Allergy: where did it come from and what to do with it?

2024 Author: Seth Attwood | [email protected]. Last modified: 2023-12-16 15:55

It is unlikely that in our time you can find a person who has not heard anything about allergies. Alas, in one form or another, this disease occurs very, very often. Unfortunately, even allergy sufferers themselves have little idea of what exactly they suffer from.

The classic definition of allergy is that it is "hypersensitivity of the immune system", but it would be more accurate to say - "mistaken reaction of the immune system." This is where allergies are - a mistake. Absolutely harmless substances: dust, skin flakes, food, pollen - are perceived by the immune system as the worst enemies, which is accompanied by a violent reaction that destroys these harmless substances, and at the same time damages cells and tissues around, which can even lead to death. You can endlessly classify allergies into different types.

There are classifications according to the mechanism of development of the reaction and speed, according to symptoms, according to severity, according to allergens. But it is much more interesting to understand the traditional questions: "Who is to blame?" and "What to do?"

Where did it come from?

The emergence of this disease is to blame … modern civilization. At a time when a person was much closer to nature, no one heard about allergies - then people were occupied with more pressing questions - for example, where to find food and how not to poison it. The level of hygiene, even taking into account the Roman aqueducts and Russian baths, was, frankly, much simpler. No antibiotics, no fridge, and cooking food was used more to make chewing easier than to sterilize.

Almost everyone, from peasants to kings, had fleas, lice, worms and a whole set of other parasites (everything is like in nature - try to find a lion without fleas in the African savannah). For the immune system, such a situation was normal, even if it is impossible to get rid of an infinite number of parasites, at least their number and destructive activity can be controlled.

Caution scammers

Allergy is a fertile niche for charlatans. Allergy is incurable, you can only achieve a condition without symptoms, remission. Therefore, those who promise to completely cure allergies are disingenuous. No dietary supplements, herbs or laser devices that "expel parasites" can help with this. There are no "revolutionary technologies" with the use of mumiyo and other biological exoticism. Scientists are working on this problem, but, alas, there is no solution yet.

Distinguish between food intolerances (PN) and food allergies (PA). PN is a complex of symptoms caused by eating foods to which the body does not respond adequately. There can be many reasons for PN: gastrointestinal diseases; toxic properties of products; the use of foods that cause the release of histamine (egg white, crabs, strawberries, tomatoes, chocolate, pineapples, peanuts); eating foods that contain a lot of histamine and similar active substances (red wine, salami, ketchup, eggplant, bananas, hard cheeses); taking medications that suppress histamine-degrading enzymes.

In any case, PN is not caused by any of the four types of immune hypersensitivity reactions and is not associated with allergies. Despite this, some "diagnosticians" present PN as the true cause of allergic manifestations and diagnose using immunoglobulin G tests, tests with neutrophils, erythrocytes, etc. Meanwhile, PN is a separate (moreover, rare) pathology that is not detected by these tests.

For this control, we have a full-fledged, specialized link of immunity: eosinophils, mast cells, basophils, lymphocytes connected to a special system of receptors and signaling molecules, as well as rapid-response molecules (the most famous of them is histamine), and all this happens with the participation of immunoglobulin E (IgE). What is this system doing in a modern civilization obsessed with hygiene, when the presence of a parasite in the body, as well as a serious infection, are quite rare situations?

What to do?

By solving the situation "Who is to blame?" and "What to do?" Doctors and scientists work within the framework of the hygienic hypothesis - a fairly new area of immunology. It would seem that if increasing the level of hygiene and getting rid of parasites causes an increase in allergies, then in order to cure it, it is enough to stop washing and start eating unwashed fruits and vegetables and half-baked meat for infection with helminths.

It sounds quite logical, although the result will be far from what was expected: in the presence of an allergy, the probability of "retraining" the immune system by finding the right activity for it is small, but the risk of poisoning and getting severe helminthiasis is very high. Nevertheless, numerous clinical trials are already underway to treat very severe cases of allergies by infecting a patient with modified (for greater safety) live helminths. Moreover, the results of these tests look very promising.

But there are still nicer and safer ways. The first thing that comes to mind when you mention allergies is dust. It is not only a strong allergen, but also serves as a home for the formidable enemies of allergy sufferers - house dust mites. That is why it is important to reduce the number of woolly, dusty and hairy surfaces in the house as much as possible - remove carpets, replace curtains with blinds, replace down and feather pillows and blankets with synthetic ones, and do wet cleaning once a week.

