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Review
. 2023 Aug;78(8):2121-2147.
doi: 10.1111/all.15724. Epub 2023 Apr 10.

Is exposure to pollen a risk factor for moderate and severe asthma exacerbations?

Isabella Annesi-Maesano  1 , Lorenzo Cecchi  2   3 , Benedetta Biagioni  4 , Kian Fan Chung  5 , Bernard Clot  6 , Martine Collaud Coen  6 , Gennaro D'Amato  7 , Athanasios Damialis  8 , Javier Dominguez-Ortega  9 , Carmen Galàn  10   11 , Stefanie Gilles  12 , Stephen Holgate  13 , Mohamed Jeebhay  14 , Stelios Kazadzis  15 , Nikolaos G Papadopoulos  16   17 , Santiago Quirce  9 , Joaquin Sastre  18 , Fiona Tummon  6 , Claudia Traidl-Hoffmann  12   19   20 , Jolanta Walusiak-Skorupa  21 , Pablo Alonso-Coello  22   23 , Carlos Canelo-Aybar  22   23 , Yahveth Cantero-Fortiz  22   23 , David Rigau  22   23 , Josefina Salazar  22   23 , Francisca Verdugo-Paiva  22   23 , Marek Jutel  24 , Cezmi A Akdis  25 , Ioana Agache  26
Affiliations
Review

Is exposure to pollen a risk factor for moderate and severe asthma exacerbations?

Isabella Annesi-Maesano et al. Allergy. 2023 Aug.

Abstract

Limited number of studies have focused on the impact of pollen exposure on asthma. As a part of the EAACI Guidelines on Environment Science, this first systematic review on the relationship of pollen exposure to asthma exacerbations aimed to bridge this knowledge gap in view of implementing recommendations of prevention. We searched electronic iPubMed, Embase, and Web of Science databases using a set of MeSH terms and related synonyms and identified 73 eligible studies that were included for systemic review. When possible, meta-analyses were conducted. Overall meta-analysis suggests that outdoor pollen exposure may have an effect on asthma exacerbation, but caution is needed due to the low number of studies and their heterogeneity. The strongest associations were found between asthma attacks, asthma-related ED admissions or hospitalizations, and an increase in grass pollen concentration in the previous 2-day overall in children aged less than 18 years of age. Tree pollen may increase asthma-related ED visits or admissions lagged up to 7-day overall in individuals younger than 18 years. Rare data show that among subjects under 18 years of age, an exposure to grass pollen lagged up to 3 days may lower lung function. Further research considering effect modifiers of pollen sensitization, hay fever, asthma, air pollution, green spaces, and pre-existing medications is urgently warranted to better evaluate the impacts of pollen on asthma exacerbation. Preventive measures in relation to pollen exposure should be integrated in asthma control as pollen increase continues due to climate change.

Keywords: aerobiology; asthma; pollen.

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References

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