Why are seasonal allergies getting worse. How does climate change affect pollen levels. What are the most effective treatments for allergic rhinitis. How can you reduce exposure to allergens at home. When should you see an allergist for your symptoms.

Understanding Seasonal Allergies: Causes and Mechanisms

Seasonal allergies, also known as allergic rhinitis or hay fever, affect millions of people worldwide. These allergies occur when the immune system overreacts to harmless substances in the environment, such as pollen from trees, grasses, and weeds. To fully grasp the impact of seasonal allergies, it’s crucial to understand their underlying mechanisms.

The Immune System’s Role in Allergic Reactions

How does the immune system contribute to allergic reactions? When an allergen enters the body, the immune system mistakenly identifies it as a threat. In response, it produces antibodies called Immunoglobulin E (IgE). These antibodies attach to specific cells, causing them to release chemicals like histamine. It’s these chemicals that trigger the all-too-familiar allergy symptoms: sneezing, itching, congestion, and watery eyes.

Common Allergens in Different Seasons

Which allergens are most prevalent during specific seasons? Here’s a breakdown:

• Spring: Tree pollen (oak, birch, elm, maple)
• Summer: Grass pollen
• Fall: Weed pollen (ragweed, sagebrush)
• Year-round: Mold spores, dust mites, pet dander

The Rising Tide of Seasonal Allergies: Factors Behind the Increase

Recent years have seen a significant uptick in the severity and duration of seasonal allergies. Several factors contribute to this trend, making life increasingly challenging for allergy sufferers.

Climate Change and Its Impact on Pollen Production

How does climate change affect seasonal allergies? Rising temperatures and altered precipitation patterns have a profound impact on plant behavior and pollen production:

• Extended growing seasons lead to longer periods of pollen production
• Warmer temperatures stimulate increased pollen output from plants
• Higher CO2 levels can boost pollen production in some species
• Changing rainfall patterns affect plant growth and pollen dispersal

These climate-related changes result in higher pollen concentrations and longer allergy seasons, exacerbating symptoms for many individuals.

Urban Development and Reduced Biodiversity

Urban expansion and loss of natural habitats contribute to the allergy problem in several ways:

1. Increased planting of allergenic species in urban landscapes
2. Reduced biodiversity, leading to less varied pollen exposure
3. Creation of urban heat islands, which can extend pollen seasons
4. Increased air pollution, which can interact with pollen and worsen allergic reactions

Recognizing Seasonal Allergy Symptoms: Beyond the Sneezes

While most people associate seasonal allergies with sneezing and a runny nose, the range of symptoms can be quite diverse. Recognizing these symptoms is crucial for proper diagnosis and treatment.

Common Symptoms of Seasonal Allergies

What are the telltale signs of seasonal allergies? Here’s a comprehensive list:

• Sneezing and runny nose
• Nasal congestion
• Itchy or watery eyes
• Itchy throat or ears
• Postnasal drip
• Coughing
• Fatigue
• Headaches
• Dark circles under the eyes (allergic shiners)

Distinguishing Allergies from Other Conditions

How can you tell if your symptoms are due to allergies or another condition? Here are some key distinctions:

• Allergies typically don’t cause fever, unlike colds or flu
• Allergy symptoms often worsen when exposed to triggers (e.g., going outdoors)
• Allergies can last for weeks or months, while colds usually resolve within 7-10 days
• Allergy symptoms tend to come on suddenly when exposed to allergens

Effective Management Strategies for Seasonal Allergies

While seasonal allergies can be challenging to manage, various strategies can help alleviate symptoms and improve quality of life for sufferers.

Medications for Allergy Relief

What are the most effective medications for managing seasonal allergies? Here’s an overview of common options:

1. Antihistamines: Block histamine, reducing sneezing, itching, and runny nose
2. Decongestants: Relieve nasal congestion (use with caution due to potential side effects)
3. Nasal corticosteroids: Reduce inflammation in the nasal passages
4. Leukotriene modifiers: Block substances that cause allergy symptoms
5. Eye drops: Relieve itchy, watery eyes
6. Nasal sprays: Provide localized relief for nasal symptoms

It’s important to consult with a healthcare provider to determine the most appropriate medication regimen for your specific symptoms and medical history.

Natural Remedies and Lifestyle Changes

Are there natural ways to alleviate allergy symptoms? While not a substitute for medical treatment, some natural remedies and lifestyle changes may offer relief:

• Nasal irrigation with saline solution to flush out allergens
• Local honey consumption (may help build tolerance to local pollen)
• Essential oils like peppermint or eucalyptus for congestion relief
• Acupuncture (some studies suggest potential benefits)
• Stress reduction techniques (stress can exacerbate allergy symptoms)
• Regular exercise to boost overall immune function

Minimizing Allergen Exposure: Prevention Strategies

Reducing exposure to allergens is a crucial component of managing seasonal allergies. By implementing certain strategies, you can significantly decrease your contact with allergy triggers.

Indoor Allergen Control

How can you reduce allergens in your home environment? Consider these effective methods:

• Use high-efficiency particulate air (HEPA) filters in your home
• Keep windows closed during high pollen days
• Vacuum regularly using a vacuum with a HEPA filter
• Wash bedding in hot water weekly
• Use allergen-proof covers for mattresses and pillows
• Keep indoor humidity below 50% to prevent mold growth
• Bathe pets regularly if you’re allergic to pet dander

Outdoor Allergen Avoidance

What steps can you take to minimize allergen exposure when outdoors? Try these strategies:

1. Check pollen forecasts and plan outdoor activities accordingly
2. Wear sunglasses to protect your eyes from airborne pollen
3. Use a pollen mask when doing yard work
4. Avoid going outside during peak pollen times (usually early morning and late afternoon)
5. Change clothes and shower after spending time outdoors
6. Keep car windows closed while driving

The Role of Immunotherapy in Long-Term Allergy Management

For individuals with severe or persistent allergies, immunotherapy can offer a long-term solution by modifying the immune system’s response to allergens.

