The impact of pollen exposure on population allergic illness is poorly characterized. We explore the association of tree pollen and over-the-counter daily allergy medication sales in the New York City metropolitan area. Dates of peak tree pollen (maple, oak, and birch) concentrations were identified from 2003 to 2008. Daily allergy medication sales reported to the city health department were analyzed as a function of the same-day and lagged tree pollen peak indicators, adjusting for season, year, temperature, and day of week. Significant associations were found between tree pollen peaks and allergy medication sales, with the strongest association at 2-day lag (excess sales of 28.7% (95% CI: 17.4–41.2) over the average sales during the study period). The cumulative effect over the 7-day period on and after the tree pollen peak dates was estimated to be 141.1% (95% CI: 79.4–224.1). In conclusion, tree pollen concentration peaks were followed by large increases in over-the-counter allergy medication sales.
Climate change could affect allergic diseases, especially due to pollen. However, there has been no epidemiologic study to demonstrate the relationship between meteorological factors, pollen, and allergic patients. We aimed to investigate the association between meteorological variations and hospital visits of patients with tree pollen allergy.
The study subjects were adult patients who received skin prick tests between April and July from 1999 to 2008. We reviewed the medical records for the test results of 4,715 patients. Patients with tree pollen allergy were defined as those sensitized to more than 1 of 12 tree pollen allergens. We used monthly means of airborne tree pollen counts and meteorological factors: maximum/average/minimum temperature, relative humidity, and precipitation. We analyzed the correlations between meteorological variations, tree pollen counts, and the patient numbers. Multivariable logistic regression analyses were used to investigate the associations between meteorological factors and hospital visits of patients.
The minimum temperature in March was significantly and positively correlated with tree pollen counts in March/April and patient numbers from April through July. Pollen counts in March/April were also correlated with patient numbers from April through July. After adjusting for confounders, including air pollutants, there was a positive association between the minimum temperature in March and hospital visits of patients with tree pollen allergy from April to July(odds ratio, 1.14; 95% CI 1.03 to 1.25).
Higher temperatures could increase tree pollen counts, affecting the symptoms of patients with tree pollen allergy, thereby increasing the number of patients visiting hospitals.
Considering clinical and animal evidence suggesting a relationship between allergy and anxiety, we hypothesized that, from low to high aeroallergen exposure, changes in anxiety symptom scores in patients with primary mood disorders will correlate with changes in allergy symptom scores. We also anticipated that sensitization to tree pollen, as determined by allergen specific IgE antibodies, will predict a greater worsening of anxiety during exposure to tree pollen. 51 patients with unipolar or bipolar disorder (age: 19-63 years, 65% female) were recruited. Tree- pollen IgE positive subjects (12) were included as the experimental group and patients negative to a multi-allergen serological test (39) were included in the control group. Self reports of anxiety and allergy symptoms were obtained once during the peak airborne pollen counts and once during the period of low airborne pollen counts, as reported by two local pollen counting stations. Using linear regression models, we confirmed a significant positive association between allergy scores and anxiety scores (p<0.04); however, the IgE specific tree pollen positivity was not significantly associated with changes in anxiety scores. Because changes in anxiety scores relate to changes in depression scores, the relationship between allergy and anxiety involves states rather than only traits, and as such, our results lead to future efforts to uncover potential anxiety triggering, exacerbating or perpetuating role of allergens in vulnerable individuals.
anxiety; depression; allergen; allergy; rhinitis; atopy; allergen specific IgE; tree pollen
A computerized statistical analysis of allergy skin test results correlating patient reactivities initiated our interest in the cross-reactive allergens of mesquite tree pollen. In-vitro testing with mesquite-sensitized rabbits and a variety of deciduous tree pollens revealed so many cross-reactivities that it became apparent there could be more allergens in mesquite than previously described in the world literature. Our purpose was to examine the allergens of mesquite tree pollen (Prosopis juliflora) which elicit an IgE response in allergic humans so that future research could determine if these human allergens cross-react with various tree pollens in the same manner as did the mesquite antiserum from sensitized rabbits.
