and the maximum daily pollen counts depend on the start and the duration of the ragweed pollen season. However, no significant changes were detected in either the eight independent variables as a function of increasing latitude. This is probably due to a mixed climate induced by strong geomorphological inhomogeneities in Europe. [ABSTRACT FROM AUTHOR]

Abstract: Background: The aim of this study was to investigate the prevalence of epidemiologic and physician‐diagnosed pollen‐induced AR (PiAR) in the grasslands of northern China and to study the impact of the intensity and time of pollen exposure on PiAR prevalence. Methods: A multistage, clustered and proportionately stratified random sampling with a field interviewer‐administered survey study was performed together with skin prick tests (SPT) and measurements of the daily pollen count. Results: A total of 6043 subjects completed the study, with a proportion of 32.4% epidemiologic AR and 18.5% PiAR. The prevalence was higher in males than females (19.6% vs 17.4%, P = .024), but no difference between the two major residential and ethnic groups (Han and Mongolian) was observed. Subjects from urban areas showed higher prevalence of PiAR than rural areas (23.1% vs 14.0%, P < .001). Most PiAR patients were sensitized to two or more pollens (79.4%) with artemisia, chenopodium, and humulus scandens being the most common pollen types, which were similarly found as the top three sensitizing pollen allergens by SPT. There were significant regional differences in the prevalence of epidemiologic AR (from 18.6% to 52.9%) and PiAR (from 10.5% to 31.4%) among the six areas investigated. PiAR symptoms were positively associated with pollen counts, temperature, and precipitation (P < .05), but negatively with wind speed and pressure P < .05). Conclusion: Pollen‐induced AR (PiAR) prevalence in the investigated region is extremely high due to high seasonal pollen exposure, which was influenced by local environmental and climate conditions. [ABSTRACT FROM AUTHOR]

Thunderstorm asthma and increased childhood leukemia risk near high-voltage power lines (HVPL) are occurrences whose mechanism of effect is not fully understood. This paper proposes and discusses a key similarity: both thunderstorms and HVPL generate a high enough electrical field in the environment to ionize nearby air and air-borne particles. I argue that the repeatedly demonstrated acute asthma response to pollen-laden air during thunderstorms is largely due to ionization of air-borne allergens, which adhere more readily and in greater quantity in the lungs than non-ionized particles. If these bind to mucous or phagocytic cells, it would enhance immune response. A rapid temperature drop and high ozone also seem to be drivers of thunderstorm asthma. This causal nexus provides strong support for the parallel situation of prolonged exposure to ionized particles near HVPL and an increased rate of childhood leukemia. Here, it is proposed that upwind carcinogens are ionized when passing HVPL and then residential and business areas. Published evidence for most steps are presented, but have not previously been published as a coherent whole, nor has it been suggested that the inhaled ionized micro-particle explanation for acute asthma may also explain development of childhood leukemia over time. The demonstrated series of events leading to increased deposition and retention of ionized particles in airways provides support for explaining both adverse health outcomes: acute thunderstorm asthma and increased risk of childhood leukemia near HVPL. Further support for this explanation of both outcomes is provided by effects of on-going proximity to highways. [ABSTRACT FROM AUTHOR]

Pollen from wind-pollinated plants is the predominant cause of pollinosis which corresponds mainly to allergic rhinitis and conjunctivitis. Bacterial communities associated to leaves and roots surface were analysed for many years with both culture-dependent and independent methods. However, microbiota of pollen grains was rarely investigated and never with a molecular fingerprint technique. The aim of this study was to perform a preliminary analysis of the pollen microbiota by applying PCR-TTGE method. Pollen samples were collected from various anemophilous trees genera (Cephalotaxus, Cupressus, Pinus, Platanus and Quercus) in Montpellier (France) in 2013. Thorough pollen preparation was essential to a successful recovery of DNA from pollen. Regarding the results, pollen microbiota was tree genus-dependent. In addition, intra-tree genus variations were also observed. The Gammaproteobacteria class was the most represented in pollen samples whatever the tree genus. Among this class, some bacteria were recognized as phytopathogens (Pseudomonas, Erwinia) but also opportunistic human pathogens (Pseudomonas, some enterobacteria). PCR-TTGE is a suitable tool to analyse the microbiota associated with pollen responsible for phytopathogenicity or affecting the human respiratory tract. [ABSTRACT FROM AUTHOR]

Summary: Background: Children whose 11th fetal week falls in pollen season (spring) reportedly have an increased risk of sensitization to food allergens. No such finding has been reported for pet allergens. Objective: The aim of the study was to (i) evaluate the incidence of pet (dog and cat) sensitization according to the season of the 11th fetal week and (ii) whether the association between pet exposure and respective sensitization is modified by the coincidence of the 11th fetal week with pollen season. Methods: The study population comprised all children (born between 2001 and 2006) in the province of South Karelia, Finland (N = 5920). Their data of immunoglobulin E antibodies and skin prick tests to pet allergens (N = 538) were collected from patient records and linked with questionnaire data on pet exposure. Results: The seasonal incidence peak of cat sensitization was observed in children whose 11th fetal week occurred in June (7.4%) and that of dog sensitization in April (3.8%) and June (4.7%). The relative rate (RR) for cat sensitization was 2.92 (95% CI 1.40‐6.08) in children with cat exposure alone, 8.53 (4.07‐17.86) in children with cat and fetal pollen exposures and 0.61 (0.20‐1.83) in children exposed to pollen alone, compared with children without these exposures. The respective RRs for dog sensitization were 2.17 (1.13‐4.19), 4.40 (2.19‐8.83) and 1.65 (0.77‐3.53). Conclusions and clinical relevance: Coincidence of the first fetal trimester with pollen season strengthens the association between pet exposure and respective sensitization. Pollen exposure at early pregnancy may deviate immune system towards Th2‐type reactivity promoting development of specific allergy in case allergen exposure occurred. Therefore, primary prevention of allergic diseases may need to begin during early pregnancy. [ABSTRACT FROM AUTHOR]