Allergy Shots (Subcutaneous Immunotherapy)

How do allergy shots work to reduce allergy symptoms? This form of immunotherapy involves regular injections of small amounts of allergens over time. The process typically follows these steps:

1. Build-up phase: Increasing doses of allergens are administered weekly
2. Maintenance phase: Once the effective dose is reached, injections are given less frequently
3. Long-term effects: Over time, the immune system becomes less sensitive to the allergens

Allergy shots can be effective for a wide range of allergies, including pollen, dust mites, and pet dander.

Sublingual Immunotherapy (SLIT)

What is sublingual immunotherapy, and how does it differ from allergy shots? SLIT involves placing drops or tablets containing allergen extracts under the tongue. Key points about SLIT include:

• Can be self-administered at home
• May be preferred by those who dislike injections
• Currently FDA-approved for certain grass and ragweed allergies
• Requires daily administration for several months to years

When to Seek Professional Help: Consulting an Allergist

While many people can manage seasonal allergies with over-the-counter treatments, there are situations where professional medical advice is necessary.

Signs You Should See an Allergist

When should you consider consulting an allergist for your allergy symptoms? Look out for these indicators:

• Symptoms significantly impact your quality of life
• Over-the-counter medications are ineffective or cause side effects
• You experience allergic asthma symptoms
• You’re unsure of your specific allergen triggers
• You have frequent sinus infections or ear infections
• You want to explore immunotherapy options

What to Expect During an Allergy Evaluation

What happens during a visit to an allergist? A typical allergy evaluation may include:

1. Detailed medical history and symptom review
2. Physical examination
3. Skin prick tests or blood tests to identify specific allergens
4. Lung function tests if asthma is suspected
5. Discussion of treatment options and management strategies

An allergist can provide a comprehensive treatment plan tailored to your specific needs and allergen sensitivities.

The Future of Allergy Treatment: Emerging Therapies and Research

As our understanding of allergies deepens, new treatment approaches and technologies are being developed to provide more effective relief for allergy sufferers.

Biologics and Targeted Therapies

How are biologics changing the landscape of allergy treatment? These innovative medications target specific components of the allergic response:

• Anti-IgE therapies: Block the antibodies responsible for allergic reactions
• Interleukin inhibitors: Target specific inflammatory pathways
• Personalized treatments based on individual immune profiles

While currently used primarily for severe allergic conditions, these therapies may become more widely available for seasonal allergies in the future.

Advances in Immunotherapy

What new developments are occurring in immunotherapy? Researchers are exploring several promising avenues:

1. Epicutaneous immunotherapy: Delivering allergens through skin patches
2. DNA vaccines: Targeting the genetic basis of allergic responses
3. Combination therapies: Pairing immunotherapy with other treatments for enhanced efficacy
4. Faster up-dosing protocols: Reducing the time required to reach maintenance doses

These advancements aim to make immunotherapy more effective, convenient, and accessible to a broader range of allergy sufferers.

Living with Seasonal Allergies: Coping Strategies and Support

Managing seasonal allergies extends beyond medical treatments. Developing effective coping strategies and seeking support can significantly improve quality of life for allergy sufferers.

Emotional and Psychological Impact

How do seasonal allergies affect mental health and well-being? Chronic allergy symptoms can lead to:

• Decreased productivity at work or school
• Sleep disturbances and fatigue
• Mood changes, including irritability and depression
• Social isolation during peak allergy seasons
• Anxiety about outdoor activities or travel

Recognizing these impacts is the first step in developing strategies to address them.

Building a Support Network

What resources are available for allergy sufferers seeking support? Consider these options:

1. Join online forums or support groups for allergy sufferers
2. Educate friends and family about your allergy needs
3. Connect with local allergy awareness organizations
4. Explore workplace accommodations if allergies impact your job performance
5. Consider counseling if allergies significantly affect your mental health

Building a strong support network can provide both practical assistance and emotional support in managing seasonal allergies.

Seasonal Allergies and Climate Change: Preparing for the Future

As climate change continues to influence pollen production and allergy seasons, it’s crucial to consider long-term strategies for managing seasonal allergies.

Adapting to Changing Allergy Seasons

How can individuals and communities prepare for evolving allergy patterns? Consider these approaches:

• Stay informed about local pollen forecasts and trends
• Be prepared to start allergy treatments earlier in the season
• Consider year-round allergy management strategies
• Support urban planning initiatives that prioritize low-allergen landscaping
• Advocate for policies that address climate change and air quality

The Role of Research and Public Health Initiatives

What efforts are being made to address the growing impact of seasonal allergies? Key areas of focus include:

1. Improved pollen monitoring and forecasting systems
2. Research into climate-resilient, low-allergen plant varieties
3. Development of more effective and targeted allergy treatments
4. Public education campaigns on allergy prevention and management
5. Integration of allergy considerations into urban planning and healthcare policies

By staying informed and engaged with these initiatives, individuals can play a role in shaping a future that better accommodates those with seasonal allergies.

No, You’re Not Imagining It: Seasonal Allergies Are Getting Worse | BU Today

One reason for the spike in seasonal allergies in recent years? Drier springs and summers mean less rain to tamp down airborne pollen. Photo by Freestocks/Unsplash

Seasonal Allergies

School of Medicine’s Fred Little on reasons for the spikes and what you can do about it

April 27, 2023

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It’s that time of year again—you’re sitting outdoors enjoying the sunshine, when all of a sudden, you start to feel…itchy. Within an hour, that itch has turned into a full-blown sneeze attack complete with watery eyes and congestion, and now you’re running to the nearest pharmacy to buy some Zyrtec.

Seasonal allergies—or an allergic reaction to the tree and grass pollens that float around in the spring and summer, known as allergic rhinitis—affect nearly 60 million people in the United States every year. In recent years, they’ve become particularly bad in the Northeast, which can largely be attributed to climate change, says longtime allergist Fred Little, a Boston University Chobanian & Avedisian School of Medicine clinical associate professor of medicine and the director of the Boston Medical Center allergy-immunology fellowship. And this year, record-high pollen counts have caused seasonal allergies to start even earlier than usual—which means prolonged symptoms for allergy-sufferers.

