Impact of climate change on aerobiology, rhinitis, and allergen immunotherapy: Work Group Report from the Aerobiology, Rhinitis, Rhinosinusitis & Ocular Allergy, and Immunotherapy, Allergen Standardization & Allergy Diagnostics Committees of the American Academy of Allergy, Asthma & Immunology

Tolly E. Epstein, University of Cincinnati School of Medicine, Division of Rheumatology, Allergy, & Immunology, Cincinnati, and Allergy Partners of Central Indiana, Indianapolis, Ind. Electronic address: epsteite@uc.edu.
Andrew C. Rorie, Department of Medicine, Division of Allergy and Immunology, University of Nebraska Medical Center, Omaha, Neb.
German D. Ramon, Instituto de Alergia e Inmunología del Sur, Hospital Italiano Regional del Sur, Bahía Blanca, Argentina.
Anjeni Keswani, Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC.
Jonathan Bernstein, University of Cincinnati College of Medicine, Department of Internal Medicine, Division of Rheumatology, Allergy and Immunology, Cincinnati, Ohio.
Rosa Codina, Allergen Science & Consulting, Lenoir, and the Division of Allergy and Immunology, University of South Florida College of Medicine, Tampa, Fla.
Christopher Codispoti, Department of Internal Medicine and Pediatrics, Rush University Medical Center, Chicago, Ill.
Timothy Craig, Medicine, Pediatrics, and Biomedical Sciences, Penn State University, Hershey, and Vinmec International Hospital, Times City, Hanoi, Vietnam.
Mark Dykewicz, Section of Allergy & Immunology, Department of Internal Medicine, Saint Louis University School of Medicine, St Louis, Mo.
Denisa Ferastraoaru, Division of Allergy-Immunology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY.
Daniel Katz, School of Integrative Plant Science, Cornell University, Ithaca, NY.
Jean Kim, Johns Hopkins University School of Medicine, Johns Hopkins Asthma and Allergy Center, Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology, Allergy and Clinical Immunology, Baltimore, Md.
Désirée Larenas-Linnemann, Center of Excellence in Asthma and Allergy, Hospital Médica Sur, Mexico City, Mexico.
Anil Nanda, Asthma and Allergy Center, Lewisville and Flower Mound, and the Division of Allergy and Immunology, University of Texas-Southwestern Medical Center, Dallas, Tex.
Anh Nguyen, Division of Pediatric Allergy, Immunology & Rheumatology, University of California Davis Health, Davis, Calif.
Mahesh Padukudru Anand, Department of Respiratory Medicine, JSS Medical College and Hospital, JSSAHER, Mysore, Karnataka, India.
Amber Patterson, ENT and Allergy Specialists of Northwest Ohio, Findlay, Ohio.
Punita Ponda, Department of Medicine and Pediatrics, Division of Allergy & Immunology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Great Neck, NY.
Elina Toskala, Department of Otolaryngology, Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pa.
Anita N. Wasan, Allergy and Asthma Center, McLean, Va.

Document Type

Journal Article

Publication Date

4-18-2025

Journal

The Journal of allergy and clinical immunology

DOI

10.1016/j.jaci.2025.01.048

Keywords

Climate change; aerobiology; immunotherapy; rhinitis; sinusitis

Abstract

Climate change is imposing a profound effect on health conditions triggered by environmental exposures. Climate change has affected aeroallergens in numerous ways, including: (1) changes in the vegetation microbiome distribution, (2) increases in C grasses globally, (3) increased occurrence of acute weather events, (4) increases in ambient temperature that amplify fungal spore concentration and pollen season duration, and (5) increased allergenicity of pollen and fungi due to exposure to higher levels of carbon dioxide, ozone, and diesel exhaust particles. In addition, greenhouse gases and air pollutants disrupt the epithelial barrier, trigger eosinophilic inflammation, and serve as adjuvants that stimulate IgE-mediated responses. All of these factors have influenced the prevalence and morbidity of allergic rhinitis, nonallergic rhinitis, and chronic rhinosinusitis. Data regarding changes in aeroallergen exposures due to climate change are lacking, and longitudinal sensitization data are rarely available. Allergists need to adapt diagnostic and treatment strategies to limit aeroallergen and air pollutant exposure and facilitate desensitization. Steps needed to address these challenges include: (1) expanding local measurement of pollen and fungal spores, (2) increasing the intensity of allergen avoidance measures, (3) addressing supply chain issues, and (4) promoting collaboration between allergists, insurance companies, aeroallergen manufacturers, and regulatory agencies.

Department

Medicine

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