Immunologist advices how to live a normal life with seasonal allergies

Let's start with the main thing - the doctor's answer to the question 'how to live a normal life with seasonal allergies'.

How to live a normal life with seasonal allergy?

It is no exaggeration to say that accurate diagnosis is the basis for the continued normal life of a patient with pollinosis.

(Pollinosis is a seasonal allergic inflammatory disease caused by plant pollen - ed.)

Since every allergic reaction is triggered by a specific allergen, the main purpose of diagnosis is to identify this allergen and thus provide the right treatment. Such an approach ensures that the patient feels well during the blooming season.

If seasonal allergies are diagnosed, simple remedies should also be followed to prevent flaring up at the time of flowering:

• limit outdoor activities;
• limit the amount of fresh air in the room, and preferably use air conditioning. If no air conditioning is available, open windows should be covered with damp sheets to keep the pollen in check;
• after returning from a walk, take a shower and wash your hair and change your clothes to freshly laundered ones;
• damp-clean every day;
• wear sunglasses;
• establish a hypoallergenic lifestyle and avoid the use of chemicals in cleaning as much as possible.

What are the main signs and symptoms of seasonal allergy?

Pollen allergy, allergic rhinitis, hay fever, spring catarrh, pollen asthma and seasonal allergy are the most common names for one of the most widespread diseases on earth. According to some estimates at present pollen allergy affects about 10% of children and 20-30% of adults on the planet, 75% of city dwellers and 25% of village dwellers.

The main symptoms of seasonal allergy are: itching and red eyes, a feeling of "sand" in the eyes, lacrimation, copious mucous discharge from the nose, attacks of sneezing, nasal breathing difficulties, blunted sense of smell, hyperemia and maceration of the skin under the nasal vestibule.

If acute inflammation develops in the respiratory tract mucosa, symptoms of allergic rhinitis and conjunctivitis may be accompanied by bronchial asthma (choking, coughing). Rarely, patients have specific skin manifestations (angioedema, urticaria).

How can it manifest itself in different patients?

In children, pollinosis is often accompanied by enlarged tonsils and allergic inflammation spreads to the sinuses, nasopharynx, auditory tubes and throat, causing itching in the ear canals and trachea.

In general, unlike school-age children, in whom pollen allergy has the same course as in adults, preschool-age children do not usually have profuse nasal discharge and sneezing attacks, but may be accompanied by nasal tickling and nasal breathing difficulties due to swelling.

In autumn, allergic symptoms of the upper respiratory tract are often accompanied by otitis media, which is characterised by a slight increase in body temperature, ear pain and a worsening of the general condition.

What factors usually cause seasonal allergies?

Seasonal allergies are caused by pollen of plant origin, and the disease itself usually occurs when certain plants are in bloom, so it is clearly seasonal.

In general, thepollen causing seasonal allergy has a number of features, including

• allergy-provoking properties;
• the strong volatility of the pollen and the wide distribution of the plant, which together cause the pollen concentration in the air;
• the pollen grain size of 25 to 30 μm for deep breath penetration.

The human upper respiratory tract is the first barrier, a place of accumulation and natural "conductor" of pollen from the environment into the body. It is the inhalation route for allergens to enter the body during seasonal allergy that contributes to violation of the barrier properties of the upper respiratory tract mucous membrane.

Allergic diseases of the upper respiratory tract are formed due to prolonged contact between allergens and the mucous membrane.

It is worth noting that allergen penetration into the body and the development of pollen allergy contribute to non-specific factors - microclimatic conditions, breach of temperature and humidity, associated respiratory diseases and others.

What are the peculiarities of the seasonality of this disease?

Pollinosis is notable for its seasonality.

Thus, in Ukraine there are 3 main periods of flowering and, consequently, an increased risk of allergy:

• The spring season, which starts in early March and lasts until mid-May, is the period of flowering of trees: alder, birch, hazel, oak, ash, hornbeam, lilac;
• Summer season - runs from mid-May to the end of July and causes pollen allergy in people allergic to pollen from grasses and cereals such as dandelion, timothy, feverfew, wheatgrass, rye, oats and maize;
• Summer-fall season - starts in mid-July and lasts until October. The seasonal allergies of this period are due to the flowering of weeds: wormwood, goosefoot, plantain, nettle, ragweed.

However, this division into seasons is very tentative, as flowering periods of trees and plants may vary depending on the region and specific weather conditions.