We spoke with Little about how allergies work and what you can do to cut down on the sneezing, itching, and watery eyes.

Q&A

with Fred Little

BU Today: So, what are allergies, exactly?

Little: Allergies are an abnormal immune response to normally harmless substances that are in the environment. Allergies aren’t like other diseases, such as cystic fibrosis or sickle cell anemia, where there’s a very strong hereditary [component]. Allergies are a mix of heredity and environment. 

What’s basically involved [for nonfood allergies] is that one becomes exposed to allergens in the environments that are part of normal day-to-day living. These harmless proteins—like cat dander and pollen—are seen by the immune system as a threat, which leads to an immune response where certain immune cells are activated and release substances that cause congestion in the nose. That can also lead to sneezing from histamine release in other cells and excessive mucus production in the conducting airways. And there are other cells which release mediators that cause narrowing of the airways beyond what excess mucus does, which is what leads to the symptoms of wheeze and asthma for people that have allergic asthma. 

Allergic responses can develop in adulthood as well as in childhood. We often see patients at Boston Medical Center who grew up in a different ecological environment from the Northeast and may not have had problems with allergies when they were younger. But two or three years after arriving here, their immune system gets primed to start developing that maladaptive response. Over time, that can lead to symptoms of hay fever—the technical term is allergic rhinitis—like sinus inflammation or asthmatic symptoms. So, that’s a general background of how people can be susceptible to developing sensitization to allergens.

BU Today: Why have seasonal allergies been so bad lately?

Little: There are several things that contribute to allergy symptoms being worse in recent years. For one, I think people are wearing masks a lot less compared to previous allergy seasons. Masks obviously provide a little bit of protection from being exposed to allergens outdoors and indoors. 

Last year, the grass pollen counts also started to climb a little earlier in the season than usual. People who are allergic to grass pollen started having symptoms earlier than before. That’s related to climate change, as well as things that contribute to more pollen generation in general (like a warm, wet spring that helps plants grow). I’m not a climate scientist so I can’t get into the nitty-gritty science, but certainly, over the last 20 years, there have been longer pollen seasons throughout the temperate climates of the United States. Warmth is definitely a factor; if it’s warmer—and warmer longer and earlier on—before and during allergy season, that particular area is going to have more pollen production. Drought and dryness is also a factor: dryness during allergy season increases pollen levels just because rain cuts down on airborne pollen.  

One interesting tidbit: pine pollen—the yellow pollen you see on cars and in storm drains—is not actually as allergenic as pollen that comes from deciduous, or leafy, trees, like birch, maple, and oak. People may have a perception that the pollen levels are terrible because they see yellow stuff all over the place, but that doesn’t necessarily correlate with the pollen that is the most allergenic.

BU Today: What can people do to decrease their pollen exposure?

Little: Unlike somebody with a food allergy, who can control their exposure to that food, it’s very hard to control exposure to pollens, as they’re so pervasive. Even indoors: as we come in and out of our houses, we wear the clothes we were wearing outdoors and bring pollens into the house. There are some things that can be done to minimize pollen levels in the house. For one, if you have the resources, keep windows closed during the night and day and use air conditioners to keep the air cool. 

For people with really bad allergies to pollens, they might want to change out of their outside clothes when they come inside and wash them [as soon as possible]. That can be helpful for people who have severe allergies (or live with someone who does) and want to keep the house as pollen-free as possible. But no house or apartment is airtight, so it can be hard to keep the outdoor environment from coming indoors.

BU Today: What about allergy medications? Are there any tips or tricks to remember?

Little: From a medical standpoint, there are medications that people can get used to. A good example is topical decongestants like Afrin [nasal spray]. The active ingredient in those is oxymetazoline, a decongestant that causes blood vessels to constrict [in the nasal passages]. You know, you have a really bad cold and you do a few squirts and you can breathe better. But, those shouldn’t be used for more than three days at a time. After that, there can be a rebound effect where the nasal tissues themselves become accustomed to the spray and almost dependent on it. You can actually end up worse off than you were at the beginning. 

Instead, a mainstay treatment [for congestion] is nasal steroid sprays like Flonase or Rhinocort, which are available both over the counter and by prescription. They can, however, take two or three weeks to kick in and have the maximal effect. If someone uses a spray for a week without noticing a difference in symptoms, it’s not because it’s not working anymore. It’s because nasal steroids take a longer time to modify the abnormal immune response.

An interesting tidbit for allergy sufferers in New England is that our tree pollen season starts before our local trees are even producing pollen. It’s because of all the leafy trees up and down the Eastern Seaboard that pollinate earlier than ours do and send pollen up the jet stream. I’ll often have patients start their nasal sprays in mid-March to prime the pump, so to speak, for immune protection against tree pollen.

Then there are things like antihistamines, which work in a day or two after taking them. There are many patients with mild hay fever symptoms who do fine with just taking Zyrtec or fexofenadine or loratadine once or twice a day. Others with more severe symptoms, particularly nasal congestion, won’t be helped much by antihistamines alone and will need something like a nasal steroid to help control that.

BU Today: One last question: How can you tell the difference between allergies and COVID-19?

Little: The truth is, it can be very difficult to differentiate allergy symptoms from mild COVID symptoms during allergy season. The main differentiators are that people with allergies should not have a fever, and certainly not the high fever that you can get with COVID, nor experience the fatigue that’s associated with COVID. We do have to remember that people who have allergic asthma can also develop respiratory symptoms during their allergy season, which can make it a little bit harder to differentiate. But people with asthma are usually familiar with their asthma symptoms and should be able to tell them apart from COVID-19 pneumonia symptoms.

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High pollen count: Why are my allergies so bad right now?

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 — 

Pollen has exploded to eye-watering levels this spring in some parts of the country after warm weather pushed plants out of their winter slumber much earlier than normal.

In Atlanta, the pollen count sky rocketed to “extremely high” in early March and stayed high through much of April, according to the Atlanta Allergy and Asthma physicians practice. Farther north in Washington, DC, allergy sufferers have been dreading the lime-green film of pollen covering that covers windshields and porches and piles up on streets and sidewalks.