Pollen grains from Populus tomentosa, a widely cultivated tree in northern area of China, are considered to be an important aeroallergen causing severe allergic diseases. To gain insight into their allergenic components, mature Populus tomentosa pollen proteins were analyzed by two-dimensional gel electrophoresis (2-DE) and matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF/TOF MS). A total of 412 spots from mature pollen were resolved on pH 4-7 immobilized pH gradient (IPG) strips and 159 distinct proteins were identified from 242 spots analyzed. The identified proteins were categorized based on their functional role in the pollen, which included proteins involved in energy regulation, protein fate, protein synthesis and processing, metabolism, defense/stress responses, development and other functional categories. Moreover, among the identified proteins, 27 proteins were identified as putative allergens using the Structural Database of Allergenic Proteins (SDAP) tool and Allergen Online. The expression patterns of these putative allergen genes indicate that several of these genes are highly expressed in pollen. The identified putative allergens have the potential to improve specific diagnosis and can be used to develop vaccines for immunotherapy against poplar pollen allergy. [ABSTRACT FROM AUTHOR]

Background Ragweed pollen represents a major allergy risk factor. Ragweed extracts contain five different isoforms of the major allergen Amb a 1. However, the immunological characteristics of Amb a 1 isoforms are not fully investigated. Here, we compared the physicochemical and immunological properties of three most important Amb a 1 isoforms. Methods After purification, the isoforms were physicochemically characterized, tested for antibody binding and induction of human T-cell proliferative responses. Their immunological properties were further evaluated in vitro and in vivo in a mouse model. Results Amb a 1 isoforms exhibited distinct patterns of IgE binding and immunogenicity. Compared to Amb a 1.02 or 03 isoforms, Amb a 1.01 showed higher IgE-binding activity. Isoforms 01 and 03 were the most potent stimulators of patients' T cells. In a mouse model of immunization, Amb a 1.01 induced higher levels of IgG and IgE antibodies when compared to isoforms 02 and 03. Interestingly, ragweed-sensitized patients also displayed an IgG response to Amb a 1 isoforms. However, unlike therapy-induced antibodies, sensitization-induced IgG did not show IgE-blocking activity. Conclusion The present study showed that naturally occurring isoforms of Amb a 1 possess different immunogenic and sensitizing properties. These findings should be considered when selecting sequences for molecule-based diagnosis and therapy for ragweed allergy. Due to its high IgE-binding activity, isoform Amb a 1.01 should be included in diagnostic tests. In contrast, due to their limited B- and T-cell cross-reactivity patterns, a combination of different isoforms might be a more attractive strategy for ragweed immunotherapy. [ABSTRACT FROM AUTHOR]

The Poaceae family comprises over 12 000 wind-pollinated species, which release large amounts of pollen into the atmosphere. Poaceae pollen is currently regarded as the leading airborne biological pollutant and the chief cause of pollen allergy worldwide. Sensitization rates vary by country, and those variations are reviewed here. Grass pollen allergens are grouped according to their protein structure and function. In Poaceae, although species belonging to different subfamilies are characterized by distinct allergen subsets, there is a considerable degree of cross-reactivity between many species. Cross-reactivity between grass pollen protein and fresh fruit pan-allergens is associated with the appearance of food allergies. The additional influence of urban pollution may prompt a more severe immunological response. The timing and the intensity of the pollen season are governed by species genetics, but plant phenology is also influenced by climate; as a result, climate changes may affect airborne pollen concentrations. This article reviews the findings of worldwide research which has highlighted the major impact of climate change on plant phenology and also on the prevalence and severity of allergic disease. [ABSTRACT FROM AUTHOR]

Ambrosia pollen was first reported as an important allergen in North America at the end of the nineteenth century, and many European countries have recently reported its increasing significance for pollen allergy. The aims of this study were to determine whether the highly allergenic Ambrosia pollen recorded during the studied period could be the result of long-distance transport (LDT) and to identify the potential sources of Ambrosia pollen grains. The study investigates Ambrosia pollen episodes during the peak term of six yearly periods between 2010 and 2015 by examining source regions in Ambrosia pollen in Bursa, Turkey. A volumetric trap was used for collecting the pollen samples, and the back-trajectory model was used to identify a potential source of atmospheric Ambrosia pollen. The days when pollen levels exceeded 30 P m were computed, and clusters were shown on the figures. The study indicates that the Ambrosia pollen grains recorded during the episode in Bursa were not produced by local sources but transported long distances from potential source regions around the Azov Sea in Russia and Ukraine, Black Sea region of Turkey, Romania, and Bulgaria. Note that atmospheric concentrations of Ambrosia pollen exceeded the clinical threshold during 28 days during the investigation period. Taking into consideration the high allergenicity of Ambrosia pollen, the present findings suggest that the number of ragweed-sensitized individuals might increase in the near future in the region. [ABSTRACT FROM AUTHOR]