How do seasonal allergies usually develop?

There are three stages in the development of a true allergic reaction, which are also characteristic of pollinosis:

I. The immune response (immunological) stage. In this stage the first contact of human organism with allergen occurs, as a result of which allergic antibodies of E-class immunoglobulins and sensibilized lymphocytes are formed and accumulate in human organism. As a result the body becomes hypersensitive to a specific allergen. Reintroduction of specific allergen into the organism results in formation of allergen-antibody complex, which causes development of next stage of allergic reaction.

III. Biochemical reaction stage (pathochemical). Due to complex biochemical processes caused by the formation of allergen-antibody complexes new biologically active substances (mediators of allergy) are released. At this stage mediators of allergy interact and carry IgE complexes with specific allergen.

III. The stage of clinical manifestations (pathophysiological) represents reaction of cells, organs and tissues of organism upon mediators which formed in previous stage. As a consequence of this reaction, histamine is released, which is responsible for the various clinical symptoms of allergy.

Is there a risk of an exacerbation or the development of a chronic form?

Without appropriate diagnosis and treatment, seasonal allergy itself can be considered a chronic condition, as it is recurrent, and the severity of the condition depends on several factors, such as the state of the immune system, the concentration of pollen in the air, etc.

However, without proper treatment, seasonal allergies can complicate existing chronic diseases. Allergic rhinitis, for example, which if left untreated, may cause inflammation of the sinuses and ears, followed by an accumulation of mucus which provides an ideal environment for bacteria.

It is worth noting that in some patients untreated allergic rhinitis may develop over time to the more threatening condition of bronchial asthma.

What are the therapeutic methods for dealing with seasonal allergies? What are the advantages and disadvantages of each?

Seasonal allergy can only be treated under the supervision of an allergist, as allergy treatment is complex and consists of several components: diagnosis, elimination of the acute process, basic therapy and preventive measures. Successful treatment can only be achieved by paying sufficient attention to each component:
diagnostics, treatment of the acute process, basic therapy and preventive measures. Successful treatment can only be achieved by paying sufficient attention to each of the components.

What diet or nutrition may help to control the symptoms of seasonal allergy?

The basis of any allergic disease treatment is elimination of the allergen, i.e. termination of human contact with the allergen. In actual fact, with pollen allergy, you should limit your exposure to the air during flowering season, try to open windows less frequently and do more damp cleaning.

It is not uncommon, however, to observe a situation in which allergic diseases of the respiratory tract are accompanied by symptoms of food cross-allergy.

Cross-reactions between pollen and food allergens are due to shared antigenic determinants in these allergens:

• in cases of seasonal allergy to birch, alder and hazel pollen, cross-allergy to hazelnuts, almonds, apples, pears, cherries, apricots, peaches, kiwi, celery and potatoes may occur;
• people with pollen allergy frequently react to celery, potatoes, fennel, parsnips, anise, dill, red pepper, sunflower seeds and wormwood drinks (vermouth, balsams).
• with pollen-induced pollen allergy to oil, halva, mayonnaise and mustard, cross-food allergies may occur;
• ragweed sensitivity may be accompanied by intolerance to bananas and melons; cereal pollen allergy is often accompanied by food intolerance to tomatoes, melons, peanuts, grains and soya.

Sensitised individuals may then develop an itching sensation in the mouth and/or throat, ears and swelling of the lips and tongue within 2-3 hours after eating fruit and vegetables.

In such situations it is particularly important to consult an allergist, as patients with cross-food allergy require a special elimination diet in addition to the standard treatment.

What medicines are available over-the-counter to alleviate the symptoms of seasonal allergies? Is there a risk of self-treatment and what are the consequences?

A patient with seasonal allergy symptoms should always consult a doctor.

The specific allergy test involves taking an allergy history, physical examination and allergy testing, which requires skin tests or the determination of specific antibodies to the allergen in the blood. Diagnosing an allergy using in vitro laboratory methods is safer, as it excludes the patient from contact with the allergen.

Sinevo European Network of Medical Laboratories offers a wide range of ImmunoCAP tests to determine individual sensitivity to allergens - from screening tests to specific allergen components, recognised as the "gold standard" of molecular allergy diagnosis by the WHO and the World Allergy Organisation.

Allergen-specific immunotherapy (ASIT) - treatment with identified causative allergens in low doses with gradual increase in dose - is also available. For a complete cure, the treatment is administered according to an individualised course for each patient.