Italian/Mediterranean/Funeral cypress

Further Reading

Cypress t222

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Code: t23
Latin name: Cupressus sempervirens
Source material: Pollen
Family: Cupressaceae
Common names: Italian funeral cypress, Mediterranean cypress

Not to be confused with other trees of the Cupressaceae family: Juniper, Mountain cedar/Mountain juniper, Japanese cypress/False cypress, Western red cedar, Eastern red cedar, Eastern white cedar

Allergen Exposure

Geographical distribution
Italian funeral cypress grows wild in the Mediterranean area and is distributed eastward to Iran, Greece and Israel. It is planted as an ornamental in Australia, New Zealand, Chile, and India, along the Rhone valley in France, and in Britain. Cupressaceae is the most widely distributed of all gymnosperm families, occurring in diverse habitats on all continents except Antarctica.

Cupressus sempervirens is an evergreen tree, forming a tall, dark-green column 12 to 20 m in height and normally no more than 1 m wide. The tree has a perfect conical shape with a pointed crown. The leaves are scale-like and along with the branches form tight, thick foliage. The tree is resinous, aromatic and monoecious. Some species live well over 3,000 years.

Italian cypress flowers from March to April. The flowers are inconspicuous. Pollination usually occurs in late winter or spring. In certain areas, e.g., Israel, pollen dispersal starts in January and peaks in March or April (1). (Pollination may occur any time from late summer to early winter for some species of Cupressaceae.) The fruit is oval in shape, dry and hard, and brown in colour. Seed maturation occurs in late summer or autumn. The seeds in the cones may remain on the tree for several seasons.

Environment
Cypress grows in dry areas, where it has adapted well. C. sempervirens is cited very often in classical literature, and was planted as an ornamental. It has often been cultivated in cemeteries, a tradition dating back to the time when the Greeks made wreaths of Cypress to place on the heads of their sacrificial animals, which could be offerings to the dead.

Italian cypress is often used for framing gardens, as an accent around large buildings, or in other formal landscapes. The wood may be used for fence posts.

Allergens
Seventeen IgE-binding proteins in the molecular weight range 14-96 kDa have been isolated. A protein of approximately 42 kDa reacted with 81.3% of the sera of allergic subjects (2). C. sempervirens shows a wider diversity of allergens than does C. arizonica, which, however, shows a higher content of the major 43 kDa allergen (3).

The following allergens have been characterised:
  • Cup s 1, a pectate lyase (4-5).
  • Cup s 3 (4,6-7).
  • Cup s 8, a profilin (8).

Potential cross-reactivity

Intense cross-reactivity exists among Italian funeral cypress tree, Arizona cypress tree and Mountain juniper tree, as well as other members of the Cupressaceae family (9-10).

Recombinant Cup a 1 (C. arizonica) has been shown to be highly homologous with the major allergens of Mountain cedar (Jun a 1), Japanese cypress (Cha o 1) and Japanese cedar (Cry j 1), confirming the cross-reactivity of conifer pollens (11-12). By inference, Italian funeral cypress tree pollen would share cross-reactivity with these allergens.

Cry j 2 may confer cross-allergenicity among Taxodiaceae and Cupressaceae (13).

Italian funeral cypress tree pollen has been shown to have common epitopes with Olive, Birch, Mugwort, Pine, and Cypress pollens (14).

Cross-reactivity has also been demonstrated among White cypress, Pine, Italian cypress, Rye grass, Birch, Cocksfoot, Couch grass, Lamb’s quarters, Wall pellitory, Olive, Plantain and Ragweed (15).

Podocarpus gracilior (Yellowood) and Callitris verrucosa contain allergens that cross-react with Italian funeral cypress tree pollen (16).

Complex glycan structures have been identified among the causes of the high degree of cross-reactivity between the Cupressaceae and Taxodiaceae families (17).

In a Spanish study examining sensitivity of patients with asthma and/or rhinoconjunctivitis to Cupressaceae pollen using skin prick tests, all the Cupressus-sensitive patients were found to be positive to Olea and Fraxinus, compared to 77% and 51% in the 2 Cupressus-negative groups (18).

Cross-reactivity between Italian funeral cypress pollen and Peach as a food has been reported in seven individuals. Symptoms of oral allergy syndrome, urticaria or angioedema occurred immediately following the ingestion of Peach: lip pruritus and oedema (n=3), urticaria (n=3) and angioedema (n=1). Italian funeral cypress pollen and Peach were shown to share a common allergen of 45 kDa (19).

Clinical Experience

IgE-mediated reactions
Pollen from Italian funeral cypress can cause asthma, hayfever and conjunctivitis (20-23).

The prevalence of sensitisation to Italian funeral cypress pollen in patients with hayfever may be as high as 24%-32%, depending on the region. In an Israeli study, 13% of all those found to be sensitive to this pollen were monosensitised. In this group of patients, 70% had rhinitis, 30% also had asthma, and 18% had conjunctivitis. Symptoms lasted from February until April (1). Some authors suggest that hayfever due to Cupressaceae pollen sensitivity has become a public health priority (24).

In Japan, where Cypress tree pollen is a prominent aeroallergen, the efficacy of using specific IgE assays has been demonstrated (25). In a Japanese study evaluating the relationship of various specific IgE in the serum to 12 inhalant allergens in patients with allergic conjunctivitis during various times of the year, it was found that the highest sensitisation rate for those affected in spring was 68.8% for Cedar pollen, followed by Cypress pollen at 59.4% (26).

