Respiratory Allergies: Cause and Treatment

What is Respiratory Allergy?

If you have ever found yourself sneezing like crazy or feeling like your nose is constantly stuffed or running, you might be dealing with respiratory allergies.

Okay, picture this: your immune system is like a superhero, always ready to defend your body. But sometimes, it gets a little too irresponsible and starts giving over-response against harmless stuff like pollen, dust, pet dander etc.

Why Allergy Occurs?

1. Genetics: If you've got family members who suffer from allergies, there's a good chance you might also suffer because Genes play a big role in determining the susceptibility to allergies. It's like inheriting a genetic sensitivity to sneeze at pollen or when exposed to certain foods.

2. Early Childhood Exposure: They say exposure builds immunity, BUT sometimes, too much exposure to certain allergens early in life (means first few years of life) can actually backfire. Babies exposed to allergens like dust mites or pet dander before their immune systems are fully developed may be more likely to develop allergies later on. So, introduce solid foods and expose to environment/animals/chemicals gradually and cautiously to reduce the likelihood of developing allergies to food, dust, mites etc.

3. Hygiene Hypothesis: Believe it or not, after a certain age, being too clean might actually be a bad thing when it comes to allergies. Our modern obsession with cleanliness and sanitation may limit exposure of our immune systems to nature or environment leading to under-developed immune system causing an increased risk of allergies.

 How Allergy Happens?

Allergies are like a glitch in our immune system's software. It's trying to protect us, but sometimes it gets confused and goes into unwanted activity. So, what exactly are these irritating allergens:

1.  Pollen: Pollen from flowers, trees, grasses, and weeds is a common allergen, causing seasonal allergic rhinitis (hay fever) in many individuals.

2. Dust Mites: Microscopic creatures found in household dust, particularly in bedding, upholstery, and carpets, can trigger allergic reactions.

3.  Pet Dander: Small scales (made of proteins) from animal skins, hair or bird feathers, and saliva of pets such as cats, dogs, and rodents can provoke allergic responses in susceptible individuals.

4.  Mold Spores: Mold (fungus) grows in damp indoor and outdoor environments and releases spores into the air, triggering allergic reactions when inhaled.

5. Outdoor Air Pollution: Pollutants such as vehicle emissions, industrial smoke, and particulate matter can worsen respiratory allergy symptoms.

6. Indoor Air Pollution: Indoor allergens such as tobacco smoke, cooking fumes, and volatile organic compounds (VOCs) from household products (paints, disinfectants, air fresheners, deodorants new furniture) can trigger respiratory allergies.

7. Foods: This occurs because the proteins in certain foods are similar to those found in certain pollens, triggering allergic reactions. Common examples include: Apples, Milk products, cherries, peaches, pears, plums, Carrots, celery, parsley, pepper, Almonds, hazelnuts, walnuts, spices and herbs.

Allergy causing agents

Symptoms:

1.  Sneezing: Frequent rounds of sneezing, especially after exposure to allergens.

2.  Nasal Congestion: Stuffiness or blockage of the nasal passages.

3.  Runny or Itchy Nose: Clear nasal discharge or itching sensation in the nose.

4.  Itchy, Watery Eyes: Redness, itching, and tearing of the eyes.

5.  Postnasal Drip: Excess mucus dripping down the back of the throat.

6. Cough: Dry or productive cough, particularly at night due to dripping nasal discharge in throat causing irritation and cough. Occasionally, acid reflux—though not an allergy—can irritate the throat and lead to coughing, especially at night or when lying down.

7. Wheezing: High-pitched whistling sound while breathing, often associated with asthma.

8.  Shortness of Breath: Difficulty breathing or feeling of tightness in the chest.

 

Can Allergy be Cured?

As of now, there is no cure for allergies. BUT it is possible to detect allergy causing agents, avoid them and if exposed there are various treatment options available to manage and relieve allergy symptoms. These treatments aim to reduce the severity of allergic reactions, improve quality of life, and minimize the risk of complications.

Identify allergens

First and foremost, it’s important to detect the allergy causing agents using following tests:

1.   Skin Prick Test (SPT):

During this test, a small amount of allergen extract is placed on the skin, usually on the forearm or back. The skin is then pricked or scratched with a sterile lancet to allow the allergen (such as pollen, dust mites, pet dander, mold spores, and certain foods) to enter the skin. If you are allergic to the substance, a raised bump or hive at the site of the prick will develop within 15-20 minutes.

Skin prick testing can be performed for a wide range of respiratory allergens, including pollen, dust mites, pet dander, mold spores, and certain foods.

2.   Blood Test (Specific IgE Test):

Before the IgE test is performed, healthcare providers typically select specific allergens to test on basis of patient’s medical history, symptoms, and suspected allergens. Its introduction in the body follows a blood test. Which measures the levels of IgE antibodies in the blood that are specific to certain allergens.

This test may be recommended if any medical condition prevents you from undergoing skin prick testing.

3.   Nasal Provocation Test:

Nasal provocation testing involves the controlled exposure of the nasal passages typically performed under medical supervision to specific allergens to assess the body's response. During this test, a small amount of allergen is sprayed into the nose, and observe the symptoms, such as sneezing, nasal congestion, and itching.

Avoid Allergens

• Many local weather websites and allergy apps provide daily pollen and mold spore counts to help you plan outdoor activities accordingly.
• Keep windows and doors closed to prevent pollen from entering your home.
• Use mask outdoors
• Consider using HEPA air purifiers in your home to filter out allergens like pollen, dust mites, pet dander, and mold (fungus) spores.
• Keep pets out of bedrooms and other areas where you spend a lot of time. Vacuum carpets and furniture frequently to remove pet dander.
• Avoid exposure to tobacco smoke, strong odors, and other environmental irritants that can trigger respiratory symptoms.
• Shower and change clothes after spending time outdoors to remove allergens from your skin and clothing.

 Treatment to control respiratory allergy?

1.   Nasal Corticosteroids: Nasal corticosteroids are considered first-line treatment for allergic rhinitis (hay fever) and other respiratory allergies. They work by reducing inflammation in the nasal passages, relieving symptoms such as nasal congestion, sneezing, runny nose, and itching. Nasal corticosteroids used are:

Fluticasone propionate

Mometasone furoate

Budesonide

Triamcinolone acetonide

These have low side effects and can be used 2 times per day but consult the doctor before the use.

2. Antihistamines: Antihistamines are effective at relieving symptoms such as sneezing, itching, runny nose, and watery eyes by blocking the action of histamine, a chemical released during allergic reactions. Some popular options include:

Loratadine

Cetirizine

Fexofenadine

Azelastine nasal spray

Common side effects include Drowsiness, dry mouth/nose/throat, constipation, or fatigue so consult healthcare provider before the use.

3. Decongestants: Decongestants help relieve nasal congestion by constricting blood vessels in the nasal passages, reducing swelling and congestion. They are available in both oral and nasal spray forms. Examples include:

Pseudoephedrine

Phenylephrine

Oxymetazoline nasal spray

Common side effects include insomnia, anxiety, tremor and irregular heartbeat.

4. Leukotriene Receptor Antagonists: Leukotriene receptor antagonists are oral medications that help reduce inflammation and relieve symptoms of allergic rhinitis and asthma. Examples include:

Montelukast

Zafirlukast

Side effects includes: upper respiratory tract infection, cough, ear infection, sinusitis, diarrhea etc.