BACKGROUND

The Philippines has a wide variety of plant species with potential to produce allergenic pollen grains. Most of the study subjects which are residents in Manila tested positive to Fabaceae and Amaranthaceae. Weeds, especially the Amaranthaceae and Fabaceae families, are relevant triggers of allergy as they are highly adaptive and can grow despite adverse weather conditions. However, only a few allergens have been identified among these families and listed in the International Union of Immunological Societies allergen nomenclature database. Currently, local pollen grains are being processed at the Medical Research Laboratory of our institution to produce crude pollen extracts for use in specific diagnostic skin tests and in subcutaneous immunotherapy of patients with respiratory allergies all over the country. However, these extracts have not been characterized and data of cross-reactivity is limited.

This study aimed to evaluate the IgE binding activity of allergen extracts from Philippine weeds and trees, and determine their cross-reactive components.

Pollen extracts from Amaranthus spinosus (pigweed), Mimosa pudica (makahiya), Tridax procumbens (wild daisy), Albizia saman (acacia), Leucaena leucocephala (ipil-ipil), Mangifera indica (mango), and Cocos nucifera (coconut) were extracted and analyzed for crossreactivity using ELISA and Western blot. 

Cross-reaction was observed between ipil-ipil and coconut, and between makahiya and wild daisy. IgE bound to protein components at ~20, 18, and 15 kDa of the weeds, while for the trees, IgE bound to protein components at ~35 and ~15 kDa which may be responsible for the cross-inhibitions observed.

Data may contribute to the development of immunotherapeutic strategies and diagnostic applications for respiratory allergies, comprising the production of standardized panel of allergens thus eliminating unwanted side effects and providing patients with safer diagnosis and therapy.

Objective:The prevalence of seasonal allergic rhinitis （AR） and its combined diseases have been increasing recently. The purpose was to investigate the clinical characteristics and treatment of seasonal AR in northern China. Methods:A cross-sectional study was conducted in AR patients. The Visual analogue scale （VAS）, combined diseases, clinical features, allergic pollen and treatments were analyzed. Results:Of the 789 AR subjects included, 54.1% had a family history of atopic disease. The mian course wa s（7.4±5.9） years. 95.4% of the subjects had moderate to severe AR. The prevalence rates of allergic conjunctivitis （AC）, allergic asthma （AA）, and pollen food allergy syndrome （PFAS） were 71.1%, 19.0%, and 39.5% respectively. Among the patients, 13.8% presented with only AR, while 39.3% had an AR combined with other disease, and 1.9% exhibited comorbidity involving five different diseases. VAS was positively correlated with the number of comorbidities（r=0.186, P<0.001）. The mugwort exhibited the highest rate of pollen sensitization （48.9%）, closely followed by cypress （48.3%）. The prevalence of mono-sensitization to pollen was 20.2%, while the positive rates for double-sensitized pollens and more than three sensitized pollens were 17.4% and 62.4%, respectively. Among the study participants, 19.9% did not receive any form of treatment, while 66.2% were administered oral medication and 27.5% underwent nasal steroid spray therapy. The proportion of individuals receiving anti-IgE monoclonal antibodies was 4.3%, and allergen immunotherapy （AIT） treatment was undergone by 11.8%. Meanwhile, 41.2% of patients undergoing anti-IgE monoclonal antibody treatment also received AIT. The distribution of therapy types among patients was as follows: 44.7% received a single type, 22.2% received two types, and 9.8% received three types of therapy. Additionally, there was a subset of patients（1%） who were undergoing five distinct forms of treatment. The VAS score exhibited a significant negative correlation with no treatment（r=-0.199, P<0.001）, while it showed a positive association with the number of treatment modalities（r=0.245, P<0.001）. Conclusion:Mugwort and cypress are the predominant allergenic pollens responsible for seasonal AR in northern China. The majority of cases present with moderate to severe AR, often accompanied by various comorbidities, necessitating consideration of diverse treatment modalities. However, the current rate of adoption for AIT remains relatively insufficient.
Humans ; China/epidemiology* ; Cross-Sectional Studies ; Rhinitis, Allergic, Seasonal/therapy* ; Pollen/immunology* ; Adult ; Male ; Female ; Young Adult ; Adolescent ; Middle Aged ; Child ; Prevalence ; Allergens/immunology* ; Asthma/epidemiology* ; Conjunctivitis, Allergic

