Réseau National de Surveillance Aérobiologique

Pollen allergy poses a significant health and economic burden in Europe. Disease patterns are relatively homogeneous within Central and Northern European countries. However, no study broadly assessed the features of seasonal allergic rhinitis (SAR) across different Southern European countries with a standardized approach. To describe sensitization profiles and clinical phenotypes of pollen allergic patients in nine Southern European cities with a uniform methodological approach. Within the @IT.2020 multicenter observational study, pediatric and adult patients suffering from SAR were recruited in nine urban study centers located in seven countries. Clinical questionnaires, skin prick tests (SPT) and specific IgE (sIgE) tests with a customized multiplex assay (Euroimmun Labordiagnostika, Lübeck, Germany) were performed. Three hundred forty-eight children (mean age 13.1 years, SD: 2.4 years) and 467 adults (mean age 35.7 years SD: 10.0 years) with a predominantly moderate to severe, persistent phenotype of SAR were recruited. Grass pollen major allergenic molecules (Phl p1 and/or Phl p 5) ranged among the top three sensitizers in all study centers. Sensitization profiles were very heterogeneous, considering that patients in Rome were highly poly-sensitized (sIgE to 3.8 major allergenic molecules per patient), while mono-sensitization was prominent and heterogeneous in other cities, such as Marseille (sIgE to Cup a 1: n = 55/80, 68.8%) and Messina (sIgE to Par j 2: n = 47/82, 57.3%). Co-sensitization to perennial allergens, as well as allergic comorbidities also broadly varied between study centers. In Southern European countries, pollen allergy is heterogeneous in terms of sensitization profiles and clinical manifestations. Despite the complexity, a unique molecular, multiplex, and customized in-vitro IgE test detected relevant sensitization in all study centers. Nevertheless, this geographical diversity in pollen allergic patients imposes localized clinical guidelines and study protocols for clinical trials of SAR in this climatically complex region.

Allergic rhinitis (AR) is a major non-communicable disease that affects the health-related quality of life (HRQoL) of patients. However, data on HRQoL and symptom control in AR patients with comorbid asthma (AR+asthma) are lacking. In this multicentre, cross-sectional study, patients with AR were screened and administered questionnaires of demographic characteristics and health conditions (symptoms/diagnosis of AR and asthma, disease severity level, and allergic conditions). HRQoL was assessed using a modified version of the RHINASTHMA questionnaire (30, 'not at all bothered' - 150 'very much bothered') and symptom control was evaluated by a modified version of the Control of Allergic Rhinitis/Asthma Test (CARAT) (0, 'no control' - 30, 'very high control'). Out of 643 patients with AR, 500 (78%) had asthma as a comorbidity, and 54% had moderate-severe intermittent AR, followed by moderate-severe persistent AR (34%). Compared to the patients with AR alone, patients with AR+asthma had significantly higher RHINASTHMA (e.g., median RHINASTHMA-total score 48.5 vs. 84, respectively) and a significantly lower CARAT score (median CARAT-total score 23 vs. 16.5, respectively). Upon stratifying asthma based on severity, AR patients with severe persistent asthma had worse HRQoL and control than those with mild persistent asthma. The association was significantly higher among non-obese participants compared to obese ones, with RHINASTHMA-upper symptoms score but not with CARAT. Our observation of poorer HRQoL and symptoms control in AR patients with comorbid asthma supports the importance of a comprehensive approach for the management of AR in case of a comorbid allergic condition.

Background: Allergic rhinitis (AR) is a major non-communicable disease that affects the health-related quality of life (HRQoL) of patients. AR is significantly related to asthma also affecting HRQoL. However, data on HRQoL and symptom control in AR patients with comorbid asthma are lacking. Objective: To assess the differences of symptom control and HRQoL in AR patients with and without comorbid asthma. Methods: In this multicentre, cross-sectional study, patients with AR were screened and administered questionnaires of demographic characteristics and health conditions (symptoms/diagnosis of AR and asthma, disease severity level, and allergic conditions). HRQoL was assessed using a modified version of the RHINASTHMA questionnaire and symptom control was evaluated by a modified version of the Control of Allergic Rhinitis/Asthma Test (CARAT). Results: Out of 643 patients with AR, 500 (78%) had asthma as a comorbidity, and 54% had moderate-severe intermittent AR, followed by moderate-severe persistent AR (34%). Patients with both AR and asthma had significantly higher RHINASTHMA scores than the patients with AR alone (e.g., median RHINASTHMA-total score 84 vs. 48.5, respectively). Conversely, CARAT scores were significantly lower in AR with comorbid asthma than in the patients with AR alone (median CARAT-total score 16.5 vs. 23, respectively). Upon stratifying asthma based on severity, AR patients with severe persistent asthma had worse HRQoL and control than AR patients with mild persistent asthma. Conclusions: Our observation of poorer HRQoL and symptoms control in AR patients with comorbid asthma supports the importance of a comprehensive approach for the management of AR in case of a comorbid allergic condition.