Proteins from commercial mesquite tree pollen were separated by polyacrylamide gel electrophoresis in the presence of sodium-dodecyl-sulphate. These mesquite proteins were subjected to Western blotting using pooled sera from ten mesquite-sensitive patients and goat anti-human IgE. The allergens were detected using an Amplified Opti-4-CN kit, scanned, and then interpreted by Gel-Pro software.
Thirteen human allergens of mesquite pollen were detected in this study.
The number of allergens in this study of mesquite exceeded the number identified previously in the literature. With the increased exposure to mesquite through its use in "greening the desert", increased travel to desert areas and exposure to mesquite in cooking smoke, the possible clinical significance of these allergens and their suggested cross-reactivity with other tree pollens merit further study.
Background: Aeroallergen sampling provides information
regarding the onset, duration and severity of the pollen season that clinicians
use to guide allergen selection for skin testing and treatment.
Objectives: This atmospheric survey reports (1) airborne pollen
contributions in Adana in one-year period (2) pollen onset, duration and
peak level (3) the relationship between airborne pollen and selected
meteorological variables and; (4)
effects on symptoms in pollen allergic children.
Methods: Pollen sampling was performed with a volumetric Burkard
Spore Trap. Meteorological data were measured daily from April 2001 to
April 2002. Asthma symptom scores were investigated in 186 pollen allergic
children that were on follow up in pediatric
allergy outpatient clinics during same period.
Results: Average measurements included 82.5% tree pollen,
7.7% grass pollen and 9.8% herb pollen 54 taxa were identified
during one year. The most prominent tree pollens were Cupressaceae,
Eucalyptus and Pinus. The most common herb was Chenopodiaceae
pollen family. When airborne pollen levels were examined in relation to
single meteorological conditions; daily variations in total pollen counts
were not significantly correlated with any variable studied (humidity,
rainfall, temperature and wind) (p>0.05). On the
other hand, statistically significant relationship between pollen concentration and symptom scores
were found (p>0.05). Positive correlations were seen
between both Gramineae and Herb pollen, and humidity and rainfall from March to
July. However, positive correlations were detected between tree pollen
counts and temperature and humidity in May and June.
Conclusion: This survey is the first volumetric airborne
pollen analysis conducted in the survey area in Adana. This study
suggested that the effects of weather on pollen count and symptom
scores in this population could not be clearly identified with the evaluation
of one-year data. However, pollen counts had effect on allergic symptoms
in pollen allergic children. Examination of the complex interaction of multiple
whether parameters would perhaps more fully elucidate the relationship
between meteorology and aerobiology and provide the clinician with
information necessary to forecast pollen prevalence. An awareness of
the ever chancing, local aeroallergen patterns requires regular monitoring. Such
awareness serves as a useful guide in the effective
testing and treatment of atopic patients.
Although growing evidence supports an association between allergy, allergens and depression, it remains unknown if this relationship is between “states” (possible triggers) or “traits” (possible vulnerabilities). We hypothesized that patients with recurrent mood disorders who are sensitized to tree pollen (as determined by allergen specific IgE antibodies), in comparison to those who are not sensitized, would report larger negative changes in mood during exposure to tree pollen in spring. We also hypothesized that differences between high and low tree pollen periods in self reported allergy symptoms would correlate positively with differences in self reported depression scores. We present 1-year preliminary data on the first 51 patients with unipolar or bipolar disorder (age: 19-63 years, 65% female, twelve patients were tree-pollen IgE positive). Ratings of mood and allergic disease status were performed once during the peak airborne pollen counts and once during the period of low airborne pollen counts, as reported by two local pollen counting stations. Linear regression models were developed to examine associations of changes in depression scores (dependent variable) with tree pollen sensitization, changes in the allergy symptom severity score, adjusted for gender and order of testing. We did not confirm the hypothesized relationship between a specific tree pollen sensitization and changes in mood during tree pollen exposure. We did confirm the hypothesized positive relationship between the changes in allergy symptoms and changes in subjects' depression scores (adjusted p<0.05). This result is consistent with previous epidemiological evidence connecting allergy with depression, as well as our recent reports of increased expression of cytokines in the prefrontal cortex in victims of suicide and in experimental animals sensitized and exposed to tree pollen. A relationship between changes in allergy symptom scores and changes in depression scores supports a state-level rather than only trait-level relationship, and thus lends optimism to future causality-testing interventional studies, which might then lead to novel preventative environmental interventions in mood disorders.
