Intranasal levels of lead as an exacerbation factor for allergic rhinitis in humans and mice

J Allergy Clin Immunol. 2021 Jul;148(1):139-147.e10. doi: 10.1016/j.jaci.2021.03.019. Epub 2021 Mar 23.


Background: Air pollutants are suspected to affect pathological conditions of allergic rhinitis (AR).

Objectives: After detecting Pb (375 μg/kg) in Japanese cedar pollen, the effects of intranasal exposure to Pb on symptoms of AR were investigated.

Methods: Pollen counts, subjective symptoms, and Pb levels in nasal epithelial lining fluid (ELF) were investigated in 44 patients with Japanese cedar pollinosis and 57 controls from preseason to season. Effects of intranasal exposure to Pb on symptoms were confirmed by using a mouse model of AR.

Results: Pb levels in ELF from patients were >40% higher than those in ELF from control subjects during the pollen season but not before the pollen season. Pb level in ELF was positively associated with pollen counts for the latest 4 days before visiting a hospital as well as scores of subjective symptoms. Intranasal exposure to Pb exacerbated symptoms in allergic mice, suggesting Pb as an exacerbation factor. Pb levels in ELF and nasal mucosa in Pb-exposed allergic mice were higher than those in Pb-exposed nonallergic mice, despite intranasally challenging the same amount of Pb. Because the increased Pb level in the nasal mucosa of Pb-exposed allergic mice was decreased after washing the nasal cavity, Pb on the surface of but not inside the nasal mucosa may have been a source of increased Pb level in ELF of allergic mice.

Conclusions: Increased nasal Pb level partially derived from pollen could exacerbate subjective symptoms of AR, indicating Pb as a novel hazardous air pollutant for AR.

Keywords: Air pollutant; Japanese cedar pollen; exacerbation factor; intranasal exposure; lead; seasonal allergic rhinitis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Air Pollutants / immunology*
  • Allergens / immunology*
  • Animals
  • Cryptomeria / immunology
  • Female
  • Humans
  • Lead / immunology*
  • Male
  • Mice
  • Mice, Inbred BALB C
  • Middle Aged
  • Nasal Cavity / immunology*
  • Nasal Lavage Fluid / immunology
  • Nasal Mucosa / immunology*
  • Pollen / immunology
  • Rhinitis, Allergic / immunology*
  • Rhinitis, Allergic, Seasonal / immunology
  • Seasons


  • Air Pollutants
  • Allergens
  • Lead