Objective:To investigate the clinical characteristics and major allergens of patients with pollen-food allergy syndrome（PFAS） and their correlation with the severity of symptoms, and to provide a basis for identifying high-risk patients, optimizing the allergen testing process and developing individualized dietary management strategies. Methods:The clinical data of 166 patients with PFAS admitted to our hospital from January 2021 to July 2023 were retrospectively analyzed. The clinical symptoms, pollen types and food allergy of the patients were analyzed by questionnaire survey and serum specific IgE detection. phi coefficient, Apriori algorithm modeling and multivariate logistic regression analysis were used to evaluate the association between allergen and symptom severity. Results:Artemisia pollen was the most common allergen in this area, with a positive rate of 96.39%. Peach and mango were the most common food allergens, which caused allergic reactions in 24.10% and 22.89% of patients, respectively. Oral mucosal symptoms were the main symptoms. Correlation analysis showed that there was a correlation between pollen allergens and allergenic food. Association rule analysis showed that when the patient was allergic to the combination of peanuts and trees, the probability of high severity of symptoms was 82.35%. Multivariate analysis showed that ragweed allergy was significantly positively correlated with the severity of PFAS symptoms. Conclusion:Artemisia pollen and related food allergens play an important role in the pathogenesis of PFAS. Association rule mining and network map analysis revealed direct associations between peanut and tree combination allergy and symptom severity, as well as potential links between other inhaled allergens and specific food allergies. Ragweed and peach allergy are independent risk factors for the aggravation of PFAS symptoms, which can be used as early warning indicators. These results help to improve the screening of high-risk patients and the construction of regional allergen databases.
Humans ; Food Hypersensitivity/immunology* ; Allergens/immunology* ; Retrospective Studies ; Pollen/immunology* ; Cross Reactions ; Immunoglobulin E/blood* ; Rhinitis, Allergic, Seasonal/immunology* ; Artemisia/immunology* ; Male ; Female ; Adult ; Prunus persica/immunology* ; Arachis/immunology* ; Middle Aged ; Surveys and Questionnaires ; Oral Allergy Syndrome

BACKGROUND

The Philippines has a wide variety of plant species with potential to produce allergenic pollen grains. Most of the study subjects which are residents in Manila tested positive to Fabaceae and Amaranthaceae. Weeds, especially the Amaranthaceae and Fabaceae families, are relevant triggers of allergy as they are highly adaptive and can grow despite adverse weather conditions. However, only a few allergens have been identified among these families and listed in the International Union of Immunological Societies allergen nomenclature database. Currently, local pollen grains are being processed at the Medical Research Laboratory of our institution to produce crude pollen extracts for use in specific diagnostic skin tests and in subcutaneous immunotherapy of patients with respiratory allergies all over the country. However, these extracts have not been characterized and data of cross-reactivity is limited.

This study aimed to evaluate the IgE binding activity of allergen extracts from Philippine weeds and trees, and determine their cross-reactive components.

Pollen extracts from Amaranthus spinosus (pigweed), Mimosa pudica (makahiya), Tridax procumbens (wild daisy), Albizia saman (acacia), Leucaena leucocephala (ipil-ipil), Mangifera indica (mango), and Cocos nucifera (coconut) were extracted and analyzed for crossreactivity using ELISA and Western blot. 

Cross-reaction was observed between ipil-ipil and coconut, and between makahiya and wild daisy. IgE bound to protein components at ~20, 18, and 15 kDa of the weeds, while for the trees, IgE bound to protein components at ~35 and ~15 kDa which may be responsible for the cross-inhibitions observed.

Data may contribute to the development of immunotherapeutic strategies and diagnostic applications for respiratory allergies, comprising the production of standardized panel of allergens thus eliminating unwanted side effects and providing patients with safer diagnosis and therapy.

