129 research outputs found

    Does change of residence affect pollinosis? A study of Japanese university students

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    The effects of change of residence on pollinosis symptoms remain unclear. We investigated the effects of geographical change of residence on pollinosis symptoms among university freshmen. All freshmen (n = 2142) entering Shinshu University in 2011 completed self-administered questionnaires. Associations between history of pollinosis and environmental factors were assessed. Subjects were classified into three groups according to pollen count at previous residences (stationary, low pollen, and high pollen). Pollinosis both before and after relocation were compared among and within the groups. Of the 1558 subjects, 540 (34.7%) developed pollinosis before and 483 (31.0%) after entering university. The rates of pre- and post-university entrance pollinosis were 40.0 and 32.5% in the high pollen group (P < 0.001) but were similar in the other two groups. Pollinosis symptoms decreased among students that moved from high to low pollen areas, indicating that pollinosis was affected by geographic environmental factors.ArticleINTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH. 23(5):380-391 (2013)journal articl

    Occupational and food allergy: focus on allergen extracts

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    The aim of this thesis is, first, the diagnostic work-up of occupational and food allergies in the absence of well-validated commercially available standardised extracts for Skin Prick Test. Second, to investigate cross-reactivity in occupational and food allergic patients. Third, the treatment of, employees with an occupational allergy in order to enable the continuation of work. The number of work-related symptoms among greenhouse workers is increasing and the prevalence of food allergies is rising. The sequence of diagnostic procedures is the history first, followed by skin tests and RAST tests, and challenge tests as final instruments. Unfortunately, commercial standardised extracts to diagnose the more uncommon allergies caused by relatively unknown allergens are generally not available. Therefore, we made new in house manufactured extracts, for the diagnosis of occupational and food allergies e.g. several flower pollen, A. cucumeris, latex, fruits (peach, kiwi, banana, avocado), and hazelnut

    Airborne Allergens

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    Prevalence of allergic rhinitis among healthcare workers and its impact on their work: A cross-sectional survey at a tertiary healthcare centre in Pakistan

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    A study was conducted to determine the frequency of allergic rhinitis among healthcare professionals and its impact on their work at the Aga Khan University Hospital Karachi Pakistan. Healthcare workers including doctors, nurses, technicians and pharmacists were included. Participants were asked to fill a questionnaire consisting of score for allergic rhinitis (SFAR), and work productivity and activity impairment questionnaires. Out of 167 workers, 101 were males. Mean age of the participants was 29.0 ± 5.9 years. Overall prevalence of allergic rhinitis among healthcare workers was found to be frequency (19.2%). We noted that 13 individuals reported to have missed their work in the past week accounting to 4.3% of their work. When calculated with the actual work hours 35.9% of their work was reported to have been impaired due to this condition

    Research progress on aerobiology in the last 30 years. A focus on methodology and occupational health

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    Aerobiology, as a scientific discipline, developed during the last century and has been applied to different types of organisms and scenarios. In the context of the Integrated Evaluation of Indoor Particulate Exposure (VIEPI) project, we conducted a bibliometric study of the scientific literature on aerobiology from the last three decades, establishing the recent advances and the critical issues regarding the application of aerobiological methods to occupational settings. The data were collected from Scopus,Web of Science and PubMed. We explored the distribution of the articles in different years and research areas and realized a bibliometric analysis using the CiteSpace software. The results indicated that the number of publications is increasing. The studies related to environmental sciences were the most represented, while the number of occupational studies was more limited. The most common keywords were related to pollen, fungal spores and their relation with phenology, climate change and human health. This article shows that aerobiology is not restricted to the study of pollen and spores, extending the discipline and the application of aerobiological methods to occupational settings, currently under-explored

    Undertreatment of allergy: Exploring the utility of sublingual immunotherapy

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    ABSTRACT Allergic syndromes are highly prevalent and are comprised of a wide variety of clinical problems, including rhinitis, conjunctivitis, atopic dermatitis and urticaria, asthma, and food allergies. Numerous studies have shown that allergic syndromes are both underdiagnosed and undertreated. This is related to many factors, including trivialization of allergic conditions by physicians and patients, failure to adhere to diagnostic and treatment guidelines, and dissatisfaction with conventional pharmacologic treatments. Immunotherapy involves the administration of allergen extracts in an attempt to induce immunologic tolerance and has been used for the treatment of allergic syndromes and the prevention of long-term complications. Conventional subcutaneous immunotherapy is effective but is also associated with a risk of serious adverse events, requires administration by a trained health care professional, and is contraindicated in certain populations. By contrast, sublingual immunotherapy has been used extensively in Europe and possesses most of the benefits of subcutaneous immunotherapy along with increased safety, tolerability, and convenience. This narrative review explores data from selected clinical studies and concludes that sublingual immunotherapy may be well suited to fill the gap posed by the undertreatment of allergic syndromes in the United States

