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Key cases – Treatable traits
Published in Vibeke Backer, Peter G. Gibson, Ian D. Pavord, The Asthmas, 2023
Vibeke Backer, Peter G. Gibson, Ian D. Pavord
Daily ICS/LABA as well as ICS/LABA when needed Increase the adherence – prescribe two similar devices – one for his bathroom and one for his bag Initiation of immunotherapy towards grass and possible also house dust mites. Until effect of immunotherapy, increase the nasal steroid with antihistamine (e.g. Dymista) during pollen season.
Immunologically Mediated Diseases and Allergic Reactions
Published in Julius P. Kreier, Infection, Resistance, and Immunity, 2022
Kim A. Campbell, Caroline C. Whitacre
Allergic rhinitis (hay fever) is the most common type of immediate hypersensitivity reaction. Hay fever affects between ten to twenty percent of the U.S. population. Hay fever is a misnomer because hay does not cause the problem nor is there any fever associated with the symptomatology. The symptoms of hay fever that occur following exposure to ragweed pollen or other allergens include sneezing, itchy nose, watery eyes, headache, congestion, and sinusitis. Seasonal allergic rhinitis occurs between the months of June and September when concentrations of windborne fungus and pollen from grass, trees, and weeds are greatest. The culprits of perennial rhinitis can include pet hair, dust mites, mold spores, and cockroaches. Bronchial asthma, eczema, urticaria (hives), and food allergies are less common than hay fever but are additional examples of immediate hypersensitivity reactions to environmental allergens.
Aerobiology for the Clinician
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
The knowledge of the pollen calendar of the local region is essential for two basic reasons. Firstly, only the relevant antigens need to be tested on the patients. There are many antigen kits available in the market and most of them will not be specific to the locality. Hence, selection of the right antigens is ensured by consulting the local pollen calendar. Secondly, many patients suffer from seasonal allergic manifestations due to the seasonal occurrence of pollen types. The seasonal pollen types are identified through the pollen calendar. The magnitude and the quality of the annual pollen load in the atmosphere vary significantly. Therefore, it is essential that the aerobiological survey of an area is conducted continuously over the years and the pollen calendars should be compiled and updated every year (Agashe 1994). In addition, awareness has to be created among clinicians, patients and the public about the results of the air being monitoring. In the western countries, particularly in the USA, daily counts of airborne pollen and spores are published through mass media such as radio, television and newspapers.
Family, neighborhood and psychosocial environmental factors and their associations with asthma in Australia: a systematic review and Meta-analysis
Published in Journal of Asthma, 2022
K. M. Shahunja,, Peter D. Sly,, Tahmina Begum, Tuhin Biswas, Abdullah Mamun
Other outdoor exposures, such as living less than 200 m from a major road was associated with current wheeze (aOR, 1·38; 95% CI, 1·06–1·80) (52). Six studies examined the level of pollen in the air and its association with asthma-symptoms. Although we could not perform pooled analysis due to the lack of odds or risk ratio (most of the studies did linear regression), out of six studies, five studies reported statistically significant association with asthma-symptoms due to the increase of pollen count in the air (57,59,64–66). In our search, we also found one article regarding the relation between green space and asthma-symptoms. In this paper, Xiaoqi Feng et al. found the association between heavy traffic and asthma to be significantly lower for participants living in areas with over 40% greenspace coverage (aOR 0·32, 95% CI 0·12–0·84). However, when children were exposed to high-traffic volumes and areas with zero to 20% green space quantity, the risk of asthma was significantly high (aOR 1·87, 95% CI 1·37–2·55) (49).
2016 Thunderstorm-asthma epidemic in Melbourne, Australia: An analysis of patient characteristics associated with hospitalization
Published in Canadian Journal of Respiratory, Critical Care, and Sleep Medicine, 2021
Nur-Shirin Harun, Philippe Lachapelle, Gayan Bowatte, Caroline Lodge, George Braitberg, Louis Irving, Timothy Hinks, Shyamali Dharmage, Jo Douglass
Given that most patients were symptomatic of asthma in the lead up to the event (66%) regardless of whether they had a previous diagnosis of asthma, and almost all had allergic rhinitis (96%), it may be that targeting recognition of symptoms of asthma and allergic rhinitis in public health campaigning prior to pollen season could be more effective at preventing morbidity overall. Symptomatic patients would be directed toward local healthcare providers for further evaluation and management, including education on medication adherence. Moreover, despite TA events being sporadic, education of providers on the importance of screening, assessing and optimizing seasonal asthma and rhinitis treatment may be an important tool in reducing pollen allergy burden even in the absence of thunderstorms (Figure 2).16
Update on pollen-food allergy syndrome
Published in Expert Review of Clinical Immunology, 2020
Pascal Poncet, Hélène Sénéchal, Denis Charpin
Of the 151 families of proteins described as being allergenic, only some contain cross-reactive allergens and not all family members give rise to cross-reactivity, which is sometimes seen with a low peptide sequence identity (38% between Dau c 1 of carrot and Bet v 1 of birch pollen; 21.8% between the polygalacturonases of tomato and Japanese cedar pollen). The reverse may also be observed, and strong sequence identity is not necessarily associated with cross-reactivity (case of GRPs, Poncet and Sénéchal, unpublished results). In such cases, cross-reactivity appears to be underpinned by structural elements of the polypeptide chain that correspond to domains required to include one or more IgE epitopes. The mechanisms of allergic sensitization leading to the selection of one or more clones of B and T cells remain unknown. To result in the symptomatic allergic response several levels of key points have to be overcome and to synergize such as the regulatory mechanisms that lead to the IgE isotype switch and the activation/inhibition of different molecular and cellular components.