What are Allergies?
Allergies have become one of the most common chronic conditions. The most diagnosed form of allergic reaction is allergic rhinitis. This is a more specific medical term used to describe what’s commonly known as hay fever or seasonal allergies. These uncomfortable reactions are familiar to many, affecting around 20% of the U.S. population. The symptoms of allergic rhinitis are caused by an immune reaction that begins in the nose when environmental allergens such as pollen or animal dander are inhaled. Since these reactions are so widespread and have tremendous impact on quality of life, antihistamines such as Zyrtec, Claritin, and Benadryl have become one of the leading classes of medications.
Fun Fact: Rhinitis literally means “nose-swelling”; “rhinos” is Latin for nose (think rhinoceros) and “-itis” is a suffix that means swelling and is commonly used in medical jargon.
How does the body develop an allergy?
Allergy symptoms are the result of an immunoglobulin E (IgE)-mediated reaction. This occurs when the body is exposed to something that it doesn’t recognize. Everyone’s body makes a unique judgement when it encounters a foreign body- it can perceive it as safe and allow it to coexist as a neutral element, which results in no allergic reaction. On the other hand, the immune system can alternately choose to attack it upon exposure. In this situation, it will produce specific “IgE” antibodies that are designed to bind and ultimately remove the foreign product. This molecule will be flagged as an allergen moving forward, so the next time that you are exposed, your body will and be prepared to destroy and eliminate it.
What causes allergy symptoms?
Once the IgE receptors on immune cells, such as mast cells and basophils (think of these as immune patrollers), bind to allergens they release a cascade of pro-inflammatory molecules such as histamine, prostaglandins, and cytokines. The combination of these molecules leads to the uncomfortable symptoms such as mucus production (to trap and expel allergens) and bronchoconstriction (narrowing of airways to help keep allergens out of the depths of the lungs). Some other reactions caused by these immune cells are anaphylactic shock, eczema, and food sensitivities. While this process has the goal of keeping you safe, it can be directed towards seemingly random targets such as dust. IgE reactions can present as a full spectrum which range from uncomfortable to life-threatening.
How are allergies treated?
Avoidance: Once diagnosed with allergies, the first recommendation from your provider will be to avoid the allergens that are triggering your reactions altogether. If you aren’t exposed to the allergen, your body has nothing to respond to.
Immunotherapy: This may be indicated for people suffering from severe allergies that don’t respond to other forms of treatment. This route involves a series of injections over time that expose you to purified allergen extracts. This aims to desensitize the immune system to specific allergens, reducing or eliminating allergic reactions over time
Medication: A variety of medications are available for treating symptoms of allergies. The most common are antihistamines, which block the effects of histamine and alleviate symptoms like itching and sneezing; decongestants, which reduce nasal congestion by narrowing blood vessels; and corticosteroids, which decrease inflammation and allergic reactions when applied topically or taken orally, providing relief for a range of allergy symptoms.
Epinephrine: This medication is commonly prescribed in an injectable form called an “Epi Pen”. This can be rapidly administered to someone with a severe allergy to rapidly counteract severe symptoms by constricting blood vessels, relaxing airway muscles, and alleviating anaphylaxis. However, it’s important to note that although someone may feel and appear fine after receiving a dose of epinephrine, this just subdues their symptoms until they can access medical care. It is important to get them emergency care as soon as possible or else they can reenter anaphylactic shock.
Sources
· https://www.mayoclinic.org/diseases-conditions/allergies/diagnosis-treatment/drc-20351503#:~:text=Your%20provider%20might%20suggest%20nonprescription,provider%20might%20recommend%20allergen%20immunotherapy. Assessed and Endorsed by the MedReport Medical Review Board