allergy; aeroallergen; tree pollen; allergen specific IgE; major depression; bipolar disorder
It has been reported that allergies are associated with depression and possibly suicide in women. Aggression is an important behavioral component that predisposes depressed individuals to suicidal acts. In the present study we examined the relationship between allergies and aggression to determine a potential contribution of allergies in factors of risk for suicidal behavior. Because stress plays a critical role in the manifestation of clinical symptoms of allergies and also in suicidal behavior, we also studied the role of acute stress. Female inbred Brown Norway rats known for their susceptibility to respiratory allergies were sensitized and challenged with a mixture of tree pollen and evaluated in the resident-intruder test for detection of aggressive behaviors. They were also subjected to acute stress by sessions of inescapable forced swimming and re-evaluated in the resident intruder test. Animals made allergic to tree pollen and subjected to acute stress displayed increased aggressive-like behavior as compared with control-saline treated animals or to their own aggressive scores previous to the stress session. These results suggest that allergies and stress increases aggressive-like behavior, indicating that these conditions may be important factors promoting altered emotional reactivity with the potential to influence suicidal behavior.
neuroimmune; intranasal; Brown Norway; inbred; female; resident-intruder
Type I allergy is a major health problem in industrialized countries where up to 15% of the population suffer from allergic symptoms (rhinitis, conjunctivitis, and asthma). Previously, we identified a cDNA clone that encoded a birch pollen allergen as profilin. Profilins constitute a ubiquitous family of proteins that control actin polymerization in eukaryotic cells; in particular, profilin participates in the acrosomal reaction of animal sperm cells. Although profilins had been unknown in plants so far, our finding led to the assumption that profilins might have similar functions in pollens during plant fertilization and therefore represent allergenic components in almost all pollens. We show that profilins are prominent allergens that can be isolated from tree pollens (Betula verrucosa, birch), from pollens of grasses (Phleum pratense, timothy grass), and weeds (Artemisia vulgaris, mugwort). About 20% of all pollen allergic patients tested (n = 65) displayed immunoglobulin E (IgE) reactivity to recombinant birch profilin that was expressed in pKK223-3. An IgE inhibition experiment performed with recombinant birch profilin and purified natural profilins from timothy grass and mugwort indicates common IgE epitopes. Moreover, all pollen profilins purified from these far distantly related plant species, and likewise the purified recombinant birch profilin, are able to elicit dose-dependent histamine release via high affinity Fc epsilon receptor of blood basophils from profilin allergic patients. The presence of profilin and possibly related proteins as crossreacting allergenic components in various plants therefore provides an explanation as to why certain allergic patients display type I allergic reactions with pollens and even food from distantly related plants. A functional pan-allergen, like profilin, available as purified recombinant protein, may be a useful diagnostic and probably therapeutic reagent.
Although Palm Springs, California, offers a pleasant desert climate that is often advantageous in treatment of respiratory allergies, physicians should be made aware in referring their patients that definite pollen factors must be taken into consideration in recommending a visit to Palm Springs, and should try to determine the compatibility of their patient's allergic sensitivity pattern and the particular seasonal incidence of pollen concentration in Palm Springs. It is believed that the most important pollens there are those of Bermuda grass, olive tree, mesquite, dicoria, false ragweed, scales, and hymenoclea salsola. A favorable climate alone does not permit a patient to disregard good allergic management.
A history of respiratory or other allergic symptoms during the Christmas season is occasionally obtained from allergic patients and can be related to exposure to conifers at home or in school. Incidence and mechanism of production of these symptoms were studied. Of 1657 allergic patients, respiratory and skin allergies to conifers occurred in 7%. This seasonal syndrome includes sneezing, wheezing and transitory skin rashes. The majority of patients develop their disease within 24 hours, but 15% experience symptoms after several days' delay. Mould and pollen studies were carried out in 10 test sites before, during and after tree placement in the home. Scrapings from pine and spruce bark yielded large numbers of Penicillium, Epicoccum and Alternaria, but these failed to become airborne. No significant alteration was discovered in the airborne fungi in houses when trees were present. Pollen studies showed release into air of weed, grass and tree pollens while Christmas trees were in the house. Oleoresins of the tree balsam are thought to be the most likely cause of the symptoms designated as Christmas tree allergy.
