The topic of allergies and allergies is most often associated with children’s problems. Indeed, for many people, allergic diseases often begin in childhood, and their various forms accompany them throughout their lives. However, it should be remembered that allergic reactions can occur at any age in people who have never been diagnosed with any allergies.
People most susceptible to the development of various types of allergies are the so-called atopics. These are people with an inborn tendency to overproduce IgE antibodies against specific allergens. Healthy people, who are not atopic, show full tolerance to it when they come into contact with a specific allergen, e.g. cat’s hair. Atopic individuals, when exposed to an exemplary cat’s hair, produce a large amount of IgE antibodies directed against cat hair antigens. At this stage, they have no symptoms of the disease, but there is a constantly increasing number of IgE antibodies in their blood. Repeated exposure to the allergen causes an increase in the antibody titer and at a certain stage, after another contact with the cat’s hair, symptoms of an allergic disease appear: runny nose, cough, watery eyes. Then the atopic turns into an allergy sufferer. On the basis of his innate predisposition to produce an excessive number of IgE antibodies, i.e. atopy, a disease with its pathological symptoms, i.e. allergy, develops. Since atopy is an inborn trait, often passed on from parents to children, these people usually begin to get sick in childhood, and problems with various types of allergies persist throughout their lives, sometimes taking the form of very serious conditions such as asthma.
However, allergies may also appear in people who do not show signs of atopy, basically at any stage of life. This also applies to pregnant women, although the influence of pregnancy on the course of allergic diseases has not been fully investigated. Pregnancy itself can exacerbate and alleviate the course of allergic diseases. This is the case, for example, in the case of allergy to Hymenoptera venom, allergy to latex or drug reactions. The mechanism of disease development is similar – as a result of repeated exposure to an allergen, the body begins to recognize it as dangerous and develops a hypersensitivity reaction in which the main mediators are IgE antibodies directed against the allergen. The first contact with the substance does not cause symptoms. Each subsequent exposure and further stimulation of the immune system to produce antibodies causes the development of disease symptoms.
For example, the symptoms of insect venom allergy are common in beekeepers and their family members repeatedly bitten by bees. Initially, they show typical local symptoms. However, after exceeding a certain critical number of bites, they develop an allergy that can potentially be life-threatening. It is known that the bites of Hymenoptera (mainly bees, wasps and hornets in Poland) are one of the main causes of anaphylactic reactions. The problem is that it is impossible to tell how many bites in what time will cause an allergy in a given person. The predisposition to this type of reaction is variable and very individual. In all cases, however, the disease develops as a result of repeated exposure to a specific substance.
It is known that not only the frequency of exposure matters, but also the dose of the allergen to which we are exposed. Very small doses of the allergen are most often ignored by our immune system, very large doses of the allergen somehow “deafen” our immune system and induce tolerance, while medium doses usually cause the production of IgE antibodies. Therefore, an allergic disease appears as a result of several factors: our individual predisposition as well as the strength and frequency of exposure to a given allergen. These reactions remain largely unpredictable, and the mechanisms behind them are still not fully understood and involve very complex interactions between cells in our immune system. This fact also makes them difficult to prevent. So, the only thing that remains is the diagnosis of allergies and their treatment.
Allergological diagnosis is often a tedious and complicated process. This is due to the limitations of the available diagnostic methods. The diagnosis is based on a carefully collected interview from the patient, and additional tests only confirm that the symptoms reported by the patient are an allergic reaction. Unfortunately, there are no tests to predict the occurrence of an allergic reaction in a person who had no previous allergic symptoms. In case of doubt, it is possible to carry out provocation tests, in which – to protect the patient against a possible serious allergic reaction – the substance suspected of causing symptoms (e.g. medicine, food) is administered in a controlled manner.
Treatment of allergic diseases is mainly symptomatic treatment. Ideally, the symptoms that can be achieved by stopping exposure to the allergen causing them are eliminated. Unfortunately, very often it is impossible to remove the exposure to the substance that causes the symptoms, and the drugs used at that time are intended to reduce the nuisance. These are mainly antihistamines, in situations of very severe symptoms, steroids are also used. Attempts are also made to “desensitize”, that is, to tolerate the allergen that was causing the symptoms of the disease. However, this treatment is limited to a few selected allergens and is very time-consuming, and its effects usually take several years.
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