EAACI过敏与哮喘环境科学指南——减轻花粉暴露对呼吸道过敏影响的基于证据的预防和公共卫生行动建议
2026/06/30
摘要
本EAACI指南采用GRADE方法制定，为过敏性鼻炎（AR）和哮喘的花粉减少/避免策略的有效性、监测花粉诱发哮喘的生物标志物的效用以及缓解措施和公共卫生策略的效率提供基于证据的建议。系统综述、叙述性综述和卫生经济分析支持这些建议。根据GRADE，证据的确定性为中等至极低，因此提供条件性建议，以指导医疗专业人员、患者和政策制定者制定个性化、预防性和可扩展的干预措施。应建议减少/避免花粉暴露以降低严重哮喘加重的风险。肺功能下降和呼出一氧化氮增加可能预测花粉诱发的哮喘加重。实时花粉监测和基于花粉浓度的预测可能被推荐用于管理花粉诱发的过敏性鼻炎和/或哮喘。应在花粉信息系统中包含污染物信息。结合天气、花粉和污染物的综合预测及预警系统可能减轻雷暴哮喘（TA）的影响。应在花粉季节和雷暴哮喘期间加强急诊科/哮喘相关服务。日常实践中需要涵盖花粉类型、致敏潜力、协同致敏物及每位患者易感性的个性化框架。应进一步优先考虑预防的根本作用。
EAACI Guidelines on Environmental Science for Allergy and Asthma-Evidence-Based Recommendations for Prevention and Public Health Action to Mitigate the Impact of Pollen Exposure on Respiratory Allergy
Lorenzo Cecchi, Isabella Annesi-Maesano, Benedetta Biagioni, Kian Fan Chung, Bernard Clot, Gennaro D'Amato, Athanasios Damialis, Stefano Del Giacco, Javier Dominguez-Ortega, Carmen Galán, Stefanie Gilles, Stephen Holgate, Mohamed Jeebhay, Stelios Kazadzis, Kari Nadeau, Nikolaos G Papadopoulos , Santiago Quirce, Joaquin Sastre, Claudia Traidl-Hoffmann, Fiona Tummon, Jolanta Walusiak-Skorupa, Magdalena Zemelka-Wiacek, Marek Jutel, Cezmi A Akdis, Ioana Agache
Abstract
Developed using the GRADE methodology, these EAACI guidelines provide evidence-based recommendations on the effectiveness of pollen reduction/avoidance strategies for allergic rhinitis (AR) and asthma, the utility of biomarkers for monitoring pollen-induced asthma and the efficiency of mitigation measures and of public health strategies. Systematic and narrative reviews and health economic analysis support the recommendations. According to GRADE, the certainty of evidence was moderate to very low, therefore conditional recommendations are provided to guide healthcare professionals, patients, and policymakers in developing personalized, preventive, and scalable interventions. Reducing/avoiding exposure to pollen should be recommended to reduce the risk of severe asthma exacerbations. Lung function decrease and exhaled nitric oxide increase may be predictive for pollen-induced asthma exacerbations. Real-time pollen monitoring and pollen concentration-based forecast may be recommended for managing pollen-induced AR and/or asthma. Pollutant information should be included in pollen information systems. Combined forecast (weather, pollen, pollutants) and warning systems might reduce the impact of thunderstorm asthma (TA). Emergency department/asthma-related services should be strengthened during pollen season and in TA. Personalized frameworks covering the types and allergenic potential of pollen, the coaggressors and the vulnerability of each patient are needed in daily practice. The fundamental role of prevention should be further prioritized.
本EAACI指南采用GRADE方法制定，为过敏性鼻炎（AR）和哮喘的花粉减少/避免策略的有效性、监测花粉诱发哮喘的生物标志物的效用以及缓解措施和公共卫生策略的效率提供基于证据的建议。系统综述、叙述性综述和卫生经济分析支持这些建议。根据GRADE，证据的确定性为中等至极低，因此提供条件性建议，以指导医疗专业人员、患者和政策制定者制定个性化、预防性和可扩展的干预措施。应建议减少/避免花粉暴露以降低严重哮喘加重的风险。肺功能下降和呼出一氧化氮增加可能预测花粉诱发的哮喘加重。实时花粉监测和基于花粉浓度的预测可能被推荐用于管理花粉诱发的过敏性鼻炎和/或哮喘。应在花粉信息系统中包含污染物信息。结合天气、花粉和污染物的综合预测及预警系统可能减轻雷暴哮喘（TA）的影响。应在花粉季节和雷暴哮喘期间加强急诊科/哮喘相关服务。日常实践中需要涵盖花粉类型、致敏潜力、协同致敏物及每位患者易感性的个性化框架。应进一步优先考虑预防的根本作用。
（北京朝阳医院呼吸与危重症医学科 顾宪民 摘译 中日友好医院呼吸与危重症医学科 林江涛 审校）
（Allergy. 2026 Jun 26. doi: 10.1111/all.70423. Online ahead of print.）
（Allergy. 2026 Jun 26. doi: 10.1111/all.70423. Online ahead of print.）
EAACI Guidelines on Environmental Science for Allergy and Asthma-Evidence-Based Recommendations for Prevention and Public Health Action to Mitigate the Impact of Pollen Exposure on Respiratory Allergy
Lorenzo Cecchi, Isabella Annesi-Maesano, Benedetta Biagioni, Kian Fan Chung, Bernard Clot, Gennaro D'Amato, Athanasios Damialis, Stefano Del Giacco, Javier Dominguez-Ortega, Carmen Galán, Stefanie Gilles, Stephen Holgate, Mohamed Jeebhay, Stelios Kazadzis, Kari Nadeau, Nikolaos G Papadopoulos , Santiago Quirce, Joaquin Sastre, Claudia Traidl-Hoffmann, Fiona Tummon, Jolanta Walusiak-Skorupa, Magdalena Zemelka-Wiacek, Marek Jutel, Cezmi A Akdis, Ioana Agache
Abstract
Developed using the GRADE methodology, these EAACI guidelines provide evidence-based recommendations on the effectiveness of pollen reduction/avoidance strategies for allergic rhinitis (AR) and asthma, the utility of biomarkers for monitoring pollen-induced asthma and the efficiency of mitigation measures and of public health strategies. Systematic and narrative reviews and health economic analysis support the recommendations. According to GRADE, the certainty of evidence was moderate to very low, therefore conditional recommendations are provided to guide healthcare professionals, patients, and policymakers in developing personalized, preventive, and scalable interventions. Reducing/avoiding exposure to pollen should be recommended to reduce the risk of severe asthma exacerbations. Lung function decrease and exhaled nitric oxide increase may be predictive for pollen-induced asthma exacerbations. Real-time pollen monitoring and pollen concentration-based forecast may be recommended for managing pollen-induced AR and/or asthma. Pollutant information should be included in pollen information systems. Combined forecast (weather, pollen, pollutants) and warning systems might reduce the impact of thunderstorm asthma (TA). Emergency department/asthma-related services should be strengthened during pollen season and in TA. Personalized frameworks covering the types and allergenic potential of pollen, the coaggressors and the vulnerability of each patient are needed in daily practice. The fundamental role of prevention should be further prioritized.
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气候变化背景下高温、花粉与大气污染对变应性鼻炎及哮喘的协同效应：一项为期20年的时间序列研究
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