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Original Article


Cypress Pollen: An Unexpected Major Sensitizing Agent in Different Regions of Italy


B Sposato,1 G Liccardi,2 M Russo,2 I Folletti,3 A Siracusa,3 N Scichilone,4 MT Ventura,5 G Rolla,6 A Raie,6 M Milanese,7 R Pio,8 A Pio,9 R Scala,10 C Pareo,11 C Micucci,11 C Micheletto,12 L Billeri,13 A Musarra,14 C Cavaliere,15 G Agolli,15 S Masieri,15 M Scalese,16 D Capitani17

1Pneumology Unit, Azienda Ospedaliera Misericordia, Grosseto, Italy
2Department of Chest Diseases, Division of Pneumology and Allergology, High Speciality A. Cardarelli Hospital, Naples, Italy
3Department of Clinical and Experimental Medicine, Occupational Allergology, University of Perugia, Az. Ospedaliera Santa Maria, Terni, Italy
4DIMPEFINU, Unit of Pneumology and Medicine, University of Palermo, Palermo, Italy
5Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
6Allergy and Clinical Immunology, University of Torino & Ospedale Mauriziano Umberto I, Torino, Italy
7Division of Pneumology, S.Corona Hospital, Pietra Ligure, Italy
8Allergy and Clinical Immunology Unit, University Federico II, Naples, Italy
9Allergy and Clinical Immunology Unit, Mercato S. Severino, Salerno, Italy
10Unit of Pneumology and UTIP, “S.Donato” Hospital, Arezzo, Italy
11Unit of Pneumology, “Carlo Urbani” Hospital, Jesi, Italy
12Unit of Pneumology, “Mater Salutis” Hospital, Legnago, Italy
13Allergy and Laboratory Unit, University Hospital Padova, Padova, Italy
14Allergy Unit, National Healthcare System, Reggio Calabria, Italy
15Otolaryngology Clinic, Policlinico Umberto I, University “Sapienza”, Rome, Italy
16Institute of Clinical Physiology, National Research Council (CNR), Pisa, Italy
17ESTAV sud-est, ICT, Azienda Ospedaliera Misericordia, Grosseto, Italy

J Investig Allergol Clin Immunol 2014; Vol. 24(1): 23-28



Objectives: In this multicenter survey, we assessed the impact of sensitization to cypress in atopic patients in Italy and determined whether cypress pollen concentration changed over time.

Methods: Allergists were required to collect the results of 100-200 consecutive skin prick tests (SPTs) performed during 2012. Seasonal symptoms were also recorded, as were airborne cypress pollen concentrations (data from the Italian Aerobiology Association) in 1998- 2000 and 2010-2012.

Results: We examined 2258 atopic outpatients (56% females; age, 2-84 years) sensitized to at least 1 of the aeroallergens tested (Dermatophagoides species, grass, pellitory, olive, cypress, birch, Alternaria tenuis, and dog and cat dander). We found that 62.9%, 16.1%, and 32.7% of patients living in central, northern, and southern Italy, respectively, were sensitized to cypress (P<.0001). The cypress pollen concentration peak was delayed from February to March in 1998-2000 and 2010-2012 in all 3 regions, with a shift in pollination towards spring. Patients who were monosensitized to cypress reported mainly rhinitis (90.7%-97.6%) and conjunctivitis (38.1%-100%). In polysensitized patients, the prevalence of rhinitis, conjunctivitis, and asthma increased progressively (P<.0001) from southern to northern Italy. The same trend was observed for the prevalence of reported winter symptoms typical of cypress allergy (28%-65%).

Conclusions: Today, cypress pollen is the most frequent sensitizing aeroallergen (assessed by SPT) in several areas of central Italy. Variations in the timing of the cypress pollination period may have favored this increased sensitization. Rhinitis and conjunctivitis are the predominant symptoms. The clinical impact of this allergy was poor in southern Italy and increased in central areas before reaching its peak in northern regions.

Key words: Respiratory allergy. Cypress. Cupressaceae. Sensitization. Skin prick tests. Airborne pollen concentration. Prevalence.