AERO-POLLENS: THE ENVIROMENTAL TRIGGERS OF ALLERGIC REACTION OF PUBLIC HEALTH IMPORTANCE. PRESENTED BY DR.ADEIGA A.A. MOUNTAIN TOP UNIVERSITY KM 12 LAGOS –IBADAN EXPRESS WAY IBAFO . Pre-PROJECT WORKSHOP/CONFERENCE WITH THE THEME: THE ALLERGINIC ACTIVITIES OF POLLEN AND SPORES OF NIGERIAN PLANTS AND THEIR SPATIIAL PATTERN ORGANISED BY DEPT OF BOTANY AT UNIVERSITY OF LAGOS ON 22ND NOV. 2016

OUTLINE BACKGROUND SIGNIFICANCE OF SUBJECT. PROCESS OF ALLERGIC REACTION. MAJOR PLAYERS IN ALLERGY. PATHOLOGIC EFFECT OF MEDIATORS RELEASED FROM GRANULES. RISK FACTORS. DIAGNOSIS. PREVENTIONS. TRANSLATIONAL BENEFITS. CONCLUSION

BACKGROUND Pollen and fungi spores are bioparticles released from plants into the air abundantly as allergens to cause Polinosis or Hay fever. As they are carried by wind in the air, the eyes and body air pathways are direct targets. Respiratory contact with air pollen through inhalation triggers body reactions. This results in immediate hypersensitivity disorders called ALLERGY in genetically predisposed individual and late hypersensitivity in others after a second contact.

BACKGROUND

BACKGROUND

BACKGROUND CONTD. Symptoms include allergic rhinitis, allergic alveolitis, asthma, atopic dermatitis , conjuctivitis (Cakmak et al 2005). Allergic disorders is as high as 30% of world population, this increased interest of scientists studying the environment to know the presence and movement of the bioparticles in the air and the impact on human health(Loureiro et al 2005). This interdisciplinary approach is called AEROBIOLOGY.

BACKGROUND CONTD. Bioparticles causing the allergy include pollens , fungal spores, insect debris, house dust mites, chemicals etc. Many studies have been conducted on aero-pollens in Nigeria, but little information on the linkage to public health. Though 50 million Nigerians were presumed to be suffering from asthma, majority were presumed to be induced by aeropollens.(Erhabor 2010).

SIGNIFICANCE OF THE SUBJECT The ill-health impact caused by aero-pollens makes the subject a high public health importance. Poor awareness of aero-pollens and fungal spores as causing allergy of high degree of severity needs improvement. Increased awareness will improve prevention strategies from the population.

PROCESS OF ALLERGIC REACTION Two immune systems are involved in allergic reaction: the innate and the adaptive immune systems. Immune cells of the innate include: dendritic cells, mast cells, basophils and eosinophils. Immune cells of the adaptive are T and B lymphocytes.

ALLERGIC PROCESS CONTD Dendritic cells trap the pollen and digest it to produce allergen protein (Antigen) which is sent via the lymphatic tract to the lymph node, where T-lymphocytes are activated to produce Th2 cells. The Th2 cells get activated to stimulate the B cells which transform to plasma cells to produce IgE antibodies against the allergen protein which is the antigen.

ALLERGIC PROCESS CONTD. Eosinophils, Basophils, and Mast cells are part of blood cells that are major participants of allergic process. They have receptor sites to attach to Fc fragment of the IgE antibody produced. IgE antibody get attached to mast cells and basophil cells in the blood by the Fc region and to eosinophils at later phase of the reaction by the same process.

ALLERGIC PROCESS CONTD.

ALLERGIC PROCESS CONTD. When these cells that are attached to the IgE antibody are cross linked by the antigen, the cells are activated to release the granules containing mediators e.g. histamine, serotonin, prostaglandins and leukotrienes. These mediators released cause vascular permeability, vasodilation and bronchial and visceral muscle contraction. This is Immediate hypersensitivity or Anaphylactic Reaction.

ALLERGIC PROCESS CONTD

ALLERGIC PROCESS CONTD. Release of the mediators elicit the following symptoms: Eyes- Itching and watery eyes, conjuctivitis. Nose &Throat:- Sneezing, runny nose , allergic rhinitis, swelling and inflammation of nasal passages, nose and throat itching, nose and sinus congestion, increased mucus production and asthma. Skin:- hives and rashes.

