Goosefoot, Lamb’s quarters
Summary
Goosefoot (Chenopodium album) is a wind-pollinated, annual plant that usually grows to a height of around 0.1-1.5 m. The pollination period of this plant typically initiates from July and extends till September. A goosefoot plant can produce around 20,000 pollen grains in a season. This plant is prevalently found in brush burns, cultivated fields, desert grasslands, juniper-pine forests, overgrazed lands, and logged openings. This species (Chenopodium album) is claimed to originate from Eurasia; however, it is presently naturalized all over North America. The pollen from this plant can induce allergic conditions such as conjunctivitis, allergic rhinitis, and asthma. Goosefoot weed pollen allergens Che a 1, Che a 2, and Che a 3 have been identified and listed in the IUIS database. Goosefoot pollen exhibits cross-reactivity with other members of the Chenopodiaceae family, alder, birch pollen, black locust, lilac, sugar beet, timothy grass, and olive.
Epidemiology
Worldwide distribution
The goosefoot (Lamb’s quarters) has been found to be a moderate producer of weed pollen. Specifically, in the United States (US), this plant has been found to be a significant trigger of allergic rhinitis (hay fever). Additionally, this weed is also claimed to be a crucial airborne allergen in mid-Europe.
A Spain-based study conducted on 362 children has reported positive skin prick test (SPT) towards Chenopodium album (goosefoot) in 10.2% of children.
A cross-sectional study conducted in Iran on 972 allergic patients reported chronic urticaria in 67, atopic dermatitis in 129, asthma in 224, and allergic rhinitis in 624 patients. Lamb’s quarters (goosefoot) was claimed to be one of the common aeroallergens to trigger sensitization, with a positive SPT of 50.7% among the tested population.
A study conducted in China on 7148 patients with allergic rhinitis (self-reported) has reported 81.5% (5080/7148) as the prevalence of sensitization towards goosefoot allergen among the study population.
Route Of Exposure
Main
The route of exposure for goosefoot (Lamb’s quarters) weed pollen is through inhalation.
Clinical Relevance
Pollen from wind-pollinated plants like Chenopodium album (goosefoot, Lamb’s quarters) has been observed to be one of the critical contributors of IgE-mediated Type I allergic conditions like asthma, allergic rhinitis, and conjunctivitis.
Allergic rhinitis (AR) and allergic rhino-conjunctivitis (ARC)
A cross-sectional study in Iran conducted on 567 allergic rhinitis patients reported a significant (p=0.035) prevalence of positive SPT towards Chenopodium album (goosefoot) in 9.6% of patients with intermittent (mild, moderate-severe) AR and 90.4% of patients with persistent (mild, moderate-severe) AR.
A China-based study conducted on 406 allergic rhinitis patients (with confirmed SPT towards aeroallergen) reported 61.6% of patients to exhibit positive SPT towards Chenopodium.
A study conducted on 179 pollen-sensitized patients (9 to 69 years) in Spain reported rhino-conjunctivitis in 29% of patients and 70% of the patients with both asthma and rhino-conjunctivitis. SPT -mediated sensitization profile revealed 65.9% (118/179) of the study population to be sensitive towards Chenopodium album (goosefoot).
Asthma
An Iran-based cross-sectional study conducted on 187 asthmatic patients reported a significant (p=0.003) correlation between sensitivity towards Chenopodium album (goosefoot) pollen and asthma severity.
A cross-sectional retrospective study was conducted on 100 asthmatic children in Saudi Arabia. The incidence of positive SPT towards Chenopodium album (goosefoot, Lamb’s quarters) pollen was reported as 23%.
Oral Allergy Syndrome (OAS)
As per a study, pollen allergic patients with positive SPT towards Chenopodium album (goosefoot, Lamb’s quarters) pollen also reported OAS (symptoms like laryngeal edema, pharyngitis, swelling of throat, tongue, and lips, hoarseness, oral pruritus) towards fresh fruits like peach, melon, and banana.
Prevention And Therapy
Prevention strategies
Avoidance
One of the main measures is to reduce the pollen amount in the respiratory system. During pollen season, allergic patients are suggested to stay indoors or wear a mask outdoors to keep away from pollen allergens. In worsening conditions, patients may be recommended to move or live in a pollen-free area.
Cross-Reactivity
Studies have reported strong cross-reactivity between members of the Chenopodiaceae family.
High cross-reactivity among polcalcin proteins from Chenopodium album (goosefoot, Lamb’s quarters), olive, timothy grass, lilac pollens have been reported.
Che a 2 (profilin) and Che a 3 (polcalcin) are claimed to demonstrate extensive cross-reactivity with corresponding proteins (profilin and polcalcin) found in olive pollens due to the presence of conserved amino acid sequences.
Extensive cross-reactivity between Che a 1 (Chenopodium album, goosefoot) and Sal k 5 (Salsola Kali) has been reported in a study.
Chenopodium album (goosefoot) pollen has been found to be cross-reactive with Robinia pseudoacacia (Black Locust) pollen.
Che a 2, profilin protein from Chenopodium album (goosefoot) pollen, has been claimed to be cross-reactive with Beta vulgaris (sugar beet) pollens.
Che a 3 (a polcalcin protein) from Chenopodium album (goosefoot) pollen possesses sequence identity and exhibits strong cross-reactivity with other polcalcin proteins (allergens) like Aln g 4 (Alder; 89%), Ole e 3 (Olive; 89%), and Bet v 4 (Birch; 90%). Additionally, Che a 3 was also reported to be cross-reactive to polcalcin from grass pollen (Phl p 7).
References
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