    Estudio de sensibilización de alergenos de polen de Estambul

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    The Istanbul Pollen Allergen Sensitization Study (IPASS) addresses multiple aspects linked to standardized aerobiological pollen monitoring with a volumetric Hist type sampler in western Istanbul from 2013 - June 2016. One aspect concerns the management of pollinosis in collaboration between aerobiologists and health practitioners. In a clinical panel study (Chapter 1) sensitizations rates of 60 patients to allergens relevant for the area were delineated using the European Standard Panel (ESP) for Skin Prick Testing (SPT) and additional single allergens corresponding to pollen taxa identified in the pollen monitoring. The output was a recommendation on a SPT panel designed for the geographical area of Istanbul. The study proved that the neophyte Ambrosia has started sensitizing allergy sufferers in Istanbul. The ESP was found to be suitable for Istanbul when grasses from the Pooideae subfamily (Phelum pratense) and Panicoideae subfamily (Sorghum halepense) were included. Besides grasses, Fagales, Oleaceae (Fraxinus and Olea) were important allergens. Morus and Rumex sensitizations often appeared in polysensitized patients, which might involve pan-allergen sensitization. A key message for the implementation of future clinical SPT studies is to refrain from including cereal allergens, as they may distort results. The next issue addressed is the pollen season in Istanbul – this time from the environmental perspective (Chapter 2). Research software designed for aerobiological analysis, the AeReobiology package in R, facilitated this comprehensive study on pollen seasons of individual taxa, and the intensity of the flowering. Poaceae, Cupressaceae, Pinaceae, Fagaceae and Ambrosia were the five pollen taxa with the greatest intensity in western Istanbul. The time series of the monitoring was disturbed by a change in the trap height due to a construction project in 2013. The location of the pollen trap at higher altitude mainly affected pollen concentrations of taxa growing in the immediate surrounding, especially of Poaceae. The definition of the pollen season, referring to the period when 95 % of the Annual Pollen integral (APIn) is dispersed, seemed adequate due to low concentrations of airborne pollen. Also 5 non zero daily records were used to define the pollen season start. For Pinaceae, Platanus, Fraxinus, Olea, as well as for Poaceae and Plantago, the method of consecutive 5 non zero daily records could be an alternative to the percent-method. Over the study period there was great variability in the seasons, especially in woody taxa. An outstanding high tree pollen season was observed in 2016. Pollen data were analysed regarding the influence of meteorological factors. Abundant water availability a year ahead was linked to this high tree pollen season in taxa of the Betulaceae family, but not only. Therefrom the hypothesis of a masting phenomenon across taxa and populations arose. Indeed, research from East Europe on high birch pollen levels in 2016 endorses this assumption. The effect of meteorological factors was studied with Generalized Additive Models (GAMs). The effect on the phenology of trees flowering in spring was the opposite on weeds flowering mainly in summer. GAMs showed short term effects during the peak flowering period. Temperature had a negative and relative humidity a positive effect in spring flowering trees. Drops in temperature slowed anther dehiscence, while sunny spells after rainfall favoured it. Mean relative humidity changes over the day, so that rather decreasing humidity levels during the day caused dehiscence when (due to rain) humidity was actually elevated. Summer flowering weeds dispersed their pollen when temperatures increased as the season progressed. The effect was, thus, positive. GAMs can be used to study the oscillating effect of meteorological variables.The city stretches over 80 km along the coast from west to east, so that the pollen spectrum on the less urbanized western fringes of the city were different compared to published pollen data from Central Istanbul. Differences in the importance of pollen contributing taxa between the city centre and the suburbs suggest that one trap in the city centre and one each at the western and eastern outskirts of the city would assure representable pollen information for Istanbul. In Turkey, unlike in many western European countries, public pollen warning is developing. Threshold levels of pollen concentrations leading to symptoms have not been defined. For a sound definition of low, moderate or high exposure risks, threshold levels need to address the local pollen situation. In the third study (Chapter 3) GAMs were used again. This time, to assess the dose response relationship of Poaceae, Betulaceae/Fagales, Ambrosia, Total pollen and PM10 on symptom and medicine scores from crowd sourced data. Hereby the Patient’s Hay-fever Diary (PHD), for allergy patients recording their symptoms, provided data on morbidity. For the scope of a research paper on Southeast Europe, data from Yuvojvod, Serbia, was included in the study. Thresholds of