It would seem that there is still a long six months before the plants begin to flower and hay fever develops, but allergists recommend starting examination and treatment now. Here’s how they explain why it is necessary to look for the cause of hay fever and fight pollen allergies in the fall:

To identify the causative allergen that causes hay fever and bronchial asthma, specific diagnostics are carried out – the so-called “allergy tests». 

Allergy tests must be carried out outside of exacerbation of an allergic disease. If we are talking about seasonal pollen allergies (hay fever, hay fever), then the examination should begin at a time when there is no active flowering of plants and the air is clear of pollen. During the period of activation of the allergic reaction, allergy tests may be insufficiently reliable or completely negative. However, if the problem is “all-season” in nature, then the examination can be carried out at any time of the year, waiting until the acute inflammatory symptoms subside.

The causative factors for the development of hay fever are 3 main groups of allergenic plants: 

  • woody plants, 
  • cereal plants and herbs, 
  • weeds. 

These groups of plants have different flowering periods, so patients note an exacerbation of hay fever at different periods of time: 

  • the first peak of incidence – in the spring – is associated with tree pollen (late March or April – late May). The most common allergies are to pollen from birch, oak, hazel, alder, maple, and ash.
  • The second peak in the incidence of hay fever occurs in early June and lasts until the end of July. It is associated with the flowering of such cereals as timothy, meadow fescue, cocksfoot, wheatgrass, meadow grass, corn and rye.
  • The third rise in incidence occurs in mid-July – early September. Symptoms of hay fever during this period are caused by weeds such as quinoa, ragweed, wormwood, and also sunflower.

In mid-September, or earlier in cool weather, the plants begin to bloom and the symptoms of hay fever subside. The most favorable time is coming for allergy diagnostics and initiation of specific treatment.

Who is indicated for allergy tests:

  • All patients with seasonal allergic rhinitis, sinusitis, conjunctivitis, bronchial asthma;
  • All patients in whom the doctor suspects the allergic nature of chronic rhinitis, rhinosinusitis and/or conjunctivitis;
  • If you are allergic to unspecified foods and medications;
  • For allergic dermatitis with an unknown provoking factor.

Why are allergy tests performed?

In order to draw up an effective plan for individual prevention and treatment of an allergic disease, such as allergic rhinitis, conjunctivitis or bronchial asthma, an allergist must have information about the allergens that provoke the development of the disease in a particular patient.

What methods of treatment and prevention of seasonal exacerbations of hay fever can be recommended to patients after allergy diagnosis?

1). To reduce the severity of seasonal exacerbations of hay fever, an allergist recommends patients an individual prevention plan, which includes:

  • Teaching the patient about prevention techniques (reducing the concentration of pollen in the house, refusing to ventilate during the flowering season of causative plants, using air conditioners, humidifiers and air purifiers, using water vacuum cleaners for cleaning);
  • Planning a vacation during the flowering season with travel to a different climate zone;
  • Limiting exposure to the open air in sunny, windy weather;
  • A diet excluding foods that are cross-allergic to causative pollen allergens;
  • Exclusion of herbal medicine;
  • Postponement of preventive vaccination and planned operations to a period when there are no flowering plants that cause an allergic reaction in the patient.

2). For drug therapy during the period of exacerbation of hay fever, the following are usually used:

  • Various antihistamines;
  • Local vasoconstrictor and anti-inflammatory treatment (drops in the nose, in the eyes);
  • Bronchodilators and anti-inflammatory drugs in the form of inhalers to prevent and relieve attacks of bronchial asthma;
  • Ointments and gels that protect the nasal mucosa from pollen allergens.

3). Allergen-specific immunotherapy to prevent seasonal exacerbations or reduce the severity of such exacerbations is carried out outside the flowering season of plants.

What allergy tests and allergy studies are used in our clinic:

  • Laboratory tests (blood tests) to determine the level of group and specific antibodies (immunoglobulins) to panels of allergens;
  • Skin tests: patch (skin) tests; prick tests and skin prick tests;
  • Provocative tests in cases where laboratory and skin tests contradict each other or do not provide complete clarity;

You cannot perform more than 12-15 skin tests during one visit. The most reliable results can be obtained by combining laboratory diagnostics and skin allergy tests.

Can allergy tests be wrong?

Allergy tests are a reliable method of identifying the causes of allergic reactions, which is why this diagnostic method is called the “gold standard”. Can allergy diagnostic results be inaccurate? In rare cases they can, and here’s why:

  • Violation of the technology for conducting allergy tests: improper storage of the allergen solution, non-compliance with the research technique;
  • Reduced skin reactivity while taking antihistamines and some other drugs, as well as against the background of concomitant diseases;
  • Reduced skin reactivity against the background of an existing focus of allergic inflammation;

Sometimes positive allergy tests are observed in the absence of a clinical picture of an allergic disease. The reason for this may be either a hidden (latent) allergy or a nonspecific reactivity of the body.

Allergists, taking into account the rare possibility of both false-positive and false-negative results, always recommend conducting a comprehensive diagnosis and confirming the results of skin allergy tests with laboratory methods for identifying specific antibodies to allergens in the patient’s blood.

Are there any contraindications to allergy tests?

In order for allergy tests to be as accurate as possible and not cause harm to the patient’s health, they should be carried out during a period when there is no:

  • exacerbation of allergic disease;
  • acute infectious, including viral, diseases;
  • exacerbation of any chronic disease;
  • intensive treatment for concomitant diseases;
  • pregnancy and lactation;
  • acute reaction to known allergens in the past;
  • anamnestic indications of anaphylactic shock, toxicoderma (Lyell or Stevens-Johnson syndrome);
  • no treatment with antihistamines or glucocorticoids;

What is allergen-specific immunotherapy or specific allergen vaccination?

The method of allergen-specific immunotherapy dates back more than 100 years; it was first used in 1911 to treat seasonal allergic rhinitis. Since then, in various modifications, it has been used for decades, showing the highest effectiveness in the treatment of all forms of hay fever.

Currently, methods based on the introduction of ultra-low doses of an allergen into the patient’s body are called differently:

  • SIT – specific immunotherapy;
  • ASIT – allergen-specific immunotherapy;
  • specific desensitization;
  • specific hyposensitization;
  • allergen immunotherapy;
  • allergy vaccination.

Essentially, all these terms are synonymous. The principle of the immunovaccination method is the introduction into the patient’s body of a solution of an allergen to which allergic sensitivity has been identified. Treatment begins with the smallest doses, increasing the concentration of the solution with each subsequent administration. As a result, it is possible to achieve a decrease in sensitivity to the allergen and, as a result, alleviation of the clinical picture of the allergic disease until complete recovery. It is believed that timely initiation of SIT (ASIT), even in 1-2 courses, prevents the disease from progressing to a severe form, expanding the range of causative allergens, and carrying out a full allergy vaccination program can reverse the disease for many years.

Currently, specialists use various SIT (ASIT) schemes and methods of allergen administration. An individual choice is always made by a doctor during a face-to-face appointment.

In fact, SIT is the only method of treating allergic diseases that is aimed at the cause of the allergic reaction, without suppressing the perverted immune response, as conventional drugs do, but directing it back to normal.

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