Pascal Chanez, Jarmila Zídková, Youcef Shahali, Denis Charpin, Pascal Poncet, Jordina Belmonte, Christian Pichot, Hélène Sénéchal, Jean Pierre Sutra, Adhésion et Inflammation (LAI), Assistance Publique - Hôpitaux de Marseille (APHM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS), Aix Marseille Université (AMU), Ecologie des Forêts Méditerranéennes [Avignon] (URFM 629), Institut National de la Recherche Agronomique (INRA), Institute of Environmental Science and Technology [Barcelona] (ICTA), Universitat Autònoma de Barcelona [Barcelona] (UAB), Department of Animal Biology, Plant Biology and Ecology, Biochemistry Department, Allergy and Environment Research team, Hôpital Armand Trousseau, Assistance Publique - Hôpitaux de Paris (AP-HP), University of Chemistry and Technology, Prague, Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organisation (AREEO ), Centre de Recherche et Innovation Technologique (CITECH), Institut Pasteur [Paris], Ecologie des Forêts Méditerranéennes (URFM), Universitat Autònoma de Barcelona (UAB), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), ICTA 'Unit of Excellence' (MinECo)MDM2015-0552, Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut Pasteur [Paris] (IP), Adhésion et Inflammation ( LAI ), Assistance Publique - Hôpitaux de Marseille ( APHM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Aix Marseille Université ( AMU ) -Centre National de la Recherche Scientifique ( CNRS ), Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre National de la Recherche Scientifique ( CNRS ), Aix Marseille Université ( AMU ), Ecologie des Forêts Méditerranéennes ( URFM 629 ), Institut National de la Recherche Agronomique ( INRA ), Institute of Environmental Science and Technology, Autonomous University of Barcelona (UAB), Universitat Autònoma de Barcelona [Barcelona] ( UAB ), Hôpital Armand Trousseau, Assistance Publique - Hôpitaux de Paris ( AP-HP ), Agricultural Research, Education and Extension Organisation ( AREEO ), and Assistance et services informatiques CITECH ( CITECH )
Cypress (Cupressus sp.pl) is a genus within the Cupressaceae family. This family covers all of the Earth's continents except for Antarctica, and it includes about 160 species. The most important taxa for allergic diseases belong to five different genera: Cupressus, Hesperocyparis, Juniperus, Cryptomeria, and Chamaecyparis. Cupressaceae species share a common pollen type that can even include the genus Taxus (Taxaceae) when this plant is also present. As Juniperus oxycedrus pollinates in October, Cupressus sempervirens in January and February, Hesperocyparis arizonica (prev. Cupressus arizonica) in February and March, and Juniperus communis in April, the symptomatic period is long-lasting. Due to global warming, the pollination period tends to last longer, and there is a trend for Cupressaceae bioclimate niches to migrate north. In Mediterranean areas, C. sempervirens (Italian cypress or Mediterranean cypress) is by far the most common pollinating species. It accounts for half of the total pollination level. The group 1 major allergens belong to the pectate-lyase family, and members share 70 to 97% sequence homology within the different Cupressaceae. Group 2 allergens correspond to the polygalacturonase protein family, while group 3, a minor allergen, belongs to the family of "thaumatin-like proteins," a pathogenesis-related protein 5. Group 4 allergens are Ca++-binding protein (4 EF-hands). Aside from these four groups, about 15 other allergens have been reported. Prominent among these is a basic low-molecular mass cross-reactive allergen that was identified recently, and which is suspected to be involved in pollen food syndromes which are common with peach and citrus. The prevalence of cypress allergy in the general population ranges from 0.6 to 3%, depending on the degree of exposure to the pollen. Depending on the geographic area and the studied population, 9 to 65% of outpatients consulting an allergist may have sensitization to cypress pollen. Repeated cross-sectional studies performed at different time intervals have demonstrated a threefold increase in the percentage of cypress allergy around the Mediterranean area. Risk factors include a genetic predisposition and/or a strong exposure to pollen, and the natural history of cypress allergy allows identification of a subgroup of patients as allergic rather than atopic. Concerning the clinical expression, rhinitis is the most prevalent symptom, while conjunctivitis is the most disabling. Pharmacological treatment of cypress allergies is not different from that of other seasonal allergies. Immunotherapy has been used, initially by subcutaneous injections, but currently mostly through the sublingual route. Although clinical trials have included only a limited number of patients, it has proven effective and safe. Avoidance can be implemented at the individual level, as well as at the community level, through the use of alternative plants, low-pollinating cypresses, or by trimming hedges before pollination.