Allergic Conjunctivitis in Patients with Respiratory Allergic Symptoms; a Retrospective Study in Greece.

Here, we report on the prevalence of allergic conjunctivitis and positive skin prick test (SPT) results in relation to respiratory allergic conditions among patients with symptoms of allergies at a respiratory outpatient clinic. A questionnaire survey of symptoms (i.e., asthma-like, rhinitis, and conjunctivitis symptoms) involving 1522 patients was carried out. The responses of 1242 patients indicated that they had allergic conjunctivitis, asthma, rhinitis, or a combination of these conditions, and 869 of these patients underwent SPTs that assessed responses to 40 allergens. Allergic conjunctivitis was found to be very common (40%, 497 out of 1242 patients) among those with symptoms of allergies. Conjunctivitis was slightly more common among women, while rhinitis was more common among men. Patients with both conjunctivitis and rhinitis were more likely to undergo SPTs, and they had a higher rate of positive SPTs. The coexistence of two or more comorbidities increased the risk of having an immunoglobulin E (IgE)-mediated allergy (based on the SPT results) compared to having each of the conditions alone. In conclusion, allergic conjunctivitis can occur either alone or with asthma and/or rhinitis. It is not always accompanied by rhinitis, but the coexistence of these conditions was the strongest indicator of IgE-mediated allergies.

Estimating the abundance of airborne pollen and fungal spores at variable elevations using an aircraft: how high can they fly?

Airborne pollen and fungal spores are monitored mainly in highly populated, urban environments, for allergy prevention purposes. However, their sources can frequently be located outside cities' fringes with more vegetation. So as to shed light to this paradox, we investigated the diversity and abundance of airborne pollen and fungal spores at various environmental regimes. We monitored pollen and spores using an aircraft and a car, at elevations from sea level to 2,000 m above ground, in the region of Thesssaloniki, Greece. We found a total of 24 pollen types and more than 15 spore types. Pollen and spores were detected throughout the elevational transect. Lower elevations exhibited higher pollen concentrations in only half of plant taxa and higher fungal spore concentrations in only Ustilago. Pinaceae and Quercus pollen were the most abundant recorded by airplane (>54% of the total). Poaceae pollen were the most abundant via car measurements (>77% of the total). Cladosporium and Alternaria spores were the most abundant in all cases (aircraft: >69% and >17%, car: >45% and >27%, respectively). We conclude that pollen and fungal spores can be diverse and abundant even outside the main source area, evidently because of long-distance transport incidents.

Allergic conjunctivitis and the most common allergens in Northern Greece.

BACKGROUND: Ocular allergies affect a great part of the general population and often co exist with other allergic manifestations. In the present study, the prevalence of allergic conjunctivitis and the commonest allergens in allergic patients at an outpatient unit in Thessaloniki, Greece were evaluated. METHODS: This is a retrospective study regarding allergic patients who referred to an outpatient clinic between the 1st of January of 1996 and the 31st of December 2010. They completed relative questionnaires concerning their allergic condition. The patients who were included in our study had allergic conjunctivitis confirmed by ophthalmologists and were divided into 4 groups. The criteria used were the existence of allergic conjunctivitis alone or with other allergic co- morbidities. The patients then underwent skin prick tests after consent according to current guidelines. RESULTS: The archives of 1239 allergic patients were evaluated and 497 patients (40,11%) who manifested eye allergic symptoms were included in our study. 448 patients (90.14%) had allergic conjunctivitis in conjunction with asthma or rhinitis or both. 370 patients underwent skin prick tests and 284 of them (124 males-160 females) were positive for at least 1 of the 8 tested allergens (76.75%). 166 were positive to a grass mix (58.45%), 130 to olea European (45.77%), 124 to dust mites mix (43.66%), 58 to cypress (20.42%), 71 to parietaria officinalis (25.00%), 67 to cat dander (23.59%), 35 to dog dander (12.32%) and 32 to Altenaria (11.26%). CONCLUSIONS: Symptoms of ocular allergy are very common in patients with allergic rhinitis and asthma. Men had slightly higher percentages of positive skin prick tests, except for dog dander and Altenaria. Conjunctivitis should not be overlooked as an allergic entity when evaluating allergic patients.

Dust mite species in the households of mite-sensitive dogs with atopic dermatitis.