However, dust is an important, but not the only factor. The food diet has a serious impact on the manifestation of allergies. Beneficial bacteria in the intestine are able to eat and break down some of the allergens, they also give the immune system constant signals to reduce the level of reaction - "tolerogenic signals", and these signals work not only in the digestive system, but also at the level of the whole organism.

So, correcting the situation in the gastrointestinal tract (GIT), you can reduce allergic conjunctivitis or rhinitis. However, one should not be carried out on advertising of magic yoghurts and dietary supplements, sometimes it is enough just to increase the amount of "live" food: raw vegetables and fruits, fermented milk products.

Any type of reaction is based on an inadequate response of the immune system: instead of protecting the body, it destroys its own tissues and cells. The first contact with an allergen causes the formation of a large number of IgE antibodies (rarely IgG4). These antibodies are fixed on mast cells and basophils.

When the allergen enters the body for the second time, antibodies on the cell surface recognize it, the cells are activated and release a huge amount of molecules that cause allergy symptoms and tissue damage around the site of contact with the allergen - histamine, heparin, serotonin, platelet-activating factor, prostaglandins, leukotrienes, etc. Depending on which molecules prevail, and how many of them are thrown away, various manifestations of allergies develop: from itching and runny nose to difficulty breathing (asthma) and even anaphylaxis, for example, in the form of Quincke's edema.

Another important factor is the climate. The worst option for an allergy sufferer is a cold, windy and humid climate. The best is dry and warm, with a small amount of lush tropical growth. That is why a trip "to the sea" is a great option. Salty seawater helps relieve skin allergies, and the sun triggers another tolerance mechanism linked to vitamin D, increased skin heating and regulatory T cells. It so happens that two weeks of sea vacation for allergy sufferers is enough to "hold out" with less manifestations of allergies for a whole year until next summer. In severe cases, you can think about climate change.

However, this does not always help, and the medical aspects have nothing to do with it. For example, the Australian government, during the years of settling desert and semi-desert areas on the continent, purposefully studied statistics on allergies. It turned out that due to the absence of allergens (plants and animals) and almost zero humidity, these places are just a gift for allergy sufferers. True, after the settlement of the territories, the situation changed - people quickly provided themselves with allergens, building greenhouses with wildly flowering plants, establishing an irrigation system and bringing home animals.

Another universal tip is to stop self-medication with antibiotics altogether. These medications should only be taken as directed by your doctor. Self-reduction of the dose and duration - and you can grow a colony of resistant bacteria that survived on an incomplete course. They will resist normal microflora, reduce its tolerogenic signals, causing allergy manifestations. On the contrary, the use of antibiotics at every "sneeze" will lead to the suppression of beneficial microflora and the emergence of antibiotic-resistant strains - the most tenacious and harmful.

Get to know the enemy by sight

As you can see, there are a lot of factors that can cause allergies. To reduce its manifestations, it is necessary to reduce contact with allergens, but how to determine what exactly is causing the reaction?

In the case of food allergies, especially in children, you have to act by trial and error - one by one (not a set of ten!) To introduce new foods, controlling the reaction. This method is good, but it has a huge disadvantage - it so happens that an allergy does not develop to food, but, say, to dishwashing liquid.

In this case, the coincidence of various factors can lead to completely incorrect conclusions: for example, those foods that are eaten cold from a plate and spoon, on which this liquid has remained, will lead to allergic manifestations, but those that are eaten hot will not (the allergen is destroyed) … So, while engaging in a food diary, you should not be carried away with restrictions without looking back and from time to time it is worth carefully returning prohibited foods, since the reaction may change (especially in children).

Allergy Weapons

All medicinal treatments for allergies should be prescribed exclusively by an allergist or dermatologist. They depend on the type of allergic reaction and where it occurs. There are several groups of drugs. Antihistamines … These drugs suppress the response of cells in the immune system to histamine, reducing allergy symptoms. The old generation drugs (tavegil, suprastin) suppress all types of histamine receptors, causing drowsiness and other side effects, the latest generation drugs (H1-specific) are devoid of this drawback (loratadine group, cetirizine (zirtec), telfast and others).