By now, the efficacy and safety of sublingual immunotherapy (SLIT) have been well established, but as for all long-term treatments, adherence to the treatment is essential. Patient-related outcome measures, such as the patients' satisfaction with the treatment, have become more crucial for they may affect treatment adherence.
To evaluate patient satisfaction with SLIT treatment (Staloral, Stallergenes S.A., France) we designed a prospective, observational, multicenter study. Treatment satisfaction was measured using the QUARTIS questionnaire (= Questionnaire on Respiratory Allergies Treated by Sublingual Immunotherapy). As medical parameters effectiveness and adverse events were documented. Patients with allergic rhinitis and/or conjunctivitis due to tree pollen, grass pollen or house dust mites were included in the study.
226 patients (94 male, 132 female, median age 37 years) participated in this study. Treatment satisfaction: Compared to a period before treatment, patients reported improved nasal symptoms (13.03 vs. 9.70; P < 0.0001) and eye symptoms (6.11 versus 4.43; P < 0.0001). After treatment, the allergy was less bothersome in everyday life (9.62 versus. 7.27; P < 0.0001). 69.2% of treated patients experienced a better tolerability than they had expected. No relevant differences were observed between the different allergen groups. Effectiveness: The severity of nasal symptoms was reduced by 53.2% (2.35 versus 1.10; P < 0.0001). For eye symptoms the severity was reduced by 57.0% (2.14 versus 0.92; P < 0.0001). Only 36.1% of the patients needed symptomatic medication in the treatment period compared to 70.1% before treatment. 88.0% of the investigators assessed the patients' well-being as "much better" or "better" after treatment. Adverse events: The overall tolerability was assessed as "good" or "very good" in approximately 90% of the evaluable cases. Only 11.9% of patients experienced adverse events (AEs). The most common AEs were gastrointestinal disorders.
Patients treated with SLIT in a real-life setting were satisfied with the treatment: It was tolerated well, patients' symptoms improved and their allergy had less impact on daily life. The patients' high level of treatment satisfaction as well as the good tolerability and effectiveness of the extract are important factors for they may help to improve treatment adherence.
The pollen coat is the first structure of the pollen to encounter the mucosal immune system upon inhalation. Prior characterizations of pollen allergens have focused on water-soluble, cytoplasmic proteins, but have overlooked much of the extracellular pollen coat. Due to washing with organic solvents when prepared, these pollen coat proteins are typically absent from commercial standardized allergenic extracts (i.e., “de-fatted”), and, as a result, their involvement in allergy has not been explored.
Using a unique approach to search for pollen allergenic proteins residing in the pollen coat, we employed transmission electron microscopy (TEM) to assess the impact of organic solvents on the structural integrity of the pollen coat. TEM results indicated that de-fatting of Cynodon dactylon (Bermuda grass) pollen (BGP) by use of organic solvents altered the structural integrity of the pollen coat. The novel IgE-binding proteins of the BGP coat include a cysteine protease (CP) and endoxylanase (EXY). The full-length cDNA that encodes the novel IgE-reactive CP was cloned from floral RNA. The EXY and CP were purified to homogeneity and tested for IgE reactivity. The CP from the BGP coat increased the permeability of human airway epithelial cells, caused a clear concentration-dependent detachment of cells, and damaged their barrier integrity.
Using an immunoproteomics approach, novel allergenic proteins of the BGP coat were identified. These proteins represent a class of novel dual-function proteins residing on the coat of the pollen grain that have IgE-binding capacity and proteolytic activity, which disrupts the integrity of the airway epithelial barrier. The identification of pollen coat allergens might explain the IgE-negative response to available skin-prick-testing proteins in patients who have positive symptoms. Further study of the role of these pollen coat proteins in allergic responses is warranted and could potentially lead to the development of improved diagnostic and therapeutic tools.
