[Green coffee bean allergy and ultrafine particles exposure in Trieste dock workers]. / Allergia a caffè verde ed esposizione a particelle ultrafini nei lavoratori del porto di Trieste.

SUMMARY: The paper reviews allergy to green coffee bean and castor bean in dock workers and in coffee processing workers from '80 to nowadays in Trieste (NE of Italy). The avoidance of use of jute sacks contaminated with castor bean caused a decrease in sensitization to castor bean and the better work practices to handle jute sacks permitted to reduce airborne exposure to green coffee been powders, that resulted below occupational exposure limits. However, the measurement of ultrafine particles emitted during the handling of sacks showed exposure to high level of particles below 40 nm and permitted to identify some work tasks that can cause a more elevated exposure. Moreover, some sacks, coming from Tanzania, are still contaminated with castor bean, causing mild allergic symptoms. The work condition in dock workers in Trieste improved in years with a reduction of exposure to these allergens. However, the adoption of protective measures as well as periodical medical surveillance are needed to prevent sensitization or to detect the early onset of new cases.

Artemisia pollen is the main vector for airborne endotoxin.

BACKGROUND: Endotoxin (LPS) released from gram-negative bacteria causes strong immunologic and inflammatory effects and, when airborne, can contribute to respiratory conditions, such as allergic asthma. OBJECTIVES: We sought to identify the source of airborne endotoxin and the effect of this endotoxin on allergic sensitization. METHODS: We determined LPS levels in outdoor air on a daily basis for 4 consecutive years in Munich (Germany) and Davos (Switzerland). Air was sampled as particulate matter (PM) greater than 10 µm (PM > 10) and PM between 2.5 and 10 µm. LPS levels were determined by using the recombinant Factor C assay. RESULTS: More than 60% of the annual endotoxin exposure was detected in the PM > 10 fraction, showing that bacteria do not aerosolize as independent units or aggregates but adhered to large particles. In Munich 70% of annual exposure was detected between June 12th and August 28th. Multivariate modeling showed that endotoxin levels could be explained by phenological parameters (ie, plant growth). Indeed, days with high airborne endotoxin levels correlated well with the amount of Artemisia pollen in the air. Pollen collected from plants across Europe (100 locations) showed that the highest levels of endotoxin were detected on Artemisia vulgaris (mugwort) pollen, with little on other pollen. Microbiome analysis showed that LPS concentrations on mugwort pollen were related to the presence of Pseudomonas species and Pantoea species communities. In a mouse model of allergic disease, the presence of LPS on mugwort pollen was needed for allergic sensitization. CONCLUSIONS: The majority of airborne endotoxin stems from bacteria dispersed with pollen of only one plant: mugwort. This LPS was essential for inducing inflammation of the lung and allergic sensitization.

Frequency and Pattern of IgE-mediated Sensitization to Aero and Food Allergens in Ahvaz, Province of Khuzestan in Southwestern Iran.

Efficient diagnosis of allergy and proper treatment need identification of the causative allergens eliciting clinical symptoms. The present study was performed to identify the most common aero- and food allergens and determine the pattern of sensitization among people of Ahvaz (southwestern Iran), one of the most polluted cities worldwide. Based on the physical examination and medical records, patients were referred to the Allergy laboratory for "in vitro" IgE determination. Specific and total IgE was determined by the ImmunoCAP system (Thermo Fisher-Phadia, Uppsala, Sweden). A total of 666 consecutive patients (51.1% female) were tested for 202 different allergens. The majority of requests (57%) belonged to food allergens. Sensitization to at least one allergen was found in 47.6% of patients. In a selected group of allergens for which specific IgE had been tested in at least 100 patients, the most common sensitizing aeroallergens were Russian thistle, grass pollen, and willow; while wheat, honey, and shrimp were the most frequent food allergens, respectively. Sensitization profiles based on measurement of specific IgE indicated that Russian thistle, grasses, and wheat were the most prevalent allergens in people with allergic symptoms living in Ahvaz.

Aeroallergens in North-Central Nigeria.