Poaceae, Betulaceae/Fagales, Ambrosia and Total pollen were determined by visual interpretation of non-linear effect curves. A saturation in the effect curves of Poaceae after 20 p/m3 in Istanbul, and of Ambrosia after 15 p/m3 in Yuvojvod, was the threshold for severe symptoms. At the beginning of the season patients suffered more than later in the season and morbidity did not further increase at higher pollen concentrations. From the effect estimates of the GAM outputs the Relative Risk (RR) associated with morbidity can be assessed. The RR, either to develop symptoms or to use medication or both, was increased in all independent variables. The RR for Poaceae, Betulaceae and Ambrosia was pronounced (110-120%), while Total pollen and PM10 had an increased RR of 1-3%. Total pollen can provide a small additive effect to the risk of symptom development, but cannot be an indicator for symptoms caused by taxa with varying allergenicity and seasonality. To conclude, IPASS provides allergists with information that will aid them in the selection of allergens to use in testing and treatment. It facilitated patient allergy self-management by propagating the electronic PHD. Knowledge on pollen seasons in Istanbul is important to understand future environmental effects caused by climate change in this vulnerable area. The challenge of issuing threshold levels on symptoms and medicine use has been addressed by using crowd sourced data from the PHD of Istanbul, Turkey and Yuvojvod, Serbia. We proposed a way to delineate regional threshold levels by means of GAMs that could be applied all over Europe within the European Aeroallergen Network (EAN). This study adds to aerobiological knowledge in Turkey in the light of developing public pollen information.Este estudio, sobre sensibilización a alérgenos del polen en Estambul (IPASS, siglas en inglés), aborda múltiples aspectos relacionados con el monitoreo aerobiológico estandarizado de polen, con un muestreador volumétrico tipo Hirst, en Estambul desde 2013 hasta junio de 2016. En primer lugar, se presenta el estudio sobre polinosis como resultado de una colaboración entre aerobiológos y profesionales de la salud. Sobre el panel clínico para el área de estudio (Capítulo 1), se presentaron las tasas de sensibilización a alérgenos relevantes en 60 pacientes en base al Panel Estándar Europeo (ESP, siglas en inglés) para pruebas cutáneas (SPT, siglas en inglés), añadiendo alérgenos individuales adicionales correspondientes a taxones de polen identificados en el monitoreo de polen. El resultado ha sido presentar una recomendación para el SPT diseñado para el área geográfica de Estambul. Este estudio ha demostrado que Ambrosia artemisiifolia, especie recientemente invasora en esta región, ha comenzado a sensibilizar a los pacientes de alergia en Estambul. El ESP ha sido presentado para Estambul, una vez incluida la subfamilia Pooideae (con Phleum pratense) y la subfamilia Panicoideae (con Sorghum halepense). Además de las gramíneas, el orden Fagales y la familia Oleaceae (Fraxinus y Olea) han sido considerados como alérgenos importantes. Por otro lado, la sensibilización al polen de Morus y Rumex se ha presentado en pacientes polisensibilizados, lo que podría considerarse como una sensibilización panalergénica. Un mensaje clave, para la puesta en marcha de futuros estudios clínicos de SPT, es evitar incluir alérgenos de cereales, ya que estos podrían distorsionar los resultados. Un segundo paso se ha dirigido a la definición de la estación polínica de Estambul, en esta ocasión desde una perspectiva ambiental (Capitulo 2). El software AeReobiology package in R, diseñado para realizar análisis aerobiológicos, ha facilitado realizar un estudio exhaustivo sobre la estación polínica para diferentes taxones, y sobre la intensidad de la floración. Poaceae, Cupressaceae, Pinaceae, Fagaceae y Ambrosia fueron los cinco taxones polínicos mejor representados en el oeste de Estambul. Durante el periodo de muestreo, hubo un cambio en altura del captador, debido a un proyecto de construcción en 2013. Esta altura más elevada repercutió, principalmente, en la detección de polen de taxones que crecen en el entorno inmediato, especialmente de Poaceae. La definición de la estación polínica, considerando el 95 % de la Integral de Polen Anual (APIn, siglas en inglés), pareció adecuada debido a las bajas concentraciones de polen en el aire. Para definir el inicio de estación polínica se consideraron, además, cinco días consecutivos con polen. Para Pinaceae, Platanus, Fraxinus, Olea, así como para Poaceae y Plantago, el método de cinco días consecutivos con polen podría ser una alternativa al método porcentual. Durante el período de estudio hubo una gran variabilidad en las estaciones polínicas, especialmente en taxones leñosos. En 2016 se observó alta concentración de polen de especies leñosas. Se ha realizado un análisis sobre la influencia de factores meteorológicos sobre el contenido de polen en el aire. La disponibilidad hídrica del año previo está relacionada con elevadas concentraciones polen en taxones de la familia Betulaceae, además de otros. De ahí surgió la hipótesis de partida sobre el fenómeno de vecería entre taxones y poblaciones. De