Persistent nasal symptoms and mediator release after continuous pollen exposure in an environmental challenge chamber

Okuma, Yusuke; Okamoto, Yoshitaka; Yonekura, Syuji; Iinuma, Tomohisa; Sakurai, Takeshi; Hamasaki, Sawako; Ohki, Yuji; Yamamoto, Heizaburo; Sakurai, Daiju

doi:10.1016/j.anai.2016.05.015

Cited by 7 publications

(7 citation statements)

References 31 publications

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“…However, we observed a specific and reproducible decrease in nasal nitric oxide directly after the allergen challenge in patients with allergic rhinitis, whereas this was not observed in healthy participants. This effect has been previously described 4,21 and is probably attributable to the swelling of the nasal mucosa that hampers the release of nitric oxide from the paranasal sinuses. 22 After a period of 22 hours, when the nose is no longer congested, the increase in nitric oxide is measurable.…”

Section: Discussionmentioning

confidence: 55%

Specificity and reproducibility of nasal biomarkers in patients with allergic rhinitis after allergen challenge chamber exposure

Badorrek

Müller

Koch

et al. 2017

Annals of Allergy, Asthma & Immunology

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Section: Discussionmentioning

confidence: 55%

Specificity and reproducibility of nasal biomarkers in patients with allergic rhinitis after allergen challenge chamber exposure

Badorrek

Müller

Koch

et al. 2017

Annals of Allergy, Asthma & Immunology

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“…Although few community‐based studies have assessed the relationship between outdoor pollen exposure, lung function and airway inflammation, the findings have not been integrated systematically, especially at a detailed mechanistic level. Laboratory challenge studies may not be representative of outdoor pollen exposure because they involve direct introduction of allergens into the nostrils, 25 do not take into account other seasonal factors or environmental co‐stimulants 26 and often impose extremely high pollen concentrations that are unlikely to occur in pollen seasons 27,28 . Here, we synthesized the available evidence to determine the strength and magnitude of the association between outdoor pollen exposure and lung function and airway inflammation at the community level.…”

Section: Introductionmentioning

confidence: 99%

“…Laboratory challenge studies may not be representative of outdoor pollen exposure because they involve direct introduction of allergens into the nostrils, 25 do not take into account other seasonal factors or environmental co-stimulants 26 and often impose extremely high pollen concentrations that are unlikely to occur in pollen seasons. 27,28 Here, we synthesized the available evidence to determine the strength and magnitude of the association between outdoor pollen exposure and lung function and airway inflammation at the community level. As an extension, we also aimed to classify whether the inflammatory data reflect a predominantly type-2 immune response, or alternatively a more non-specific/ innate response.…”

Section: Introductionmentioning

confidence: 99%

Outdoor pollen‐related changes in lung function and markers of airway inflammation: A systematic review and meta‐analysis

Idrose

Walters

Zhang

et al. 2021

Clin Experimental Allergy

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Background Experimental challenge studies have shown that pollen can have early and delayed effects on the lungs and airways. Here, we qualitatively and quantitatively synthesize the evidence of outdoor pollen exposure on various lung function and airway inflammation markers in community‐based studies. Methods Four online databases were searched: Medline, Web of Science, CINAHL and Google Scholar. The search strategy included terms relating to both exposure and outcomes. Inclusion criteria were human‐based studies published in English that were representative of the community. Additionally, we only considered cross‐sectional or short‐term longitudinal studies which investigated pollen exposure by levels or season. Study quality assessment was performed using the Newcastle‐Ottawa scale. Meta‐analysis was conducted using random‐effects models. Results We included 27 of 6551 studies identified from the search. Qualitative synthesis indicated associations between pollen exposure and predominantly type‐2 inflammation in both the upper and lower airways, but little evidence for lung function changes. People with ever asthma and/or seasonal allergic rhinitis (SAR) were at higher risk of such airway inflammation. Meta‐analysis confirmed a positive relationship between pollen season, eosinophilia and eosinophil cationic protein (ECP) in people with ever SAR but the results between studies were highly variable. Heterogeneity was reduced after further subgrouping by age, and the forest plots indicated that eosinophilic airway inflammation to outdoor pollen exposure increased with age. Conclusion Among people with ever asthma and ever SAR, exposure to increased ambient pollen triggers type‐2 upper and lower airway inflammation rather than a non‐specific or innate inflammation. These findings can lead to the formulation of specific pollen immunotherapy for susceptible individuals. Future research should be directed towards investigating lagged associations and effect modifications using larger and more generalized populations. Systematic review registration CRD42020146981 (PROSPERO).

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“…These results suggest that an increase in the antigen amount in the active drug or continuation of more than 2 years is desirable for enough effect manifestation. Previous studies to expose subjects with cedar-induced allergic rhinitis to pollen in a pollen challenge test chamber outside of the cedar pollen season showed that nasal symptoms increased immediately after pollen exposure and plateaued within 2 h [4][5][6]. In these studies, symptoms such as nasal obstruction, rhinorrhea and sneezing continued in all subjects for 3-4 days after leaving the chamber, even though they were no longer exposed to pollen.…”

Section: Discussionmentioning

confidence: 60%

“…In Japan, Japanese cedar (Cryptomeria japonica) pollen is the major causal allergen of pollen-induced allergic rhinitis [1,6]. Cedar forests cover nearly 18% of the total forested area of Japan, and they produce enormous quantities of pollen annually.…”

Section: Introductionmentioning

confidence: 99%

The Relationship of Pollen Dispersal with Allergy Symptoms and Immunotherapy: Allergen Immunotherapy Improves Symptoms in the Late Period of Japanese Cedar Pollen Dispersal

Sakurai

Yonekura

Iinuma

et al. 2018

Int Arch Allergy Immunol

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Background: The severity of symptoms of pollen-induced allergic rhinitis is affected by the amount of scattered pollen. However, the relationships between the pollen dispersal pattern, symptom severity, and treatment efficacy are not clear. Methods: Between 2007 and 2012, we performed 4 randomized, placebo-controlled studies of sublingual immunotherapy (SLIT) on patients with Japanese cedar-induced allergic rhinitis who lived in or around Chiba, Japan. The participants were asked to avoid using rescue medicines during the cedar pollen season as much as possible and to record their nasal symptoms in allergy diaries. The amount of pollen dispersed daily was quantified using the Durham method, and the season was divided into early and late periods based on the pollen count. Results: A total of 721 patients were enrolled in the 4 studies during the 6-year study period. In the placebo group (n = 349), a correlation was observed between the amount of pollen dispersed and the severity of symptoms in the early but not late period of pollen dispersal. Treatment with SLIT (n = 372) significantly improved symptom severity in the late but not early period. Conclusion: For patients with Japanese cedar pollen-induced allergic rhinitis, the fluctuation of daily pollen dispersal had a minimal effect on the severity of symptoms during the late period. SLIT was remarkably effective in alleviating symptoms during this period but not in the early period.

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Persistent nasal symptoms and mediator release after continuous pollen exposure in an environmental challenge chamber

Cited by 7 publications

References 31 publications

Specificity and reproducibility of nasal biomarkers in patients with allergic rhinitis after allergen challenge chamber exposure

Specificity and reproducibility of nasal biomarkers in patients with allergic rhinitis after allergen challenge chamber exposure

Outdoor pollen‐related changes in lung function and markers of airway inflammation: A systematic review and meta‐analysis

The Relationship of Pollen Dispersal with Allergy Symptoms and Immunotherapy: Allergen Immunotherapy Improves Symptoms in the Late Period of Japanese Cedar Pollen Dispersal

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