Background Short ragweed ( Ambrosia artemisiifolia) allergies affect more than 36 million people annually. Ragweed pollen grains release subpollen particles ( SPP) of respirable size upon hydration or a change in air electrical conditions. The aim of this study was to characterize the proteomes and allergomes of short ragweed SPP and total pollen protein extract ( TOT), and compare their effects with those of standard aqueous pollen protein extract ( APE) using sera from short ragweed pollen-sensitized patients. Methods Quantitative 2D gel-based and shotgun proteomics, 1D and 2D immunoblotting, and quantitative ELISA were applied. Novel SPP extraction and preparation protocols enabled appropriate sample preparation and further downstream analysis by quantitative proteomics. Results The SPP fraction contained the highest proportion (94%) of the allergome, with the largest quantities of the minor Amb a 4 and major Amb a 1 allergens, and as unique, NADH dehydrogenases. APE was the richest in Amb a 6, Amb a 5 and Amb a 3, and TOT fraction was the richest in the Amb a 8 allergens (89% and 83% of allergome, respectively). Allergenic potency correlated well among the three fractions tested, with 1D immunoblots demonstrating a slight predominance of IgE reactivity to SPP compared to TOT and APE. However, the strongest IgE binding in ELISA was noted against APE. New allergenic candidates, phosphoglycerate mutase and phosphoglucomutase, were identified in all the three pollen fractions. Enolase, UTP-glucose-1-phosphate uridylyltransferase and polygalacturonase were observed in SPP and TOT fractions as novel allergens of the short ragweed pollen, as previously described. Conclusion and Clinical Relevance We demonstrated that the complete major (Amb a 1 and 11) and almost all minor (Amb a 3, 4, 5, 6, 8 and 9) short ragweed pollen allergen repertoire as well as NADH oxidases are present in SPP, highlighting an important role for SPP in allergic sensitization to short ragweed. [ABSTRACT FROM AUTHOR]

Pollen is one of the most common causes of allergy worldwide, making the study of their molecular composition crucial for the advancement of allergy research. Despite substantial efforts in this field, it is not yet clear why some plant pollens strongly provoke allergies while others do not. However, proteases and protease inhibitors from allergen sources are known to play an important role in the development of pollen allergies. In this study, we aim to uncover differences in the transcriptional pattern of proteases and protease inhibitors in Betula verrucosa and Pinus sylvestris pollen as models for high and low allergenic potential, respectively. We applied RNA sequencing to Betula verrucosa and Pinus sylvestris pollen. After de-novo assembly we derived general functional profiles of the protein coding transcripts. By utilization of domain based functional annotation we identified potential proteases and protease inhibitors and compared their expression in the two types of pollen. Functional profiles are highly similar between Betula verrucosa and Pinus sylvestris pollen. Both pollen contain proteases and inhibitors from 53 and 7 Pfam families, respectively. Some of the members comprised within those families are implicated in facilitating allergen entry, while others are known allergens themselves. Our work revealed several candidate proteins which, with further investigation, represent exciting new leads in elucidating the process behind allergic sensitization. [ABSTRACT FROM AUTHOR]

The protein Bet v 1 represents the main cause for allergic reactions to birch pollen in Europe and North America. Structurally homologous isoforms of Bet v 1 can have different properties regarding allergic sensitization and Th2 polarization, most likely due to differential susceptibility to proteolytic cleavage. Using NMR relaxation experiments and molecular dynamics simulations, we demonstrate that the initial proteolytic cleavage sites in two naturally occurring Bet v 1 isoforms, Bet v 1.0101 (Bet v 1a) and Bet v 1.0102 (Bet v 1d), are conformationally flexible. Inaccessible cleavage sites in helices and strands are highly flexible on the microsecond-millisecond time scale, whereas those located in loops display faster nanosecond-microsecond flexibility. The data consistently show that Bet v 1.0102 is more flexible and conformationally heterogeneous than Bet v 1.0101. Moreover, NMR hydrogen-deuterium exchange measurements reveal that the backbone amides in Bet v 1.0102 are significantly more solvent exposed, in agreement with this isoform's higher susceptibility to proteolytic cleavage. The differential conformational flexibility of Bet v 1 isoforms, along with the transient exposure of inaccessible sites to the protein surface, may be linked to proteolytic susceptibility, representing a potential structure-based rationale for the observed differences in Th2 polarization and allergic sensitization. [ABSTRACT FROM AUTHOR]

Ragweed ( Ambrosia artemisiifolia L.) is a noxious plant that not only is a troublesome agronomic weed that causes economic damage to agricultural crops but also − and even more importantly − causes severe health problems due to its severe allergenicity. The pollen of invasive ragweed has become a major allergenic risk factor in urban areas in newly occupied regions. Many urban areas prohibit herbicide application; thus, mowing is the most widely used control measure. Counting pollen is labour intensive; therefore, pollen production data are mainly based on estimations. Field experiments were conducted to determine the effects of different mowing scenarios, plant density and cutting height on the biomass, pollen production and seed production of common ragweed plants. Ragweed plants were mown twice: just before the flowering of terminal racemes (BBCH 59) and when the flowers of the re-sprouting lateral shoots reached BBCH 59. A 1- to 3-cm cutting height produced the greatest pollen reduction compared to that of intact control plants (94%) based on a season-long pollen collection. The number of female flowers also significantly decreased (97%). Compared to the control, the onset of pollen discharge was delayed by 5 weeks and the length of the pollen discharge period decreased from 9 to 4 weeks. The season-long unique and reproducible pollen production data can be integrated with airborne pollen modelling and population management strategies. [ABSTRACT FROM AUTHOR]

For nearly a decade, the majority of the world's population has been living in cities, including a considerable percentage of people suffering from pollen allergy. The increasing concentration of people in cities results in larger populations being exposed to allergenic pollen at the same time. There is almost no information about spatial distribution of pollen within cities as well as a lack of information about the possible impact to human health. To obtain this increasing need for pollen exposure studies on an intra-urban scale, a novelty screening network of 14 weekly changed pollen traps was established within a large metropolitan area-Berlin, Germany. Gravimetric pollen traps were placed at a uniform street-level height from March until October 2014. Three important allergenic pollen types for Central Europe-birch ( Betula), grasses (Poaceae), and mugwort ( Artemisia)-were monitored. Remarkable spatial and temporal variations of pollen sedimentation within the city and the influences by urban local sources are shown. The observed differences between the trap with the overall highest and the trap with the overall lowest amount of pollen sedimentation were in the case of birch pollen 245%, grass pollen 306%, and mugwort pollen 1962%. Differences of this magnitude can probably lead to different health impacts on allergy sufferers in one city. Therefore, pollen should be monitored preferably in two or more appropriate locations within large cities and as a part of natural air quality regulations. [ABSTRACT FROM AUTHOR]