BACKGROUND

Allergic respiratory diseases are prevalent in the Philippines, with allergic rhinitis and asthma occurring at 20% and 8.7% of the population, respectively. The diagnosis of respiratory allergies is achieved by a combination of patient history and different screening tools, especially for the identificati on of the allergic triggers such as allergy skin prick test (SPT) and serum-specific IgE enzyme-linked immunosorbent assays (sIgE ELISA). The Philippines, being a tropical country, have a wide variety of plant species with potential to produce allergenic pollen grains. Knowledge of the sensitization profiles of Filipino allergic patients to our local pollen allergens is currently limited.

The aim of this study is to determine the sensitization profile of patients with respiratory allergies (allergic rhinitis and/or asthma) through the allergy skin prick test (SPT) using allergenic local pollen extracts. It also aimed to determine if there is a positive agreement between the SPT and sIgE ELISA positivity rate and whether the results have relationship with the pollen purity and the protein content of the extracts.

Pollen allergens were extracted from Amaranthus spinosus (pigweed), Mimosa pudica (makahiya), Tridax procumbens (wild daisy), Imperata cylindrica (cogon), Oryza sativa (rice), Pennisetum polystachion (foxtail grass), Sorghum halepense (Johnson grass), Albizia saman (acacia), Cocos nucifera (coconut), Leucaena leucocephala (ipil-ipil), and Mangifera indica (mango). SPT was performed at the Allergy Clinic of the University of the Philippines-Philippine General Hospital on patients with allergic rhinitis and/or bronchial asthma. Blood samples were collected from patients who developed wheal diameters of 3 mm or more than the negative control. Sera were tested against the same pollen extracts using ELISA.

Of the one hundred sixty-five (165) patients who submitted for skin prick test, 129 showed positive SPT results to the pollen extracts. Weeds were the most sensitizing (51.9%-58.1%). Blood samples were collected from these patients and tested for sIgE ELISA and among them, 71 were positive in the sIgE ELISA. Highest sensitization rates in sIgE ELISA were found in coconut, pigweed, Johnson grass, and rice. The highest positive agreements or the proportion of patients with positive sIgE ELISA among those with positive SPT were in coconut, followed by Johnson grass, pigweed, and rice. Most of the pollen sensitized patients on SPT are polysensitized.

SPT is a safe, simple, and rapid method for the diagnosis of IgE-mediated allergy. The lower number of positive patients in sIgE ELISA may be attributed to the low serum IgE levels and low quantities of effectual allergen components in extracts. Results of both SPT and ELISA must be correlated with a patient's clinical history, particularly the patient’s exposures, and physical examination.

Oral allergy syndrome (OAS) is an IgE-mediated hypersensitivity. Patients with pollen allergy will experience oropharyngeal allergy after eating fresh fruits or vegetables containing homologous pathogenesis-related allergen, occasionally accompanied by systemic symptoms, it is a special type of food hypersensitivity in which respiratory allergens and food allergens are similar structurally and lead to the cross-reactivity. At present, there is little research and attention to it in China. To master the definition, epidemiological characteristics, pathological mechanism, diagnosis, prevention and treatment of OAS is very important to the prevention and control of OAS. This article reviews the research progress of OAS, providing reference and prevention basis for clinicians to improve the diagnosis and differential diagnosis of OAS.
Humans ; Pollen ; Food Hypersensitivity/diagnosis* ; Rhinitis, Allergic, Seasonal/therapy* ; Allergens ; Fruit ; Cross Reactions

Pollen food allergy syndrome (PFAS) is an IgE-mediated allergic reaction that occurs when some pollinosis patients ingest certain plant-derived food that contains cross-reactive allergenic components. PFAS is prevalent in both children and adult pollinosis patients. In most cases, PFAS symptoms are confined to the oropharynx and occur within several minutes after oral contact with food. Therefore, PFAS has been also referred as oral allergy syndrome (OAS). A small proportion of PFAS patients would experience systemic symptoms or anaphylaxis. Currently, the diagnosis of PFAS is mainly based on clinical history and allergic tests [skin prick tests and(or) serum specific IgE tests]. Oral provocation tests are used to verify atypical patients. Component-resolved diagnosis is essential for further precise diagnosis and treatment. Management options for PFAS include lifestyle adjustment, symptomatic medication, and immunotherapy. The efficacy and appropriate population for immunotherapy need further investigation. This article aims to update the knowledge on epidemiology, pathogenesis and clinical management of PFAS, thereby enhancing clinicians' understanding as well as treatment progress of this disease entity.
Adult ; Child ; Humans ; Rhinitis, Allergic, Seasonal/therapy* ; Syndrome ; Food Hypersensitivity/therapy* ; Pollen ; Fluorocarbons ; Immunoglobulin E

