Global atlas oF allerGy
3g GRASS POLLEN
Jörg Kleine-Tebbe
Allergy & Asthma Center Westend
Berlin, Germany
BOTANICAL RELATIONSHIP
Grasses are ubiquitous plants in
most parts of the world. The grass
section a - Allergy - from genetics to mechanisms
family (Poaceae
genera and >11,000 recognized
species with a wide distribution.
grass species belong to three sub-
families; Pooideae, Chloridoideae
and Panicoideae (Figure 1 and 2).
GLOBAL DISTRIBUTION
Depending on climate and geogra-
phy, grass pollens represent major
contributors of airborne allergens
during spring as well as summer.
They grow on all continents and
earth´s vegetation. Pooideae dom-
inate temperate climate zones;
Chlorodoideae cover the North
American, African and Australian
continents and Panicoideae grow
in tropical and subtropical envi-
ronments of Asia, Australia, Africa
and South America (Figure 3).
ALLERGENS OF GRASS POLLEN
Grass pollen allergens are grouped
according to their protein struc-
ture and function (Table 1). They
- groups, are based on similar bio-
cial nomenclature (www.allergen.
org), i.e.: Phl p 1 = grass group 1 al-
lergen from Phleum pratense (tim-
othy grass). Ten designated groups
22
ALLERGENS
Janet Davies
The University of Queensland
Brisbane, Australia
Ke y m essag es
• Pollens from diverse grass plants are main contributors to
seasonal inhalant allergies worldwide
• Grass group 1 and 5 allergens represent highly cross-reactive
and potent major allergens, group 5 present only in temperate
climate grasses (Pooideae)
• Depending on climate and region, global sensitization rates to
•
pollen extracts
- been adopted by the European
tion rate, SR) and minor allergens Medicines Agency (EMA).
-
dance and potency, grass group CLINICAL ALLERGY BASED ON
1 and 5 allergens are considered SENSITIZATIONS
immunodominant major Pooideae Sensitizations to grass pollen al-
pollen allergens (Figure 4). While lergens, indicated by grass pollen
group 5 allergens are restricted allergen (extract) positive skin
to the Pooideae subfamily, group
1 allergens are present through- plant distribution and pollen ex-
out the subfamilies of Poaceae. In posure. Population based sensiti-
zation rates are mainly available
for Europe and the US and vary
contribute to ubiquitous cross-re- considerably between and within
activity between grass, tree and countries (Figure 5). Grass pollen
allergy is a global problem (Figure
pollen sensitized subjects. Present 5c). At least half of grass pollen
concepts of homologous allergen allergen sensitized subjects will
suffer from symptoms of allergic
chemical composition, homology rhinoconjunctivitis and/or bron-
and immune cross-reactivity re- chial asthma, particularly during
the warm seasons in moderate cli-
taxonomic relationship and have mate regions.
Grass pollen allergens
Global atlas oF allerGy

a b

section a - Allergy - from genetics to mechanisms

Figure 1 Pictures of different grass species and their pollen : a - Timothy grass (Phleum pratense), subfamily Pooideae;
b-Bermuda grass (Cynodon dactylon), subfamily Chloridoideae; c - Bahia grass (Paspalum notatum), subfamily Panicoideae.

Family Subfamily Tribe Genus Common name (US)

Poaceae Bambusoideae Oryzeae Oryza (Rice)

Arundinoideae Arundineae Phragmites (Common reed)

Chloridoideae Chlorideae Cynodon (Bermuda grass)

Paniceae Paspalum (Bahia grass)

Panicoideae
Sorghum (Johnson grass)
Andropogoneae
Zea (Corn, maize)

Dactylis (Orchard grass)

Festuca (Meadow fescue)
Poeae
Lolium (Perennial rye)
Poa (Kentucky bluegrass)

Anthoxanthum (Sweet vernal grass)

Avena (Cultivated oat)
Aveneae
Pooideae Holcus (Velvet grass)
Phleum (Timothy grass)

Bromeae Bromus (Smooth brome grass)

Hordeum (Barley)
Triticeae Secale (Cultivated rye)
Triticum (Wheat)

Figure 2 Taxonomy of grasses (important subfamilies within colored boxes). Overlapping circles (colored lines) indicate

Grass pollen allergens 23

 Global atlas oF allerGy

In: Lockey RF, Ledford DK, ed-

itors. Allergens and Allergen
Immunotherapy. 4th Edition ed:
Informa Healthcare, New York;

2. Andersson K, Lidholm J. Charac-

teristics and immunobiology of
grass pollen allergens. Int Arch Al-
lergy Immunol 2003;130
3. Hrabina M, Peltre G, van Ree R,
a Moingeon P. Grass pollen allergens.
Clin Exp Allergy Rev 2008;8
4. Gangl K, Niederberger V, Va-
lenta R. Multiple grass mixes as
opposed to single grasses for
allergen immunotherapy in al-
lergic rhinitis. Clin Exp Allergy
2013;43
5. Lorenz AR, Lüttkopf D, May S,
Scheurer S, Vieths S. The princi-
section a - Allergy - from genetics to mechanisms

ple of homologous groups in reg-

b ulatory affairs of allergen prod-
ucts--a proposal. Int Arch Allergy
Immunol 148
European Medicines Agen-
cy (EMA). Guideline on aller-
gen products:production and
quality issues. (EMEA/CHMP/

