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Pollinosis – Causes, Symptoms & Treatment

Pollinosis is an allergic reaction to airborne flower pollen and is one of the most common allergies worldwide. It causes symptoms such as sneezing, watery eyes, and a runny nose.

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Things worth knowing about "Pollinosis"

Pollinosis is an allergic reaction to airborne flower pollen and is one of the most common allergies worldwide. It causes symptoms such as sneezing, watery eyes, and a runny nose.

What is Pollinosis?

Pollinosis, commonly known as hay fever, is an allergic disease triggered by the inhalation of airborne pollen from trees, grasses, and weeds. It belongs to the group of seasonal allergic rhinitis and affects hundreds of millions of people globally. Symptoms typically appear during specific pollen seasons and can significantly reduce the quality of life of those affected.

Causes

Pollinosis results from an exaggerated immune response to otherwise harmless pollen proteins. The immune system produces immunoglobulin E (IgE) antibodies against specific pollen allergens. Upon repeated exposure, mast cells release histamine and other inflammatory mediators, triggering the characteristic allergy symptoms.

Common pollen allergens include:

Tree pollen: Birch, alder, hazel, ash (spring)
Grass pollen: Rye, timothy, cocksfoot (early summer)
Weed pollen: Mugwort, ragweed, plantain (late summer and autumn)

Risk Factors

Several factors may increase the likelihood of developing pollinosis:

Genetic predisposition (family history of allergies)
Presence of other atopic conditions (e.g., eczema, asthma)
Living in areas with high pollen exposure
Early childhood exposure to air pollutants

Symptoms

The symptoms of pollinosis primarily affect the mucous membranes of the airways and eyes:

Nose: Sneezing, watery nasal discharge, nasal congestion
Eyes: Itching, redness, tearing (allergic conjunctivitis)
Throat and palate: Itching and irritation
Lungs: Coughing, wheezing (in cases with co-existing asthma)

In more severe cases, fatigue, difficulty concentrating, and sleep disturbances may occur, significantly impacting everyday activities.

Diagnosis

Pollinosis is diagnosed through a combination of the following assessments:

Medical history: Evaluation of symptoms and their seasonal pattern
Skin prick test: Cutaneous testing with standardized pollen extracts to identify the causative allergen
Specific IgE blood test (RAST/ImmunoCAP): Laboratory detection of allergen-specific antibodies
Nasal provocation test: Used in specialist settings to confirm diagnosis

Treatment

Allergen Avoidance

Reducing exposure to pollen is the first and most important step. This includes monitoring local pollen forecasts, wearing sunglasses outdoors, keeping windows closed during peak pollen times, and changing clothes after spending time outside.

Pharmacological Therapy

Antihistamines: Block the effects of histamine, relieving sneezing, itching, and runny nose
Nasal corticosteroids: Anti-inflammatory nasal sprays, considered the most effective treatment for nasal symptoms
Decongestants: Provide short-term relief from nasal congestion
Eye drops: Antihistamine-based drops for allergic conjunctivitis

Allergen Immunotherapy (Desensitization)

Allergen immunotherapy (AIT) is the only disease-modifying treatment for pollinosis. It gradually desensitizes the immune system to the causative allergen by administering progressively increasing doses – either as injections (subcutaneous immunotherapy, SCIT) or as tablets or drops placed under the tongue (sublingual immunotherapy, SLIT). Treatment typically lasts three years.

References

Bousquet J. et al. - Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines, Allergy, 2019.
World Health Organization (WHO) - Prevention of Allergy and Allergic Asthma, 2004.
Brożek J.L. et al. - Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines – 2016 revision, Journal of Allergy and Clinical Immunology, 2017.

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