Pollen is an important cause of respiratory allergic reactions. As individual sanitation has improved, allergy risk has increased, and this trend is expected to continue due to climate change. Atmospheric pollen concentration is highly influenced by weather conditions. Regression analysis and modeling of the relationships between airborne pollen concentrations and weather conditions were performed to analyze and forecast pollen conditions. Traditionally, daily pollen concentration has been estimated using regression models that describe the relationships between observed pollen concentrations and weather conditions. These models were able to forecast daily concentrations at the sites of observation, but lacked broader spatial applicability beyond those sites. To overcome this limitation, an integrated modeling scheme was developed that is designed to represent the underlying processes of pollen production and distribution. A maximum potential for airborne pollen is first determined using the Weibull probability density function. Then, daily pollen concentration is estimated using multiple regression models. Daily risk grade levels are determined based on the risk criteria used in Korea. The mean percentages of agreement between the observed and estimated levels were 81.4-88.2 % and 92.5-98.5 % for oak and Japanese hop pollens, respectively. The new models estimated daily pollen risk more accurately than the original statistical models because of the newly integrated biological response curves. Although they overestimated seasonal mean concentration, they did not simulate all of the peak concentrations. This issue would be resolved by adding more variables that affect the prevalence and internal maturity of pollens. [ABSTRACT FROM AUTHOR]

Air pollutants and their interaction with environmental allergens have been considered as an important reason for the recent increase in the prevalence of allergic diseases. The aim of this study was to investigate the traffic pollution effect, as a stressor, on Platanus orientalis pollen allergens messenger RNA (mRNA) and protein expression. P. orientalis pollen grains were collected along main streets of heavy traffic and from unpolluted sites in Mashhad city, in northeast Iran. The pollen samples were examined by scanning electron microscopy. To assess the abundance of pollen allergens (Pla or 1, Pla or 2, and Pla or 3) from polluted and unpolluted sites, immunoblotting was performed. Moreover, the sequences encoding P. orientalis allergens were amplified using real-time PCR. Scanning electron microscopy showed a number of particles of 150-550 nm on the surface of pollen from polluted sites. Also, protein and gene expression levels of Pla or 1 and Pla or 3 were considerably greater in pollen samples from highly polluted areas than in pollen from unpolluted areas ( p < 0.05). In contrast, no statically significant difference in Pla or 2 protein and mRNA expression level was found between samples from the two areas. We found greater expression of allergens involved in plant defense mechanisms (Pla or 1 and Pla or 3) in polluted sites than in unpolluted ones. The high expression of these proteins can lead to an increase in the prevalence of allergic diseases. These findings suggest the necessity of supporting public policies aimed at controlling traffic pollution to improve air quality and prevent the subsequent clinical outcomes and new cases of asthma. [ABSTRACT FROM AUTHOR]

Spring pollinosis has become a part of life for many people throughout the world. A wide range of knowledge about the allergenic potential of individual pollen allergen types is documented well, but the starting point of the pollen allergens expression regulation in plants itself is still not fully answered. Expression analysis of pollen allergens does not yet have any specific protocols or methods developed, despite a very good sequence background available in public bioinformatics databases. However, research in this area of interest has a great application potential for breeding and biotechnology of allergenic plants that may benefit from the knowledge of the expression of allergen coding genes in individual varieties or genotypes. Here, a brief review of up-to-date knowledge about the coding sequences of central and eastern European spring pollen allergens is introduced together with real-time based analysis of the expression of two of the main pollen allergens-PR protein type and profilin type of birch and hazelnut. [ABSTRACT FROM AUTHOR]

Background: Local allergic rhinitis (LAR) has been observed in patients without atopy. However, LAR is still underdiagnosed in patients with perennial or seasonal nasal symptoms. Objective: The aim of this study was to determine the prevalence of LAR in young patients with a previous diagnosis of nonallergic rhinitis or suspicion of allergy. Methods: A total of 121 patients, ages 12-18 years old, with confirmed nonallergic rhinitis and typical seasonal nasal symptoms were examined. Skin-prick tests; serum and nasal specific immunoglobulin E (IgE) measurements; and nasal provocation tests by using grass (Phleum partense), Artemisia, and birch pollens were performed. A control group of age-matched patients with a diagnosis of seasonal allergic rhinitis underwent the same procedures as the test group. Results: LAR to grass pollen (P. partense), Artemisia, and birch was confirmed in 17 (16.6%), 6 (5.9%), and 9 (8.9%) of patients, respectively. Polyvalent allergy was established in 21 subjects (20.8%): grass and Artemisia, 11 patients (10.9%); and grass and birch, 10 patients (9.9%). The remaining 48 patients (47.5%) were diagnosed with nonallergic rhinitis. The results of the nasal provocation tests and the concentrations of nasal IgE were similar among the analyzed groups. Furthermore, the concentration of nasal IgE increased faster in patients with LAR than in patients with allergic rhinitis; however, this difference was not statistically significant. Conclusion: LAR is a serious problem in young patients; however, its significance is still unappreciated. [ABSTRACT FROM AUTHOR]