But these aren’t isolated trends. As the planet warms, researchers say allergy season is starting earlier and lasting longer. And a study from the journal Nature published last year found that pollen count is projected to increase by 200% by the end of the century if planet-warming pollution continues to rise.

Climate Central, a nonprofit focused on climate news and research, recently analyzed how warmer temperatures have affected allergy season in 203 US cities since 1970.

It found that on average, the growing season – the period between the last freeze in spring to the first freeze of fall – is lasting 16 days longer in the Southeast, 15 days longer in the Northeast and 14 days longer in the South.

In the West, growing season is 27 days longer on average, Climate Central reported. Reno, Nevada, for example, has seen a shocking increase of 99 days.

And a longer growing season means a longer allergy season.

Growing season in the US has lengthened by 15 days on average, according to a Climate Central analysis.

Climate Central

“Because of climate change, we’re now seeing an earlier and longer growing season for plants, which of course make pollen, which is the enemy of many Americans that suffer from pollen allergies – and mold allergies as well,” Lauren Casey, a meteorologist with Climate Central, told CNN. “Pollen can also trigger an asthma attack, which of course is much more serious for people that suffer from asthma.”

When plants reproduce, typically during the spring, many release tiny pollen grains that are carried by wind. The pollen grains are small enough to be inhaled, and some people’s immune systems react very poorly to the miniscule particles.

More than 24 million people in the US have pollen-induced respiratory allergies like hay fever, according to the Centers for Disease Control and Prevention. The center’s data shows that more than one in four adults suffered from seasonal allergies in 2021.

Growing season has lengthened by 34 days in Atlanta, according to a Climate Central analysis.

Climate Central

Growing season has lengthened by 20 days in Washington, DC, according to a Climate Central analysis.

Climate Central

A longer and earlier start to pollen season could trigger a public health emergency, researchers say. As temperatures get warmer in the South and drought plagues the Southwest, pollen from plants like ragweed or poaceae – a plant that typically grows in grasslands or salt-marshes – is projected to be higher across those regions than in the North.

Wind-driven pollen, which plays an important role in plant fertilization, is closely tied to temperature and precipitation changes. So, as spring seasons get warmer earlier due to climate change, plants could pollinate much earlier and for a longer period of time than they currently do.

Plant pollen isn’t the only trigger of seasonal allergies. Mold, a type of fungi that reproduces with tiny airborne spores, can also be allergenic for some people and can exacerbate seasonal allergies, according to the report.

While outdoor mold is not as well-studied as pollen, according to the report, one thing is clear: Warmer and wetter weather – conditions that many locations are seeing more of amid the climate crisis – is favorable for mold development.

Adobe Stock

Allergy season will start much earlier than normal and be far more intense because of climate crisis, study suggests

“With climate change, we’re seeing increases in warming in all seasons, but particularly the fastest warming season for most locations across the US is the winter season,” Casey said. “So now we’re dealing with mold at a time of year that we typically wouldn’t.”

Casey also pointed out that the climate crisis is making extreme precipitation more likely, which provides that crucial dampness for mold to grow. The report highlights the link between allergens and thunderstorms, which researchers say spread pollen and mold spores through the air more efficiently.

“The problem with pollen grains is that when they get wet, they rupture, and they break into tinier bits called sub-pollen particles,” Casey said. “Those tinier bits are more easily dispersed by the wind when they dry out, and they have an easier time getting into your nasal passages.”

Oak trees are pumping out pollen in the Southeast, contributing to extremely high levels early in the season.

Andrei Zhigaltsov/iStockphoto/Getty Images

Dr. Mitchell Grayson, chair of the Asthma and Allergy Foundation of America’s Medical Scientific Council and chief of the division of allergy and immunology at Nationwide Children’s Hospital, said he has seen pollen allergies arrive earlier than usual.

“In general, we may be seeing people a little earlier in the spring with symptoms – so mid-February from what might have been early March in the past – but there is significant year-to-year variability in this,” he told CNN. “I haven’t seen worse symptoms, but I’m in a hospital that provides specialist care, and we do see people with all ranges of severity.”

CNN Weather

After a record warm February, winter cold is returning

The treatment of allergies won’t change even as the season gets longer, Grayson said. But it’s important to be aware of what you’re allergic to and know where these triggers are in the environment.

Experts recommend:

• Staying indoors, especially early in the morning or late in the afternoon, when most plants release pollen.
• Wear masks outdoors when possible to mitigate the effects, Amiji said.
• Keeping windows closed in your home and car to minimize your exposure to pollen particles.
• Changing air filters more frequently for your A/C and heating systems in your home and car, according to the manufacturer’s instructions.
• Preparing early by stocking up on anti-allergy medications. If you use a steroid nasal spray, Grayson said it’s important to start using it one to two weeks before your allergy season and to continue through the full season.

Casey, the meteorologist, also noted that allergy season could be a financial burden on low-income families, especially those whose members have asthma, due to the “billions of dollars spent a year on the medical costs of asthma and allergies. ”

She said awareness is key, especially as the world pumps more carbon pollution into the atmosphere, which could worsen allergy seasons.

“You know your own body and are aware of what a typical year is going to look like for you, especially if you’re an allergy sufferer,” she said. “But that whole paradigm is changing with this increase in the growing season, so having awareness that you may be suffering now and going forward in times of the year when you typically wouldn’t, so be prepared for that in your daily life.”

Correction: A photo previously included in this article incorrectly identified a plant as ragweed. The image has been removed.

Read online “Allergy” by Alexei Svetlov – Litres

Introduction

Hello, dear readers!

I am glad that you have my next book in your hands. Until now, in my books in the No Incurable Diseases series, I have told you about how to deal with diseases that occur in adults. But as a pediatrician, parents very often turn to me for various tips on treating diseases in babies, so I decided to devote several books to children’s health.

So, this time we will talk about allergies.

Many of us have children. We take care of them, we try to do everything so that they are healthy. After all, it was not without reason that one of the great ones said: “Children are the flowers of life.” We know every mole on a child’s body, every pimple. And we are immediately alarmed by the appearance of some redness, scratching.

