Pollen allergy: Clinical problems and variety of pathomechanisms

Krystyna Obtulowicz, Teresa Kotlinowska, Antonina Mazurkiewicz, Barbara Kacalska

Department of Industrial Allergy, Chair of Professional Medicine and Occupational Diseases, Collegium Medicum of the Jagiellonian University, Krakow, Poland

Published in: R. Spiewak (Editor): "Pollens and Pollinosis: Current Problems". Institute of Agricultural Medicine, Lublin (Poland) 1995, pages 89-90.

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Po Polsku

Objective

The aim of the study was to establish the atopy frequency in patients suffering from pollen allergy and the attempt to explain different efficacy of the same classical therapy at very similar symptoms of the illness.

Material and Methods

The studies were performed in the group of 100 patients suffering from pollen allergy (50 women, 50 men aged 15-61) being in the continuous clinical supervision for many years.

Results

1. Atopy was confirmed only in a part of the patients. Positive familiar anamnesis as well as allergic diathesis in childhood were present in 20% of patients. Increase of blood eosinophilia was revealed also in the 20% of patients. 50% of them had the increase of the total IgE. Also cytograms of nasal mucosa carried out in first days of seasonal symptoms were various (eosinophilic, neutrophilic or mixed).
2. In all cases grasses were the reason of the allergy (positive skin prick test, increase of sIgE in serum, symptoms during increase of grasses pollen grains in aeroplankton). In 20% of patients we confirmed the additional allergy to trees and in 30% to weeds. The most important taxa were: Phleum, Dactylis, Secale, Lolium, Poa from grasses, Alnus, Betula and Salix from trees and Plantago, Artemisia and Chenopodium from weeds.
3. 40% of patients had the inflammatory focus in the naso-pharynx associated with the positive early skin reaction to Polyvaccinum (Biomed).
4. 30% had positive skin prick test to moulds (Cladosporium, Alternaria) present in the high amount in aeroplankton during the pollen season.
   - 30% had also allergy to some foods, such as apples, nuts, tomatoes, honey.
   - 25% were hyperreactive to bee and wasp venom.
   - 15% had parallelly positive skin prick test to mites and dust but without any features of allergy to them.
5. Natural occurrence of the nontreated illness usually after few seasons causes the development of pollen asthma. In some cases in addition to the classical symptoms from the upper airways, skin symptoms and alimentary tract disordes also develop.

Discussion

The results reveal that in spite of very similar clinical symptoms of pollen allergy only in a part of patients we can show the features of atopy or IgE related reactions. On other side, pollen allergy may be accompanied by moulds allergy, bacterial allergy and alimentary allergy.

At the same time we should take into consideration that similar symptoms of pollen allergy may be the effect of different pathomechanisms which can account for various efficacy of the same drugs as well as of the specific immunotherapy in patients with pollen allergy.

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