Hayfever

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Do you have a constant, or seasonal runny nose and/or watery eyes? Do you suffer from sneezing at certain times? Do you get itching eyes, nose or mouth? If so, then you are showing the symptoms of a person who is allergic to something in the air we call an "allergen". An allergen is any substance that will provoke an allergy. We call hay fever, "allergic rhinitis" which is a more accurate term. The seasonal hay fever reaction can occur one or two days after exposure, particularly after rain - the rain water causing the bursting of pollen grains. The pollen grains being the "trigger".    Similarly, pollen grains encountering the moist surface of the inside of the nose, will rapidly burst to discharge their allergy-causing proteins right on the spot.

If you also have asthma, this can also be caused by the same allergens that cause your hayfever. If your asthma is due to pollen it tends to begin later in the pollen season than hayfever.

You should suspect hayfever in its broader sense, if you tend to sneeze or get a runny nose in the presence of a pet animal, when near dried leaves or rotting wood, feathers or in dusty areas or near specific substances, particularly chemicals.

WHAT IS HAY FEVER?

Hay fever in its strictest meaning is confined to pollen allergy. However, in popular

understanding it is taken to mean a runny nose due to allergy.  There are a number of allergies that will cause a runny nose (allergic rhinitis) and pollen is only one of these. Hayfever triggers include not only grass, flower and tree pollens, but also animal fur, dust mite, chemical fumes, microorganisms such as bacteria or viruses and molds as well as some foods. It is the most common form of allergy and has reached alarming proportions in the community, now affecting almost one in every two individuals at some time.  Once symptoms to hayfever have emerged they tend to persist for a long time. Seasonal hay fever comes from seasonal allergens such as pollens.  On the other hand persistent, or year long hay fever comes from perennial allergens such as moulds (molds) and mites.  

It is wind-borne pollen from grasses and certain trees like the pine that is the main cause of pollen-induced hayfever. This type of pollen is very light in order to be carried on the wind. Pollen that is insect-borne is generally heavier and sinks to the ground when released into the wind. This type of pollen is found in flowers and fruit trees.

Airborne irritants may produce rhinitis. These include Pine pollen, hairs from different fruit, smoke (particularly tobacco smoke), gases, chemicals, car exhaust fumes, polishes, cleaning fluids, paints, bleaches, formaldehyde from furnishings, rubber, carpets, paper, curtaining, leather, cosmetics, shampoos, soaps, sprays, dusts, flour, ozone emissions, plastics, photocopiers, new fabrics, new clothes and volatile plant substances.

Infective rhinitis, or inflammation of the nose, also produces a runny nose. The common cold is a good example. However, these infections usually last only a short time, unlike allergic rhinitis or hayfever.

Vasomotor rhinitis is a term reserved for rhinitis without obvious cause and thought to be due to blood vessel reactions within the nose.

WHY DO WE GET HAY FEVER?

The reason one becomes sensitised to allergens is unknown (even herds of cattle can get hayfever) but appears to be related to continued exposure. In humans, there is some evidence that chronic exposure to smoke, particularly tobacco smoke and car exhaust fumes, may sensitise the  mucosa (lining) of the nose, throat and trachea (windpipe) to protein particles in the air over a one or two year period. This can produce allergic reactions to inhaled proteins. For example, soya bean dust. There is increasing evidence that modern air pollution, containing a host of known and unknown chemicals is partly responsible for the increase in airborne allergy in recent times. Allergic rhinitis appears to be a mainly recent phenomenon (within the last 150 years).

Triggers are any substance that precipitates an allergic reaction in a person sensitised to a particular allergen. House dust mite and cockroaches are one of many triggers. The critical threshold of mite contact likely to lead to sensitisation of the nasal mucosa is around 2mcg of allergen/g of house dust. The level of dust mite in the residences of people who are allergic to dust mite is usually around 10mcg/g dust.  In hay fever sufferers, attacks can be brought about by exposure to these triggers.