Objective: To investigate the species, concentration and seasonal trends of main airborne allergenic pollen in 4 districts and 5 counties of Hohhot City. Methods: The Department of allergy, Beijing Shijitan Hospital Affiliated to Capital Medical University conducted a cross-sectional study about monitoring the airborne allergenic pollen from August 1, 2021 to July 31, 2022 by the gravitational method in 4 districts and 5 counties of Hohhot City, which include Yuquan District, Xincheng District, Huimin District, Saihan District, Tuoketuo County, Helingeer County, Tumotezuoqi County, Wuchuan County and Qingshuihe County. Daily pollens were counted and identified by optical microscopy, and the data were analyzed. Results: The airborne allergenic pollen was collected every month all year round in 4 districts and 5 counties of Hohhot city. Through the whole year of the total quantity of pollens ranged from 24 850 to 50 154 grains per 1 000 mm² and two peaks of pollen concentration in air were observed,which happened in spring (from March to May) and in summer and autumn (from July to September). In spring, the main pollens were tree pollens, which principally distributed in Populus pollen (18.29%), Ulmus pollen (8.36%), Pinus pollen (6.20%), Cupressaceae pollen (5.23%), Betulaceae pollen (2.73%), Salix pollen (1.80%) and Quercus pollen (1.16%). In summer and autumn, the main pollens were weed pollens, which mainly included Artemisia pollen (42.73%), Chenopodiaceae pollen or Amaranthaceae pollen (7.46%), Poaceae pollen (2.26%), Humulus pollen or Cannabis pollen (0.60%). Conclusion: There were two peaks of main airborne allergenic pollen in 4 districts and 5 counties of Hohhot City. In the spring peak of pollen, the main airborne pollens were tree pollens. In the summer and autumn peak of pollen, the main airborne pollens were weed pollens. The Artemisia pollen was the most major airborne pollen in this area.
Humans ; Cross-Sectional Studies ; Pollen ; Hospitals

The study was aimed to analyze the seasonal pollen allergen spectrum of patients with allergic rhinitis (AR) in Nanchang city, and to provide evidence for improving the clinical diagnosis, treatment, prevention and epidemiology of seasonal AR. A retrospective analysis was conducted on the results of skin prick test (SPT) among 1 752 patients with AR in outpatient at Department of Otolaryngology, the First Affiliated Hospital of Nanchang University from September 2020 to August 2021 (a total of 1 069 males and 683 females, age ranged from 2 to 84 years old). SPSS 22.0 software was used to analyze the positive rates of main allergens and their differences in gender, age, and month of visit. Differences among groups were compared by student t test, Wilcox rank sum test, or χ² test. The results showed that among 1 752 SPT-positive patients, the number of simple seasonal AR and the number of perennial combined seasonal AR were 102 (5.82%) and 281 (16.04%), respectively. There was no significant difference between male and female patients in positive seasonal pollen allergens (χ²=2.181, P>0.05), but the positive rate of indoor seasonal pollen allergens in males was higher than that in females (χ²=7.901, P<0.05). The seasonal pollen allergens ranking top 5 of the positive rates were willow (6.62%, 116/1 752), humulus scandens (5.71%, 100/1 752), rape (5.54%, 97/1 752), grey pigweed (4.62%, 81/1 752) and birch (3.60%, 63/1 752). The positive rates of indoor and seasonal pollen allergens increased first and then decreased in different age groups, and the highest positive rates of seasonal pollen allergens were in the age group of 31-40 years old, with statistical significance compared with other groups (χ²=61.269, P<0.05). The seasonal allergen positive rate showed two peaks in time: March to May and September to November. The positive rate of pollen in spring was 60.27% (132/219), which was significantly higher than that in autumn (39.73%,87/219) (χ²=9.247, P<0.05). The positive rate of pollen combination in spring and autumn was 68.29% (112/164), which was significantly higher than that in spring and autumn alone (18.9%,31/164) and (12.8%, 21/164) (χ²=14.731, P<0.05). In summary, pollen allergy in Nanchang City cannot be ignored, accounting for more than 20% of the total number of AR. The incidence of seasonal AR in Nanchang City showed two peaks (March to May and September to November). The common allergens for seasonal AR in Nanchang City were willow, humulus scandens, rape, grey chenopods and birch.
Humans ; Female ; Male ; Adult ; Child, Preschool ; Child ; Adolescent ; Young Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Retrospective Studies ; Seasons ; Rhinitis, Allergic ; Pollen ; Hospitals ; Allergens

