Further Reading

White Pine t16

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Code: t213
Latin name: Pinus radiata
Source material: Pollen
Family: Pinaceae
Common names: Pine tree, Monterey pine, Radiata pine
P. radiata should not to be confused with the Australian pine (Casuarina equisetifolia) t73 or White pine (Pinus strobus) t16.

Allergen Exposure

Geographical distribution
Pine tree is a common name for a family of coniferous trees, of widespread distribution in northern temperate areas. Of the 100 different species included in the genus, almost all are found in the Northern Hemisphere. P. radiata has become the most important in the Southern Hemisphere. Family members include the Douglas fir tree (Pseudotsuga taxifolia), the Spruce tree (Picea excelsa), and the White pine tree (Pinus strobus), which is native to northeastern North America. Pines can be divided into 2 groups, hard Pines and soft Pines.

The Pine tree is an evergreen reaching a height of 15-35 m, with upward-pointing branches and a rounded top. The outer bark is narrowly ridged, and the inner bark is resinous. The leaves (“needles”) are bright green, occur in clusters of 3, and are 10-15 cm long with blunt tips. They persist on the tree for approximately 3 years. Cones are 7.5-14 cm long, brown, egg-shaped, and usually set asymmetrically on a branch; they are attached at an oblique angle (1). The Pine tree can live for 90 years.

Most Pinus species flower in early summer. The male and female flowers are separate but on the same tree. Pollination occurs from January to February in the Northern Hemisphere, but may be extended due to high temperatures. The pollen count is often high, but the pollen grains are large; this is a possible reason for the low induction of sensitisation. Cones are produced annually. They may remain closed for several years, depending upon temperature and humidity.

Pines grow in a wide range of habitats, from sea level to altitudes of 2,400 m in Europe. The climate where Pine trees grow best is humid with mild temperatures year-round. The optimum soil is an acidic, deep, sandy loam with a clay layer.

To date, 5 allergenic proteins have been detected: of 82 kDa, 67 kDa, 54 kDa, 44 kDa, and 38 kDa (2).

Potential cross-reactivity

A high cross-reactivity among P. nigra, P. sylvestris, P. radiata and P. strobus has been demonstrated using ImmunoCAP® RAST inhibition (3).

IgE studies have demonstrated that pollen extracts from Olive, Birch, Mugwort, Pine, and Cypress contain proteins that share common epitopes recognisable by sera from Olive-allergic individuals (4). The possibility of cross-reactivity between Pinus and Rye grass (Lolium perenne) has also been suggested (2). Enzyme immunoassay inhibition studies have revealed that leached P. radiata pollen proteins could partially inhibit serum IgE binding to Rye grass-specific IgE. This provides preliminary evidence for allergen cross-reactivity between these 2 unrelated species (5).

Importantly, allergy to Pine nuts (P. edulis) can occur with no symptoms of sensitisation to Pine pollen. Immunoblot experiments have demonstrated the presence of IgE antibodies in serum against several components of Pine nuts and pollen, and some cross-reacting components were found. The authors of this study suggest that development of Pine pollinosis may require a longer period of exposure to allergens, but that given the cross-reactivity between Pine nut and Pine pollen extracts, co-sensitisation to these 2 allergens is possible (6).

Clinical Experience

IgE-mediated reactions
Pine tree pollen may cause asthma, allergic rhinitis and allergic conjunctivitis.

Pinus pollen allergy has been generally considered to be rare and clinically insignificant. Although Pine pollen is released in large quantities, IgE-sensitisation to it occurs in only 1.5% to 3% of atopic patients, according to studies from northern Arizona and France (7-8). This has been thought to be due to the large size of the pollen from this tree.

However, a Spanish study suggests that Pine tree pollen is a significant pollen aeroallergen and should be considered in assessment of pollen-allergic individuals. In the study, Pinus pollen (in this instance, P. pinaster and P. radiata) was shown to be among the predominant pollens in an area of Spain. The majority of patients were monosensitisated to Pinus pollen and suffered from seasonal rhinoconjunctivitis (9). The sensitising Pine pollen seemed to depend on which species of Pine tree was present in the vicinity.