Newson RB, van Ree R, Forsberg

B, Janson C, Lotvall J, Dahlen SE
c et al. Geographical variation in
the prevalence of sensitization to
common aeroallergens in adults:
the GA2LEN survey. Allergy
Figure 3 Global distribution of selected grass species (10): a- Timothy grass
2014;69
(Phleum pratense), subfamily Pooideae; b-Bermuda grass (Cynodon dactylon), sub-
family Chloridoideae; c-Bahia grass (Paspalum notatum), subfamily Panicoideae. 8. Salo PM, Arbes SJ Jr, Jaramillo R,
Calatroni A, Weir CH, Sever ML,
DIAGNOSIS AND TREATMENT gual home use of droplets or tab- et. al Prevalence of allergic sen-
Positive skin prick tests and ele- lets with monopreparations of one sitization in the United States:
grass species, but also grass mixes Results from the National Health
pollen preparations indicate al- and Nutrition Examination Sur-
(mainly Pooideae), with or without
J Al-
lergic sensitizations, being clini- adjuvants. lergy Clin Immunol 2014 (in press).
cally relevant only in case of cor-
responding symptoms. Measuring Acknowledgement: We kindly Davies JM. Grass pollen aller-
acknowledge Andreas Nandy gens globally; the contribution of
IgE to major allergens (i.e. Phl p 1
(Allergopharma, Reinbek, Germa- subtropical grasses to burden of
and 5) increases analytical spec- allergic respiratory diseases. Clin
- ny), Jonas Lidholm and Kerstin Wall Exp Allergy 2014;44
len allergy, particularly in case of (ThermoFisher, Uppsala, Sweden)
10. Simon BK, Clayton WD, Harman
sensitizations to cross-reactive for additional information and KT, Vorontsova M, Brake I, Healy
- helpful suggestions. D and Alfonso Y. 2011. Grass-
munotherapy is most successfully World, http://grassworld.mys-
applied for at least three years by KEY REFERENCES pecies.info/ (Accessed April 25,
subcutaneous injections or sublin- 1. Esch RE. Grass pollen allergens. 2014).

24 Grass pollen allergens

Global atlas oF allerGy

TABLE 1
Grass pollen allergen groups
Allergen Biochemical Molecular- Member in IgE
Features
group function weight [kDa] Phleum pratense reactivity
Glycoprotein, major grass pollen allergen,
1 -expansin Phl p 1
produced by every grass species
highly homologous to group 3 and
2 Unknown 11 Phl p 2
C-terminal portion of group 1 allergens
highly homologous to group 2 and
3 Unknown 11 - 14 Phl p 3
C-terminal portion of group 1 allergens
Glycoprotein, Berberine bridge enzyme
Oxidoreduc-
4 Phl p 4 family member, plant pathogen response
tase
system
found in Pooideae grass species, associated
5 Unknown Phl p 5 with submicronic cytoplasmic starch
particles
homologous to internal group 5 sequences,
Unknown 12 - 13 only in Anthoxanthum odoratum, Phleum
pratense and Poa pratensis

section a - Allergy - from genetics to mechanisms

Polcalcin, Ca++- Panallergen, dimer assembly in grass
8 - 12
binding protein pollen, broad pollen-related crossreactivity
Glycoprotein, similar structure to pollen
Ole e 1-related
11 Phl p 11 allergens from olive tree pollen (Ole e 1)
protein
and lamb´s quarter (Che a 1)
Panallergen, highly conserved, broad pollen
12 13 - 14 Phl p 12
and plant food-related crossreactivity
Polygalacturo- Glycoprotein, susceptible to protease
13 Phl p 13
nase degradation
-

Prevalence

Group
1
Group Figure 4 Involvement of
High
4 Group
grass pollen allergens in patient
5 sensitization (3).
Group
2/3
50% Group
Group 13
11

Low Group
12
Group
Group 7
10

Low 40% High Potency

(mean IgE level)

Grass pollen allergens 25

 Global atlas oF allerGy

14.5 17
25

21
20
22

23.5
b
17
22 29.5
22.5
10
10 11
24.5 28.5 21.5

24 15.5
18
12.5
section a - Allergy - from genetics to mechanisms

c
a

Saudi Arabia
Taiwan (AR, 419)
61% AR (54)
10%,
Southern USA 2.1%
57% AR (429) Thailand (AR, 100)
21%,
16%
India
17%
12.5%, (AR/A, 48)
52% (GPA, 133)

Malaysia (A, 100)

20.5%,
SPT test:
6.5%
Johnson GP
Bahia Australia (GPA, 48)
Bermuda GP Zimbabwe 77%
(number tested) 50.4% AR (341) 81%
Subject group: d 84%
A, asthma
AR, allergic rhinitis,
GPA, grass pollen allergic

Figure 5 Sensitization rates to grass pollen (Pooideae

26 Grass pollen allergens