Background: Patients often report adverse reactions to wheat. Interpretation of sensitization to wheat pollen and flour with/without sensitization to grass pollen is a clinical problem. Aim: We set out to determine the prevalence of wheat allergy in a birth cohort (10/11 year olds) and investigate the usefulness of performing skin prick tests (SPT), specific IgE tests and component resolved diagnostics to wheat pollen and flour. Methods: The Food Allergy and Intolerance Research (FAIR) birth cohort included babies born on the Isle of Wight (UK) between September 2001-August 2002 (n = 969). Children were followed up at 1, 2, 3 and 10/11 years. 588 children had SPTs to wheat pollen and grass during the 10 year follow-up. 294 children underwent further SPT to wheat flour and 246 had specific IgE testing to wheat and grass. Results: Eight children underwent oral food challenges (OFC). We diagnosed 0.48 % (4/827; 95 % CI 0-1 %) children with wheat allergy based on OFC. 16.3 % (96/588) were sensitized to grass pollen, 13.4 % (79/588) to wheat pollen; 78 % (75/96) sensitized to both. Only one child was sensitized to wheat flour and wheat pollen, but not grass pollen. For specific IgE, 15.0 % (37/246) and 36.2 % (89/246) were sensitized to wheat and grass pollen, with 40.5 % (36/89) sensitized to both. Of the 37 children sensitized to wheat, 3 (8.1 %) were sensitized to omega 5 gliadin, 1 (2.7 %) to wheat lipid transfer protein and 1 to wheat gliadin. Conclusion: Clinicians should be aware of the high level of cross-sensitization when performing tests to wheat and grass pollen i.e. sensitisation to wheat specific IgE and wheat pollen SPT should be assessed in the presence of grass pollen SPT and/or specific IgE. [ABSTRACT FROM AUTHOR]

Background: Plant food allergies associated with lipid transfer protein (LTP) have been widely described in the Mediterranean Basin. Objective: The aim of this work was to describe the clinical profile and pollen sensitization of plant foodallergic patients sensitized to LTP in a non-Mediterranean area. Methods: Patients with clear IgE-mediated symptoms associated with plant foods and a positive skin prick test (SPT) to Pru p 3 were included in a prospective study in the north of Spain. Reported symptoms were analyzed together with a battery of food and pollen SPTs and specific IgE components by ISAC microarray. Cross-inhibition studies were performed by ImmunoCAP with plane tree, mugwort and rPru p 3. Results: Among the 72 patients included, the most frequent food allergy reported was to peaches (69%) followed by nuts (walnuts 55%, peanuts 54% and hazelnuts 43%). Most patients suffered from symptoms with multiple plant foods (a median of 6 foods per patient). Regarding the patients' pollen sensitization, 36% were sensitized to mugwort pollen (72% showing sIgE to Art v 3), 33% to grass pollen and 24% to plane tree pollen (94% with sIgE to Pla a 3). Inhibition studies showed that specific IgEs against mugwort and plane tree pollen are inhibited by Pru p 3 in a strong manner, whereas Pru p 3 was less inhibited by pollen extracts. Conclusions: LTP syndrome occurs in a non-Mediterranean area and is related to multiple sensitizations to foods and pollens such as plane tree and mugwort. In these pollen sensitizations, Pru p 3 seems to be the primary sensitizer. [ABSTRACT FROM AUTHOR]

Background Non-specific lipid transfer proteins (ns LTP) are considered to provoke allergic symptoms to plane tree pollen, which are frequently associated with peach allergy. Objective The objective was to clone the cDNA of plane pollen ns LTP Pla a 3, to characterize IgE-binding and allergenic potency of recombinant Pla a 3 in comparison to its natural counterpart and peach ns LTP Pru p 3. Methods Natural Pla a 3 was purified from plane pollen and analysed by mass spectrometry ( MS). Recombinant Pla a 3 was characterized by SDS- PAGE and CD spectroscopy. Specific IgE to extract, components of plane pollen and Pru p 3 was measured by Immuno CAP in sera of patients allergic to either plane pollen ( n = 10), peach ( n = 15) or both ( n = 15). Biological potency of the proteins was investigated by in vitro mediator release assays and IgE cross-reactivity by competitive ELISA. Results Two Pla a 3 isoforms were identified. Recombinant Pla a 3 showed high purity, structural integrity, IgE-binding capacity comparable to nPla a 3 and biological potency. Sensitization to plane pollen extract was confirmed in 24/25 plane pollen allergics. The frequency of sensitization to Pla a 3 was 53% among patients allergic to both plane pollen and peach and 10% among plane pollen allergics tolerating peach where most patients were sensitized to Pla a 1. Pla a 3 and Pru p 3 showed strong bi-directional IgE cross-reactivity in patients allergic to peach and plane pollen, but not in peach allergics tolerating plane pollen. Levels of IgE-binding were generally higher to Pru p 3 than to Pla a 3. Conclusion Sensitization to Pla a 3 is relevant in a subgroup of plane pollen allergics with concomitant peach allergy. IgE testing with Pla a 3 may serve as a marker to identify plane pollen allergic patients at risk of LTP-mediated food reactions and thereby improve in vitro diagnostic procedures. [ABSTRACT FROM AUTHOR]

