Charpin D, Calleja M, Pichot C, Penel V, Hugues B, Poncet P
Inserm UMR 600, CNRS UMR 6212, service de pneumologie-allergologie, clinique des bronches, allergie et sommeil, Aix-Marseille université, chemin des Bourrelly, 13015 Marseille, France.
Rev Mal Respir. 2013 Dec;30(10):868-78. doi: 10.1016/j.rmr.2013.09.014. Epub 2013 Nov 8.
Cypress belongs to the Cupressaceae family, which includes 140 species with non-deciduous foliage. The most important genera in allergic diseases are Cupressus sempervirens or Green cypress, Cupressus arizonica or Blue cypress, Juniperus oxycedrus, Juniperus communis and Thuya. Because J. oxycedrus pollinates in October, C. sempervirens in January and February, C. arizonica in February and March, J. communis in April, the symptomatic period is long-lasting. Because of global warming, the pollination period is tending to last longer and Cupressaceae species are becoming established further the north. In Mediterranean countries, cypress is by far the most important pollinating species, accounting for half of the total pollination. The major allergens belong to group 1. The other allergens from cypress and Juniper share 75 to 97 % structural homology with group 1 major allergens. The prevalence of cypress allergy in the general population ranges from 5 % to 13 %, according to exposure to the pollen. Among outpatients consulting an allergist, between 9 and 35 %, according to different studies, are sensitized to cypress pollen. Repeated cross-sectional studies performed at different time intervals have demonstrated a threefold increase in the percentage of cypress allergy. Risk factors include a genetic predisposition and/or a strong exposure to pollen, but air pollutants could play a synergistic role. The study of the natural history of cypress allergy allows the identification of a subgroup of patients who have no personal or family history of atopy, whose disease began later in life, with low total IgE and often monosensitization to cypress pollen. In these patients, the disease is allergic than rather atopic. In the clinical picture, rhinitis is the most prevalent symptom but conjunctivitis the most disabling. A cross-reactivity between cypress and peach allergy has been demonstrated. The pharmacological treatment of cypress allergy is not different from that for other allergies. Hyposensitization has been used, at first by injection, but nowadays mostly through the sublingual route, but clinical trials have included few patients. Avoidance can be implemented at the individual level but also at the community levels using alternative plants, low-pollinating cypresses or by trimming hedges prior to pollination.
柏树属于柏科，该科包括140种常绿植物。在过敏性疾病中最重要的属是意大利柏木或绿柏、亚利桑那柏或蓝柏、刺柏、欧洲刺柏和崖柏。由于刺柏在10月授粉，意大利柏木在1月和2月授粉，亚利桑那柏在2月和3月授粉，欧洲刺柏在4月授粉，所以症状期持续时间长。由于全球变暖，授粉期趋于延长，柏科物种在更北的地区扎根。在地中海国家，柏树是迄今为止最重要的授粉物种，占总授粉量的一半。主要过敏原属于第1组。来自柏树和刺柏的其他过敏原与第1组主要过敏原具有75%至97%的结构同源性。根据花粉暴露情况，普通人群中柏树过敏的患病率在5%至13%之间。在咨询过敏症专科医生的门诊患者中，根据不同研究，有9%至35%对柏树花粉过敏。在不同时间间隔进行的重复横断面研究表明，柏树过敏的百分比增加了两倍。风险因素包括遗传易感性和/或强烈的花粉暴露，但空气污染物可能起协同作用。对柏树过敏自然史的研究有助于识别一组患者，他们没有特应性个人或家族史，疾病在生命后期开始，总IgE水平低，通常对柏树花粉单敏。在这些患者中，疾病更倾向于是过敏性的而非特应性的。在临床表现中，鼻炎是最常见的症状，但结膜炎是最致残的。已证实柏树过敏与桃子过敏之间存在交叉反应。柏树过敏的药物治疗与其他过敏症的治疗没有区别。已使用过脱敏疗法，起初是通过注射，但现在大多是通过舌下途径，但临床试验纳入的患者很少。可以在个人层面实施避免措施，也可以在社区层面通过使用替代植物、低花粉授粉的柏树或在授粉前修剪树篱来实现。