INTRODUCTION AND OBJECTIVES: Aeroallergens are airborne organic substances which are responsible for allergenic diseases in hypersensitive individuals. People are exposed to their allergens either directly or after their entrance into the interiors. The spatio-temporal pattern of aeroallergens and their relationship with weather variability in Abuja and Nassarawa, North-Central Nigeria was studied. MATERIALS AND METHODS: Aerosamples were trapped with modified Tauber-like pollen traps. Samples were collected monthly and centrifuged at 2500rpm for 5 min and subjected to acetolysis. Meteorological data were collected from the Nigerian Meteorological Agency. RESULTS AND CONCLUSION: Aeroallergens concentration were unequivocally regulated by weather variables in both locations, indicating the possible use of aeroallergens especially pollen and spores as bio-indicators of weather variations and change. Aeroallergens encountered were fungal spores, pollen, diatom frustules, fern spores, algal cyst/cells in decreasing order of dominance. Among pollen group, Poaceae, Amarathaceae/Chenopodiaceae and Hymenocardia acida dominated. Spores of Smut species, Puccinia, Curvularia and Nigrospora were major contributors among aeromycoflora. Fungal spores morphotype dominated during the rainier months and were major contributors of the aeroallergen spectrum with those belonging to Deuteromycete preponderant. Aeroallergens which were previously identified as triggers of conjunctivitis, asthma, allergic sinusitis and bronchopulmonary allergic diseases were frequently present in both locations. Pollen prevailed more during the harmattan, influenced by northeast trade wind. Pollen component differed and was based on autochthonous source plants, indicating difference in sub-vegetational types.

Poaceae, Secale spp. and Artemisia spp. pollen in the air at two sites of different degrees of urbanisation.

INTRODUCTION: Among herbal plants, most cases of allergic reactions, like seasonal inflammation of nasal mucosa, conjunctivitis and pollen asthma, are related to the allergens from grass pollen. As the blossoming and pollination of rye is known to start the pollen season of grasses, information about the airborne rye pollen count permits alerting the people allergic to certain allergens contained in rye pollen. An important cause of allergy is also the pollen from wormwood, blossoming in late summer, as its two main allergens produce cross-reactions with many other plant allergens. OBJECTIVE: The aim of the study was to evaluate the risk of allergic reactions in persons with pollinosis on the basis of the pollen calendar, analysis of concentrations of pollen grains of grass and rye, and comparison of diurnal pattern of airborne pollen grain concentrations at two sites with different degrees of urbanisation (Gudowo in the country and the city of Szczecin) in 2012-2014. MATERIALS AND METHODS: The concentration of pollen was measured by the volume method. Length of the pollination season was determined by the method of 98%, assuming that the beginning and the end of the pollen season are the days on which 1% and 99% of the annual sum of pollen appeared. RESULTS: The first pollen grains to appear in the air are those produced by rye, followed by those produced by grass and wormwood. The pollen seasons of grasses and wormwood started about one week earlier in Gudowo than in Szczecin, while the pollen season of rye started at almost the same time in the country and in the city. Airborne pollen counts of grasses, rye and wormwood were much higher in the country than in the city. The differences most probably result from the different floristic composition at these two sites and reflect the local contribution of the taxa studied in the country. CONCLUSIONS: The risk of allergy caused by the pollen of the taxa analysed was much higher in Gudowo (in the country), than in Szczecin city.

Indoor and Outdoor Allergies.

In last 30 to 40 years there has been a significant increase in the incidence of allergy. This increase cannot be explained by genetic factors alone. Increasing air pollution and its interaction with biological allergens along with changing lifestyles are contributing factors. Dust mites, molds, and animal allergens contribute to most of the sensitization in the indoor setting. Tree and grass pollens are the leading allergens in the outdoor setting. Worsening air pollution and increasing particulate matter worsen allergy symptoms and associated morbidity. Cross-sensitization of allergens is common. Treatment involves avoidance of allergens, modifying lifestyle, medical treatment, and immunotherapy.

Morphometric analysis of inflammation in bronchial biopsies following exposure to inhaled diesel exhaust and allergen challenge in atopic subjects.

