Monitoring, distribution and clinical relevance of airborne pollen and fern spores in Southeast Asia - A systematic review.

Southeast Asia is witnessing a rapid increase in the prevalence of allergic diseases, including asthma and allergic rhinitis. Pollen grains stand out as one of the primary triggers for allergy, and monitoring aeroallergens plays a pivotal role in allergy prevention. However, our understanding of the diversity and abundance of allergenic pollen in tropical regions, as well as their clinical significance, remains limited. This review aims to address this issue by identifying the most potentially allergenic plants in Southeast Asia, examining sensitization rates to their pollen allergens, describing the dynamics of pollen seasons, and discussing the current state of aerobiological monitoring in the region. The selection of plants was conducted through a systematic review process (following PRISMA guidelines), by screening the Scopus and PubMed databases, and focusing on studies that provided clinical and aerobiological data. As a result, 73 studies related to pollen allergy in Southeast Asia were identified and reviewed. The list of potentially allergenic plants posing the highest risk in Southeast Asia has been narrowed down to 10, including 5 woody species, 2 primarily weed families, grasses, palms, and ferns. The descriptions of these plants are supplemented with information on their ecology, pollen seasons dynamics, and clinical significance.