To study the efficacy and compliance analysis of pollen allergen drops in the treatment of allergic rhinitis. The method of single-center controlled was used to analyze the dates' results. From July 2021 to September 2021, 80 patients with seasonal allergic rhinitis were referred to the clinic of otorhinolaryngology in First Hospital of Shanxi Medical University.40 patients received sublingual immunotherapy (SLIT group), and the other 40 patients received symptomatic drug treatment as the control group. The total rhinoconjunctivitis symptom score (TRSS), the visual analogue scale(VAS), total medication score (TMS) and combined scores of medication and rhinoconjunctivitis symptoms (CSMRS) of the patient before the start of the treatment and after the first year of the treatment were compared to assess the efficacy of sublingual immunotherapy of Artemisia pollen. Follow the shedding during the study, the safety of the drug and the causes for compliance analysis were analyzed and recorded. The results of comparison with TRSS, VAS, TMS and CSMRS in two groups in the period of pretherapy were as follows: TRSS(12.393±3.023, 12.450±3.029, t=-0.077, P=0.939), VAS(8.357±1.026, 8.400±0.982, t=-0.173, P=0.862), TMS(3.214±0.568, 3.175±0.501, t=0.301, P=0.764), CSMRS (5.286±0.680, 5.253±0.677, t=0.199, P=0.843), there was no significant difference (P>0.05); lower observed symptom scores were got in the post-treatment pollen peak SLIT group compared to the control group, TRSS(3.964±1.551, 7.750±2.169, t=-7.918, P<0.05), VAS(2.893±0.956, 5.175±1.481, t=-8.286, P<0.05), TMS (1.821±0.863, 3.175±0.501, t=-8.163, P<0.05), CSMRS (2.489±0.921, 4.468±0.601, t=-10.723, P<0.05), and the differences between the groups were statistically significant (P<0.05); the SLIT group significantly reduced all symptom scores at the first peak compared to the starting, TRSS(12.393±3.023, 3.964±1.551, t=20.576, P<0.05), VAS (8.357±1.026, 2.893±0.956, t=30.070, P<0.05), TMS (3.214±0.568, 1.821±0.863, t=7.151, P<0.05), CSMRS(5.286±0.680, 2.489±0.921, t=14.533, P<0.05) and there was statistical difference (P<0.05). No significant adverse reactions occured during medication in the SLIT group. A total of 12 cases were shed in the SLIT group, so the compliance rate was 70%. The four reasons were that patients considered the course was long (4 cases, 33%); the drugs were expensive (3 cases, 25%); patients were busy with their work and life (3 cases, 25%); patients were affected by the outbreak (2 cases, 17%). In summary, Artemisia pollen sublingual drops may improve the symptoms of the patients who got allergic rhinitis caused by Artemisia pollen after the treatment for one year. However, due to the lack of sufficient understanding of immunotherapy or the difficulty in adhering to standardized medication, the compliance with sublingual immunotherapy is still poor, the compliance with sublingual immunotherapy needs to be further improved through patient education.
Humans ; Rhinitis, Allergic, Seasonal/therapy* ; Rhinitis, Allergic ; Pollen ; Ambulatory Care Facilities ; Allergens