D2.143 - Cypress pollen as a major aeroallergen in paediatric respiratory allergy: experience in Gaziantep, south-eastern Türkiye

Cypress pollen is an important aeroallergen in Mediterranean climates; however, paediatric data from south-eastern Türkiye are limited. This study aimed to evaluate the frequency of respiratory aeroallergen sensitisation in children with allergic symptoms, determine the prevalence of cypress pollen sensitisation, and describe the main clinical characteristics of sensitised patients.

Children attending the paediatric allergy and immunology clinic of a tertiary university hospital between 1 May and 31 December 2024 were retrospectively analysed. Skin prick testing was performed in 1498 patients using a standard respiratory allergen panel including cypress pollen; a wheal diameter ≥3 mm greater than the negative control was considered positive. Demographic characteristics, family history of atopy, clinical diagnoses, symptoms, treatments, eosinophil counts, total IgE, cypress-specific IgE and spirometry findings were recorded.

Sensitisation to at least one respiratory aeroallergen was detected in 560 children (37.3%). Grass mix was the most common sensitisation (71.3%), followed by Alternaria (37.7%) and cypress pollen (36.4%). Overall, 204 patients were sensitised to cypress pollen, while monosensitisation was uncommon (4.9%). Cypress pollen sensitisation frequently co-occurred with grass mix (84.8%), olive tree (43.6%) and Artemisia vulgaris (39.7%). Among sensitised children, 67.2% were male and 51.5% had a positive family history of atopy. The predominant symptoms were cough, dyspnoea and rhinoconjunctivitis. Diagnoses included isolated allergic rhinitis in 29.4%, isolated asthma in 26.5%, and combined asthma and allergic rhinitis in 35.3% of patients. During the preceding year, 97.1% had received pharmacological treatment, most commonly intranasal corticosteroids. Cypress-specific IgE was positive in 94.8% of tested patients and showed a weak but significant positive correlation with age. In those who underwent spirometry, bronchodilator responsiveness was modest, with reversibility observed in 11.5%.

Cypress pollen sensitisation is common among children with allergic respiratory diseases in south-eastern Türkiye and usually occurs alongside grass and other tree pollens. It is strongly associated with allergic rhinitis and asthma, and intranasal corticosteroids constitute the mainstay of treatment. These findings support the routine inclusion of cypress pollen in skin prick test panels and highlight the importance of regional environmental factors in paediatric respiratory allergy.