Current and Future Effects of Climate Change on Airborne Allergens.

PURPOSE OF REVIEW: Delineation of the impact of elevated carbon dioxide and concomitant global warming on airborne allergens is performed. RECENT FINDINGS: European tree pollen trends in general showed earlier start and end dates and increased total pollen release, with some differences both in locale and among species. Earlier flowering was also seen with grasses and weeds. In the case of some boreal trees, flowering was delayed due to a pre-seasonal requirement for necessary accumulated chilling temperature to achieve bud-set. Anthropogenic climate change induced rise in temperature and CO2 levels has resulted in demonstrable increases in aeroallergens. This has been most dramatic in tree pollen annual load, but also seen with grasses and weeds. Collected data is greatest for the Northern Hemisphere, especially the European continent, with supporting data from North America and Australia.

Assessing cross-reactivity in allergen immunotherapy.

Knowledge of patterns of pollen cross-reactivity is crucial for formulation of immunotherapy vaccines. As phylogenetic relationships have become better clarified through the use of tools such as gene sequencing, it is apparent that cross-reactivity reflects taxonomy in the vast majority of cases. Contradictory observations of unexpected cross-reactivity between distantly related plants require explanation. There are many proteins, presumably performing vital functions, tightly preserved throughout the evolutionary tree from plants to animals. Examples are profilins, lipid transfer proteins, and pathogenesis-related proteins. These may function as panallergens. The small differences that exist between these ubiquitous proteins may explain why these are frequently minor allergens, not reacting in the majority of allergic sera. This article summarizes cross-reactivity from older studies using crude pollen extracts as well as newer research of purified or recombinant allergenic proteins. The patterns of cross-allergenicity that emerge should be helpful in guiding therapeutic decisions.

Allergy to oak pollen in North America.

Background: Oak pollen is an important allergen in North America. The genus Quercus (oak) belongs to the family Fagaceae under the order Fagales. Objective: The objective of this article was to narratively review the oak pollen season, clinical and epidemiologic aspects of allergy to oak pollen, oak taxonomy, and oak allergen cross-reactivity, with a focus on the North American perspective. Methods: A PubMed literature review (no limits) was conducted. Publications related to oak pollen, oak-related allergic rhinitis with or without conjunctivitis, and oak-related allergic asthma were selected for review. Results: Oak species are common throughout the United States and contribute up to 50% to overall atmospheric pollen loads. Mean peak oak pollen counts can reach >2000 grains/m³. The start of the oak pollen season generally corresponds to the seasonal shift from winter to spring based on latitude and elevation, and may begin as early as mid February. The duration of the season can last > 100 days and, in general, is longer at lower latitudes. In the United States, ∼30% of individuals with allergy are sensitized to oak. The oak pollen season correlates with increased allergic rhinitis symptom-relieving medication use and asthma-related emergency department visits or hospitalizations. Oak falls within the birch homologous group. Extensive immunologic cross-reactivity has been demonstrated between oak pollen and birch pollen allergens, and, more specifically, their major allergens Que a 1 and Bet v 1. The cross-reactivity between oak and birch has implications for allergy immunotherapy (AIT) because guidelines suggest selecting one representative allergen within a homologous group for AIT, a principle that would apply to oak. Conclusion: Allergy to oak pollen is common in North America and has a substantial clinical impact. Oak pollen allergens are cross-reactive with birch pollen allergens, which may have implications for AIT.