BACKGROUND: Allergen exposure and air pollution are two risk factors for asthma development and airway inflammation that have been examined extensively in isolation. The impact of combined allergen and diesel exhaust exposure has received considerably less attention. Diesel exhaust (DE) is a major contributor to ambient particulate matter (PM) air pollution, which can act as an adjuvant to immune responses and augment allergic inflammation. We aimed to clarify whether DE increases allergen-induced inflammation and cellular immune response in the airways of atopic human subjects. METHODS: Twelve atopic subjects were exposed to DE 300 µg.m(-3) or filtered air for 2 h in a blinded crossover study design with a four-week washout period between arms. One hour following either filtered air or DE exposure, subjects were exposed to allergen or saline (vehicle control) via segmental challenge. Forty-eight hours post-allergen or control exposure, bronchial biopsies were collected. The study design generated 4 different conditions: filtered air + saline (FAS), DE + saline (DES), filtered air + allergen (FAA) and DE + allergen (DEA). Biopsies sections were immunostained for tryptase, eosinophil cationic protein (ECP), neutrophil elastase (NE), CD138, CD4 and interleukin (IL)-4. The percent positivity of positive cells were quantified in the bronchial submucosa. RESULTS: The percent positivity for tryptase expression and ECP expression remained unchanged in the bronchial submucosa in all conditions. CD4 % positive staining in DEA (0.311 ± 0.060) was elevated relative to FAS (0.087 ± 0.018; p = 0.035). IL-4% positive staining in DEA (0.548 ± 0.143) was elevated relative to FAS (0.127 ± 0.062; p = 0.034). CD138 % positive staining in DEA (0.120 ± 0.031) was elevated relative to FAS (0.017 ± 0.006; p = 0.015), DES (0.044 ± 0.024; p = 0.040), and FAA (0.044 ± 0.008; p = 0.037). CD138% positive staining in FAA (0.044 ± 0.008) was elevated relative to FAS (0.017 ± 0.006; p = 0.049). NE percent positive staining in DEA (0.224 ± 0.047) was elevated relative to FAS (0.045 ± 0.014; p = 0.031). CONCLUSIONS: In vivo allergen and DE co-exposure results in elevated CD4, IL-4, CD138 and NE in the respiratory submucosa of atopic subjects, while eosinophils and mast cells are not changed. TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01792232.

Environmental factors and human health: fibrous and particulate substance-induced immunological disorders and construction of a health-promoting living environment.

Among the various scientific fields covered in the area of hygiene such as environmental medicine, epidemiology, public health and preventive medicine, we are investigating the immunological effects of fibrous and particulate substances in the environment and work surroundings, such as asbestos fibers and silica particles. In addition to these studies, we have attempted to construct health-promoting living conditions. Thus, in this review we will summarize our investigations regarding the (1) immunological effects of asbestos fibers, (2) immunological effects of silica particles, and (3) construction of a health-promoting living environment. This review article summarizes the 2014 Japanese Society for Hygiene (JSH) Award Lecture of the 85th Annual Meeting of the JSH entitled "Environmental health effects: immunological effects of fibrous and particulate matter and establishment of health-promoting environments" presented by the first author of this manuscript, Prof. Otsuki, Department of Hygiene, Kawasaki Medical School, Kurashiki, Japan, the recipient of the 2014 JSH award. The results of our experiments can be summarized as follows: (1) asbestos fibers reduce anti-tumor immunity, (2) silica particles chronically activate responder and regulatory T cells causing an unbalance of these two populations of T helper cells, which may contribute to the development of autoimmune disorders frequently complicating silicosis, and (3) living conditions to enhance natural killer cell activity were developed, which may promote the prevention of cancers and diminish symptoms of virus infections.

The prevalence of sensitization to inhalant allergens in children with atopic dermatitis.

BACKGROUND: The role of sensitization to inhalant allergens in atopic dermatitis (AD) in children is uncertain. The aim of our study was to assess the relationship of AD symptoms with sensitization to aeroallergens in Polish children ages 6-7 and 13-14 years. MATERIAL AND METHOD: Epidemiology of Allergic Disorders in Poland is a randomized study with medical examination according to the ECRHS II and the International Study of Asthma and Allergies in Childhood standards in nine selected regions of Poland. We studied 6-7-year-old (n = 4510) and 13-14-year-old children (n = 4721). A total of 1583 children (25%) had a medical examination and a skin-prick test (SPT) with the 15 most common aeroallergens. RESULTS: AD was diagnosed in 235 children (8.9%) (8.7%, 6-7-year-old children; 9.0%, 13-14-year-old children; 8.6% boys and 9.1% girls). AD was more frequent in urban versus rural habitants (9.6% versus 3.7%; p < 0.05) and in participants with a positive atopy history versus those without atopy (9.4% versus 5.1%; p < 0.05). Positive SPT was found in 1165 children (43.9%) (38.5% boys, 49.5% girls) and 64.72% with AD versus 41.9% without AD (p < 0.05) and more common in the rural region versus urban setting among 6-7 year-olds (71.8% versus 35.0%; p < 0.05). The most frequent allergic reaction was Dermatophagoides pteronyssinus (13.5%), Dermatophagoides farina (11.7%), and grasses/crop plants (11.8%). The same pattern was seen in participants with and those without AD. Children with AD had more frequent positive SPT for all aeroallergens (p < 0.05). CONCLUSION: AD should be more frequent in children with a positive atopy history and in children who live in the city. Aeroallergens play an essential role in pathogenesis of eczema in children. House-dust mites and grass pollen proved to be the most common relevant aeroallergens.