BackgroundDaily levels of ambient air pollution and pollen may affect lung function but have rarely been studied together. We investigated short-term exposure to pollen and air pollution in relation to lung function in school-age children from a French population-based birth cohort.MethodsThis study included 1063 children from the PARIS (Pollution and Asthma Risk: an Infant Study) cohort whose lung function and FeNO measurements were performed at age 8 years old. Exposure data were collected up to 4 days before testing. We estimated daily total pollen concentration, daily allergenic risk indices for nine pollen taxa, as well as daily concentrations of three air pollutants (particulate matter less than 10 µm (PM10), nitrogen dioxide (NO2), ozone (O3)). Children with similar pollen and air pollution exposure were grouped using multidimensional longitudinal cluster analysis. Associations between clusters of pollen and air pollution exposure and respiratory indices (FEV1, FVC, FeNO) were studied using multivariable linear and logistic regression models adjusted for potential confounders.ResultsFour clusters of exposure were identified: no pollen and low air pollution (Cluster 1), grass pollen (Cluster 2), PM10 (Cluster 3) and birch/plane-tree pollen with high total pollen count (Cluster 4). Compared with children in Cluster 1, children in Cluster 2 had significantly lower FEV1 and FVC levels, and children from Cluster 3 had higher FeNO levels. For FEV1 and FVC, the associations appeared stronger in children with current asthma. Additional analysis suggested a joint effect of grass pollen and air pollution on lung function.ConclusionDaily ambient chemical and biological air quality could adversely influence lung function in children.

Airborne fungal spores (AFS) represent the major fraction of primary biological aerosol particles (PBAPs), and they are studied worldwide largely due to their important role within the Earth system. They have an impact on climate and human health, and they contribute to the propagation of diseases. As their presence in the air depends largely on studied ecosystems, a spore trap was used to monitor their atmospheric concentrations from 2014 to December 2018 in Saclay, a suburban area in the megacity of Paris. The main objective of this work was: (1) to understand the atmospheric variability of AFS in relation to different variables such as meteorological factors, agricultural practice, and (2) to identify their geographical origin by using a source receptor model. During our period of observation, 30 taxa have been identified under a light microscope. In order of importance, Ascospores, Cladosporium, Basidiospores, Tilletiopsis, Alternaria were found to be the most abundant types respectively (50.8%, 33.6%, 7.6%, 1.8%, and 1.3%) accounting for 95% of the atmospheric concentrations. We observed a general decrease associated with a strong interannual variability. A bimodal seasonal cycle was identified with a first maximum in July and a second in October. The main parameters driving the atmospheric concentration are temperature and precipitation. The daily variability is strongly activated by successive periods of hot weather and rainfall, multiplying the concentration by a factor of 1000 in less than 12 hours. Results from the source receptor model ZeFir point out unambiguous different origins of AFS due to specific sources impacting the observation site. Our study also indicated that a hydrological stress has a direct effect on the daily concentrations. This last point should be taken into account for every stressed ecosystem studied in a global warming context. This is particularly important for Mediterranean areas where water is a key control of the growth and dispersion of fungal spores.

Aerobiology is an interdisciplinary science where researchers with different backgrounds are involved in different topics related to microorganism, airborne biological particles, e.g. pollen and spores, and phenology. Some concepts, words or expressions used in aerobiology have a clear definition, but are however frequently misused. Therefore, the working group “Quality Control” of the European Aerobiology Society (EAS) and the International Association of Aerobiology (IAA) would like to clarify some of them, their use and presentation.

Abstract. A 6-models strong European ensemble of Copernicus Atmospheric Monitoring Service (CAMS) was run through the season of 2014 computing the olive pollen dispersion in Europe. The simulations have been compared with observations in 6 countries, members of the European Aeroallergen Network. Analysis was performed for individual models, the ensemble mean and median, and for a dynamically optimized combination of the ensemble members obtained via fusion of the model predictions with observations. The models, generally reproducing the olive season of 2014, showed noticeable deviations from both observations and each other. In particular, the season start was reported too early, by 8 days but for some models the error mounted to almost two weeks. For the season end, the disagreement between the models and the observations varied from a nearly perfect match up to two weeks too late. A series of sensitivity studies performed to understand the origin of the disagreements revealed crucial role of ambient temperature, especially systematic biases in its representation by meteorological models. A simple correction to the heat sum threshold eliminated the season shift but its validity in other years remains to be checked. The short-term features of the concentration time series were reproduced better suggesting that the precipitation events and cold/warm spells, as well as the large-scale transport were represented rather well. Ensemble averaging led to more robust results. The best skill scores were obtained with data fusion, which used the previous-days observations to identify the optimal weighting coefficients of the individual model forecasts. Such combinations were tested for the forecasting period up to 4 days and shown to remain nearly optimal throughout the whole period.