Background The allergen bronchoprovocation ( ABP) test is a validated model to study asthma pathophysiology and response to treatments. The inhibitory effect of agents on the allergen-induced late asthmatic response ( LAR) is a predictor of their efficacy in asthma treatment. However, it is difficult to predict the magnitude of a LAR, which may vary according to immune responsiveness and the type of allergen used for ABP. Aim To determine the relationship between the magnitudes of early asthmatic response ( EAR) and LAR in mild asthmatic subjects according to the type of allergen inhaled and its determinants. Methods This is a retrospective analysis of a large database of ABPs, all performed with a common standardized methodology. Patients were either challenged with house dust mites ( HDMs), animals or pollens allergens. EAR was defined as a ≥ 20% fall in forced expiratory volume in 1 s ( FEV1) < 3 h following ABP and LAR as a ≥ 15% fall in FEV1 between 3 and 7 h post- ABP. The ratio of EAR % fall in FEV1/ LAR % fall in FEV1 was compared between the groups of subjects according to the allergen used for ABP. Results Data from 290 subjects were analysed: 87 had an isolated EAR and 203 had a dual response ( EAR + LAR). Dual responders had a significantly lower baseline PC20, a more marked fall in FEV1 at EAR, and a trend towards higher baseline sputum eosinophil percentages. The ratio of EAR over LAR was significantly lower in HDM compared with pollen ABP, indicating a larger LAR for a similar EAR. No correlations were observed between the ratio of EAR over LAR and the various parameters recorded in the different groups analysed. Conclusion Different mechanisms may be involved in modulating the magnitude of the LAR, according to the type of allergen. HDM seems to induce a stronger LAR than pollens, animal allergens being intermediary in this regard. [ABSTRACT FROM AUTHOR]

Proteomic analysis was used to generate a map of Populus deltoides CL. '2KEN8' mature pollen proteins. By applying 2-D electrophoresis, we resolved 403 protein spots from mature pollen. Using the matrix-assisted laser desorption/ionization time time-of-flight/time-of-flight tandem mass spectrometry method, we identified 178 distinct proteins from 218 protein spots expressed in mature pollen. Moreover, out of these, 28 proteins were identified as putative allergens. The expression patterns of these putative allergen genes indicate that several of these genes are highly expressed in pollen. In addition, the members of profilin allergen family were analyzed and their expression patterns were compared with their homologous genes in Arabidopsis and rice. Knowledge of these identified allergens has the potential to improve specific diagnosis and allergen immunotherapy treatment for patients with poplar pollen allergy. [ABSTRACT FROM AUTHOR]

Many diseases are linked with climate trends and variations. In particular, climate change is expected to alter the spatiotemporal dynamics of allergenic airborne pollen and potentially increase occurrence of allergic airway disease. Understanding the spatiotemporal patterns of changes in pollen season timing and levels is thus important in assessing climate impacts on aerobiology and allergy caused by allergenic airborne pollen. Here, we describe the spatiotemporal patterns of changes in the seasonal timing and levels of allergenic airborne pollen for multiple taxa in different climate regions at a continental scale. The allergenic pollen seasons of representative trees, weeds and grass during the past decade (2001-2010) across the contiguous United States have been observed to start 3.0 [95% Confidence Interval (CI), 1.1-4.9] days earlier on average than in the 1990s (1994-2000). The average peak value and annual total of daily counted airborne pollen have increased by 42.4% (95% CI, 21.9-62.9%) and 46.0% (95% CI, 21.5-70.5%), respectively. Changes of pollen season timing and airborne levels depend on latitude, and are associated with changes of growing degree days, frost free days, and precipitation. These changes are likely due to recent climate change and particularly the enhanced warming and precipitation at higher latitudes in the contiguous United States. [ABSTRACT FROM AUTHOR]

Background: Pollens of the Panicoideae subfamily of grasses including Bahia (Paspalum notatum) are important allergen sources in subtropical regions of the world. An assay for specific IgE to the major molecular allergenic component, Pas n 1, of Bahia grass pollen (BaGP) would have immunodiagnostic utility for patients with pollen allergy in these regions. Methods: Biotinylated Pas n 1 purified from BaGP was coated onto streptavidin ImmunoCAPs. Subjects were assessed by clinical history of allergic rhinitis and skin prick test (SPT) to aeroallergens. Serum total, BaGP-specific and Pas n 1-specific IgE were measured. Results: Pas n 1 IgE concentrations were highly correlated with BaGP SPT (r = 0.795, p < 0.0001) and BaGP IgE (r = 0.915, p < 0.0001). At 0.23 kU/l Pas n 1 IgE, the diagnostic sensitivity (92.4%) and specificity (93.1%) for the detection of BaGP allergy was high (area under receiver operator curve 0.960, p < 0.0001). The median concentrations of Pas n 1 IgE in non-atopic subjects (0.01 kU/l, n = 67) and those with other allergies (0.02 kU/l, n = 59) showed no inter-group difference, whilst grass pollen-allergic patients with allergic rhinitis showed elevated Pas n 1 IgE (6.71 kU/l, n = 182, p < 0.0001). The inter-assay coefficient of variation for the BaGP-allergic serum pool was 6.92%. Conclusions: Pas n 1 IgE appears to account for most of the BaGP-specific IgE. This molecular component immunoassay for Pas n 1 IgE has potential utility to improve the sensitivity and accuracy of diagnosis of BaGP allergy for patients in subtropical regions. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

High exposure to pollen from ornamental flowers can induce an IgE-mediated occupational allergy in florists and horticulture workers. We investigated IgE-binding antigens in chrysanthemum, freesia and gerbera pollen by immunoblot analysis and analysed the cross-reactivity of these pollen with birch, grass and mugwort pollen. In immunoblots with chrysanthemum pollen, major IgE-binding structures were seen with a molecular weight (MW) of approximately 25, 45 and 65 kD. In the immunoblots with freesia pollen, IgE from freesia pollen was directed against two proteins with an MW of approximately 15 kD. Most sera showed IgE binding to an approximately 15 kD band in gerbera pollen; with some sera additional bands were seen in the range of 30-50 kD. IgE binding to chrysanthemum pollen was inhibited by mugwort pollen only, whereas IgE binding to freesia pollen was suppressed by birch, grass and mugwort pollen. The inhibitory activity of birch and grass pollen extract on IgE binding to gerbera pollen extract was serum dependent and ranged from no inhibition to complete inhibition. Occupational exposure to many different flowers induced IgE against all three types of pollen. Exposure in greenhouses to gerbera flowers elicited mainly IgE against gerbera pollen. Mugwort pollen extract inhibited IgE binding to pollen from all three flowers. [ABSTRACT FROM AUTHOR]