For the treatment of allergic conjunctivitis, rhinitis, there are similar antihistamines in the form of eye drops or nasal spray. Anti-inflammatory … The most powerful are hormonal drugs - corticosteroids and their analogues. For the treatment of skin manifestations, there are forms in the form of creams / ointments, there are eye drops, for the treatment of asthma - inhalers, sometimes tablets. The use of this group of drugs without a doctor's prescription can lead to very serious and unpleasant side effects. On the other hand, refusal to use them if prescribed by a doctor, especially with asthma, can end very badly. Leukotriene inhibitors (another group of inflammatory molecules ) … A new group of effective drugs with anti-inflammatory effects.

They are mainly used for asthma. Bronchodilator drugs. Asthmatics need them to remove the most formidable symptom of asthma - difficulty breathing, which occurs due to spasm of smooth muscles in the airways. They are usually in the form of an inhaler, but come in pills. Sodium cromoglycate. Suppresses the release of inflammation products by mast cells, stabilizes their cell membrane. As a result, after contact with an allergen, mast cells do not cause such a serious cascade of reactions. It can be effective for all forms of allergies, and, accordingly, is available in different forms: tablets, inhalers, eye drops, nasal spray. Enterosorbents. Often helpful for food allergies.

Therapeutic fasting, combating constipation, enzyme therapy (after the diagnosis of enzyme deficiency) can also alleviate the manifestations of PA. Antibodies to IgE. It is one of the newest treatments for asthma and allergic rhinitis (type I hypersensitivity). Antibodies bind immunoglobulin IgE in the blood and prevent it from binding to immune cells, reduce the reaction of the latter to already bound IgE, and reduce the production of new IgE. Suppression of other inflammatory mediators and molecules. Basically, drugs in this group are so far studied only at the level of clinical trials.

From 3-5 years of age, it also makes sense to do allergic tests: in vitro (in a test tube) or in vivo (on the skin). However, these tests only show the likelihood of allergies (which can also change over time). Each method has its pros and cons, so the choice is up to the allergist.

A separate big topic is children and pets. Almost always (even before testing or in case of a negative result), animals are advised to get rid of, fearing the risk of developing asthma. In the concept of eliminating allergens, this approach is correct. However, statistics on huge population samples show the opposite: in families where children grew up with pets, allergies develop less often and their manifestations are much less serious.

The most significant differences are observed at the age of up to one year, the smallest - up to three years, and after five years the difference disappears. Scientists explain these data as follows: during the training period of the child's immune system, when its mechanisms have not yet been debugged, it is provided with a generous source of wool, saliva, epithelium, etc. Thus, the same non-functioning link of immunity works out its reactions to all these substances and trains correct and adequate answer.

Is it possible to be cured

Already developed allergies, alas, are incurable. Any therapy is aimed only at reducing symptoms, and the best result that can be obtained is a state of no symptoms. But this state (remission) with the right approach can last for years.

First of all, it is necessary to identify the allergen and exclude or reduce contact with it. For some types of allergies (usually to pollen, to flowering plants), a method of treatment called "specific hyposensitization" works, when the patient is injected with an allergen in an increasing concentration, switching the immune response to an adequate one. This method requires long courses of treatment (up to three years), but it can be very effective.

In the same way, “pet treatment” works, when an adult allergic person gets a cat or dog, goes through 2-3 difficult weeks, and then finds that the allergic manifestations have diminished or even disappeared. This is explained by the fact that a huge amount of allergens penetrating the skin and mucous membranes can switch the allergic reaction to an adequate one. But this method is by no means recommended for those who have severe forms of allergies, especially those with difficulty breathing (asthma), and in any case requires consultation with a doctor.

Nerve disease

In fact, almost half of the manifestations of allergies are psychosomatic: neurodermatitis, psychosomatic bronchial asthma, etc. A real allergy manifests itself regardless of whether the allergy sufferer knows that he has eaten a dangerous product. And psychosomatic - when an allergic person thinks that he has eaten a dangerous product (regardless of whether he really ate it). The latter is just the case when "all diseases are from the nerves", and you need to treat it with a competent psychotherapist, or just put your nerves in order - do physical education or your favorite hobby, and the allergy will disappear by itself.

If the nerves are not treated, the results of allergy tests will be positive all the time, and on different allergens, and the drugs will have no effect. Thus, if allergies are more likely to occur during times of stress, it is worth considering to what extent they are psychosomatic.