What is an allergy?

Allergy (sensitisation) – it is a body’s hypersensitivity to contact with allergen, i.e. a substance which causes pathological reaction of the immune system. It may manifest as a food allergy, airborne allergy or contact allergy. Each one may result in specific symptoms, such as hay fever, watery eyes or even anaphylactic shock in the most severe form. Allergic diseases may be hereditary and their occurrence is determined by specific groups of genes. But in fact we do not inherit the allergy itself, but a tendency towards it.

70%

of children in kindergarten and at early
school age suffer from allergy

Most common airborne allergens

Airborne allergy is the most common allergy throughout the world. The environment
around us is full of allergenic substances. Contact with them may result in
burdensome symptoms for the respiratory tract. The group of allergens which most
frequently cause airborne allergy consists of:

house dust mites

– they are microscopic organisms which belong to the group of arachnids. They feed on exfoliated human and animal epidermis and microorganisms (e.g. molds). Dermatophagoides pteronyssinus is the most sensitising and the most common species of mites at the same time. It can be found in all places in which dust accumulates – in bedding, mattresses and upholstered furniture.

pollen

– is mostly present in spring and autumn. It appears both outdoor and indoor. When pollen interacts with rhinitis or pharyngeal mucosa, it may cause multi-organ ailments of eyes, skin, mouth or throat.

pet allergens

– it is another group of allergens. The main source of them are proteins coming from pets’ saliva, skin and urine. Contrary to some common opinions, pets’ hair very rarely plays the role of an allergen. It is though a very good mean of transport for the allergens coming from sweat glands, saliva and urine.

fungal spores allergens

– are one of the biggest groups of living organisms. The parts of fungi, such as fungal spores or the elements of mycete can cause allergic ailments and the development of the disease. Fungi allergy usually co – exists with the sensitiveness to other aeroallergens, mainly pollen and house-dust allergens.

house dust mites allergy

Symptoms

Although sensitisation to household dust occurs year-round, its exacerbation is a diagnostic premise. It manifests in the morning and at night, most often in autumn and winter (when apartments are heated).

It was revealed that there is a linear relationship between the risk of developing asthma and the concentration of the primary allergen Dermatophagoides pteronyssinus (Der p1) in household dust - the risk is doubled every doubling of the concentration of Der p1 in a concentration range of 0.7 to 50 mg per 1 gram of dust.

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What is present in household dust?

Household dust is the most common factor causing allergic reactions. It contains nearly all allergens present at home, such as allergens of pets, molds and plant pollen.

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Where does the household dust accumulate?

It is recommended to spray areas in the apartment in which there is the highest level of household dust allergens – in particular mattresses, beds and other places where people sleep, quilts and pillows, upholstered furniture, carpets, rugs and curtains, and plush toys.

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ALLERGIC
RHINITIS

Symptoms develop as a result of inhalation of allergens by a sensitised person. Watery secretion, nasal obstruction (experienced as a sense of blocked nose), itching and sneezing appear within a few minutes since the contact with allergen. There is also a risk of acute and chronic sinusitis. Exacerbation of symptoms depends on the individual characteristics of allergy sufferer and the concentration of allergens at home. Severe cases of chronic allergic rhinitis may lead to sleep disorders and reduced daily
physical activity and cause difficulties in concentrating on learning and work. A year-round presence of sensitisation symptoms due to constant exposure to household allergens is a typical sign of allergic rhinitis. In order to distinguish this type of allergy from a common cold caused by viral infection, the attentions should be focused on duration of the symptoms. Viral rhinitis usually lasts for 10 days.

Allergic rhinitis is the most common non-infectious disease of the upper respiratory track. It was diagnosed in case of 36% of people tested ( ECAP – Epidemiology of Allergy Diseases in Poland). Allergic rhinitis may occur together with other allergic diseases such as: asthma, allergic conjunctivitis, atopic dermatitis.

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ATOPIC
DERMATITIS (AD)

Atopic dermatitis or atopic eczema is the most common skin disease, which first symptoms usually appear in early childhood.

According to some statistics, 10-20% of children and 1-3% of adults all around the world suffer from AD. 60% of children experience the first symptoms of it during the first twelve months of life. The symptoms continue up to the age of five among 90% of children.