Grass pollen allergens are a major cause of allergic respiratory disease but traditionally prescribing practice for grass pollen allergen-specific immunotherapy has favoured pollen extracts of temperate grasses. Here we aim to compare allergy to subtropical and temperate grass pollens in patients with allergic rhinitis from a subtropical region of Australia.
Sensitization to pollen extracts of the subtropical Bahia grass (Paspalum notatum), Johnson grass (Sorghum halepense) and Bermuda grass (Cynodon dactylon) as well as the temperate Ryegrass (Lolium perenne) were measured by skin prick in 233 subjects from Brisbane. Grass pollen-specific IgE reactivity was tested by ELISA and cross-inhibition ELISA.
Patients with grass pollen allergy from a subtropical region showed higher skin prick diameters with subtropical Bahia grass and Bermuda grass pollens than with Johnson grass and Ryegrass pollens. IgE reactivity was higher with pollen of Bahia grass than Bermuda grass, Johnson grass and Ryegrass. Patients showed asymmetric cross-inhibition of IgE reactivity with subtropical grass pollens that was not blocked by temperate grass pollen allergens indicating the presence of species-specific IgE binding sites of subtropical grass pollen allergens that are not represented in temperate grass pollens.
Subtropical grass pollens are more important allergen sources than temperate grass pollens for patients from a subtropical region. Targeting allergen-specific immunotherapy to subtropical grass pollen allergens in patients with allergic rhinitis in subtropical regions could improve treatment efficacy thereby reducing the burden of allergic rhinitis and asthma.
Grass pollen; Allergic rhinitis; IgE; Bahia grass pollen; Bermuda grass pollen; Ryegrass pollen
An association between allergic disease and depression has been consistently reported, but whether the key mediating ingredients are predominantly biological, psychological, or mere artifacts remains unknown. In the current study, we examine the hypothesized relationship between allergen-specific immunoglobulin E (IgE) status and changes in allergy symptoms with worsening in depression scores in depressed sensitized individuals.
In patients with recurrent mood disorders, we individually coupled sensitization to specific seasonal aeroallergens (as assessed by allergen-specific IgE) with temporal windows of exposure to aeroallergens (low versus high tree or ragweed pollen counts measured according to the National Allergy Bureau guidelines). We compared Structured Interview Guide for the Hamilton Depression Rating Scale–Seasonal Affective Disorder Version (SIGH-SAD) depression score changes in 41 patients with mood disorders [25 with major depression and 16 with bipolar I disorder, diagnosed by Structured Clinical Interview for DSM (SCID)] seropositive for tree or ragweed pollen-specific IgE antibody versus 53 patients with mood disorders (30 with major depression and 23 with bipolar I disorder) seronegative for aeroallergen-specific IgE.
Worsening in total depressive scores from low to high pollen exposure was greater in allergen-specific IgE positive patients as compared to allergen-specific IgE antibody negative patients (p = 0.01). When stratified by polarity, the association was significant only in patients with bipolar I disorder (p = 0.004). This relationship was resilient to adjustment for changes in allergy symptom scores.
To our knowledge, this is the first report of coupling a molecular marker of vulnerability (allergen-specific IgE) with a specific an environmental trigger (airborne allergens) leading to exacerbation of depression in patients with bipolar I disorder.
allergen; allergen-specific IgE antibody; allergy; bipolar disorder; depression; ragweed pollen; tree pollen
An association between pollen count (Poaceae) and symptoms is well known, but to a lesser degree the importance of priming and lag effects. Also, threshold levels for changes in symptom severity need to be validated. The present study aims to investigate the relationship between pollen counts, symptoms and health related quality of life (HRQL), and to validate thresholds levels, useful in public pollen warnings.
Material and methods
Children aged 7–18 with grass pollen allergy filled out a symptom diary during the pollen season for nose, eyes and lung symptoms, as well as a HRQL questionnaire every week. Pollen counts were monitored using a volumetric spore trap.