ALLERGIC PROCESS CONTD. This is followed by Inflammatory late phase reaction characterised by accumulation of neutrophils, eosinophils and Th2 cells in the site of allergy. This inflammatory phase is caused by cytokines produced by Th2 cells, mast cells and lipid mediators.

ALLERGIC PROCESS CONTD

ALLERGIC PROCESS CONTD.

ALLERGIC PROCESS CONTD. Th2 cells produce the ffg cytokines: IL-4, IL-5, IL-13. IL-4 activates B-cells to produce IgE ab. IL-5 activates production of more eosinophils. IL-13 stimulates epithelial cells in trachea to secrete increased amount of mucus e.g in asthma. IgE produced normally is <1µg/ml of blood. In allergy, IgE produced can rise to 1000µg/ml of blood. This promotes chance of cross-link

ALLERGIC PROCESS CONTD Cytokines:- Mast cells and basophils produce many different cytokines contributing to late phase reaction in allergy. These are IL-1, IL-4, IL-5,IL-6, IL-13, TNF-α,IL-3. Eosinophils- bone marrow granulocytes like basophils. Many in the inflammatory infiltrates of late phase reaction of allergy.

ALLERGIC PROCESS. Eosinophils are involved in many pathologic processes of allergic diseases. IL-5 activate Eosinophils to release granule contents e.g Platelet Activating Factor(PAF), Prostaglandins and Leukotrienes

MAJOR PLAYERS IN ALLERGY Pollen, Spores, Food, Drug, Chemicals. Th2 cells. B-cells, IgE, Fc of IgE. Mast cells, Basophils, Eosinophils , Macrophages & Dendritic cells. Mediators released from granules-Histamine, Serotonin, Prostaglandin, Leukotrienes. Cytokines – TNF-α, IL-1,IL-3,IL-4,IL-5,IL-6, IL-13.

PATHOLOGIC EFFECTS OF MEDIATORS RELEASED FROM THE GRANULES Histamine-causes vasodilation, vascular permeability & leakage of plasma into tissues, constriction of intestinal and bronchial smooth muscle-peristalsis & bronchospasm. Serotonin-causes vasodilation. Prostaglandins-causes vasodilation and broncho-constriction. Promotes neutrophil attraction and accumulation at inflammatory sites.

PATHOLOGIC EFFECTS CONTD Leukotrienes- causes prolonged broncho-constriction. Important in asthmatic broncho-constriction. Platelet Activating Factor(PAF).-Has direct broncho-constricting actions. Causes retraction of smooth muscle and relaxes vascular smooth muscles. These symptoms range from mild to life threatening signs and can be local or systemic.

PATHOLOGIC EFFECTS CONTD.

RISK FACTORS Hereditary Environmental exposures:- Continuous exposure to bioparticles such as pollens fungal pores, insect debris in the air house dust mites and chemical waste emissions from industries, windy desert dusts.

DIAGNOSIS RadioAllergoSorbentTest (RAST) blood test. Differential white blood cell counts showing eosinophilia. Eosinophilia of > 600cells /ml of peripheral blood is very significant. Skin prick test.

PREVENTION Observe your reaction to flowers and grasses in your environment. Observe your reaction when you visit your farms. Observe your reaction to factory or industrial emissions. Wearing a nose mask or a respirator when going to the field or farm.

PREVENTION

AFTER THE CLEARING OF THE GRASS/WEED

TRANSLATIONAL BENEFIT OF RESEARCH IN THIS AREA. Presenting Eosinophilia of >600 cells/ml as simple biomarker to diagnose pollen allergy. Raising awareness of pollens from grasses and weeds in the environment as source of allergy. Raising awareness that consistent sneezing and wheezing are signals of allergy from pollens and pores that should be reported at nearby clinic for effective management. Use of preventive measures can save lives.

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CONCLUSION Consciousness of health safety in our environment is germaine and this calls for sensitivity to what can trigger an upset. Early steps of action will avoid precipitation of severe cases in our hands.

THANK YOU FOR LISTENING.