Natural Diversity of Grass Pollen in Europe—An EAACI Perspective
ABSTRACT Grass pollen, the most clinically relevant outdoor aeroallergen in Europe and worldwide, presents a complex challenge due to the diverse nature of its subspecies. This diversity complicates the interpretation of their contribution to the overall pollen burden during the grass pollen season and the selection of the appropriate allergen immunotherapy. Almost all species of the Pooideae subfamily share important major allergens, namely the allergens of Group 1 and 5, leading to a high level of cross‐reactivity at the IgE level. However, the presence of a multitude of additional minor allergens and species‐specific epitopes adds to the complexity. Timothy ( Phleum pratense ), previously considered the most relevant allergen source among grass species, is found during the late‐blooming grass pollen season, while symptom severity and pollen concentrations already show several peaks during the early‐blooming grass and main grass pollen seasons. Current data suggest a limited regional relevance of timothy grass during the natural grass pollen season in southern Europe from both the aerobiology and allergy perspectives. This review aims to discuss the latest evidence supporting a broad‐spectrum approach to best reflect natural grass pollen exposure in allergen immunotherapy, presenting a complex but crucial aspect of allergology.
Authors
- Petra Ursula Zieglmayer (ORCID: https://orcid.org/0000-0001-5432-9459)
- Karl‐Christian Bergmann (ORCID: https://orcid.org/0000-0002-0306-9922)
- Mattia Giovannini (ORCID: https://orcid.org/0000-0001-9568-6882)
- Markus W. Ollert (ORCID: https://orcid.org/0000-0002-8055-0103)
- Giorgio Walter Canonica (ORCID: https://orcid.org/0000-0001-8467-2557)
- Óscar Palomares (ORCID: https://orcid.org/0000-0003-4516-0369)
- Sven Becker (ORCID: https://orcid.org/0000-0003-1972-3797)
- Ludger Klimek (ORCID: https://orcid.org/0000-0002-2455-0192)
- Markus Berger (ORCID: https://orcid.org/0000-0001-8297-4412)
- Friederike Bärhold (ORCID: https://orcid.org/0009-0009-8812-916X)
- Mohamed H. Shamji (ORCID: https://orcid.org/0000-0003-3425-3463)
- Uwe Edwin Berger (ORCID: https://orcid.org/0000-0002-9265-2131)
- Stefania Arasi (ORCID: https://orcid.org/0000-0002-8135-0568)
- Carmen Rondón (ORCID: https://orcid.org/0000-0003-0976-3402)
- Jean Bousquet (ORCID: https://orcid.org/0000-0002-4061-4766)
- Jan Hagemann (ORCID: https://orcid.org/0000-0002-9846-7850)
- Marı́a José Torres (ORCID: https://orcid.org/0000-0001-5228-471X)
Institutions
- Sigmund Freud Privatuniversität Wien (AT)
- Universidad Complutense de Madrid (ES)
- Humanitas University (IT)
- Vrije Universiteit Brussel (BE)
- University of Southern Denmark (DK)
- Universität Innsbruck (AT)
- Odense University Hospital (DK)
- Humboldt-Universität zu Berlin (DE)
- Centre Hospitalier Universitaire de Montpellier (FR)
- Luxembourg Institute of Health (LU)
- ENT and Allergy (US)
- Fraunhofer Institute for Translational Medicine and Pharmacology (DE)
- Hospital Regional Universitario de Málaga (ES)
- NIHR Imperial Biomedical Research Centre (GB)
- Meyer Children's Hospital (IT)
- Wiener Krankenanstaltenverbund (AT)
- Zentrum für Rhinologie und Allergologie (DE)
- Bambino Gesù Children's Hospital (IT)
- Fraunhofer Institute for Production Systems and Design Technology (DE)
- Karl Landsteiner University of Health Sciences (AT)
- Istituti di Ricovero e Cura a Carattere Scientifico (IT)
- IRCCS Humanitas Research Hospital (IT)
- Allergiezentrum Wien West (AT)
- Instituto de Investigación Biomédica de Málaga (ES)
- University of Florence (IT)
- Imperial College London (GB)
- Freie Universität Berlin (DE)
- Charité - Universitätsmedizin Berlin (DE)
- University of Tübingen (DE)
Publication Details
- Journal
- Allergy
- Published
- 2026-10-08
- DOI
- https://doi.org/10.1111/all.70536
- Primary Topic
- Allergic Rhinitis and Sensitization
- Type
- article
- Field-Weighted Citation Impact
- 0.00