Heterogeneity of atopy. I. Clinical and immunologic characteristics of patients allergic to cypress pollen

Abstract

The heterogeneity of pollen-allergic persons is well known but poorly characterized. Cypress is one of the major pollen-producing plants of the Mediterranean area. A study was undertaken to characterize the symptoms presented by patients allergic to cypress pollen and the heterogeneity of the IgE immune response between patients allergic only to cypress pollen and those who are polysensitized. Eighty-nine patients allergic to cypress pollen were studied, 26 being allergic only to cypress pollen. The IgE response was assessed by skin prick tests and the titration of serum total IgE and cypress-specific IgE by RAST. Clinical reactivity was assessed by symptom scores during the cypress pollen season and skin tests. Pollen counts were obtained. The clinical reactivity was similar in both patient groups. Rhinitis was present in all patients, conjunctivitis in 73.7-88.5%, and asthma in only 7.4-19.2%. The age of onset of symptoms caused by cypress pollen allergy was significantly greater in patients allergic to cypress pollen only. Total serum IgE was within the normal range in the cypress pollen group and significantly lower than in the polysensitized groups. Cypress pollen RAST was higher in the polysensitized group. We concluded that conjunctivitis is particularly common in cypress pollen allergy. Patients allergic only to cypress pollen may be unique in their way of expressing serum total IgE levels.

Important research questions in allergy and related diseases: nonallergic rhinitis: a GA2LEN paper

“…It has been proposed that allergic rhinitis is less common in subjects over 60 years of age than in younger subjects, possibly because the Ôallergic epidemicsÕ started more recently. However, in tree pollen allergy, many monosensitized subjects develop symptoms in old age (43,44). On the other hand, NAR appears to be more common in subjects over 50 years of age than in younger ones (8).…”

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

“…Skin sensitivity increases after the pollen season and then declines until the next season. This effect has some importance in patients with a low sensitivity (1228) and/or in patients sensitized to allergens such as cypress pollen (388).…”

“…Monosensitized patients often appear to be either children who may develop polysensitization later in life or adults who will only develop a single allergenic sensitivity (388,1365,1366).…”

Biochemical and Immunological Characterization of Pollen-Derived β-Galactosidase Reveals a New Cross-Reactive Class of Allergens among Mediterranean Trees

“…The absence of small starch granules inside tree pollen grains may partially explain the lower incidence of asthma symptoms among patients sensitive to cypress or olive as compared to grasses [11, 12], and indicate that higher atmospherical counts are needed to induce airway sensitization [10]. In addition, patients allergic only to cypress pollen have normal or subnormal total serum IgE levels and lower specific IgE, as compared with polysensitized ones [13]. …”