In the city of Vigo, Spain, several patients have tested positive for Pinus pollen extract in skin tests, and some were monosensitive. An aerobiological study conducted in this region showed that Pinus has high quantitative importance in the airborne pollen spectrum of the city, constituting 13%-20% of the total annual pollen. Data also demonstrated that the tree has a very long pollination period, from the middle of January until May. At the end of the pollination period, there was a final increase in Pinus pollen concentrations, coinciding with the pollination of P. silvestris, which is more abundant in mountainous areas far from the city (10).

In a study in Portugal of aeroallergen sensitisation in an allergic paediatric population of 557 patients, sensitisation to P. radiata was found in 7.5% (11). Other studies have demonstrated Pinus pollen to be a significant contributor to pollen in the air. In Vinkovci, in northeastern Croatia, Pinus pollen was among the top 10 contributors of 58 pollen types studied (12). Pinus pollen has been found to be the fifth-most-prevalent pollen in the air in Plasencia, Spain (13). Similarly, in studies in Estepona, on the ”Costa del Sol” of southern Spain, Pinus pollen was found to be a significant contributor to the pollen count (14).

In an aerobiology study in Zagreb, Croatia, Pinus pollen was also reported to be a significant pollen (15). In a study in Split on the Croatian Adriatic, high pollen concentrations from the closely related genus member P. halepensis were demonstrated (16). An atmospheric survey of the east-Mediterranean coast of Turkey found that the most prominent tree pollens were Cupressaceae, Eucalyptus, and Pinus. The most common herb pollen was from the Chenopodiaceae family (17).
In an Indian study, the All India Coordinated Project on Aeroallergens and Human Health, undertaken to evaluate the prevalence of aeroallergens at 18 different centres in the country, it was found that Pinus pollen was among the predominant airborne pollens (18).

In contrast to the rarity of sensitisation from Pine pollen, workers processing Pine in sawmills showed a very high frequency of IgE sensitisation to the extract of Pine wood dust. This frequency was significantly greater than that of the sensitisation to Oak in workers processing Oak (19). Airborne allergic contact dermatitis from Pine dust has been documented (20).

Occupational asthma, lung function deficits, and elevated levels of respiratory symptoms may occur in workers exposed to wood dust, but these symptoms may not necessarily be IgE-mediated, as other naturally occurring substances in Pine trees may be operative (21). Reactions to these substances may be either IgE-mediated or irritant in nature.

In a study of Pine sawmill workers, results showed that exposure to green Pine sawdust may be a risk factor for atopy. Both green and dry dust were associated with obstructive as well as restrictive pulmonary effects (22).

Other reactions
Colophony (or rosin), usually derived from Pine trees, is a complex mixture of over 100 compounds and has many domestic, industrial and commercial applications. Exposure to colophony and modified colophony is common, though not as common as previously, because of replacement of the substance by plastics in many instances. Allergic reactions are usually of the delayed type. Colophony is, in particular, among the top 10 causes of contact dermatitis (23), and among the most common causes of occupational asthma (24).

Allergic reactions to a caterpillar (Thaumetopoea pityocampa) have been documented among occasional visitors to Pine tree plantations, and in particular among Pine forest workers. Dermatitis and ocular lesions may occur through an IgE, mechanical or toxic route. Allergists should take this insect into consideration when evaluating adverse reactions to Pine tree (25).

Allergic alveolitis from Pine sawdust has been reported (26).

In a study of workers in the Danish furniture industry, sensitisation to Pine wood dust was demonstrated with Pine-specific IgE tests in 11 exposed and 3 non-exposed subjects. In the group with clinically defined asthma, 8 (5.4%) individuals were shown to have Pine-specific IgE, compared with 6 (1.8%) in the group without asthma. In the groups with and without respiratory symptoms, 13 (3.8%) and 1 (0.7%) subjects, respectively, had Pine-specific IgE (27).

Compiled by Dr Harris Steinman,


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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.