In the Oleaceae family, the most allergenic pollen is produced by Olea europaea, the olive tree, which in the Mediterranean area has been recognized as one of the most important cause of seasonal respiratory allergy The olive pollination season lasts from May to the end of June and sometimes causes severe symptoms (oculorhinitis and/or bronchial asthma). Olive pollinosis is quite rare in the form of monosensitization. Although adults are affected the most, olive sensitization can be recognized in children, too. However, it is not easy to be sure about the clinical relevance of allergic sensitization to olive, even in patients with positivity to this pollen, as results from allergological tests in vivo and/or in vitro, because positivity to Olea pollen is not equivalent to clinical responsibility, above all in patients without seasonal respiratory symptomatology. Studies on the allergenic content of O. europaea pollen are currently in progress. In Northern and Central Europe, where there are no olive trees, there are two commonly occurring genera of the Oleaceae family, namely Fraxinus and Ligustrum, but these have a low frequency of allergic sensitization. A fourth anemophilous member of the Oleaceae, Phillyrea, has a more regional distribution in some parts of the Mediterranean. Other nonanemophilous and usually not allergenic Oleaceae genera are Forsythia, Jasminum and Syringa.

Venous thromboembolism (VTE) is a common complication of malignancies and epidemiological studies suggest that lung cancer belonged to the group of malignancies with the highest incidence rates of VTE. Risk factors for VTE in lung cancer patients are adenocarcinoma, NSCLC in comparison with SCLC, advanced disease, pneumonectomy, chemotherapy including antiangiogenic therapy. Other risk factors are pretreatment platelet counts and increased release of TF-positive microparticles. Elevated D-dimer levels do not necessarily indicate an increased risk of VTE but have been shown to be predictive for a worse clinical outcome in lung cancer patients. Mechanisms responsible for the increase in venous thrombosis in patients with lung cancer are not understood. Currently no biomarker is recognized as a predictor for VTE in lung cancer patients. Although several clinical trials have reported the efficacy of antithrombotic prophylaxis in patients with lung cancer who are receiving chemotherapy, further trials are needed to assess the clinical benefit since these patients are at an increased risk of developing a thromboembolism.

Since the discovery of immunoglobulin E (IgE) antibodies thirty-six years ago, our understanding of the mechanisms of allergy has improved to such an extent that we can now better differentiate allergy from non-allergic hypersensitivity, and allergic/atopic from intrinsic/non-atopic bronchial asthma. IgE antibodies are crucial immune mediators of airway inflammation in allergic atopic asthma and IgE-mediated hypersensitivity reactions are the likely mechanisms of allergen-induced airway obstruction. In addition, IgE may cause chronic airway inflammation in asthma through effector cells activated via high-affinity (Fcepsilon RI) or low-affinity (Fcepsilon RII) IgE receptors. Therapeutic anti-IgE antibodies able to reduce free IgE levels and to block the binding of IgE to Fcepsilon RI without cross-linking IgE and triggering degranulation of IgE-sensitised cells have been developed. This non-anaphylactogenic anti-IgE monoclonal antibody (rhuMAb-E25; omalizumab) binds IgE at the same site as these antibodies bind Fcepsilon RI and Fcepsilon RII. As a consequence, omalizumab inhibits IgE effector functions by blocking IgE binding to high-affinity receptors on IgE effector cells and does not cause mast cell or basophil activation because it cannot bind to IgE on cell surfaces where the Fcepsilon R1 receptor already masks the anti-IgE epitope. Studies in patients with atopic asthma demonstrated that omalizumab decreases serum IgE levels and allergen-induced bronchoconstriction during both the early and late-phase responses to inhaled allergen. In several clinical controlled trials omalizumab resulted to be able to reduce asthma-related symptoms, to decrease corticosteroid use and to improve quality of life of asthmatic patients. The anti-IgE approach to asthma treatment has several advantages, including concomitant treatment of other IgE-mediated diseases (allergic rhinitis, allergic conjunctivitis, atopic dermatitis and food allergies), a favourable side-effect profile and a twice-monthly dosing frequency.

The major changes to our world are those involving the atmosphere and the climate, including global warming induced by anthropogenic factors, with impact on the biosphere and human environment. Studies on the effects of climate changes on respiratory allergy are still lacking and current knowledge is provided by epidemiological and experimental studies on the relationship between allergic respiratory diseases, asthma and environmental factors, like meteorological variables, airborne allergens and air pollution. Epidemiologic studies have demonstrated that urbanization, high levels of vehicle emissions and westernized lifestyle are correlated with an increased frequency of respiratory allergy, mainly in people who live in urban areas in comparison with people living in rural areas. However, it is not easy to evaluate the impact of climate changes and air pollution on the prevalence of asthma in general and on the timing of asthma exacerbations, although the global rise in asthma prevalence and severity could be also considered an effect of air pollution and climate changes. Since airborne allergens and air pollutants are frequently increased contemporaneously in the atmosphere, enhanced IgE-mediated response to aeroallergens and enhanced airway inflammation could account for the increasing frequency of respiratory allergy and asthma in atopic subjects in the last five decades. Pollen allergy is frequently used to study the interrelationship between air pollution and respiratory allergic diseases such as rhinitis and bronchial asthma. Climatic factors (temperature, wind speed, humidity, thunderstorms, etc) can affect both components (biological and chemical) of this interaction. Scientific societies should be involved in advocacy activities, such as those realized by the Global Alliance against chronic Respiratory Diseases (GARD).

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