89 (91%) of the included 98 children completed the study. There was a clear association between pollen count, symptom severity and HRQL during the whole pollen season, but no difference in this respect between early and late pollen season. There was a lag effect of 1–3 days after pollen exposure except for lung symptoms. We found only two threshold levels, at 30 and 80 pollen grains/m3 for the total symptom score, not three as is used today. The nose and eyes reacted to low doses, but for the lung symptoms, symptom strength did hardly change until 50 pollen grains/m3.
Grass pollen has an effect on symptoms and HRQL, lasting up to 5 days after exposure. Symptoms from the lungs appear to have higher threshold levels than the eyes and the nose. Overall symptom severity does not appear to change during the course of season. Threshold levels need to be revised. We suggest a traffic light model for public pollen warnings directed to children, where green signifies “no problem”, yellow signifies “can be problems, especially if you are highly sensitive” and red signifies “alert – take action”.
Grass pollen allergy; Rhinoconjunctivitis; Asthma; Quality of life; Children; Pollen forecasts
Among birch pollen allergic patients up to 70% develop allergic reactions to Bet v 1-homologue food allergens such as Api g 1 (celery) or Dau c 1 (carrot), termed as birch pollen-related food allergy. In most cases, specific immunotherapy with birch pollen extracts does not reduce allergic symptoms to the homologue food allergens. We therefore genetically engineered a multi-allergen chimer and tested if mucosal treatment with this construct could represent a novel approach for prevention of birch pollen-related food allergy.
BALB/c mice were poly-sensitized with a mixture of Bet v 1, Api g 1 and Dau c 1 followed by a sublingual challenge with carrot, celery and birch pollen extracts. For prevention of allergy sensitization an allergen chimer composed of immunodominant T cell epitopes of Api g 1 and Dau c 1 linked to the whole Bet v 1 allergen, was intranasally applied prior to sensitization.
Intranasal pretreatment with the allergen chimer led to significantly decreased antigen-specific IgE-dependent β-hexosaminidase release, but enhanced allergen-specific IgG2a and IgA antibodies. Accordingly, IL-4 levels in spleen cell cultures and IL-5 levels in restimulated spleen and cervical lymph node cell cultures were markedly reduced, while IFN-γ levels were increased. Immunomodulation was associated with increased IL-10, TGF-β and Foxp3 mRNA levels in NALT and Foxp3 in oral mucosal tissues. Treatment with anti-TGF-β, anti-IL10R or anti-CD25 antibodies abrogated the suppression of allergic responses induced by the chimer.
Our results indicate that mucosal application of the allergen chimer led to decreased Th2 immune responses against Bet v 1 and its homologue food allergens Api g 1 and Dau c 1 by regulatory and Th1-biased immune responses. These data suggest that mucosal treatment with a multi-allergen vaccine could be a promising treatment strategy to prevent birch pollen-related food allergy.
The daily pollen counts in the air of Seoul, Korea were measured using a rotorod sampler from June 1990 to July 1992. Two distinct pollen periods were noted: tree pollens such as alder, poplar, willow, oak and pine appeared in the spring from March to May, and weed pollens, such as Artemisia spp., Ambrosia spp. and Hop japanese appeared in the autumn from August to September. Various kinds of grass pollen appeared from June to September. The study indicated that there were two pollen peaks in Seoul composed of tree pollens in spring and weed pollens in autumn.
The dynamics of 15 taxa pollen seasons in Kraków, in 1991–2008 was monitored using a Burkard volumetric spore trap of the Hirst design. The highest daily pollen concentrations were achieved in the first half of May, and they were caused mainly by Betula and Pinus pollen. The second period of the high concentrations took place from the middle of July to the end of August (mainly Urtica pollen). Tree pollen seasons were shorter (18–24 days) in comparison with the most herbaceous pollen seasons (73–89 days), except at Artemisia and Ambrosia seasons (30 and 24 days, respectively). The season phases (percentyles) of the spring and late-summer taxa were the most variable in the consecutive years. The highest annual sums were noted for Urtica, Poaceae (herbaceous pollen seasons) and for Betula, Pinus, Alnus (tree pollen seasons), and the highest variability of annual totals was stated for Urtica, Populus, Fraxinus and the lowest for Ambrosia, Corylus, Poaceae. For the plants that pollinate in the middle of the pollen season (Quercus, Pinus and Rumex), the date of the season start seems not to be related to the season end, while for late pollen seasons, especially for Ambrosia and Artemisia, the statistically negative correlation between the start and the end season dates was found. Additionally, for the most studied taxa, the increase in annual pollen totals was observed. The presented results could be useful for the allergological practice and general botanical knowledge.
