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Background: Little is known whether sublingual immunotherapy using Japanese cedar pollen extract (cedar SLIT) is effective for not only Japanese cedar pollinosis but also Japanese cypress pollinosis. We investigated the prevalence rate of Japanese cypress pollinosis, efficacy of cedar SLIT on cypress pollinosis and patients' wish to receive cypress SLIT., Methods: We investigated a multi-center (31 institutions), cross-sectional survey using a self-administrated questionnaire with four questions for patients received cedar SLIT aged from 5 to 69 years old., Results: 2523 subjects were enrolled for analysis. 83.4% of them had pollinosis symptoms during cypress season before cedar SLIT. In such patients, 37.4% experienced lessened efficacy of cedar SLIT during cypress season. Both the prevalence of cypress pollinosis and the lessened efficacy of cedar SLIT on cypress pollinosis were significantly seen in western Japan as compared to eastern Japan. 76.1% of the subject having cypress pollinosis before SLIT wished to receive cypress SLIT if it is available., Conclusion: A lessened efficacy of cedar SLIT during cypress season was broadly seen in Japan, and further showed a regional difference. Together with the finding of high wish by patients, these results suggest a development of cypress SLIT is desirable.

Objective: To ensure that the best possible information is available for selecting treatment options in patients who have chronic rhinosinusitis with nasal polyps (CRSwNP), it is necessary to assess experiences with surgical procedures in real-world clinical practice., Methods: We used an internet questionnaire to survey 300 patients who had a history of CRSwNP surgery or had been recommended for such surgery., Results: The patients who underwent surgery showed high satisfaction with the effectiveness of the surgery. However between 20% and 30% were notably dissatisfied with the safety of the procedure, its effects on quality of life (QOL), its economic impact, and its influence on societal activities, such as attendance at work or school. This dissatisfaction tended to be particularly pronounced among older patients and those who had multiple surgeries. The primary reasons given for avoiding surgery were "afraid of surgery," "no time for hospitalization and treatment," and "surgery is too expensive.", Conclusion: Our research indicates that, although recipient patients are highly satisfied with the effectiveness of surgery for CRSwNP, a number of patients hesitate because of concerns about safety, cost, and societal activities such as work and school attendance. These findings suggest that treatment in a clinical setting should consider not only therapeutic effects but also the patient's attitude and situation.

Background: Baker's rhinitis is a kind of occupational allergic rhinitis mainly caused by intranasal exposure to wheat and/or rye flour in bakery workers. Continuous exposure to flour may induce the onset of asthma in these patients., Method: We experienced a case of 34-year-old male with baker's rhinitis without asthma, and investigated responses of IgE and peripheral blood mononuclear cells (PBMCs) to flour extracts used in the bakery in practice., Result: In the immunoblotting, the patient's IgE reacted with 18 and 30kDa molecules in the extracts of 6 flours used in the bakery. The patient's PBMC produced a substantial amount of IL-5 and IL-13 in response to these flour extracts., Conclusion: It is suggested that water/salt soluble components of wheat flour selectively induce type 2 cytokines production in baker's rhinitis.

Background: Food-dependent exercise-induced anaphylaxis (FDEIA) is characterized by anaphylactic symptoms after eating certain foods, followed by exercise. As we examine more patients who have pollinosis, we have more opportunities to see allergic disease such as FDEIA, OAS, and so on., Methods: We performed a retrospective analysis of six cases, diagnosed FDEIA for this three years., Results: Of six cases, the ages are 8 to 47 years old, and the trigger allergens were wheat, shrimp, and grapefruit. The trigger exercises were running, volleyball, as well as taking a bath. In four cases, the patients had history of allergic disease such as atopic dermatitis, allergic rhinitis, and so on. In two cases of wheat-dependent exercise-induced anaphylaxis, the IgE levels for omega5-gliadin (a major wheat allergen) in a RAST were positive., Conclusion: Of six cases diagnosed FDEIA, the trigger allergens were wheat, shrimp, and grapefruit. In cases of wheat-dependent exercise-induced anaphylaxis, the IgE levels for omega5-gliadin in a RAST were positive. After the food allergen has been identified, we advised strict restrictions on ingestion of trigger allergens in the case of shrimp and grapefruit, and on any exercise after eating foods containing wheat flour in the case of wheat.