[New progress of airborne pollen].

With the growth of disease incidence in allergic diseases of upper respiratory tract year by year, airborne pollen has been considered the most important cause of the diseases. There is an obvious positive correlation between the concentration of airborne pollen and the symptoms of the diseases. The data is collected which includes environment that patient lives in about the kinds of airborne pollen and their seasonal distribution and latest conditions of the airborne pollen at home and abroad. It is benefit for the further developments of the researches of airborne pollen and has a clinical significance for the prevention, diagnosis and treatments of allergic diseases in our country.

[Respiratory symptoms and sensitization to airborne pollen of ragweed and mugwort of adults in Southwest Germany]. / Atemwegsbeschwerden und Sensibilisierungen gegen Pollen von Ambrosia artemisiifolia und Beifuß bei Erwachsenen in Süd-West-Deutschland.

BACKGROUND AND OBJECTIVE: Allergic diseases of the respiratory tract are common atopic diseases in the population. Pollen of plants are one of their main causes. Pollen of trees, grasses, and weeds like mugwort are of particular importance in this context. The purpose of the present study was to determine the association between typical respiratory symptoms due to pollen allergens and the sensitization to pollen of ragweed and mugwort in adults. METHODS: 1039 participants (18 to 66 years) from Southwest Germany were included in this cross-sectional study. Complains typically for aeroallergens were recorded by questionnaire. In-vitro existing sensitizations were determined for grasses/early bloomer (gx1), trees (tx6), mugwort (w6 and Art-v1) and ragweed (w1 and Amb-a1) by testing for specific IgE-antibodies. RESULTS: In a screening test with a mixed allergen sample (sx1) 36.0 % of the participants showed an aeroallergen sensitization. Consecutive investigations of these 374 positive samples revealed a sensitization to grasses/early bloomer, trees, ragweed (w1), mugwort (w6) and the major allergens ragweed (Amb-a1) and mugwort (Art-v1) in 61.8 %, 54.5 %, 29.9 %, 24.3 %, 1.9 %, and 12.3 %, respectively. This corresponds to 22.2 %, 19.6 %, 10.8 %, 8.7 %, 0.7 % and 4.4 %, respectively, in the whole study population. The participants tested positively stated significantly more disorders. On average, 51.1 % had known hay fever, 65.2 % sneezing without cold and 41.5 % sneezing due to contact with grasses or flowers. In contrast, participants tested negatively stated disorders in only 4.4 %, 32.5 %, and 3.9 %, respectively. CONCLUSION: In Southwest Germany, sensitizations to plant pollen mainly are still caused by grasses, trees, and weeds like mugwort. A sensitization to pollen of ragweed alone is rare until now. However, in case of continuous allergic disorders of the respiratory tract in late summer, a sensitization to ragweed can be important for differential diagnostics.

Environmental and occupational allergies.

Airborne allergens are the major cause of allergic rhinitis and asthma. Daily exposure comes from indoor sources, chiefly at home but occasionally at schools or offices. Seasonal exposure to outdoor allergens, pollens, and molds is another important source. Exposure to unusual substances at work causes occupational asthma, accounting for about 5% of asthma in adults. Indoor and outdoor air pollutants trigger airway inflammation and increase the severity of asthma. Diesel exhaust particles increase the production of IgE antibodies. Identification and reduction of exposure to allergens is a very important part of the management of respiratory allergic diseases. The first section of this chapter discusses domestic allergens, arthropods (mites and cockroaches), molds, and mammals (pets and mice). Indoor humidity and water damage are important factors in the production of mite and mold allergens, and discarded human food items are important sources of proliferation of cockroaches and mice. Means of identifying and reducing exposure are presented. The second section discusses outdoor allergens: pollens and molds. The particular plants or molds and the amount of exposure to these allergens is determined by the local climate, and local pollen and mold counts are available to determine the time and amount of exposure. Climate change is already having an important effect on the distribution and amount of outdoor allergens. The third section discusses indoor and outdoor air pollution and methods that individuals can take to reduce indoor pollution in addition to eliminating cigarette smoking. The fourth section discusses the diagnosis and management of occupational asthma.

Fine ambient particles from various sites in europe exerted a greater IgE adjuvant effect than coarse ambient particles in a mouse model.