Italian funeral cypress has been identified as the cause of an increasing number of cases of late-winter and early-spring pollinosis in Mediterranean countries (27). In Latium, a region in central Italy, out of 1397 residents with complaints related to upper- or lower-respiratory-tract disorders or conjunctival disease, 243 (17.4%) were skin prick-positive to C. sempervirens extract, and 47 (19.3%) of this group were monosensitised. All the subjects monosensitised to Cypress pollen had symptoms from January through April. The authors assert that sensitisation to C. sempervirens has increased from 7.2% in 1995 to 22% in 1998 (28). Sensitisation to pollen from this tree has also been recorded in Madrid, Spain (29). In a Greek study of individuals with respiratory allergy, it was demonstrated that 12.7% were sensitised to Cypress pollen (30).

Further studies have confirmed the allergenicity of Cypress pollens. In a study conducted on a rural Kibbutz community (Netzer Sereni) in Israel, the most prevalent causes of atopy were House dust mite (28.9%), Sagebrush (16.5%), grasses (18.2%), Pecan (13.2%) and Cypress (11.1%) (31). In Madrid, Spain, the highest average airborne concentration from 1979 to 1993 was of Quercus spp. (17%), followed by Platanus spp. (15%), Poaceae spp. (15%), Cupressaceae spp. (11%), Olea spp. (9%), Pinus spp. (7%), Populus spp. (4%), and Plantago spp. (4%). Cypress tree pollen occurred predominantly from January to April (32).

In a study in Izmir, Turkey, of patients with seasonal respiratory allergy, 65 (14.3%) of 455 were skin prick-positive to Italian funeral cypress pollen (33.) Only 1 patient was monosensitised. Of 154 patients with rhinitis and asthma in a study in Casablanca, 20.78% were sensitised to Italian funeral cypress pollen (34).

Aerobiological studies have confirmed the relevance of pollen from this tree in the atmosphere of Eskisehir, Turkey (35); Badajoz, Burgos and Plasencia, Spain (36-38); the island of Crete (39); and Clermont-Ferrand, France (40).

While Italian funeral cypress and Arizona cypress are commonly encountered in Mediterranean regions, Mountain cedar in Europe is present only in the Balkans and the Crimea. This tree is a major cause of allergy in the USA (41).

Compiled by Dr Harris Steinman, harris@zingsolutions.com.

References

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    Allerg Immunol (Paris) 2000;32(3):92-3
  2. Ford SA, Baldo BA, Panzani R, Bass D Cypress (Cupressus sempervirens) pollen allergens: identification by protein blotting and improved detection of specific IgE antibodies. Int Arch Allergy Appl Immunol 1991;95(2-3):178-83
  3. Leduc V, Charpin D, Aparicio C, Veber C,
    Guerin L. Allergy to Cypress pollen: preparation of a reference and standardization extract in vivo. [French] Allerg Immunol (Paris) 2000;32(3):101-3
  4. International Union of Immunological Societies Allergen Nomenclature: IUIS official list http://www.allergen.org/List.htm 2008
  5. Arilla MC, Ibarrola I, Martinez A, Asturias JA. Quantification assay for the major allergen of Cupressus sempervirens pollen, Cup s 1, by sandwich ELISA. Allergol Immunopathol (Madr) 2004;32(6):319-25
  6. Togawa A, Panzani RC, Garza MA, Kishikawa R,
    Goldblum RM, Midoro-Horiuti T. Identification of italian cypress (Cupressus sempervirens) pollen allergen Cup s 3 using homology and cross-reactivity. Ann Allergy Asthma Immunol 2006;97(3):336-42
  7. Midoro-Horiuti T, Togawa A, Garza M, Goldblum R.M. PR5 allergen Cup s 3. EMBL/GenBank/DDBJ databases http://www.uniprot.org/uniprot/Q69CS3 2003;July
  8. Barderas R, Villalba M, Rodriguez R. Recombinant expression, purification and cross-reactivity of chenopod profilin: rChe a 2 as a good marker for profilin sensitization.
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  9. Barletta B, Afferni C, Tinghino R, Mari A,
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  10. Schwietz LA, Goetz DW, Whisman BA, Reid MJ.
    Cross-reactivity among conifer pollens. Ann Allergy Asthma Immunol 2000;84(1):87-93
  11. Panzani R, Yasueda H, Shimizu T, Shida T.
    Cross-reactivity between the pollens of Cupressus sempervirens (common Cypress) and of Cryptomeria japonica (Japanese cedar). Ann Allergy 1986;57(1):26-30
  12. Aceituno E, Del Pozo V, Minguez A, Arrieta I, Cortegano I, et al. Molecular cloning of major allergen from Cupressus arizonica pollen: Cup a 1.
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  13. Futamura N, Kusunoki Y, Mukai Y, Shinohara K.
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  16. Bar Dayan Y, Keynan N, Waisel Y, Pick AI, Tamir R. Podocarpus gracilior and Callitris verrucosa – newly identified allergens that crossreact with Cupressus sempervirens.
    Clin Exp Allergy 1995;25(5):456-60
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    Tinghino R, et al. Rapid isolation, characterization, and glycan analysis of
    Cup a 1, the major allergen of Arizona Cypress (Cupressus arizonica) pollen.
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    Dominguez E, Sanchez Guijo P. Sensitivity to Cupressus: allergenic significance in Cordoba (Spain). J Investig Allergol Clin Immunol  1996;6(2):117-20
  19. Hugues B, Didierlaurent A, Charpin D. Cross-reactivity between cypress pollen and peach: a report of seven cases.
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    Allergens in Japanese patients with allergic conjunctivitis in autumn.
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    Viola M, Artesani MC, et al. Prevalence of sensitization to Cupressus sempervirens: a 4-year retrospective study. Sci Total Environ 2001;270(1-3):83-7
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    Spieksma F, Giouleka P, Patakas D. Allergenic pollen records (15 years) and sensitization in patients with respiratory allergy in Thessaloniki, Greece.
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As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.