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Июн
20,
2019

Keeping allergies at bay : a global public health concern

Июн 20, 2019

Worldwide, allergies are on the rise at an alarming rate. Hay fever affects 400 million individuals globally[1], with asthma affecting 300 million and drug allergies affecting around 10 percent of the world’s population.

The World Allergy Organization (WAO) warn that «allergic diseases constitute a significant cause of morbidity worldwide and a considerable burden on the health and medical systems of both developed and emerging economies.”[2]

With 40 to 50 percent of schoolchildren[3] worldwide sensitized to one or more allergens, preventing allergies in the future is likely to have a huge impact on global health.

Allergies are a very common overreaction of the immune system to usually harmless substances. How do our bodies mistake otherwise harmless substances for potential dangers and cause the unpleasant, and sometimes even fatal, symptoms of allergy?

Understanding the roots of allergic reactions

 The mucosal immune system of the respiratory tract is specialized to continuously monitor the external environment and to protect against invading pathogens, while maintaining tolerance to innocuous inhaled particles. Allergies result from a loss of tolerance against harmless antigens characterized by formation of allergen-specific Th2 cells and IgE. Tolerance is often described as a balance between harmful Th2 cells and various types of protective “regulatory” T cells.

Understanding the basis of tolerance is essential for the rational design of novel and more efficient immunotherapies. [4]

As the WAO points out, in spite of being a major global public health issue, the public and the health establishment have generally not recognized the importance of allergic diseases.

 Methods of prevention and treatment of allergic reactions

An allergy management plan is key to preventing allergic reactions so working with a doctor to create one is essential. A good allergy management plan is based on medical history, the results of allergy tests and how severe symptoms are. It can include three treatment types: avoiding allergens, medicine options and/or immunotherapy (allergens given as a shot or placed under the tongue).

Allergy medicines currently available include nasal corticosteroids (nose sprays), reducing the swelling, antihistamines, mast cell stabilizers that keep your body from releasing histamine, decongestants reducing stuffiness by shrinking swollen membranes in the nose, and corticosteroids reducing swelling and spotting severe allergic reactions.

While common allergy medications often control symptoms, if you stop taking the medications, your allergy symptoms return shortly afterward. Immunotherapy can potentially lead to lasting remission of allergy symptoms, and it may play a preventive role in terms of development of asthma and new allergies.

Search for new treatments

Despite an effective set of treatments being offered, the search for new treatment modalities to improve the currently available is especially important for those patients unresponsive to current therapy and for children.

In Lisbon, Portugal, on June 3rd during the EAACI congress, Pr K. P. Janeczek (Department of Children’s Lung Diseases and Rheumatology in Lublin, Poland) gave a lecture about “The Effect Of Polyvalent Mechanical Bacterial Lysate On The Clinical Course Of Pollen Allergic Rhinitis In Children.” responding to the topic of the risks factors and novel treatments for children with respiratory allergies. He demonstrated that PMBL reduced nasal obstruction (PNIF increase), reduced the severity of Total Nasal Symptom Score (TNSS) and Total Ocular Symptom Score) also limited the increase in the number of eosinophils in nasal swabs during the grass pollination season.

He finally concluded that PMBL may improve the clinical course of the pollen allergic rhinitis caused by grass pollen allergens in children during the grass pollination period.

Research in the field of allergy is still developing, especially in the understanding of the mechanisms leading to disease.

REFERENCES :

[1] Allergic diseases and asthma: a global public health concern and a call to action, Ruby Pawankar, World Allergy Organization Journal 2014, https://waojournal.biomedcentral.com/articles/10.1186/1939-4551-7-12

[2] The importance of allergic disease in public health: an iCAALL statement,MarioSánchez-Borges, Bryan L.Martin, Antonella M.Muraro, Robert A.Wood, Ioana O.Agache, Ignacio J.Ansotegui, Thomas B.Casale, Thomas A.Fleisher, Peter W.Hellings, Nikolaos G.Papadopoulos, David B.Peden, James L.Sublett, Stephen A.Tilles, LannyRosenwasse, World Allergy Organization Journal 2018,https://doi.org/10.1186/s40413-018-0187-2

[3] https://www.aaaai.org/about-aaaai/newsroom/allergy-statistics

[4] Antigen-specific regulatory T-cell responses against aeroantigens and their role in allergy, Petra Bacher & Alexander Scheffold , Mucosal Immunology 11, 1537–1550 (2018), https://doi.org/10.1038/s41385-018-0038-z