The question arises: “Is this an allergy?”.

What is an allergy?

We hear this word so often, but what exactly is meant by it, many do not understand.

Let me tell you a little about allergic diseases and how they manifest themselves in children, what to do if your child has an allergy.

Part I

The concept of allergies

CHAPTER 1

TALK ABOUT ALLERGY

Some 30-35 years ago, allergies seemed irrelevant and of little danger. Now it has reached such threatening proportions (especially in industrialized countries) that it has become one of the main problems of modern medicine. All over the world there is an increase not only in the frequency, but also in the complexity of allergic diseases. Almost every day, we encounter drug and food intolerances and unusual reactions to chemicals in our home and professional environment, including synthetic clothing, jewelry, cosmetics, and more. The development of medicine (the discovery of new antibiotics, sulfonamides, a number of antiseptics) has significantly reduced the number of diseases, many infectious diseases have ceased to be fatal. Others came to the fore, including allergic ones, which depend mainly not on microbes, but on changes in the reactivity of the human body. After all, the basis of allergic diseases is precisely the altered hypersensitivity to a certain substance called an allergen.

First, let’s talk about allergens, the mechanisms of allergy development and the main allergic reactions.

Allergens

Allergens can be various compounds from simple chemicals (bromine, chromium, iodine) to the most complex ones (proteins, polysaccharides) or combinations of these or others. Some enter the body from the outside (exogenous), others are formed in the body itself (autogenous) . Exogenous allergens of non-infectious origin include: household dust, wool, animal dander, drugs, chemicals, plant pollen, animal and plant products, viruses, fungi and their metabolic products, mold. Once in the body, exogenous allergens can cause damage to various organs and systems. Exogenous allergens are divided into the following groups.

Biological allergens

Biological allergens – microbes, viruses, fungi, mold, helminths, serum and vaccine preparations.

The development of many infectious diseases (brucellosis, leprosy, tuberculosis, typhoid fever) is accompanied by allergies.

Such an allergy is called infectious, and a group of diseases caused by microbes is called fungi, or infectious viruses. Often, microbes and fungi, usually found on the skin or in the oral cavity, respiratory tract and intestines, lead to their development. The source of allergies are also foci of infection in the body – carious teeth, inflammation of the paranasal sinuses, cholecystitis and other inflammatory processes. Serums and vaccines injected into the body can cause an allergic reaction – anaphylaxis. Allergy in helminthiases develops in connection with the absorption of decay products and metabolism of helminths.

Drug allergens

Almost any drug can cause an allergic reaction. Thus, complications in the use of codeine are 1.5%, aspirin – 1.9%, sulfonamides – 6.7%, penicillin – up to 16%. Allergic complications that occur in response to the introduction of novocaine, vitamin B ₁ and many other drugs are not uncommon. The frequency of allergic reactions depends on how often and in what quantities the drugs are used. During the period of widespread use of sulfonamides, allergic reactions to them were noted more often than recently, when their use has somewhat decreased. Due to the significant spread of antibiotics, it is they, and primarily penicillin, that most often cause allergic reactions. The frequency of complications increases as the course of treatment is repeated. Penicillin is more likely than other drugs to cause severe allergic reactions, and the dose that causes the reaction can be very small. It must be remembered that taking any medication without a doctor’s prescription is extremely dangerous!

Household allergens

House dust, particles from carpets, clothes, bed linen play the main role among household allergens; fungi on the walls of damp rooms; particles of domestic insects (bugs, cockroaches, bed mites). This group also includes the so-called epidermal allergens – hair, wool, animal dander. Often the allergen is the daphnia crustacean, which serves as food for fish. In recent years, the number of allergic reactions to household chemicals, especially to washing powders, has increased. Household allergens most often cause respiratory diseases (bronchial asthma).

Pollen allergens

Allergic diseases often occur when pollen from wind-pollinated plants that does not exceed 35 microns in diameter enters the body. It causes a runny nose, conjunctivitis and other manifestations of hay fever (allergic diseases). Ambrosia weed pollen, molds that live on the walls of the bathroom, kitchen, and porches have very strong allergenic properties.

Let’s get acquainted with the most common allergic plants and the timing of their flowering.

Table 1. Average flowering time of some allergenic plants

Food allergens

Almost all foods can be food allergens. More often than others cause allergies milk, eggs, meat, fish, crayfish, tomatoes,

citrus fruits, strawberries, strawberries, chocolate. When allergens enter the body through the gastrointestinal tract, a food allergy occurs. If the allergen has entered the gastrointestinal tract in a different way, then such a lesion is called a gastrointestinal allergy. For example, an allergen that enters the body through the mucous membrane of the respiratory tract can cause an allergic reaction in any part of the gastrointestinal tract, the reaction develops very quickly.

For example, if you are allergic to milk, within a few minutes after taking it, vomiting, diarrhea, and a little later, other symptoms (urticaria, fever, itching) appear. Sometimes the first symptoms appear only after a certain period of time. Usually, food allergies develop against the background of disorders of the gastrointestinal tract. In children, overfeeding contributes to its development; often food allergens cause diathesis (exudative-catarrhal) in them. Intolerance to certain foods is not always associated with an allergic reaction. It may be due to a lack of certain enzymes in the digestive juices, which leads to indigestion of food and disorders similar to food allergies.

Industrial allergens

The rapid development of the chemical industry has led to a significant increase in the use of various substances in production and at home, which led to the occurrence of allergic reactions of various nature, mainly in the form of skin lesions – occupational allergic contact dermatitis. Industrial allergens can be: turpentine, mineral oil, nickel, chromium, arsenic, tar, tannins, naphthol and other dyes, varnishes, insectofungicides. Also substances containing bakelite, formalin, urea, epoxy resins, detergents, aminobenzenes, quinoline derivatives, chlorobenzene and many others. In hairdressing and beauty parlors, hair dyes can be allergens; in darkrooms – metol, hydroquinone, bromine compounds.

Physical allergens

A special group of allergens are physical allergens – heat, cold, mechanical irritation. It is believed that in many cases, under the influence of these factors, certain substances are formed in the body that become allergens.