Executives, office, factory and farm workers are exposed to many different chemicals in the workplace which may precipitate an allergic reaction in the form of  runny' nose,  watery eyes or bronchial asthma.  Air-conditioning may recycle moulds, chemicals, bacteria, viruses, tobacco smoke, perfumes and toiletries around the building.

Housewives and family members are similarly exposed to chemical fumes that come from furnishings around the home as well as exposure to cleaning substances.  Even clothes may have chemical smells that can trigger an allergy.  Allergies can also come from things of animal origin such as hairs of household pets. Gas fumes from heaters are known to cause illness in children as well as adults.

Allergy can come from natural honeys and chamomile tea.  Food allergy is well known in some patients with hay fever. Florido-Lopez and others showed this to be true of natural foods such as honey or chamomile tea. Nine patients with hay fever, with or without asthma, who had an allergic reaction after eating natural honey and/or drinking chamomile tea, were shown to have a high allergic reaction to sunflower pollen in the honey. Pollen of Compositae plants may be responsible for allergic reactions to certain natural foods.

Chocolate can contribute to salicylate intolerance, leading to asthma and hayfever. Among 1129  adult patients with bronchial asthma and/or allergic rhinitis 276 (24%) of the patients reported some kind of allergic symptoms on eating or handling various foods, of which hazel nut, apple and shell fish were the most often named according to Eriksson. A correlation was found between birch pollen allergy and food sensitivity with nuts, apple, peach, cherry, pear, plum, carrot and new potato. The higher the degree of birch pollen allergy, according to allergy testing the higher the frequency of food sensitivity. A correlation was found too between acetylsalicylic acid intolerance and food sensitivity with some foods, e.g. nut, strawberry, almond, green pepper, hip, chocolate, egg, cabbage, milk and wine. The high incidence of food sensitivity in acetylsalicylic acid-intolerant patients is probably explained by additives in foods as well as salicylates or benzoates naturally occurring in some food.

The case histories of 1565 hay fever patients in Germany was analyzed by Wuthrich.  Almost  8% of them were sensitized to grass or cereal pollens  However, only 18% suffered from summer hay fever, while 35% suffered from spring hay fever and 50% by weeds (Plantain, nettle, mugwort) the cause of late summer hayfever.

Ericksson stated that of 939 patients with asthma and/or hayfever 85% were allergic to cat, timothy or house dust mite.  98% of allergy patients with seasonal hayfever were found to react to timothy, birch and mugwort pollen.

Allergy reactions often manifest themselves as hay fever or bronchial asthma. The cause is often a food-associated allergy syndrome in which there is a cross-reaction between certain types of pollen (e.g. birch, alder, hazel and mugwort) and food allergens (e.g. drupes, pomes, nuts, vegetables such as celery, carrots and fennel, etc.) according to Gluck. The oral allergy syndrome (OAS) is usually restricted solely to the mouth and the throat. Following the intake of fruit the complaints are mouth ulcers, swelling of the lips and/or tongue, irritation of the hard palate, hoarseness and compulsive clearing of the throat. Nuts and celery, among others from the family Compositae, often cause acute, allergic attacks with sometimes serious general

symptoms such as swelling of the vocal cords, bronchial asthma, urticaria and even

anaphylactic shock. In the sensitization against animal allergens, it must not be forgotten that the most powerful causes, can be in the urine of small rodents (mice and rats). In the manufacture or application of fish food with red gnat larvae, people who are disposed to this will often react with an attack of bronchial asthma.

One hundred adult patients with a history of oral allergy syndrome (OAS) after ingestion of fruits and vegetables were tested by Ortolani and others. Seventy seven of the patients suffered from hay fever and 13 tested positive for pollens. Correlation between the allergy tests and allergy symptoms of hay fever existed for carrot, celery, cherry, apple, tomato, orange, and peach; better with commercial extracts for peanut, pea, and walnut; and better with serum  blood tests (RAST) for hazelnut.

Patients with allergic rhinitis/conjunctivitis (hayfever and watery eyes)  to birch pollen may have additional hypersensitivity to nuts and apples according to a study of 47 patients by Fogle-Hansson . This was worse during the pollen season. Allergy to nuts is an indication of a more severe allergy in patients with birch pollen allergic rhinitis (hayfever).