Aeropalynological monitoring; Pollen season; Season parameters; Kraków; Poland
The main obstacle to elucidating the role of CD4+ T cells in allergen-specific immunotherapy has been the absence of an adequately sensitive approach to directly characterize rare allergen-specific T cells without introducing substantial phenotypic modifications by in vitro amplification.
To monitor in physiological conditions, the allergen-specific CD4+ T cells generated during natural pollen exposure and during allergy vaccine.
Alder pollen allergy was used as a model for studying seasonal allergies. Allergen-specific CD4+ T cells were tracked and characterized in twelve alder pollen-allergic, six non-allergic and nine allergy vaccine-treated individuals using peptide-MHC class II tetramers.
Allergen-specific CD4+ T cells were detected in all of the alder pollen-allergic and non-allergic subjects tested. Pathogenic responses (CRTH2 expression and TH2-cytokine production) are specifically associated with terminally differentiated (CD27−) allergen-specific CD4+ T cells, which dominate in allergic individuals but are absent in non-allergic individuals. In contrast, CD27 expressing allergen-specific CD4+ T cells are present at low frequencies in both allergic and non-allergic individuals and reflect classical features of the protective immune response with high expression of IL-10 and IFN-γ. Restoration of a protective response during allergen-specific immunotherapy appears to be due to the preferential deletion of pathogenic (CD27−) allergen-specific CD4+ T cells accompanied by IL-10 induction in surviving CD27+ allergen-specific CD4+ T cells.
Differentiation stage divides allergen-specific CD4+ T cells into two distinct subpopulations with unique functional properties and different fates during allergen-specific immunotherapy.
Immunotherapy; allergy; pollen; T cells; CD4; peptide-MHC class II tetramer; peripheral tolerance; differentiation stage; ex vivo
We studied several flowering traits, namely, male-female cone phenology, male-female cone production per tree, mating system, sex ratio, air-borne pollen grains and pollen migration, over four successive years in two different natural populations of P. roxburghii from Garhwal Himalaya, India. Assessment of each trait mentioned except pollen dispersion was done by selecting five representative trees randomly in each population. The pollen migration was studied on naturally isolated source trees. The pollen trapping was done in all directions up to 2.5 km. The average reproductive period in P. roxburghii was 36 days with 3–5 days protandry. There were significant year and population effects for male and female cone output and pollen grains production per tree. In mass production year (1999), an average production of pollen cone per tree was estimated as 42.44 ± 8.32 × 103 at lower altitude and 28.1 ± 0.89 × 103 at higher altitude. The controlled pollination results in high level of outcrossing with 90% seed setting. We conclude that the high male-female ratio and tremendous pollen production capacity in P. roxburghii indicate high male competition among trees within populations. The isolation strip of 600 m is considered minimal for the management of seed orchard.
The evaluation of soy allergy in patients over 14 years of age suffering from atopic dermatitis. The evaluation of the correlation to the occurence of peanut and pollen allergy.
Materials and Methods:
Altogether 175 persons suffering from atopic dermatitis were included in the study: Specific IgE, skin prick tests, atopy patch tests to soy, history and food allergy to peanut and pollen allergy were evaluated.
The early allergic reaction to soy was recorded in 2.8% patients. Sensitization to soy was found in another 27.2% patients with no clinical manifestation after soy ingestion. The correlation between the positive results of examinations to soy and between the occurence of peanut and pollen allergy was confirmed in statistics.
Almost one third of patients suffering from atopic dermatitis are sensitized to soy without clinical symptoms. The early allergic reaction to soy occur in minority of patients suffering from atopic dermatitis.