Background The capacity of sublingual allergen immunotherapy (SLIT) to provide effective symptom relief in pollen-induced seasonal allergic rhinitis is often questioned, despite evidence of clinical efficacy from meta-analyses and well-powered, double-blind, placebo-controlled randomized clinical trials. In the absence of direct, head-to-head, comparative trials of SLIT and symptomatic medication, only indirect comparisons are possible. Methods We performed a meta-analysis of classes of products (second-generation H1-antihistamines, nasal corticosteroids and grass pollen SLIT tablet formulations) and single products (the azelastine-fluticasone combination MP29-02, and the leukotriene receptor antagonist montelukast) for the treatment of seasonal allergic rhinitis in adults, adolescents and/or children. We searched the literature for large (n >100 in the smallest treatment arm) double-blind, placebo-controlled randomized clinical trials. For each drug or drug class, we performed a meta-analysis of the effect on symptom scores. For each selected trial, we calculated the relative clinical impact (according to a previously published method) on the basis of the reported post-treatment or season-long nasal or total symptom scores: 100 x (scorePlacebo - scoreActive)/scorePlacebo. Results Twenty-eight publications on symptomatic medication trials and ten on SLIT trials met our selection criteria (total number of patients: n = 21,223). The Hedges' g values from the meta-analyses confirmed the presence of a treatment effect for all drug classes. In an indirect comparison, the weighted mean (range) relative clinical impacts were -29.6% (-23% to -37%) for five-grass pollen SLIT tablets, -19.2% (-6% to -29%) for timothy pollen SLIT tablets, - 23.5% (-7% to -54%) for nasal corticosteroids, -17.1% (-15% to -20%) for MP29-02, -15.0% (-3% to -26%) for H1-antihistamines and -6.5% (-3% to -10%) for montelukast. Conclusions In an indirect comparison, grass pollen SLIT tablets had a greater mean relative clinical impact than second-generation antihistamines and montelukast and much the same mean relative clinical impact as nasal corticosteroids. This result was obtained despite the presence of methodological factors that mask the clinical efficacy of SLIT for the treatment of seasonal allergic rhinitis. [ABSTRACT FROM AUTHOR]

This study aims to determine the potential origin of Olea pollen recorded in Badajoz in the Southwest of the Iberian Peninsula during 2009-2011. This was achieved using a combination of daily average and diurnal (hourly) airborne Olea pollen counts recorded at Badajoz (south-western Spain) and Évora (south-eastern Portugal), an inventory of olive groves in the studied area and air mass trajectory calculations computed using the HYSPLIT model. Examining olive pollen episodes at Badajoz that had distinctly different diurnal cycles in olive pollen in relation to the mean, allowed us to identify three different scenarios where olive pollen can be transported to the city from either distant or nearby sources during conditions with slow air mass movements. Back trajectory analysis showed that olive pollen can be transported to Badajoz from the West on prevailing winds, either directly or on slow moving air masses, and from high densities of olive groves situated to the Southeast (e.g. Andalucía). Regional scale transport of olive pollen can result in increased nighttime concentrations of this important aeroallergen. This could be particularly important in Mediterranean countries where people can be outdoors during this time due to climate and lifestyle. Such studies that examine sources and the atmospheric transport of pollen are valuable for allergy sufferers and health care professionals because the information can be incorporated into forecasts, the outputs of which are used for avoiding exposure to aeroallergens and planning medication. The results of studies of this nature can also be used for examining gene flow in this important agricultural crop. [ABSTRACT FROM AUTHOR]

Background The relevance of contact allergy to plant-related food has recently emerged. Oral allergy syndrome is one of the most characteristic symptoms of fruit allergy, although it also causes systemic reactions. Plant-food allergy is increasing at the same time as pollen allergy, and fruit-induced allergic contact urticaria could be rising as well. Objectives The present study was carried out in order to investigate whether one particular primary melon-peel allergen is responsible for contact urticaria. Methods Fourteen patients presenting with contact urticaria after touching melon peel were evaluated. A melon-peel extract was prepared and analysed by immunoblotting using the patients' sera. Molecular characterization of IgE-binding bands was performed using mass spectrometry. Melon-peel lipid transfer protein ( LTP) was purified. Inhibition studies and contact challenge with the protein were performed to confirm IgE reactivity to the purified allergen. Results An IgE-binding band of ~8-9 kDa was observed in an immunoblotting assay with all the patients' sera and was identified as an LTP. The melon-peel LTP was purified in two chromatography steps. Inhibition studies confirmed LTP as a major allergen in patients with melon-peel contact urticaria. Contact challenge with melon-peel LTP was performed in five patients, all of whom had positive results, exhibiting itchy erythema and hives in the area of contact. Conclusions This study confirmed our previous findings that melon-peel LTP is a major allergen and is responsible for contact allergy. This knowledge may be used to improve both diagnosis and treatment of patients allergic to melon. [ABSTRACT FROM AUTHOR]

Ostrya spp. and Carpinus spp. pollen was in vitro exposed to three atmospheric pollutants: CO, O and SO. Two levels of each pollutant were used, and the first level corresponds to a concentration about the atmospheric hour-limit value acceptable for human health protection in Europe and the second level to about the triple of the first level. Experiments were done under artificial solar light with temperature and relative humidity controlled. The viability of the exposed pollen samples showed a significant decrease. Also, the germination percentage showed a significant decrease in both exposed pollens, and the effect was most pronounced for SO, followed by O and CO. A general decreasing trend in the total soluble protein content of the exposed pollen samples when compared with the control was observed, but it was only statistically significant for the Ostrya spp pollen. The results showed marked effects were observed on the Ostrya spp. and Carpinus spp. pollen when exposed to air pollutant levels that can be considered safe for human health protection. [ABSTRACT FROM AUTHOR]

