The aim of our study was the evaluation of clinical and epidemiological aspects of P pollen allergy, which is a very frequent cause of respiratory allergy in the Mediterranean area, in a homogeneous group of 442 monosensitive subjects (235 females and 207 males, mean age about 30 years) living in Naples. All patients underwent the following diagnostic procedures: anamnestic evaluation with an internal questionnaire, physical examination, SPT with commercially available allergenic extracts (DHS-Bayropharm Milan Italy); sNPT, NsBPT, and serum specific IgE determinations were also carried out in three groups of 50 different subjects. The results of our study show a highly relevant intensity of SPT positivity (4+ and 3+ in about 95% of patients). The age of onset of clinical symptoms ranged between 20-25 years, and the majority of P monosensitized patients were born in the spring months, with an early exposure to P allergens. Rhinoconjunctivitis and bronchial asthma, alone or association, represent the most common clinical manifestation of this allergy. The season in which patients experience clinical symptoms is prevalently spring (75, 12%). However, many people show a multiseasonal pattern (18, 55%). The frequency of SPT positivity to P allergens is increasing in the last 15 years, probably due to increased urban air pollution. In conclusion, the results of this study demonstrate the high frequency and severity of this pollinosis and seem to confirm some epidemiological aspects connected with other allergenic pollens (birth during the seasonal period of pollination and association with a high urban air pollution).
Airborne pollen grains and small plant particles of respirable size are the main causes of rhinitis and asthma in pollinosis patients. Consequently, it could be useful to quantify atmospheric variations in these biological aerosols and their allergenic activity as a basis for establishing correlations with the clinical symptoms in these allergic subjects. Our study was conducted in Naples from May to August 1992 and from May to August 1993 and concentrated on Parietaria judaica (Par j) the most important hay fever-provoking plant in southern Italy. The aim of this study was to evaluate the day-to-day variation in counts of Par j. pollen, the day-to-day variation in allergenic activity specific for this plant, and to relate these two variables to symptom scores in patients with respiratory allergy to Par j. The airborne pollen grains were collected by a Hirst-like volumetric trap and examined through an optical microscope, while the allergenic activity of particles trapped on glass fibre filters in a high volume air-sampler was determined by immunochemical assay. The two devices were placed on the flat roof of the 'A. Cardarelli' Hospital. The results of this preliminary study suggest that both methods could have useful clinical relevance, since these two biological parameters were significantly correlated with the symptom scores of allergic patients. However, pollen count with morphological quantification of grains/m3 of air is a more simple technique.
This trial studied the behavior of a marker of eosinophilic inflammation, eosinophil cationic protein (ECP), in the peripheral blood of two groups of subjects with seasonal allergic respiratory symptoms (rhinitis and mild bronchial asthma) induced by pollen allergens of Parietaria judaica (P.j.) (one group treated and another untreated with specific immunotherapy [SIT]), to determine what contribution these serial measurements might provide, in comparison with various other tools now available for pollinosis monitoring. In a previously randomized order, we selected 25 patients with monosensitization to P.j. pollen allergens; among them, 12 had started SIT with a P.j. extract in autumn 1993. As a control group, 13 patients were untreated. All patients were studied with various tests at four different times: time I-November 1993; time II-February 1994; time III-end of May 1994; and time IV-September 1994. Blood samples for determination of serum ECP were collected at each time. Methacholine challenge tests were performed at times I and III. A pollen count was also carried out. A statistically significant difference (P < 0.05) was observed in mean ECP levels at times I and III in SIT treated and untreated patients. The interaction between groups and time was not significant. No statistically significant difference was found between PD20 FEV1 values at times I and III in either group. After 1 year of treatment, we did not find any effect of SIT on bronchial hyperresponsiveness or on ECP serum values.
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