BACKGROUND: The presence of important house dust and storage mite species in the microenvironment of atopic dogs has not been thoroughly investigated. OBJECTIVES: To compare the presence and population of five dust mite species (Dermatophagoides farinae, Dermatophagoides pteronyssinus, Acarus siro, Tyrophagus putrescentiae and Lepidoglyphus destructor) among households with mite-sensitive atopic dogs (Group A), households with clinically healthy dogs (Group B) and households without pets (Group C, n=25) in Greece. ANIMALS: Twenty mite-sensitive atopic dogs and 20 clinically healthy dogs. METHODS: Dust samples were collected with a vacuum cleaner from owners' mattresses (all groups) and from dogs' sleeping areas (Groups A and B) or living room couch (Group C), once every season of the year. Following dust flotation, mites were counted and identified. RESULTS: Dermatophagoides farinae was the most prevalent (60, 40 and 64% in Groups A, B and C, respectively), followed by D. pteronyssinus (45, 35 and 48%, respectively), whereas the three storage mites were found in fewer households. No major differences could be found between Groups A and B or between households with (Groups A and B) and without dogs (Group C) regarding the presence or numbers of the five dust mite species. CONCLUSIONS AND CLINICAL IMPORTANCE: The presence and population of five common house dust and storage mite species does not differ among Greek households with mite-sensitive atopic dogs, households with healthy dogs and households without pets.

Presence and density of domestic mites in the microenvironment of mite-sensitive dogs with atopic dermatitis.

This study was designed to investigate the presence and density of domestic mites (DMs) in households with atopic dogs sensitive to these mites (group A; n=20), in households with clinically healthy, nonatopic dogs (group B; n=20) and in households without pets (group C; n=25). Dust samples were vacuum-collected from the owner mattress (all groups) and dog sleeping area (groups A and B) or living room couch (group C) on four consecutive occasions, reflecting the four seasons of the year. DMs were found, at least once, in 19 of 20 (95%) group A, 13 of 20 (65%) group B and 21 of 25 (84%) group C households. DM numbers per gram of dust were 0-159 (median, 8.8), 0-302 (median, 3) and 0-1473 (median, 6.9) for group A, B and C, respectively. Dermatophagoides farinae predominated in all groups, since it was identified in 60% of group A, 40% of group B and 64% of group C households. Dermatophagoides pteronyssinus was found in 45%, 35% and 48% of households, in group A, B and C, respectively. No differences were found between households with (groups A and B) or without dogs (group C). When considering both sampling sites together, frequency of DM recovery was higher in group A than in group B (P=0.044). Also, both mite frequency (P=0.011) and density (P=0.015) in dog sleeping area were higher in group A than in group B. In conclusion, presence and density of DMs is higher in the microenvironment of mite-sensitive dogs with atopic dermatitis than in that of clinically healthy nonatopic dogs.

Long-term prognosis of asthma is good--a 12-year follow-up study. Influence of treatment.

The number of studies on the prognosis of bronchial asthma (BA) is rather limited. The aim of the study was to determine the evolution of BA in a long-term 12-year follow-up and to investigate possible contributing factors. One hundred and sixty-three patients who visited the Out-patient Clinic for BA from 1989 to 1993 (Visit 1) were included in the study. They were re-evaluated during 2003-2005 (Visit 2). At both visits, the patients filled in a special questionnaire, underwent skin tests, spirometry, methacholine challenge and they were classified into three severity groups according to GINA of 1992 as: Mild, Moderate, and Severe asthma. At Visit 1, 95 (58.3%) patients were classified in the mild asthma group, 45 (27.6%) in moderate and 23 (14.1%) in severe; whereas at Visit 2, 107 (65.6%) patients had mild asthma, 44 (27%) moderate and 12 (7.4%) severe. At Visit 1 asthma severity was associated with male gender, younger age, and the absence of rhinitis. At Visit 2 on the other hand, asthma severity was associated with older age, longer duration of disease, smoking and again the absence of rhinitis and increased BHR at both visits. Inhaled corticosteroid use correlated with improvement in lung function. Long-term prognosis of BA was good and outcome was favorably influenced by male gender, early and mild onset of disease, absence of smoking and presence of rhinitis.

Variations in alveolar cell populations, lymphocyte subsets and NK-cells in different stages of active pulmonary sarcoidosis.

