About 40% of people struggle with serious ailments caused by allergies. of the world’s population, including nearly half of Poles. Allergies are also a problem for children. In our country, nearly 30 percent. children suffer from various types of skin changes, allergic rhinitis or asthma. The list of allergens is endless. In children, inhalation allergens are a serious problem, among which common mites turn out to be particularly dangerous. Therefore, they should not be underestimated!
Allergy to dust mites
– Respiratory parameters in humans change with age, up to about 20 years of age. Therefore, in order for our children to avoid many diseases of the respiratory system, e.g. severe asthma, it is very important that pediatricians approach the health of the youngest patients carefully. We have tools that we can and should use rationally, says Prof. extra Paweł Majak, pediatrician and allergist, head of the Department of Pediatric Pulmonology at the Medical University of Lodz.
– Allergies are becoming more and more common in children – points out prof. Mayak – and one of those that require special attention is the allergy to mites. It is a year-round allergy, unique mainly due to the specific, negative mechanism of influence. Mite allergens are a whole cocktail of proteins, including enzymes that directly damage the mucosa of the respiratory tract. These allergens act as pathogenic bacteria and can trigger inflammatory processes in the body. And the more damaged the epithelium, the greater the inflammatory changes that spread as chronic inflammations. One of the leading allergy journals recently published an article explaining why mite allergen is so dangerous and why it damages the integrity of the human epithelium. The conclusion confirms our observations: dust mite allergy is not just an allergy! The sooner we recognize it and start therapy, the greater the chances that a child will not develop asthma.
In a child with asthma caused by dust mite allergy, we must take into account the increase in subsequent bacterial infections, most often requiring antibiotic therapy. Very often, such infections result in exacerbation of asthma, which is even more difficult to treat. – We must also take into account the fact – informs prof. Mayak – that allergy to mites increases with age, increasing the risk of not only bacterial but also viral infections. The infectious background, in turn, “drives” a more severe course of asthma.
Research shows that remission of asthma symptoms is possible, but mainly in children up to the age of 11 and without dust mite allergy. The lower the patient’s age, the higher the percentage of such remissions. In the 0–11 age group this percentage is 30%, in the 12–39 age group – 17,9%, and in the 36–69 age group – 5%. Environmental factors also play a role. The environmental isolation caused by the pandemic showed that only those who were not allergic to mites improved the clinical symptoms of asthma in preschool and early school age children (these are the results of one of the observations). In children allergic to mites, no positive changes in the assessment of health status in terms of asthma are observed.
– Taking into account the conclusions from recent research and observations, we can see that an effective solution that protects children against the development of asthma, especially severe asthma, is desensitization, i.e. allergen immunotherapy, e.g. using the sublingual method – emphasizes the doctor. It would be optimal to start it in the period from 5 to 10 years of age of the child. The advantage of this sublingual form of desensitization is that it can be used at home, of course under the guidance of an allergist. As of today, approximately 94 people would qualify for this simple and effective form of therapy. children and adolescents allergic to mite allergens.
In the opinion of prof. Paweł Majak, it should be remembered that “the more often we use antibiotics in a child without implementing immunotherapy, the more we lose the best time window of immunological plasticity and the possibility of modifying the course of an allergic disease, and at the same time we deepen dysbiotic processes, i.e. disturbances in the composition of the flora inhabiting the respiratory tract”.
– Persistent inflammation in the upper respiratory tract in children allergic to mites increases the risk of asthma threefold! Dust mite allergy is the strongest risk factor for asthma that will survive into adulthood with a risk of severe asthma where biological treatment is already required. The vicious cycle of recurring infections and allergies to mite allergens must be broken! – claims prof. Paweł Majak
The approaching summer is a good time to start your desensitization process calmly, which will reverse the process of worsening allergies and reduce the risk of full-blown asthma.
It is worth making sublingual immunotherapy in Poland a common method of treating allergies. It is effective in inhalation allergies: apart from house dust mites, also in allergies to plant pollen. It is a non-invasive, child-friendly method of desensitization that can be carried out at home. This is undoubtedly a great advantage, allowing for safe desensitization also during the current pandemic. Patients with allergic rhinitis, allergic conjunctivitis and a milder, controlled form of allergic asthma, occurring primarily in children and adolescents, benefit from immunotherapy.
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Press release prepared by the Journalists for Health Association based on a lecture by prof. Paweł Majak delivered during the XXVII edition of the Quo Vadis Medicina workshop, entitled “How to treat asthma in the COVID-19 pandemic?”, World Asthma Day 2021.
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