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The role of short-term grass pollen exposure in food skin-prick test reactivity, food allergy, and eczema flares in children

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posted on 2023-08-25, 04:37 authored by Nur Sabrina Idrose, Caroline J Lodge, Rachel L Peters, Jo A Douglass, Jennifer J Koplin, Adrian J Lowe, Kirsten P Perrett, Mimi LK Tang, Ed J Newbigin, Michael J Abramson, Bircan ErbasBircan Erbas, Don VicendeseDon Vicendese, Shyamali C Dharmage
Background: While the relationship between pollen and respiratory allergies is well-documented, the role of short-term pollen exposure in food allergy and eczema flares has not previously been explored. We aimed to investigate these associations in a population-based sample of children. Methods: We investigated 1- (n = 1108) and 6-year-old (n = 675) children in the grass pollen season from the HealthNuts cohort. Grass pollen concentrations were considered on the day of testing (lag 0), up to three days before (lag 1-lag 3) and cumulatively (lag 0–3). Associations between grass pollen and food skin-prick test reactivity (SPT ≥ 2 mm at age 1 year and ≥ 3 mm at age 6 years), eczema flares, challenge-confirmed food allergy, reaction threshold to oral food challenges (OFC), and serum food-specific IgE levels were analyzed using either logistic or quantile regression models. Atopy and family history of allergic disease were considered as potent effect modifiers. Results: Grass pollen at lag 0–3 (every 20 grains/m3 increase) was associated with an up to 1.2-fold increased odds of food SPT reactivity and eczema flares in 6-year-olds. In 1-year-olds, the associations were only observed for peanut in those with a family history of food allergy. Increasing grass pollen concentrations were associated with a lower reaction threshold to OFC and higher serum IgE levels in peanut-allergic 1-year-olds only. Conclusion: Increasing grass pollen concentration was associated with increased risk of food SPT reactivity and eczema flares in children. The associations in peanut-allergic infants may be related to immune activation and/or peanut and grass pollen cross-reactivity leading to a lower reaction threshold.


AnaphylaxiStop; Charles and Sylvia Viertel Medical Research Foundation; Ilhan Food Allergy Foundation; National Health and Medical Research Council, Grant/Award Number: 1006215 and 491233; Royal Children's Hospital Foundation, Grant/Award Number: 2018-984; University of Melbourne Developing Research Momentum; Victorian Government's Operational Infrastructure Support Program; Royal Melbourne Hospital.


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Pediatric Allergy and Immunology





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© 2022 The Authors. Pediatric Allergy and Immunology published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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