Inhalation allergy A to Z 

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Spring! A warmer wind blows, nature is bursting with green, and we have eyes full of tears and we do not part with a handkerchief? It is by no means simply emotional awakening of nature, but most likely hay fever and allergic conjunctivitis – the main symptoms of inhalation allergy. What is she? How is it treated? And how to live with her? We explain below.

Allergy from… air

Allergy, or an excessive, abnormal reaction of the body to an essentially harmless environmental factor called allergens, can arise from a variety of causes. Some are sensitized by food (food allergy), others by chemical compounds after direct contact with the skin (contact allergy), and others – by everything that enters the body through the respiratory tract (inhalation allergy). Statistics show that over the last 15-20 years the number of allergy sufferers has doubled, and inhaled allergy sufferers account for the majority of them. Air pollution, climate change, environmental conditions, active and passive smoking and genetic factors are the main culprits behind asthma and allergies – diseases known to mankind for over 2000 years. – There is also the so-called hygienic theory of allergy development. As a result of comparing the frequency of allergic diseases in East and West Germany, as well as in Poland and Sweden, it was noticed that the percentage of patients was higher in more developed countries. Hence the conclusion that the lack of exposure to infectious agents as a result of excessive cleanliness of living conditions favors the transition of certain cells towards allergies, explains Dr. Zygmunt Nowacki, MD, an allergologist, specialist in children’s diseases, lecturer at the Polish Society for Combating Allergic Diseases. – Still, it has not been explained why allergy has become a disease of civilization – he adds.

Inhale and… allergy

The group of inhalation allergens includes house dust mites, epidermis and animal hair, as well as cockroach and fungus allergens, and plant pollen. – Pollen grains are male reproductive cells necessary for the reproduction of seed plants. Insect pollinators, i.e. flower species, produce little of them, which makes them non-allergenic. On the other hand, wind-pollinated species are the main cause of ailments – explains the allergist. They are recognized by the immune system as potentially dangerous and trigger a response to eliminate them, which damages the tissues and initiates the disease process. In inhalation allergy it is manifested by allergic rhinitis (watery discharge, nasal congestion, sneezing), allergic conjunctivitis (eye inflammation, tearing and itching), headache, sleep disturbance, concentration problems and fatigue. Contaminated city air, rich in nitrogen and sulfur compounds, favors their occurrence, because these substances weaken the immunity, irritate the mucosa and, consequently, make it easier for allergens to penetrate it. – Weather conditions also influence the presence of pollen in the atmosphere. On clear and windy days, their concentration is high, and rain cleans the air of pollen, which brings relief to allergic people, says the doctor.

What turns us on, what makes us allergic

The risk of exacerbation of symptoms in inhalation allergies increases especially in the spring and summer period. Every now and then a tree, grass or fungus is dusted, which is precisely reported in the plant pollen calendar developed by regional aerobiological monitoring stations. The early spring pollination period begins at the end of February with willow, hazel and alder dusting. The late spring period – from April to May – is marked by birch, poplar, beech, oak and pine. The third period – summer – lasts even from mid-May to mid-July and is dominated by grass and cereal dusting, mainly cocksfoot, panicle, timothy, raigrass, as well as wheat and rye. In the fourth period, that is late summer or autumn – lasting from mid-July to the end of September – weeds such as mugwort, quinoa and nettle or plantain plantain dominate. – Conifer pollen does not play a large role in allergology, although some believe that pine pollen has a sort of promoting effect, i.e. by damaging the nasal mucosa, pine pollen promotes, i.e. allows easier penetration of other pollen through the damaged mucosa – concludes Dr. Zygmunt, MD, PhD. Nowacki.

The doctor will tell you the truth

The basis of allergy diagnostics is an interview with the patient and recognition of symptoms. In practice, individual diagnostic decisions adapted to the symptoms present should always be used. Among them stand out, among others diagnosis of the IgE mechanism by skin prick test (SPT). It is the most commonly used test to diagnose an allergic reaction and is performed in patients of all ages. – In young children, i.e. under 2 years of age, their value is limited due to low levels of IgE antibodies and difficulties in their implementation – emphasizes the allergist. Skin tests are used to check if there are IgE antibodies in the skin that react to the individual tested allergens. On the other hand, sIgE (allergen-specific IgE) tests are a method of checking whether the blood contains IgE antibodies reacting to the allergens used in the tests. – These methods are almost equal in effectiveness. An undoubted advantage in favor of skin tests is the low price, but their drawbacks include pain – points out Dr. Zygmunt Nowacki, MD, PhD.

Allergy? It heals!

If an allergy is diagnosed, the doctor may order desensitization (specific immunotherapy) – a method of treating the causal allergic diseases. It makes it possible to inhibit the allergy process by gradually adapting the system to the allergen through a treatment with the use of a vaccine. – This method, however, has some limitations, and therefore the qualification for immunotherapy should be carried out by an allergist – emphasizes the doctor. At the same time, patients are recommended to use second-generation antihistamines, containing e.g. bilastine – a substance approved for use in the EU in 2010. This preparation effectively eliminates eye symptoms (itching, tearing, redness) and nasal symptoms (sneezing, itching, watery discharge) ) in case of inhalation allergy in the first day after administration. Bilastine in a dose of 20 mg within about 1 hour also inhibits almost 90% of the formation of bubbles and redness in response to histamine – the mediator in the inflammatory process – and the disappearance of an allergic reaction after its administration is comprehensive and permanent (up to 24 hours). Moreover, this substance, being an inverse agonist of the histamine H1 receptor and not binding to the receptors of other amines and peptides, shows a high safety profile (negligible side effects) and tolerance in therapy.

The ABC of Doing the Right Thing

However, medical therapy is not enough. Every allergy sufferer should be aware that by implementing appropriate rules of conduct in everyday life, it can significantly reduce persistence and the occurrence of symptoms. Enough:

1.Reduce the number of rugs, blankets, stuffed animals or curtains that can accumulate dust. / allergy to dust mites /

2. take care of cleanliness and regular airing of rooms, change bedding. / allergy to dust mites /

3. avoid walks in forests and meadows in the period of increased pollen. / pollen allergy /

4. Avoid taking walks on warm, sunny and windy days. / pollen allergy /

5. ventilate the rooms after rain, when the pollen concentration decreases. / pollen allergy /

6 close windows / air intake while driving. / pollen allergy /

7. cover mouth and nose with a mask when working in the garden / on the balcony. / pollen allergy /

8. change clothes, rinse nose and wash face / hands after a walk. / pollen allergy /

9. avoid cigarette smoke and perfumes that may aggravate allergy symptoms. / pollen allergy /

10. avoid staying in damp and warm rooms. / allergy to fungal spores /

* Dr. Zygmunt Nowacki, MD, PhD – specialist in children’s diseases, allergist, lecturer at the Polish Society for Combating Allergic Diseases. Author of many guides on the principles of diagnosis and prevention of allergic diseases.