LONGITUDINAL MONITORING OF TREE AIRBORNE POLLEN IN JAPAN.

RATIONAL: In Japan patients with Japanese Cedar (JC) pollinosis have increased nation widely since the latter of 1970's. The Ministry of Health and Welfare of Japanese Governments has begun to take preventive measures against JC pollinosis and airborne pollen monitoring has begun to investigate as a causative agent since 1986. We have estimated the longitudinal investigation result for successful prevention and treatment against pollinosis in Japan. METHOD: We have monitored airborne pollen all year around since July 1986 by gravitational pollen sampler, Durham's sampler, at more than 20 locations in the Japanese Islands. Pollen samples were sent to our hospital and counted pollen number per cm2 after stained by Calberla solution and then classified main pollen grains as a causative agent of pollinosis. RESULT AND DISCUSSION: JC pollen number was the most of all, more than 40%, next cypress family, about 20%. They were occupied of more than 60% of all and they increased with the remarkable annual fluctuation as the allergen of JC pollinosis. Beech family pollen counting were also increasing and occupied about 10% of all pollen counts. In Hokkaido the prevalence of birch family pollen count was larger than that in other districts. There is cross-reactivity between beech and birch family which related with oral allergic syndrome.Perspective and Conclusion: In future new occurrences of oral allergy syndrome due to increasing allergic tree pollen grains would be appeared. The contentious pollen research should be important for patients with pollinosis in Japan.

[Evaluation of quality of life (QOL) and efficacy of drug therapy on nasal symptoms and QOL disturbances in the patients with Japanese Cedar Pollinosis during the season of 2003 in Kyushu and Okinawa districts].

AIM: The aim of the study is to investigate nasal symptom severity (NSS) and disturbance of quality of life (QOLD) of patients with Japanese Cedar Pollinosis (JCP) during the JC season of 2003, and to evaluate the efficacy of drug treatment on the NSS/QOLD by the data based on disease specific Japan Rhino-conjunctivitis Quality of Life Questionnaire (JRQLQ). SUBJECTS, METHODS AND RESULTS: 3173 patients with JCP from 149 clinics of 8 prefectures in Kyushu and Okinawa districts were subjected. Degree of NSS/QOLD was scored as 1 to 4 in order (1 for a little and 4 for extremely severe or bothered respectively). (1) About 23% of 3173 subjects analyzed complained NSS score > or =3 and about 64% score > or =2. About 10% complained QOLD score > or =3 and about 20-30% score > or =2. (2) Preventive effect of pre-seasonal medication was analyzed. We evaluated the data from 583 patients (177 : received pre-seasonal medication and 406 : not received) who first answered questionnaire before peak of pollen dispersion as the effects on rising-up of symptoms in early stage of pollen scattering, and the data from 1223 patients (431 : received pre-seasonal medication and 792 : not received) who answered during the whole season as the effects on symptoms in whole season. The results of the both analyses indicated that the pre-seasonal medication significantly reduced NSS/QOLD in early stage of pollen scattering as well as during whole season as a preventive effect. (3) Effect of drugs prescribed at the first reply to the questionnaire was analyzed in 582 patients who answered the questionnaire twice before and after the peak of JC pollen scattering (February 28th), with at least 7 days intervals between 2 answers. When a proper designate of prescribed drug was not specified, results of second answer from 582 patients showed significant reduction of NSS/ QOLD score (p<0.001). (4) Single drug which effect was able to be evaluated was anti-allergic drug (mainly second generation of anti histamine: aH) in 81 cases, or anti-leukotriene (aLT) in 25 cases. Although the both drugs were effective, the comparison analysis of effectiveness of 2 drugs indicated that effect of aLT on reduction of NSS/QOLD score was higher than that of aH. Effect of combination drug treatment was able to be evaluated in aH + topical steroids (tS) in 95 cases, aLT + tS in 12 cases and aH + aLT in 25 cases. Those 3 ways of combination were effective, especially the combination with topical steroids with either aH or aLT showed significant higher effect on reduction of NSS/QOLD. CONCLUSION: JRQLQ is useful questionnaire for general clinic to evaluate the QOL disturbances induced by JCP and to follow clinical process relating to QOL changes including effect of drug treatment.