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Spring brings us warmer days, more sun, lots of greenery and lots of flowers, and thus – increased production of endorphins by the body and better well-being. Unfortunately, he also generously gives us pollen from plants that cause allergy symptoms in every tenth person who comes into contact with them. Learn about the most common allergic disease of the respiratory system – seasonal allergic rhinitis, often called pollinosis due to the cause (allergic to pollen of grasses, trees and weeds).
One inhalation for allergy – pollinosis
Pollinosis is an allergy to pollen from wind-pollinating plants. Symptoms of this disease are noted quite often, especially in the group of young people. – Among 6-7-year-olds, we observe an increasing increase in the incidence. Children aged 3-4 years also suffer from this disease more and more often – says Dr. Zygmunt Nowacki, MD, an allergologist, specialist in children’s diseases, lecturer at the Polish Society for Combating Allergic Diseases. – The symptoms of allergic rhinitis in a young child are often only a stuffy nose and / or periodic leakage of mucous secretions. Symptoms in this group differ significantly from those typical for older children and adults, therefore we also pay attention to the following symptoms: allergic salute (a characteristic way of rubbing the nose), facial grimaces, nasal blistering, wrinkles and dark circles around the eyes, snoring. At the same time, the frequent viral infections and adenoid hypertrophy at this age overlap with the symptoms of allergy make it difficult to diagnose only the symptoms of allergic rhinitis in young children – adds the doctor. Symptoms are noted in 10-20% of the population of developed countries, where environmental contamination is much higher. It turns out that compounds such as carbon monoxide, nitrogen oxides or sulfur dioxide irritate the mucous membranes of the respiratory tract and damage the coating of pollen grains, which makes pollen more allergenic and easier. Also, good hygienic conditions and a properly balanced diet make infectious infections rare in Western countries. In this situation, the immune system has nothing to fight against. As “enemies”, he begins to treat in fact harmless factors (allergens), such as pollen from plants, attacking them “just in case”. As a result, there is an immediate allergic reaction. The first time it comes into contact with pollen, the body produces specific IgE antibodies. Upon repeated contact, IgE antibodies present on the surface and in the mucosa of the nose, conjunctiva or bronchi combine with the allergen, stimulating the mast cells of the mucous membranes to release inflammatory mediators – e.g. histamine, serotonin, leukotrients, prostaglandins. They are responsible for the strong irritation of the mucous membranes, and as a result – allergy symptoms in a child or an adult.
Allergy oh that’s you! Pollen allergy – symptoms
Histamine released from mast cells stimulates peripheral sensory nerves, causing sneezing attacks. This and other inflammatory mediators also lead to the appearance of a profuse and watery discharge from the nose, known as hay fever (in this case also known as pollen rhinitis – ANNp). Everything is accompanied by nasal blockage, a noticeable effect of the swelling of the mucosa and persistent itching. Although the nasal symptoms of pollinosis are the most common, they are not the only ones. Patients may also suffer from allergic conjunctivitis (itching, burning and redness of the conjunctiva, watery eyes and swelling of the eyelids), pollen asthma (paroxysmal dry cough) or skin problems (urticaria, angioedema, exacerbated course of atopic dermatitis). – Patients may also develop Oral Allergy Syndrome (OAS), most often after eating raw fruit and / or vegetables in people who are allergic to pollen of grasses, trees (especially birch) or weeds (especially mugwort). This syndrome is characterized by itching, burning, tingling, swelling of the lips and / or the palate and / or the tongue. One should also be aware of the risk of systemic symptoms and even an anaphylactic reaction. Patients suffering from bronchial asthma at the same time are most at risk – explains Zygmunt Nowacki, MD, PhD. A characteristic feature of all these symptoms is the seasonality of their occurrence – coupled with the pollen season of the sensitizing plant. So far, the most effective method of combating them are the new generation antihistamines, such as bilastine, which eliminate the negative effects of histamine and block its biological activity. Due to the fact that this substance has an affinity only for the histamine H1 receptor, the side effects of the therapy are minimal, and the drug is safe and effective. Bilastine is especially recommended due to its fast (maximum plasma concentration achieved 1,3 hours after administration) and long-term (up to 24 hours) action and wide application (nasal, ocular and skin pollinosis symptoms).
The trees shot pollen – why are they allergic?
About 100 plant species (belonging to wind-pollinated, common and producing large amounts of pollen containing a component that stimulates the human body to produce IgE antibodies) have allergenic properties. They are particularly expansive on warm and windy days (the symptoms of asthma are favored by rainfall). It is possible to be allergic to pollen of grasses and trees (mainly deciduous, less coniferous), cereals or weeds. Their pollen is invisible to the eyes. It is difficult to see an object with a diameter of approximately 17 to 58 micrometers (one thousandth of a millimeter). In general, pollen grains perform a reproductive function. However, apart from the male genetic material, they also contain substances (proteins and glycoproteins) signaling the mutual relations between the pollen and the female inflorescence. Some of them, unfortunately, cause hypersensitivity in people. Pollen is deposited on the nasal mucosa and on the conjunctiva. There they burst, and the allergens released from them cause allergy symptoms. – Among the plant allergens in our climate zone, the most common cause of allergic reactions are pollen from grasses, birch and mugwort. Probably their “success” in allergy reactions is related to the pollen duration, prevalence and size. In other climatic zones, they most often sensitize those wind-pollinating plants that have the longest pollen season and are very widespread. – indicates the doctor. However, they do not sensitize insect-pollinated plants. Their pollen is too heavy and easily sticks to the legs of insects. Only people exposed to long-term contact with flowers – working in florists, plantations or greenhouses – are at increased risk of allergies.
And when May, June comes … – what when it dusts?
If the patient is allergic to pollen, the symptoms may become visible during the pollen season of the allergenic plant. Pollen enters the atmosphere in four phases – from early spring to autumn. The highest and most dangerous pollen concentration is about 51-100 pollen grains per 1 m3 air. In the first phase – from February to mid-May – the amount of pollen from angiosperm trees such as birch, oak, hazel, alder, poplar and willow increases in the air. Interestingly, these trees emit pollen before the leaves grow. In this way, they make it easier for them to move around. In the second stage of pollen – from mid-May to the end of June – they are pollinating, among others fir and pine. Although pine pollen is slightly allergic (it is covered with a wax coating, preventing its dissolution and direct contact of the allergen with the mucosa), it is harmful to us in a different way. By settling in the respiratory tract, it damages the lining of the mucosa, which predisposes to allergic reactions to grass and weed pollen. The allergy to grass pollen most often manifests itself from the end of May to mid-July (the third pollen phase). At this time, grains also begin their dusting activity. The pollen season of weeds generally falls on the fourth pollen phase – from mid-July to the end of September. You should also remember about the possibility of the so-called cross allergy. Some of the proteins present in plant pollen are chemically similar to the food allergens in some fruits and vegetables. If the antigens (allergens) have identical (or very similarly structured) elements (epitopes), IgE antibodies probably will not recognize differences in their structure. They then ‘wrong’ and attack all similar proteins. – Such reactions are unfortunately encountered more and more often. They usually concern adolescents and adults. However, these types of allergy symptoms in a child are also numerous cases. However, you should not limit or eliminate vegetables and fruits from your toddler’s diet “just in case”. If you experience symptoms of Oral Allergy Syndrome (OAS), then only then should the fruit or vegetable be avoided. Consuming them cooked does not usually cause a reaction – concludes the allergist.
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.