Effect of tree and grass pollens and fungal spores on spring allergic rhinitis: a comparative study.
BACKGROUND: Current literature indicates tree pollen is less important than grass pollen as the cause of spring allergic rhinitis. The role of fungal spores is secondary and uncertain. OBJECTIVE: To assess the relative allergenicity of tree and grass pollen and fungal spores as the cause of spring allergic rhinitis in central Indiana. METHODS: (1) Chart review of 189 Indiana natives with seasonal allergic rhinitis to ascertain clinical sensitivity to tree or grass pollens. (2) A prospective study conducted in the spring of 1997 in 51 patients, correlating patients' symptom and medication scores with daily pollen and spore counts, obtained with a Burkard spore trap. RESULTS: One hundred thirty of 189 patients (69%) reported symptoms before May with positive prick test to at least one tree pollen. One hundred thirty-four patients (71%) had symptoms in May and June with positive test to grass pollen. The ratio between the two groups is 1:1, in contrast to a ratio of 1:4 derived from the literature. The prospective study revealed a symptom score increase parallel to the rise of tree pollen counts beginning in mid-March and reaching a plateau in early May prior to the onset of grass season. Medication use continued to increase and peaked at the height of grass pollination. Spore counts increased in late May and stayed at high levels throughout June, yet symptom and medication scores steadily declined following the peak of grass pollination in early June. CONCLUSIONS: This study suggests that in central Indiana, tree pollen is more important as the cause of spring allergic rhinitis than that suggested by the literature. This study confirmed previous observations that fungal spores are substantially less allergenic than pollens.