CYPRESS POLLEN SESITIZATION IN GEORGIA: CLINICAL AND MOLECULAR CHARACTERISTICS.

Cypress pollen allergy is a widely distributed, highly prevalent and severe winter pollinosis that may be caused by several Cupresaceae species around the Mediterranean basin, in North America and Asia. Exposure to cypress pollen has increased steadily over the last few decades and the prevalence of allergy to cypress pollen has also dramatically increased from 0.6% to 9.8% in the general population and from 9% to 35% in allergic patients, probably because of the allergen load has become more intense. The objective of the study was to evaluate cypress pollen allergy in Georgia and describe clinical characteristics and the molecular profile of sensitization. Patients attended to allergy clinic with suspected cypress pollen allergy (n=492) were included in the study. Diagnostic workup was performed according to local guidelines, specific IgE antibody against cypress allergen was performed using ImmunoCAP and ISAC assay platform. The airborne pollen monitoring was performed with a Burkard Seven Day Volumetric Spore-trap (Burkard Manufacturing Co Ltd, UK) during the seasons of 2019-2020, following the recommendations of European Aerobiology Society. 37.2% of studied cases were positive to cypress diagnostic test. From cypress positive 183 patients only 17 patients (9.2%) had no symptoms during the cypress season. The most frequent symptoms were sneezing and ocular itching (82.9% of patients for both symptoms), rhinorrhea was reported in 77.7% of cases and dry cough and shortness of breath - only in 22.3% (each symptoms). More than half of frequent symptoms were reported as severe. The cypress positive patients were mostly co-sensitized to plant allergen components: grasses (nCyn d1- 61.5% of ISAC positive cases, rPhl p 1 -72.5%, rPhl p 5 - 46.8%), trees (rBet v 1 - 27.5%, nCry j 1 - 78.9%, nPla a 2 - 32.1%) and weeds (nAmb a 1 - 48.6%, nArt v 1 - 20.2%). Our data show that in Georgia, the prevalence of sensitization to cypress pollen in patients attending the allergy clinic is high (every third patient). The clinical symptoms predominantly associated with allergic rhinitis and atopic conjunctivitis, in most cases which are expressing by acute sneezing and ocular itching during the pollen season and all patients are poly-sensitized. This was the first study to give a detailed description of the clinical characteristics of cypress pollen allergic patients in Georgia.