Airborne allergy is persistent in places like Ticino, Switzerland where in a study by Gilardi and others, patients were found to have symptoms of hay fever almost 10 months a year. Asthmatic symptoms were found in about 23% of the patients. At the top of the allergen list were grass-pollens (72% of the patients had  sensitivity); rye (69%); olive tree (54%); birch (46%); chestnut (37%); ash tree (36%); alder tree (33%); ragweed (17%); parietaria (18%). Of  real interest in this study area are, besides the classical allergy-inducing pollens, those of chestnut, parietaria, olive tree, ash tree and cypress. Chestnut pollens represent about 30% of the airborne pollens in this region. 30% of the patients had  sensitivity against dust mites and

20% against cats. Sensitivity against 8 mould spores was 2-9%.

Susuki and others tested 267 patients with allergic rhinitis (hay fever), in Japan and found allergy to conifers - Japanese cedar, mite and Japanese cypress. One-third of patients were allergic to the silkworm moth. Correlations between silkworm moth and silk, and silkworm moth and chironomid midge were found to be significant. Silkworm moth allergen is important in patients with allergic rhinitis in Japan.                                      

A study by Guerin and others to determine the relative importance of mites as a cause of hay fever and asthma on the western Indian Ocean island of Mauritius measured allergy to common inhalant allergens in Mauritians claiming to have allergic symptoms. By far the most prevalent allergy was to one or both of the common house dust mites being present in almost two-thirds of the people studied. Allergy to a limited number of moulds was detected in 22% of the Mauritians. Three quarters were asthmatic, and 75% of these asthmatic individuals had allergy to  mites. In contrast, only one third of the Mauritians with hayfever without asthma were sensitive to mites. On the bases of this survey, Guerin concluded that the house dust mite D. pteronyssinus is the principal cause of allergic sensitivity and asthma in that tropical environment.

Hypersensitivity to cockroach antigen has been recognized as an important cause of perennial allergic rhinitis and asthma. Twenty-two of 61 patients who had a history of cockroach exposure had positive skin tests and 23 of those showed specific antibodies against oriental and German cockroaches according to Pola and others. Approximately 15% of asthmatics in the Madrid area are sensitive to cockroaches.

Airborne pollutants may cause a wide variety of allergies according to a review from Bethesda, USA.. Airborne pollutants, both chemical and natural, may cause localised and general body reactions producing either overactivity or suppression of the immune system.  For the most part, airborne pollutants (small molecular weight chemicals) have to be coupled with other substances (proteins or conjugates) before they can be recognized by the immune system and exert their effects. Fortunately, this encounter is thought to rarely causes allergy.

To find the cause of  an allergy needs considerable diagnostic skills, otherwise a lot of money and time can be spent looking at the wrong answer before you get to the correct answer. This is where allergy testing is able to save you money.

WHAT CAN I DO ABOUT MY HAY FEVER

Sometimes, allergy to hayfever is merely a minor inconvenience and can be controlled by avoiding areas where these allergens are present, if that is known. You can usually tell where the allergens are present because you get a reaction when you go to that place.

When Doctors are Needed:

However, if the symptoms become severe, they can become an important problem to the health and lifestyle. In this case, treatment may be needed by a doctor.

You should definitely seek medical advice if your hayfever is accompanied by asthma, or if you want to know what allergen is the cause of your rhinitis. In most cases an Environmental Physician or Allergist can provide immunotherapy which will build up your tolerance and can usually provide good relief from symptoms. There must however be a positive skin reaction to an allergen for immunotherapy to work. Sometimes the beneficial response to immunotherapy can be quite dramatic.

What to expect when you consult a professional: If  you ask your doctor to help you, then he or she will give you a full allergy assessment which will involve a physical examination and various pathology tests and perhaps X-rays to help determine the effect of the allergy on your body and to try and locate the exact allergen responsible for your condition.

HOW CAN I BE TESTED FOR HAY FEVER?

