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      Prevalence of pollen‐induced allergic rhinitis with high pollen exposure in grasslands of northern China

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          Abstract

          Background

          The aim of this study was to investigate the prevalence of epidemiologic and physician‐diagnosed pollen‐induced AR (Pi AR) in the grasslands of northern China and to study the impact of the intensity and time of pollen exposure on Pi AR prevalence.

          Methods

          A multistage, clustered and proportionately stratified random sampling with a field interviewer‐administered survey study was performed together with skin prick tests ( SPT) and measurements of the daily pollen count.

          Results

          A total of 6043 subjects completed the study, with a proportion of 32.4% epidemiologic AR and 18.5% Pi AR. The prevalence was higher in males than females (19.6% vs 17.4%, =  .024), but no difference between the two major residential and ethnic groups (Han and Mongolian) was observed. Subjects from urban areas showed higher prevalence of Pi AR than rural areas (23.1% vs 14.0%, <  .001). Most Pi AR patients were sensitized to two or more pollens (79.4%) with artemisia, chenopodium, and humulus scandens being the most common pollen types, which were similarly found as the top three sensitizing pollen allergens by SPT. There were significant regional differences in the prevalence of epidemiologic AR (from 18.6% to 52.9%) and Pi AR (from 10.5% to 31.4%) among the six areas investigated. Pi AR symptoms were positively associated with pollen counts, temperature, and precipitation ( <  .05), but negatively with wind speed and pressure <  .05).

          Conclusion

          Pollen‐induced AR (Pi AR) prevalence in the investigated region is extremely high due to high seasonal pollen exposure, which was influenced by local environmental and climate conditions.

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          Most cited references33

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          Allergenic pollen and pollen allergy in Europe.

          The allergenic content of the atmosphere varies according to climate, geography and vegetation. Data on the presence and prevalence of allergenic airborne pollens, obtained from both aerobiological studies and allergological investigations, make it possible to design pollen calendars with the approximate flowering period of the plants in the sampling area. In this way, even though pollen production and dispersal from year to year depend on the patterns of preseason weather and on the conditions prevailing at the time of anthesis, it is usually possible to forecast the chances of encountering high atmospheric allergenic pollen concentrations in different areas. Aerobiological and allergological studies show that the pollen map of Europe is changing also as a result of cultural factors (for example, importation of plants such as birch and cypress for urban parklands), greater international travel (e.g. colonization by ragweed in France, northern Italy, Austria, Hungary etc.) and climate change. In this regard, the higher frequency of weather extremes, like thunderstorms, and increasing episodes of long range transport of allergenic pollen represent new challenges for researchers. Furthermore, in the last few years, experimental data on pollen and subpollen-particles structure, the pathogenetic role of pollen and the interaction between pollen and air pollutants, gave new insights into the mechanisms of respiratory allergic diseases.
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            Recommendations for standardization of clinical trials with Allergen Specific Immunotherapy for respiratory allergy. A statement of a World Allergy Organization (WAO) taskforce.

            Specific Immunotherapy for respiratory allergy is used since about one century and there is now solid documentation of its efficacy. Nevertheless, the methods and experimental designs used in clinical trials are quite heterogeneous and there is no unanimously accepted methodological standard. Many studies are planned with study designs that may not confirm the clinical value of SIT as an effective treatment to reduce disease severity. To ensure that patients are treated based on sound scientific evidence and to minimize the risk of misusing limited financial resources for scientific studies, the World Allergy Organization (WAO) convened a group of experts to provide guidelines for the methodology of future immunotherapy studies. This document summarizes the recommendations for study design, patients' selection, appropriate outcomes and statistical treatment to be used in planning and performing clinical trials with specific immunotherapy.
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              Climate Change and Future Pollen Allergy in Europe