Autoallergy

Autoallergy is an increased and altered ability of the body to respond to its own proteins of tissue cells that become allergens (endoallergens).

The emergence of the doctrine of autoallergy as one of the mechanisms of the development of the disease is associated with the name of the Russian physiologist-scientist IP Mechnikov.

A distinction is made between natural and acquired endoallergens.

Natural endoallergens include some proteins of normal tissues (brain, lens). Acquired – these are body proteins that have acquired alien (allergic) properties during burns, radiation sickness, other processes, as well as when combined with bacterial toxins, drugs. The body is able to distinguish “its” proteins from foreign ones. Under normal conditions, there is resistance to the body’s own components, and body tissues are not damaged, i.e., sensitized lymphocytes and antibodies (autoantibodies) are not formed against them. The essence of this process lies in the fact that the action of protective mechanisms is directed against their own tissues. If the damaging effect of the mechanisms on the tissue becomes sufficiently pronounced, the process turns into an autoallergic disease. These diseases include: hemolytic anemia, myasthenia gravis (severe muscle weakness), rheumatoid arthritis, glomerulonephritis. It is also suggested that autoallergens are involved in the development of rheumatism, ulcerative colitis, and in some cases bronchial asthma.

Allergy mechanism

Even in ancient times, Hippocrates, Avicenna, Galen described cases of intolerance to certain foods, leading to gastrointestinal disorders and urticaria. Allergies have haunted humanity since ancient times, but in the present there are much more allergens due to the deteriorating environmental situation and the abundance of household, food and industrial chemicals.

What is an allergy and why does it occur

Allergy – is a process that occurs in the human body against the background of exposure to an allergen (foreign substance) and is accompanied by tissue damage and the development of inflammation.

It is well known that the body’s immune system protects human health from a wide variety of infections and other external influences. In the body, all people, without exception, produce protective proteins – immunoglobulins of several types (A, M, G, E). Immunoglobulins E involved in allergic reactions are usually not produced too much (for example, they are needed to destroy worms).

But it turns out that absolutely all people react to various external stimuli (house dust, household and industrial chemicals, animal hair, plant pollen and mold) by increasing the amount of immunoglobulins E in the blood.

This need is of a protective nature: immunoglobulins E act as watchdogs, rushing at a stranger, and most do not cause any external manifestations.

But when a lot of immunoglobulin E is produced in the body, allergic reactions that are well known to us all occur.

How it happens

development of inflammatory symptoms. Histamine is released from mast cells, and allergy sufferers experience swelling of the places where the allergen has entered, itching, rash, and discharge, for example, from the nose. A protective biological function arises – the vessels expand and other active blood cells are attracted to the affected area, which also release substances that destroy foreign proteins.

Immunoglobulins are specific when they react only to a certain irritant, for example, plant pollen or some food product (eggs, chocolate).

In order to form antibodies in the body, allergens must satisfy two conditions: they must be large enough to be antigenic, i.e. provoke the production of antibodies, and they must be large enough to pass through the epidermis of the skin, the epithelium of the respiratory tract and the gastrointestinal tract, molecular weight from 40,000 to 50,000 (?).

For the occurrence of a clinical picture (a set of signs of the disease, its manifestations, characteristics) of an allergic reaction, at least 2 contacts of the body with the allergen are required. Upon contact with the first dose (small), the body seems to get acquainted with a foreign substance. The second dose of exposure – a large (permissive) – is accompanied by the development of clinical manifestations of an allergic reaction. Allergic reactions of the immediate type can occur within a few seconds or minutes, or 5-6 hours after repeated contact of the body with the allergen. In some cases, a long-term existence of the allergen in the body is possible. In this regard, it is almost impossible to draw a clear line between the impact of the first, sensitizing, and repeated, resolving, doses of the allergen.

Causes of allergies

Doctors are unanimous that one of the main causes of allergic reactions is certain malfunctions in the gastrointestinal tract. If a child develops dysbacteriosis due to taking antibiotics and other drugs, then large protein allergen molecules (normally they are digested to constituent amino acids and lose their allergenic properties) enter the bloodstream. Then the body begins to respond to the invasion of uninvited strangers with various and sometimes excessive reactions from simple urticaria, itching and runny nose to severe Quincke’s edema and shock. During the day, a person encounters about 120 food allergens, most often without any harm to health. When overeating, when there are a lot of allergens, with poor digestion or inflammation of the intestines, with dysbacteriosis or the presence of parasites in the gastrointestinal tract that secrete waste products that are toxic to humans, the risk of developing allergies is very high.

In a word, everything starts with gastrointestinal pathology or poor functioning of the liver if it does not fulfill its cleansing function, which happens after hepatitis, cholecystitis or giardiasis.

Allergies can also be caused by kidney failure, when the kidneys cannot cope with their excretory function.

In infancy, allergies often develop when breastfeeding is stopped too early and the transition to artificial feeding. Enzyme deficiency can also join allergies, it’s just that a small child did not have time to form and improve the mechanism for assimilation of adult food, and they are already beginning to give him a variety of complementary foods. Doctors admit that it is almost impossible to identify such an enzymatic deficiency. All of them unanimously (although absolutely independently of each other) add that much more often than the notorious enzyme deficiency, which almost always disappears by itself, the cause of allergies, or rather, pseudo-allergies in a child (as well as in adults) is banal dysbacteriosis.

It’s all about the constant self-poisoning of the body by a mass of harmful substances produced by pathogenic bacteria that are present in large numbers in the intestines and produce histamine, which causes a variety of inflammatory symptoms.

Which of the children and adults has never caught a cold in their life? And which of them was not prescribed antibiotics? After such treatment, dysbacteriosis for both a child and an adult is practically guaranteed. It is detected elementarily – with the help of fecal analysis (stool culture). And it is treated very simply – with the help of intestinal antiseptics of a new generation, which selectively destroy harmful flora while maintaining the beneficial one, or with the help of bifid preparations in capsules. Usually bifidobacteria are almost completely digested in the stomach, their “super usefulness” is nothing more than a publicity stunt. Of course, they play a positive role in maintaining a healthy flora in the intestines, but they can hardly cope with bacteriosis.