hecho, el estudio sobre los altos niveles de polen de abedul, en Europa del Este durante 2016, corrobora esta suposición. El papel de los parámetros meteorológicos se ha estudiado con Modelos Aditivos Generalizados (GAMs, siglas en inglés), observándose una relación con la fenología de los árboles que florecen en primavera, contraria al de las plantas herbáceas que florecen principalmente en verano. Los GAMs mostraron un impacto a corto plazo durante el período de máxima floración. La temperatura tuvo una relación negativa y la humedad positiva en los árboles de floración primaveral. Los descensos de temperatura retrasaron la dehiscencia de las anteras, mientras que los períodos soleados, posteriores a las lluvias, la favorecieron. La humedad relativa cambia a lo largo del día, observándose que descensos de humedad, tras eventos de lluvia, favorecen la dehiscencia. Las especies herbáceas que florecen en verano liberan su polen cuando aumentan las temperaturas a medida que avanzaba la temporada. El papel de la precipitación fue negativo. Los GAMs pueden ser una alternativa para estudiar el impacto de variables meteorológicas dependiendo de su rango de variación. La ciudad se extiende a lo largo de 80 km de la costa de oeste a este, por lo que el espectro de polen en las franjas occidentales menos urbanizadas de la ciudad fue diferente en comparación con los datos de polen en el centro de Estambul. Las diferencias en la importancia de los taxones que contribuyen al polen entre el centro de la ciudad y la periferia sugieren la necesidad de contar con un captador de polen en el centro de la ciudad y otro en los alrededores del este y oeste de la ciudad, de esta forma se asegura una información representativa sobre el polen de Estambul. En Turquía, a diferencia de muchos países de Europa occidental, está surgiendo la necesidad de un sistema público de alerta. De momento no se han definido los niveles de umbral de las concentraciones de polen que conducen a síntomas. Para definir bien los riesgos de exposición bajos, moderados o altos, se deben presentar los niveles de umbral del polen local. En el tercer estudio (Capítulo 3) se han vuelto a utilizar modelos GAMs. En esta ocasión se ha tratado de evaluar la relación dosis-respuesta con Poaceae, Betulaceae/Fagales, Ambrosia, Total de Polen y PM10 en los índices de síntomas y medicamentos a partir de fuentes múltiples. La App pollen diary, utilizada por pacientes de alergia para registrar sus síntomas (PHD, siglas en inglés), proporcionó datos sobre la morbilidad. Tratando de ampliar el estudio al sudeste de Europa, se ha contado con datos de Yuvojvod, Serbia. Los umbrales de Poaceae, Betulaceae/Fagales, Ambrosia y Polen Total se han definido mediante una interpretación visual de curvas no lineales. Para Estambul 20 p/m3 de Poaceae se ha considerado como umbral de síntoma grave, en Yuvojvod se han considerado para este síntoma 15 p/m3 de Ambrosia. Los pacientes sufrieron más síntomas al inicio de la estación polínica que al final y la morbilidad no aumentó con el aumento de las concentraciones de polen. A partir de las estimaciones del efecto de los resultados del GAM, se ha podido evaluar el Riesgo Relativo (RR) asociado con la morbilidad. El RR, ya sea para desarrollar síntomas o para el uso de medicación, o para ambos, se observó una tendencia creciente de los umbrales. El RR para Poaceae, Betulaceae y Ambrosia fue pronunciado (110-120%), mientras que para el Total de Polen y partículas PM10 se obtuvo un RR que aumentó de 1-3%. El Polen Total proporciona un pequeño efecto aditivo al riesgo de desarrollo de síntomas, pero no puede ser un indicador de los síntomas causados por taxones que cuentan con una alergenicidad y estacionalidad variable. Para concluir, IPASS ofrece a los alergólogos una información que ayuda a la selección de alérgenos para las pruebas de alergia y para su tratamiento. La participación en el PHD ha facilitado el autocontrol de la alergia del paciente. El conocimiento sobre las estaciones polínicas en Estambul permitirá comprender mejor futuros efectos ambientales causados por el cambio climático en esta área vulnerable. El desafío de presentar niveles de umbral sobre los síntomas y el uso de medicamentos se ha conseguido con el uso de datos de fuentes múltiples del PHD de Estambul, Turquía, y Yuvojvod, Serbia. Propusimos una forma de determinar niveles de umbral regionales por medio de GAM que podrían aplicarse en toda Europa dentro de la Red Europea de Aeroalérgenos (EAN). Este estudio se suma al conocimiento aerobiológico en Turquía a la luz del desarrollo de información pública sobre el polen

    Current treatment strategies for seasonal allergic rhinitis: where are we heading?

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    Allergic rhinitis (AR) is very commonly caused by pollens. The symptoms of AR consist of sneezing, nasal congestion, rhinorrhea, nasal itching and airflow obstruction. The diagnosis has long been based on clinical history, skin prick tests and in vitro measurement of specific IgE, but the innovative approach of precision medicine has made diagnostic tools of much greater accuracy available
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