Ragweed Ambrosia artemisiifolia L. is rapidly spreading in Europe. Its pollen is highly allergenic, with 4-5% of Europeans being sensitized. There is an urgent need to curtail the further spread to minimize allergy costs., We simulated the spread of ragweed in Austria and southern Germany ( Bavaria) until 2050 with particular emphasis on expected climate change. Using different management scenarios and levels of management effort, we analysed the potential for reducing human allergy costs, that is, expenses caused by allergies from ragweed pollen, by curtailing the accelerating spread of ragweed. We accounted for three contrasting climate assumptions: no change in temperature and moderate (annual temperature increase of 0·025 °C) and more extreme (annual temperature increase of 0·04 °C) climate change., We found that a carefully designed management plan consisting of survey and eradication can drastically reduce the spread of ragweed. Without management, mean allergy costs for the management period (2011-2050) amount to about 290, 335 and 365 million € annually under the three climate change assumptions., Following an optimally allocated management strategy with an annual budget of 30 million € reduces mean allergy costs by 258, 295 and 325 million € per year. Thus, the management may yield substantial savings, in particular under more extreme warming, where total savings over 40 years amount to about 12 billion €., Synthesis and applications. Our study illustrates that management of invasive alien species has an economic benefit beside natural conservation. We provide guidance for the future management using the example of ragweed in Austria and Bavaria and show that although the species has expanded its range and abundance substantially in recent years, a well-designed and ambitious management programme still may yield substantial benefits. This is true for current climatic conditions as well as for future climate change scenarios, albeit management costs increase with a warming climate. However, possible gains are increasing in parallel. Given the scale of impacts on human health, and the substantial gains accrued from management, our results suggest that it is wise to halt further spread of ragweed. [ABSTRACT FROM AUTHOR]

Background: Since barrier protection measures to avoid contact with allergens are being increasingly developed, we assessed the clinical efficacy and tolerability of a topical nasal microemulsion made of glycerol esters in patients with allergic rhinitis. Methods: Randomized, controlled, double-blind, parallel group, multicentre, multinational clinical trial in which adult patients with allergic rhinitis or rhinoconjunctivitis due to sensitization to birch, grass or olive tree pollens received treatment with topical microemulsion or placebo during the pollen seasons. Efficacy variables included scores in the mini-RQLQ questionnaire, number and severity of nasal, ocular and lung signs and symptoms, need for symptomatic medications and patients' satisfaction with treatment. Adverse events were also recorded. Results: Demographic characteristics were homogeneous between groups and mini-RQLQ scores did not differ significantly at baseline (visit 1). From symptoms recorded in the diary cards, the ME group showed statistically significant better scores for nasal congestion (0.72 vs. 1.01; p = 0.017) and mean total nasal symptoms (0.7 vs. 0.9; p = 0.045). At visit 2 (pollen season), lower values were observed in the mini-RQLQ in the ME group, although there were no statistically significant differences between groups in both full analysis set (FAS) and patients completing treatment (PPS) populations. The results obtained in the nasal symptoms domain of the mini-RQLQ at visit 2 showed the highest difference (-0.43; 95% CI: -0.88 to 0.02) for the ME group in the FAS population. The topical microemulsion was safe and well tolerated and no major discomforts were observed. Satisfaction rating with the treatment was similar between the groups. Conclusions: The topical application of the microemulsion is a feasible and safe therapy in the prevention of allergic symptoms, particularly nasal congestion. [ABSTRACT FROM AUTHOR]

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Background: Two different regimens of subcutaneous immunotherapy (IT), perennial or preseasonal, may be used in the treatment of seasonal allergy. The aim of this study was to compare the efficacy and safety of perennial IT (PIT) and preseasonal IT (PSIT) in patients suffering from seasonal rhinoconjunctivitis. Methods: The study was planned as a randomized, double-blind, comparative study on the efficacy and safety of PIT and PSIT. The study group comprised 120 patients allergic to grass and rye pollen. After the observational season they were randomized to receive PIT or PSIT for 3 years. The effect of IT was assessed based on symptom severity and medication use recorded in diaries. Results: Ninety-nine patients completed the study. No difference was seen between the groups regarding combined symptom medication score (SMS) in the first season of IT. During the second season, the difference between PIT and PSIT regarding combined SMS was 27.9% (p = 0.063) and reached 42.7% (p = 0.012) in favor of PIT in the third season. Both treatments had a similar safety profile. Conclusion: PIT was more effective than PSIT in the treatment of rhinoconjunctivitis in patients allergic to grass and rye pollens. Clinicaltrials.gov registration number NCT01555736. [ABSTRACT FROM AUTHOR]

Pollen is routinely monitored, but it is unknown whether pollen counts represent allergen exposure. We therefore simultaneously determined olive pollen and Ole e 1 in ambient air in Córdoba, Spain, and Évora, Portugal, using Hirst-type traps for pollen and high-volume cascade impactors for allergen. Pollen from different days released 12-fold different amounts of Ole e 1 per pollen (both locations P < 0.001). Average allergen release from pollen (pollen potency) was much higher in Córdoba (3.9 pg Ole e 1/pollen) than in Évora (0.8 pg Ole e 1/pollen, P = 0.004). Indeed, yearly olive pollen counts in Córdoba were 2.4 times higher than in Évora, but Ole e 1 concentrations were 7.6 times higher. When modeling the origin of the pollen, >40% of Ole e 1 exposure in Évora was explained by high-potency pollen originating from the south of Spain. Thus, olive pollen can vary substantially in allergen release, even though they are morphologically identical. [ABSTRACT FROM AUTHOR]