Atopic dermatitis; pollen allergy; peanut allergy; soy allergy; specific IgE; skin prick tests
To investigate the personal characteristics and practice patterns of international medical graduates (IMGs) practising in southwestern Ontario and to compare them with the personal characteristics and practice patterns of Canadian-trained family physicians practising in the same region.
Cross-sectional analysis of data gathered from a census of family physicians.
A total of 685 family physicians.
MAIN OUTCOME MEASURES
Characteristics and practice patterns of IMG physicians and Canadian-trained physicians.
Among all family physicians practising in southwestern Ontario, 15.3% were IMGs. The IMGs were more likely than Canadian-trained medical graduates to be older and to have been in practice longer, and less likely to have completed a family medicine residency or to have been involved in undergraduate or postgraduate teaching. The IMGs were more likely to have practised longer in their current locations and to be in solo practice and accepting new patients, but were less likely to be providing maternity and newborn care. They were also more likely than Canadian-trained medical graduates were to be serving in small towns and rural and isolated communities.
The personal and practice characteristics of IMG physicians vary somewhat from those of their Canadian-trained colleagues. Policy efforts aimed at increasing and integrating IMG family physicians into the work force need to recognize these differences. Further research is needed before our results can be generalized to physicians practising beyond southwestern Ontario.
The clinical efficacy of sublingual immunotherapy (SLIT) with natural allergen extracts has been established in IgE-dependent respiratory allergies to grass or tree pollens, as well as house dust mites. Sublingual vaccines have an excellent safety record, documented with approximately 2 billion doses administered, as of today, in humans. The oral immune system comprises various antigen-presenting cells, including Langerhans cells, as well as myeloid and plasmacytoid dendritic cells (DCs) with a distinct localisation in the mucosa, along the lamina propria and in subepithelial tissues, respectively. In the absence of danger signals, all these DC subsets are tolerogenic in that they support the differentiation of Th1- and IL10-producing regulatory CD4+ T cells. Oral tissues contain limited numbers of mast cells and eosinophils, mostly located in submucosal areas, thereby explaining the good safety profile of SLIT. Resident oral Th1, Th2, and Th17 CD4+ T cells are located along the lamina propria, likely representing a defence mechanism against infectious pathogens. Second-generation sublingual vaccines are being developed, based upon recombinant allergens expressed in a native conformation, possibly formulated with Th1/T reg adjuvants and/or mucoadhesive particulate vector systems specifically designed to target oral dendritic cells.
The Children's Psychiatric Research Institute was established in February 1960 by the Mental Health Branch of the Ontario Department of Health. Its formation was the result of co-operative efforts by the Ontario Association for Retarded Children, the University of Western Ontario and the senior members of the Mental Health Division of the Ontario Department of Health. It was established in London, Ontario, because of the interest in research in this area of medicine on the part of the University of Western Ontario Faculty of Medicine.
Children suspected of being mentally retarded are accepted on referral by physicians or social agencies in southwestern Ontario. A multi-discipline team examines these patients for causal pathology, levels of function at intellectual, social and emotional parameters, and family relationships and reactions. In-patient facilities are available if required for additional investigation. The opportunity provided by the Institute and its patients for research and teaching is utilized through its close relationship with the University of Western Ontario. A postgraduate course in problems of mental retardation is offered to interested physicians.
Two hundred and fifty six attacks of acute bronchial asthma occurring in 169 children aged over 2 years were studied during a two year period. More attacks occurred during spring and autumn than at other times of the year. In 73 patients (29%) a respiratory virus infection was diagnosed, with the same seasonal variation as the asthmatic attacks. Most of the virus infections were caused by rhinovirus (45%) and respiratory syncytial virus (19%). There was no significant correlation between asthmatic attacks in patients with birch pollen, grass pollen, or Cladosporium herbarum allergy and counts of the respective pollen or spores in the air. More seasonal attacks occurred in patients with cladosporium allergy than in patients without cladosporium allergy but there was no seasonal variation among birch or grass pollen allergic patients. Information about exposure to animals was obtained in only 12% of attacks occurring in 121 patients with allergy to animal dander. The single precipitating factor most frequently associated with acute asthma was respiratory virus infection.