Unfortunately, hereditary genetic structure is one of the most important factors in the possible development of allergies. If one of the parents suffered from hay fever, asthma, eczema, food allergies, the child is very likely to experience these or other allergic reactions.

The cause of an allergy in a child may also be the non-compliance of his mother with a diet during pregnancy. Doctors advise women who are expecting a baby to refrain from classic allergens (chocolate, citrus fruits, coffee) so that the fetus does not “pick up” antibodies from the mother and the baby subsequently does not have problems. But not all mothers are able to sacrifice their interests and habits for nine months for the sake of the child’s health. Therefore, if a mother often drank coffee during pregnancy, ate eggs and oranges, then the child is found to be allergic to these products. If she was treated for any disease, then antibodies to this medicine (for example, an antibiotic) are transferred to the fetus. Therefore, I advise pregnant women to be as careful as possible: do not overcool, do not smoke (otherwise, the child, in addition to allergies, will have a whole bunch of diseases up to the most severe ones – damage to the heart, central nervous system and various malformations). The next possible cause of allergies in a child and an adult is fungi. They act as an infectious allergen and also like to settle in the intestines, releasing many toxic substances. They are also easy to identify with the help of an analysis for dysbacteriosis.

Fungi are dangerous both when they are in the intestines, and when they just “decorate” the nails or start in dandruff. All this leads to an increase in the overall sensitivity of the body to various substances. The last reason for the occurrence of allergies is the poor ecological situation around us: everything is oversaturated with chemicals. In addition to fertilizer residues, the products contain various food additives, preservatives, flavor enhancers. There is nothing to talk about household chemicals or the harmful effects of chemically active substances in various industries. There are a lot of allergy sufferers in the Donbass, Kuzbass and other coal regions. In large and small cities with enterprises that pollute water and air with industrial emissions.

Much depends on eating habits. So, a diet poor in vitamins, microelements and vegetable fiber with a high content of semi-finished and canned foods dramatically increases susceptibility to allergens. What determines the severity of allergy symptoms? water, food, frequency of use of household chemicals. Any fresh surgical operation (extraction of a tooth, tonsils, trauma, especially burns), all diseases for a long time lead to a weakening of the body, respectively, to an increase in allergic reactions or the appearance of new ones.

9 myths about allergies and why they should not be believed

Checking the myths

Ksenia Kuzmicheva

allergist, Doctis online consultation service

Author profile

400 million people – from allergic rhinitis and one in ten is allergic to drugs.

At the same time, there are many myths about allergies – I will tell you about the most common ones and why they should not be believed.

Go see a doctor

Our articles are written with love for evidence-based medicine. We refer to authoritative sources and go to doctors with a good reputation for comments. But remember: the responsibility for your health lies with you and your doctor. We don’t write prescriptions, we give recommendations. Relying on our point of view or not is up to you.

Myth No. 1

Allergy can only be developed in childhood, it cannot appear in an adult

This is the most common myth. Allergic diseases can occur at any age, but usually each age has its own forms.

Allergies – NHS

In young children, allergies are more likely to affect the skin, adolescents and adults experience respiratory symptoms: cough, runny nose, watery eyes, itchy eyelids.

This disease is characterized by a genetic predisposition, it can develop at any age if conditions are favorable. Many genes are responsible for the implementation of predisposition.

Imagine two identical twins who were born and lived until the age of 18 in Moscow, and then one moved to Sochi, and the other to the Far North. Their genetic material is the same and they did not have any allergies before. But they have a predisposition, and the one who went to the north developed bronchial asthma, and the one who went to Sochi developed allergic rhinitis.

Genetic Risk Factors for Allergic Diseases – Clinical and Experimental Allergology

This example shows that genes are affected by epigenetics – changes in how genes work under the influence of external factors, such as the environment: atmospheric pressure, air humidity, the presence or absence of contact with allergens.

The same genetic set of information in different conditions can be realized in different ways. We don’t inherit allergies to nuts or milk – we inherit a predisposition to react to certain substances.

12 important questions for allergist Umar Khasanov

This does not mean that a child of parents with allergies will necessarily have allergy symptoms, it just has a higher risk than children whose parents do not have allergic diseases.

Myth No. 2

To prevent allergies, it is necessary to exclude contact with allergens from childhood

There is a hygienic theory of allergy. According to her, the number of cases of allergic diseases is growing due to the fact that people have less contact with microbes, animals, and plants. At the same time, the immune system must react to something – and it switches to something that normally does not cause a reaction. Anything that contains protein can become an allergen: from food to tree pollen.

Hygiene Hypothesis – Journal of Allergy and Clinical Immunology

Hygiene Hypothesis – Journal of Clinical and Experimental Immunology

The hygiene theory says that dirty hands in childhood, contact with animals, not ideal cleanliness of the house is not bad. Of course, within reason. Children should be allowed to walk in puddles, play in the sand and not wipe their hands every five minutes with wet wipes: normal household dirt is also good.

A study examining the prevalence of asthma and eczema found that allergies were less common in a group of young children whose parents licked pacifiers that had fallen on the floor compared to a group of children whose parents rinsed them.

Analogues of expensive allergy medications

The authors concluded that in those families where the pacifier was licked, children had fewer allergic diseases, because the child was in contact with various microbes, including those that do not cause diseases. This prevented the development of allergies.

Concerning contact with animals, there are different data. Some publications say that the presence of a cat or dog in the house at the birth of a child and during pregnancy of the mother is also the prevention of allergies. There are studies that note the preventive effect of contact with several different animals.

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Other publications do not find a significant relationship between allergies and having pets at home.

At the same time, there is evidence that contact with a cat or dog in the first year of a child’s life can trigger allergies. In general, nothing is completely clear.

If your child has already shown signs of an allergy to animals, it is worth considering whether to get a pet. Many people with allergies live with animals, take medications, and are in good control of their condition. And others, despite taking medication, still suffer from symptoms – the disease is so pronounced – so they have to give up the pet.