For pollens, animal danders, molds and dust mite, you could have a RAST test performed by a doctor. This is a blood serum test that can be performed for hayfever by a medical laboratory. It is not always positive even in the presence of airborne allergy.

Better, you could have a skin test performed by an Environmental Physician or Allergist for pollens, animal danders, molds and dust mite. This is the most reliable test for identifying allergens. Specific allergens are used to detect reactions to specific proteins present by applying these to the skin. These skin reactions are carefully read and tested against control substances from the laboratory.

Food reactions can be tested by an Environmental Physician or Allergist.

You can have a laboratory culture and antibiotic sensitivity test performed for bacterial triggers. This would be ordered by your doctor if he suspected this as a cause of your reaction. However, viruses on the other hand, are difficult to identify and tests for these are expensive. A reaction to chemical fumes requires special testing by an Environmental Physician.

WHAT IS THE BEST TREATMENT FOR AIRBORNE ALLERGY?

If you know, or suspect, that an airborne allergen causes persistent symptoms, then testing at an Allergy Centre for sensitivity to hayfever allergens is the best way to go. This way, a vaccine can be developed to give your more permanent relief.

If you suspect a food then avoidance of that food should be attempted.

If you have not succeeded in finding the cause of your symptoms, you should seek professional help from an environmental physician or Allergist and take your test results with you.  If you have succeeded in identifying the causative food then you should avoid that food.

If you proceed to significantly restrict your diet ensure you take a multivitamin and

multimineral capsules each day to prevent vitamin or mineral deficiencies

SHOULD I BE DESENSITISED AGAINST HAY FEVER?

A course of immunotherapy (called desensitisation) should help with airborne allergens.  This removes the cause of your allergy, unlike medication, which provide only temporary relief.

SHOULD I BE VACCINATED?

Once the cause of your allergy has been ascertained, and a positive skin test obtained, then a specific vaccine can be created to desensitise you against the allergen that is triggering your symptoms. In this case, the specific airborne protein producing your allergic response.

They contain small amounts of the airborne allergens to which you are allergic.  The

body will defend itself by making antibodies to the allergens injected. This helps build up your defences against further reaction.  Also, injections "switch on" a part of your immune system which acts to reduce allergic responses.

WILL IMMUNOTHERAPY PREVENT MY ALLERGY SYMPTOMS?

No immunotherapy can guarantee complete success with everyone. However, it is possible to get complete, or almost complete relief of distressing symptoms of your allergies providing your allergy testing has correctly identified the allergens which cause your symptoms, and the immunotherapy treatment is given for a sufficient length of time.

WHAT IS INVOLVED IN A COURSE OF IMMUNOTHERAPY TREATMENT?

Immunotherapy treatment is usually given by a small injection into the outer aspect of the upper arm, and is generally given weekly or fortnightly.  Tiny amounts of a specially prepared allergen formula are placed under the skin. The injections are virtually pain free.  If the treatment is for a seasonal allergy then the best results are obtained if treatment is given  over three years for a short period before the season commences.  Each year injections are increased in strength.  The benefits of the injections, as against over-the-counter suppressive medications, is that desensitisation prevents seasonal symptoms occurring for up to ten years.

Successful desensitisation provides relief and also means medication does not need to be purchased.

For perennial or non-seasonal allergy which you suffer continually, treatment is given continually each week until symptoms cease. This means that the dose is gradually increased until symptoms are allayed. Benefit can last for up to ten years or more, and again, successful desensitisation means that relief is obtained and  medication will not need to be purchased.

Although the injections may be of a long-acting slow-release preparation it is best not to miss any.  If however, if you must skip an injection or two then the dose of the next injection may have to be modified, according to the time interval since the last injection.

Side effects from the injections are rare when properly administered and are given regularly.  Occasionally there may be slight swelling or itchiness at the site of the injection as you develop resistance to the allergen, but it should last only a brief time. If this should occur your doctor may advise you to take an antihistamine a short time before you have the desensitising injection although this should be rare.  Should the injection trigger any of your allergy symptoms then your doctor will treat your allergy and decrease the dosage of the next injection.