BACKGROUND: The type and mode of presentation of pulmonary sarcoidosis (radiologic stage, activity) influence alveolar lymphocyte number and subsets as well as other inflammatory cells. AIM: To investigate the variations in alveolar cells, lymphocyte subsets and NK-cells in different radiological stages of active pulmonary sarcoidosis. METHODS: 85 untreated, newly diagnosed patients (32 male, 53 female), median age 47.2+/-14.7 years were investigated. Patients were classified into chest x-ray stages (33 stage I, 27 stage II, 14 stage III and 11 stage IV disease). Bronchoalveolar lavage was performed with 4 portions of 50 mL. Total cells and cell differentials were counted, while CD3+, CD4+, CD8+, CD19+, CD3-CD16/56+ (NK-cells) and CD3+CD16/56+ (NKT-cells) were determined by flow cytometry. RESULTS: Lymphocytosis was high in all stages. Significant differences were found in: a) CD4 between stages I and II and I and IV. b) CD8 between stages I and IV and c) NK and NKT cells between stages I and III. CONCLUSIONS: Variations were observed in alveolar cells and lymphocyte subsets in different stages of pulmonary sarcoidosis. Cells exhibiting cytotoxic activity were increased with stage progression, CD8 from stage I to IV, NK and NKT cells from stage I to III. These cells may be involved in the inflammatory process regulating granuloma formation.

Transport of airborne pollen into the city of Thessaloniki: the effects of wind direction, speed and persistence.

We examined the effect of the wind vector analyzed into its three components (direction, speed and persistence), on the circulation of pollen from different plant taxa prominent in the Thessaloniki area for a 4-year period (1996-1999). These plant taxa were Ambrosia spp., Artemisia spp., Chenopodiaceae, Corylus spp., Cupressaceae, Olea europaea, Pinaceae, Platanus spp., Poaceae, Populus spp., Quercus spp., and Urticaceae. Airborne pollen of Cupressaceae, Urticaceae, Quercus spp. and O. europaea make up approximately 70% of the total average annual pollen counts. The set of data that we worked with represented days without precipitation and time intervals during which winds blew from the same direction for at least 4 consecutive hours. We did this in order to study the effect of the different wind components independently of precipitation, and to avoid secondary effects produced by pollen resuspension phenomena. Factorial regression analysis among the summed bi-hourly pollen counts for each taxon and the values of wind speed and persistence per wind direction gave significant results in 22 cases (combinations of plant taxa and wind directions). The pollen concentrations of all taxa correlated significantly with at least one of the three wind components. In seven out of the 22 taxon-wind direction combinations, the pollen counts correlated positively with wind persistence, whereas this was the case for only two of the taxon-wind speed combinations. In seven cases, pollen counts correlated with the interaction effect of wind speed and persistence. This shows the importance of wind persistence in pollen transport, particularly when weak winds prevail for a considerable part of the year, as is the case for Thessaloniki. Medium/long-distance pollen transport was evidenced for Olea (NW, SW directions), Corylus (NW, SW), Poaceae (SW) and Populus (NW).

Fifteen years' record of airborne allergenic pollen and meteorological parameters in Thessaloniki, Greece.

A pollen calendar has been constructed for the area of Thessaloniki and relationships between pollen transport and meteorological parameters have been assessed. Daily airborne pollen records were collected over a 15-year period (1987-2001), using a Burkard continuous volumetric pollen trap, located in the centre of the city. Sixteen allergenic pollen types were identified. Simultaneously, daily records of five main meteorological parameters (mean air temperature, relative humidity, rainfall, sunshine, wind speed) were made, and then correlated with fluctuations of the airborne pollen concentrations. For the first time in Greece, a pollen calendar has been constructed for 16 pollen types, from which it appears that 24.9% of the total pollen recorded belong to Cupressaceae, 20.8% to Quercus spp., 13.6% to Urticaceae, 9.1% to Oleaceae, 8.9% to Pinaceae, 6.3% to Poaceae, 5.4% to Platanaceae, 3.0% to Corylus spp., 2.5% to Chenopodiaceae and 1.4% to Populus spp. The percentages of Betula spp., Asteraceae (Artemisia spp. and Ambrosia spp.), Salix spp., Ulmaceae and Alnus spp. were each lower than 1%. A positive correlation between pollen transport and both mean temperature and sunshine was observed, whereas usually no correlation was found between pollen and relative humidity or rainfall. Finally, wind speed was generally found to have a significant positive correlation with the concentrations of 8 pollen types. For the first time in the area of Thessaloniki, and more generally in Greece, 15-year allergenic pollen records have been collected and meteorological parameters have been recorded. The airborne pollen concentration is strongly influenced by mean air temperature and sunshine duration. The highest concentrations of pollen grains are observed during spring (May).