              Background: Globally, pollen allergy is a major public health problem, but a fundamental unknown is the likely impact of climate change. To our knowledge, this is the first study to quantify the consequences of climate change upon pollen allergy in humans.Background: Globally, pollen allergy is a major public health problem, but a fundamental unknown is the likely impact of climate change. To our knowledge, this is the first study to quantify the consequences of climate change upon pollen allergy in humans. Objectives: We produced quantitative estimates of the potential impact of climate change upon pollen allergy in humans, focusing upon common ragweed (Ambrosia artemisiifolia) in Europe.Objectives: We produced quantitative estimates of the potential impact of climate change upon pollen allergy in humans, focusing upon common ragweed (Ambrosia artemisiifolia) in Europe. Methods: A process-based model estimated the change in ragweed’s range under climate change. A second model simulated current and future ragweed pollen levels. These findings were translated into health burdens using a dose–response curve generated from a systematic review and from current and future population data. Models considered two different suites of regional climate/pollen models, two greenhouse gas emissions scenarios [Representative Concentration Pathways (RCPs) 4.5 and 8.5], and three different plant invasion scenarios.Methods: A process-based model estimated the change in ragweed’s range under climate change. A second model simulated current and future ragweed pollen levels. These findings were translated into health burdens using a dose–response curve generated from a systematic review and from current and future population data. Models considered two different suites of regional climate/pollen models, two greenhouse gas emissions scenarios [Representative Concentration Pathways (RCPs) 4.5 and 8.5], and three different plant invasion scenarios. Results: Our primary estimates indicated that sensitization to ragweed will more than double in Europe, from 33 to 77 million people, by 2041–2060. According to our projections, sensitization will increase in countries with an existing ragweed problem (e.g., Hungary, the Balkans), but the greatest proportional increases will occur where sensitization is uncommon (e.g., Germany, Poland, France). Higher pollen concentrations and a longer pollen season may also increase the severity of symptoms. Our model projections were driven predominantly by changes in climate (66%) but were also influenced by current trends in the spread of this invasive plant species. Assumptions about the rate at which ragweed spreads throughout Europe had a large influence upon the results.Results: Our primary estimates indicated that sensitization to ragweed will more than double in Europe, from 33 to 77 million people, by 2041–2060. According to our projections, sensitization will increase in countries with an existing ragweed problem (e.g., Hungary, the Balkans), but the greatest proportional increases will occur where sensitization is uncommon (e.g., Germany, Poland, France). Higher pollen concentrations and a longer pollen season may also increase the severity of symptoms. Our model projections were driven predominantly by changes in climate (66%) but were also influenced by current trends in the spread of this invasive plant species. Assumptions about the rate at which ragweed spreads throughout Europe had a large influence upon the results. Conclusions: Our quantitative estimates indicate that ragweed pollen allergy will become a common health problem across Europe, expanding into areas where it is currently uncommon. Control of ragweed spread may be an important adaptation strategy in response to climate change.Conclusions: Our quantitative estimates indicate that ragweed pollen allergy will become a common health problem across Europe, expanding into areas where it is currently uncommon. Control of ragweed spread may be an important adaptation strategy in response to climate change. Citation: Lake IR, Jones NR, Agnew M, Goodess CM, Giorgi F, Hamaoui-Laguel L, Semenov MA, Solomon F, Storkey J, Vautard R, Epstein MM. 2017. Climate change and future pollen allergy in Europe. Environ Health Perspect 125:385–391; http://dx.doi.org/10.1289/EHP173Citation: Lake IR, Jones NR, Agnew M, Goodess CM, Giorgi F, Hamaoui-Laguel L, Semenov MA, Solomon F, Storkey J, Vautard R, Epstein MM. 2017. Climate change and future pollen allergy in Europe. Environ Health Perspect 125:385–391; http://dx.doi.org/10.1289/EHP173
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                Author and article information

                Contributors
                allergy_wxy@126.com
                dr.luozhang@139.com
                yyshijitan@126.com
                entwdy@nus.edu.sg
                Journal
                Allergy
                Allergy
                10.1111/(ISSN)1398-9995
                ALL
                Allergy
                John Wiley and Sons Inc. (Hoboken )
                0105-4538
                1398-9995
                23 March 2018
                June 2018
                : 73
                : 6 ( doiID: 10.1111/all.2018.73.issue-6 )
                : 1232-1243
                Affiliations
                [ 1 ] Department of Allergy Beijing Shijitan Hospital Capital Medical University Beijing China
                [ 2 ] Department of Otolaryngology Head and Neck Surgery Beijing TongRen Hospital Beijing Key Laboratory of Nasal Diseases Beijing Institute of Otolaryngology Capital Medical University Beijing China
                [ 3 ] Department of Pharmacy Beijing Shijitan Hospital Capital Medical University Beijing China
                [ 4 ] Department of Nephrology Beijing Shijitan Hospital Capital Medical University Beijing China
                [ 5 ] State Key Laboratory of Vegetation and Environmental Change Institute of Botany Chinese Academy of Sciences Beijing China
                [ 6 ] Department of Epidemiology and Statistics Institute of Basic Medical Sciences Chinese Academy of Medical Sciences School of Basic Medicine Peking Union Medical College Beijing China
                [ 7 ] Department of Science and Technology Beijing Shijitan Hospital Capital Medical University Beijing China
                [ 8 ] Tongliao Hospital Tongliao, Inner Mongolia China
                [ 9 ] Jarud People's Hospital Jarud Banner, Tongliao, Inner Mongolia China
                [ 10 ] Kailu People's Hospital Kailu County, Tongliao, Inner Mongolia China
                [ 11 ] Erenhot Community Health Service Center Erenhot, Inner Mongolia China
                [ 12 ] Duolun People's Hospital Duolun, Inner Mongolia China
                [ 13 ] Xiwu People's Hospital Xiwu Banner Inner Mongolia China
                [ 14 ] Xilingol Mongolian Hospital Xilinhot, Inner Mongolia China
                [ 15 ] Department of Urology Beijing Shijitan Hospital Capital Medical University Beijing China
                [ 16 ] Department of Otolaryngology Yong Loo Lin School of Medicine National University of Singapore Singapore Singapore
                Author notes
                [*] [* ] Correspondence

                Xue‐Yan Wang, Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.

                Email: allergy_wxy@ 123456126.com

                Luo Zhang, Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Capital Medical University, Beijing, China.

                Email: dr.luozhang@ 123456139.com

                Yong Yan, Department of Urology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.

                Email: yyshijitan@ 123456126.com

                and

                De Yun Wang, Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

                Email: entwdy@ 123456nus.edu.sg

                Author information
                http://orcid.org/0000-0002-0909-2963
                Article
                ALL13388
                10.1111/all.13388
                6033040
                29322523
                db9f6385-8df3-4e4f-b750-be00d885a72b
                © 2018 The Authors. Allergy Published by John Wiley and Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 22 December 2017
                Page count
                Figures: 4, Tables: 3, Pages: 12, Words: 8569
                Funding
                Funded by: National Key Specialty Funding of China
                Categories
                Original Article
                ORIGINAL ARTICLES
                Airway Diseases
                Custom metadata
                2.0
                all13388
                June 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.4.3 mode:remove_FC converted:05.07.2018

                Immunology
                allergy test,climate,pollen count and exposure,pollen‐induced allergic rhinitis,prevalence

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