An adequate course of immunotherapy can give many years of relief from symptoms.  It means you have developed long-lasting immunity. If at any time in the future the same or other allergy symptoms may arise it is possible to have further immunotherapy, with equal success.

YOU CAN HELP YOURSELF

If your allergy is severe then you should avoid hot drinks if possible as these increase the blood flow and therefore swelling and blocking of the nasal mucosa. An air filtering unit in the home will help remove unwanted dust and pollen grains in the air.

What is the best medication to use?  The following medications will help control the symptoms  of your allergy, but they do not take away the cause. To remove the cause needs proper diagnosis and treatment.

Symptomatic treatment relief for itches, rashes, a runny nose and eyes or hives can be obtained through the use of antihistamine tablets or capsules from your local chemist and these can give good relief in most cases.  It is best to use a non-sedating type which does not make you sleepy.

If you have a sinusitis, productive cough or an allergic eye condition then ask your

chemist for a suitable decongestant to use. Decongestant eye drops can also be bought and are useful for red, itchy, watery eyes.

If you have a rash or hives then your chemist can supply suitable soothing creams or creams containing antihistamines or steroid preparations which will ease the effect of the rash.

More severe conditions will require the attentions of a doctor and prescription medication, including steroids.

Females who are pregnant, or likely to become pregnant, should avoid all but essential medication until the baby is weaned. In this instant a visit to a doctor for advice and treatment is necessary.

WHERE IS THE BEST PLACE TO SEEK TREATMENT?

For simple relief you can consult your chemist. For proper investigation and treatment then you will need to consult your local doctor or visit an Environmental Physician or Allergist.

CAN I GET A CURE FOR AIRBORNE ALLERGY?

There is no "cure" as such for hay fever. Sustained, and maybe permanent relief can be obtained by staying away from highly contaminated areas and treating any exposure that occurs as soon as possible.

 . . more about allergies and your immune system.

Your body has an immune system which identifies what belongs to your body (self) and what does not belong to your body (non-self). It detects and fights invading organisms (non-self) by attacking the protein of the invader. Without the immune system we would fall helpless to infection. However, for reasons largely unknown, the immune system may become sensitised to a foreign protein and create an allergy with all the resultant discomfort.

Allergens may lurk in house dust causing an allergy to the dust. While the house may be very clean, nevertheless small particles of hayfever-causing allergens in a house will continue to be present even though you may not see the particles.

Precipitation of food allergy reactions is well known in some patients with pollinosis when they consume natural food, such as honey or chamomile tea according to a study from Jaen, Spain. The study presented 9 patients with hay fever, with or without asthma, who experienced systemic allergic reactions after ingestion of natural honeys and/or chamomile tea. Pollen analysis showed a high level in sunflower pollen (23.6% of pollen grains) in the honey. The diagnosis of food and respiratory allergy was based on history, skin prick tests and specific IgE activity against pollen from Compositae. Conjunctival challenge with chamomile extract also gave positive results. The above allergological tests and the inhibition studies carried out, suggest that pollen of Compositae may be responsible for allergic reactions to certain natural foods and that the reactions are mediated by an IgE-related mechanism. Florido-Lopez and others

 Among adult patients with bronchial asthma and/or allergic rhinitis, 1129 answered a questionnaire regarding food sensitivity (FS). 276 (24%) of the patients reported some kind of allergic symptoms on eating or handling various foods, of which hazel nut, apple and shell fish were the most often named. A correlation was found between birch pollen allergy and FS with nuts, apple, peach, cherry, pear, plum, carrot and new potato. The higher the degree of birch pollen allergy, according to skin test, RAST or provocation test, the higher the frequency of FS. A correlation was found too between acetylsalicylic acid intolerance and FS with some foods, e.g. nuts, strawberry, almond, green pepper, hip, chocolate, egg, cabbage, milk and wine. The connection between birch pollen allergy and FS is probably explained by the structural relationship between birch pollen allergen and some allergens of the foodstuffs, whereas the high incidence of FS in acetylsalicylic acid-intolerant patients is probably explained by additives in foods as well as salicylates or benzoates naturally occurring in some food. Eriksson NE.  