In the European Union (EU)-funded project Respiratory Allergy and Inflammation due to Ambient Particles (RAIAP), coarse and fine ambient particulate matter (PM) was collected at traffic dominated locations in Oslo, Rome, Lodz, and Amsterdam, in the spring, summer, and winter 2001/2002. PM was also collected in de Zilk, a rural seaside background location in the Netherlands. The aim of this study was to screen the ambient PM fractions for allergy adjuvant activity measured as the production of allergen- (ovalbumin-) specific immunoglobulin (Ig) E following subcutaneous (sc) injection into the footpad of mice. A second aim was to determine whether the 6-d popliteal lymph node (PLN) assay can be used to detect an allergy adjuvant activity. Allergy screening for IgE adjuvant activity showed that in the presence of ovalbumin (Ova) 12 out of 13 of the fine ambient PM fractions exerted a significant IgE adjuvant activity. In contrast, only 3 out of 13 of the coarse PM fractions had significant adjuvant activity. Overall, fine ambient PM exerted significantly greater IgE adjuvant activity per unit mass than coarse PM. No significant differences were observed between locations or seasons. Substantial higher levels of specific components of PM such as vanadium (V), nickel (Ni), zinc (Zn), ammonium (NH(4)), and sulfate (SO(4)) were present in the fine compared to coarse PM fractions. However, differences in the content of these components among fine PM fractions did not reflect the variation in the levels of IgE anti-Ova. Still, when comparing all seasons overall, positive correlations were observed between V, Ni, and SO(4) and the allergen specific IgE levels. The PLN responses (weight and cell number) to Ova and ambient PM in combination were significantly higher than to Ova or PM alone. Still, the PLN assay appears not to be useful as a quantitative assay for screening of allergy adjuvant activity since no correlation was observed between PLN responses and allergen specific IgE levels. In conclusion, fine ambient PM fractions consistently were found to increase the allergen-specific IgE responses more than the coarse ones. Our finding is in agreement with the notion that traffic-related air pollution contributes to the disease burden in asthma and allergy, and points to fine and ultrafine ambient PM as the most important fractions in relation to allergic diseases.

Platinum group elements enhance the allergic immune response by acting on dendritic cells.

BACKGROUND: Atmospheric pollution may play a role in the immune response to allergens either directly or by entering the food chain. While particulate platinum group elements (PLGE) emitted by catalytic converters can be considered biologically inert, approximately 10% of these species accumulate in the environment as bioavailable soluble forms. METHODS: We challenged in vitro human immature and mature monocyte-derived dendritic cells with subtoxic concentrations of soluble species of PLGE. Dendritic cells were studied both at baseline and following treatment with Na(2)PtCl(6), Na(2)PdCl(6) or Na(3)RhCl(6). (NH(4))(6)Mo(7)O(24) was included as control. The following end-points were considered: expression of differentiation markers, effectiveness of allergen presentation and Th2 cytokine production by cocultured T lymphocytes, expression of IgE-type I receptor and efficiency of IgE-dependent endocytosis. RESULTS: We found that treatment with PLGE (but not with the control metal) increased costimulatory molecule expression and antigen presentation, amplified IL-5 production by cocultured T lymphocytes, upregulated IgE-type I receptor membrane expression, and augmented IgE-type I receptor-mediated endocytosis. CONCLUSIONS: We conclude that PLGE have an adjuvant-like effect on dendritic cells that can favor and amplify the immune response to allergens.

Air pollution and allergens.

It is well known that the prevalence of allergic diseases has increased in recent decades in the industrialized world. Exposure to environmental pollutants may partially account for this increased prevalence. In effect, air pollution is a growing public health problem. In Europe, the main source of air pollution due to particles in suspension is represented by motor vehicles--particularly those that use diesel fuel. Diesel exhaust particles (DEPs) are composed of a carbon core upon which high-molecular weight organic chemical components and heavy metals deposit. Over 80% of all DEPs are in the ultrafine particle range (< 0.1 pm in diameter). Air pollutants not only have a direct or indirect effect upon the individual, but also exert important actions upon aeroallergens. Pollen in heavily polluted zones can express a larger amount of proteins described as being allergenic. Through physical contact with the pollen particles, DEPs can disrupt the former, leading to the release of paucimicronic particles and transporting them by air--thus facilitating their penetration of the human airways. Climate change in part gives rise to variations in the temperature pattern characterizing the different seasons of the year. Thus, plants may vary their pollination calendar, advancing and prolonging their pollination period. In addition, in the presence of high CO2 concentrations and temperatures, plants increase their pollen output. Climate change may also lead to the extinction of species, and to the consolidation of non-native species--with the subsequent risk of allergic sensitization among the exposed human population. In conclusion, there is sufficient scientific evidence on the effect of air pollution upon allergens, increasing exposure to the latter, their concentration and/or biological allergenic activity.