Myth No. 3

Natural household chemicals cannot cause allergies

Household chemicals based on herbs and other natural ingredients can be biodegradable, that is, they break down quickly and cause minimal harm to the environment.

But many people, on the contrary, are allergic to herbs or pollen, and they are not recommended to use anything that includes a large number of natural ingredients: herbal teas, cosmetics, household chemicals based on herbs.

Common cleaning powders and liquids have very large molecules, are reactive and have a pungent odor. They can irritate the mucous membrane and break the skin barrier, but this is not an allergy.

How to treat allergies with ASIT

For example, some people react so strongly to bleach that they have asthma-like attacks because the strong smell provokes bronchospasm. It is the same with forest fires: very large soot molecules, combustion products become an irritant for mucous membranes, but this is not an allergy.

In such cases, it is worth minimizing contact with such substances, choosing not very odorous and non-volatile products – then, most likely, there will be no symptoms.

Myth No. 4

You can take an analysis and find out what you have or will be allergic to

Tests for allergic reactions are taken only if there are symptoms, they just do not need to be carried out. Otherwise, the analysis may show an allergy, for example, to milk, while the person drinks it calmly, there are no symptoms. So, there is no need to ban such a product.

What to do? 08/13/20

What should I do if I suspect I have an allergy?

That is, a person may have antibodies in the blood that indicate the presence of an allergy, but there is no allergy itself – this happens.

Wise Choices: Don’t Test for Allergens Unless You Have Allergy Symptoms – American Family Physicians Association

If you need to know if you are likely to be allergic to, for example, a pet, you can expose yourself to a potential allergen: go to the pet store, hold it several times animal in hands, sniff. And to see if there will be symptoms upon contact with an animal and what the analysis for the corresponding allergen will show – it should be handed over in one to two months.

If a person wants to get some kind of exotic animal, but has never had contact with him and there is no such possibility, then neither the analysis nor the doctor will be able to say whether there will be an allergy or not.

In addition, there are pseudo-allergic reactions – when there are symptoms similar to allergies, but in fact there is no allergy. Such reactions have a different development mechanism.

Pseudo-allergic reactions to food – Journal of Food Allergy in Infancy and Childhood

Pseudo-allergy occurs if you eat too much strawberries, chocolate, seafood, industrial sweets, citrus fruits. If a person in such a situation tests for these allergens, the result will be negative. This suggests that there is no true allergy: you can eat such foods, but in moderation.

Myth No. 5

If you have allergies, you can’t get vaccinated

Allergies can be vaccinated. Children with atopic dermatitis, allergic rhinitis, and adults with bronchial asthma are also vaccinated. There are no contraindications if the disease is controlled, the person is taking medication and there are no symptoms.

Medical contraindications for prophylactic vaccinations with preparations of the national vaccination schedule – Ministry of Health of the Russian Federation

If severe allergic reactions to a certain vaccine have previously occurred, this does not mean that all vaccines are contraindicated, because they have a different composition.

In general, if there is a severe allergy, the person will usually already see an allergist. If there were acute allergic reactions to a component of the desired vaccine or the disease is occurring right now, and the issue of vaccination is acute – as it was, for example, with COVID-19 – then a medical commission meets and makes a decision. But these are isolated cases.

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Myth No. 6

If in childhood there was an allergy, then bronchial asthma will begin or worse

There is the concept of “atopic march” – this is the consistent development of allergic diseases in one person over time. For example, in childhood there was atopic dermatitis, and at an older age allergic rhinitis or asthma appeared. The disease consistently affects the “target” organs – the skin, mucous membranes of the nose and eyes, bronchi.

Allergies and Asthma – Mayo Clinic

Risk Factors for Asthma – American Lung Association

However, this is rare, affecting about 5% of people who had childhood allergies. In the vast majority of cases, there will be no deterioration: children “outgrow” their skin problems or food allergies and do not tolerate this into adulthood.

How should children with allergies be fed in kindergarten?

Myth No. 7

With allergies and for its prevention, it is imperative to follow a hypoallergenic diet

A diet is needed only when there is a clear link between the food and the response to it. That is, you need to exclude what causes an allergic reaction.

More often, allergies occur to some single products that are easy to exclude. Very rarely, but there are people with multiple, or polyvalent, food allergies, when a variety of ingredients cause the reaction. In such cases, a strict diet is indicated.

Food allergy management — Uptodate

As for bright fruits, berries, chocolate — they can, as I wrote above, cause pseudo-allergic reactions. A person who is not predisposed to allergies needs to eat a bucket of strawberries to get a rash, but a few berries may be enough for a person with allergies. Therefore, you just need to know your individual dose.

There is also a misconception that if a mother avoids allergenic or bright-colored foods during pregnancy, then the child has a lower chance of getting an allergy in the future. Here, the opposite is true: the more allergens a child gets to know while in the womb and soon after birth, the less likely it is that he will have an allergy.

How to eat healthy while breastfeeding?

For example, in America they love peanut butter and of course there are many severe allergic reactions to peanuts. American scientists have found that if a child is given a little peanut butter already in the first year of life – at six to seven months, then the likelihood of an allergy to peanuts decreases. The earlier a child gets acquainted with a large number of allergens in small doses, the less he will be susceptible to allergies in the future.

Primary prevention of allergic diseases: maternal diet during pregnancy and lactation – Uptodate

Myth No. 8

Allergy always occurs upon first contact with an allergen

The immune system sometimes needs time to react to an allergen, so the reaction will not always be at the first contact.

Review of Allergic and Atopic Disorders – MSD Handbook

So, on the one hand, just because a person has eaten something and hasn’t developed an allergy, it doesn’t mean they won’t. It may appear a second time and even later.

On the other hand, you can give your child a nut or shrimp for the first time and get anaphylactic shock: allergic reactions are not always predictable.

Myth No. 9

Toxins and dysbacteriosis are to blame for allergies, which means you need to drink sorbents and probiotics

Toxins cause poisoning, not allergies. With allergic reactions, people often take sorbents, but this is useless. They are not absorbed into the blood and do not clean it, but simply pass through the intestines. Such drugs are not included in clinical guidelines for the treatment of allergic diseases.