The disease is caused by genetically determined structure of the epidermal barrier. A deficiency of free fatty acids in this area facilitates the penetration of allergens which intensifies the symptoms of inflammation and itching. The epidermis is dry and thickened. Atopis dermatitis may occur together with other allergic diseases such as: bronchial asthma, allergic rhinitis, hives and food allergy. Environmental factors such as house dust allergens – mites, animal dander, pets hair, fungal spores and plants pollen have a significant influence on the development and enhancing of Atopic Dermatitis.

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Symptoms

Typical symptoms include mainly the following: pruritus, dry skin, eczema-like inflammatory lesions and thickening of the skin (lichenification). The epidermis of people with AD consists of less ceramides and free fatty acids. For this reason, less water is bounded in the epidermis, thereby it evaporates faster. This reduces the elasticity of the skin, which becomes more susceptible to microtrauma and cracks.


The disease may occur together with other atopic diseases such as: bronchical asthma, allergic rhinitis, hives and food allergy. Allergens such as mites, animal dander, pets hair, fungal spores, plants pollen and food have a direct impact on atopic dermatitis. They are absorbed through the respiratory tract, gastrointestinal tract and the skin.

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AD treatment

  • The nesessity of avoiding allergens and other irritants
  • Daily maintenance of the epidermis combined with the emolient therapy
  • Anti-inflammatory therapy

Forms of Atopic Dermatitis (AD)

1

Pediatric AD

Its symptoms manifest themselves immediately after birth – skin becomes dry or there are skin lesions, such as erythema or exudate. They are located mainly near elbows and knee creases.

2

Children's

The dryness of the epidermis is accompanied by exfoliation and roughness. Skin thickens in the skin folds and on the forehead. On the elbows and knee creases there are alveolar-follicular lesions.

3

Adult-onset AD

In adult patients, skin lesions are usually present at elbows and knee creases and at the base of the neck. The lesions can cover a large part of the body and they usually are more visible on the neck and face.

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ASTHMA

Presence of allergens in the apartment (including house dust mite allergens) may lead to chronic bronchial inflammation. Patients periodically suffer from paroxysmal shortness of breath, coughing, wheezing and increased mucous secretion. Limited air flow through the bronchi under the influence of environmental factors is called bronchial hyperresponsiveness. This is a typical feature of asthma. There has been an increase of the number of people suffering from asthma over the last few years. The recent epidemiological studies have shown that 11% of children and 9% of adults in Poland suffer from it. The indicated number can in fact be higher as asthma is a disease which is very difficult to be diagnosed. Co-occurance of asthma, allergic rhinitis and atopic dermatitis has also been noted. Childhood is the time when the severity of those is the highest.

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The following environmental factors foster development of asthma and result in exacerbation of this disease:

  • exposure to airborne allergens
  • respiratory tract infections (especially viral ones)
  • air pollution
  • exhaust fumes
  • diet (food allergies)
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Course of the disease and its treatment

Asthma is a disease with a variable course, may be perennial or seasonal. It may be related to physical exercise undertaken, harmful environmental influence or occur as a side effect of some drugs. In each case, the disease may be different – its course may be mild, moderate or severe.


A crucial element of prevention and treatment of asthma is eliminating the allergens from the environment. Effective measures may relieve the symptoms, reduce the risk of exacerbations and protect against the development of allergic disease.

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Signs and symptoms

Variable and reversible airflow limitation through the bronchi, called bronchial hyperresponsiveness, is a typical symptom of asthma. It occurs spontaneously, but also under the influence of physical, chemical or biological agents.

Sometimes symptoms become exacerbated. They are characterized by increased dyspnoea, escalating cough, wheezing, chest tightness, which may impair lung function.

 

cough
wheezing
chest tightness

Chronic inflammation leads to the pathological repair processes, that is remodelling of tissues, which aggravate respiratory dysfunction. Bronchial smooth muscle contraction, mucosal oedema and overproduction of thick mucus take place during an asthma attack. Patients then feel a transient chest tightness.

Diagnostics

While diagnosing asthma, physician recognises symptoms typical for this disease. Specialised tests, which reveal limited airflow through the airways are performed. Examination of tissues located in the bronchi acquired during biopsy has significant value during diagnostic process.

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ELIMINATION OF ALLERGENS FROM THE ENVIRONMENT

  • relieves the symptoms
  • reduces the risk of exacerbations
  • protects against the development of allergic disease