The case histories of 1565 hay fever patients in Germany were analysed.  44.2% had other allergic conditions including dermatitis, rhinitis, asthma, urticaria, food allergy, drug allergy and insect sting allergy.  97% of the pollen allergics suffered from rhinitis, 95% from conjunctivitis, 40% from bronchial asthma and another 20% from tracheobronchitis or asthmatic bronchitis.  Almost 98% of them were sensitized to grass or cereal pollens.  However, only 18% suffered from summer hay fever, 35% suffered from spring hay fever and 50% by weeds (Plantain, nettle, mugwort) the cause of late summer hayfever.  In 1% of the patients with a clear-cut history and clinical symptoms of hayfever, all the skin tests were negative.  In these cases the sensitization was probably restricted to the respiratory tract. Wuthrich B et al.

939 patients with allergic airways diseases were analysed by Eriksson. It was found that an allergen panel consisting of cat, timothy and house dust mite could detect 85% of allergic patients with asthma and/or rhinitis.  98% of allergy patients with seasonal hayfever were found to react to Timothy, birch and mugwort. It is concluded that screening methods using only three of four allergens could be used for detecting atopic allergy in patients with airways diseases. Eriksson NE

One hundred adult patients with a history of oral allergy syndrome (OAS) after ingestion of fruits and vegetables were tested in Milan, Italy. Seventy seven of the patients suffered from hay fever and 13 tested positive for pollens. Correlation between the allergy tests and allergy symptoms was better with skin prick tests using fresh food, for carrot, celery, cherry, apple, tomato, orange, and peach; better with commercial extracts for peanut, pea, and walnut; and better with serum  blood tests (RAST) for hazelnut. Tests were determined for apple, carrot, hazelnut, orange, pea, peanut, and tomato. The diagnostic accuracy of these tests in people with OAS proved comparable for peanut, carrot, hazelnut, and pea. Fresh food skin prick testing however proved more sensitive than the other methods with certain alimentary allergens, such as apple, orange, tomato, carrot, cherry, celery, and peach. Ortolani and others

To determine the relative importance of mites as a cause of allergic sensitivity and asthma on the western Indian Ocean island of Mauritius, Guerin and others,  measured specific IgE antibodies to common inhalant allergens in sera from 110 Mauritians claiming to have allergic symptoms and examined house dust samples for evidence of mites and their allergens. Sixty five of the sera tested contained detectable antibody to at least one mite, mould or pollen allergenic extract. By far the most prevalent was antibody to one or both of the common house dust mites, Dermatophagoides pteronyssinus and Dermatophagoides farinae, being present in 61% of the sera. Allergy to pollens, including the locally prevalent Bermuda grass and sugarcane, was infrequent. Antibody to a limited number of moulds was  detected in 22% of the sera tested. Of 81 subjects whose clinical history was known, 60 were asthmatic, and 75% of these asthmatic individuals had IgE antibody to mites. In contrast, only 35% of the subjects with rhinitis without asthma were sensitive to mites. On the bases of this survey, Guerin concluded that the house dust mite D. pteronyssinus is the principal cause of allergic sensitivity and asthma in that tropical environment. Guerin and others

Classical allergy symptoms manifest themselves mainly in hay fever or bronchial asthma. In a not inconsiderable number of cases, the question of oral complaints, connected with the intake of certain foodstuffs, is ignored by the medical profession according to a study from Germany. Here, we are dealing with what is known as food-associated allergy syndrome, which is largely based on a cross reaction between certain types of pollen (birch, alder, hazel and mugwort) and food allergens (drupes, pomes, nuts, vegetables such as celery, carrots and fennel, etc). Whereas following the intake of fruit the complaints are usually restricted solely to the oral cavity and the throat (aphthas, stomatitis, swelling of the lips and/or tongue, irritation of the hard palate,   hoarseness and compulsive clearing of the throat), nuts and celery among others from the family Compositae often cause acute, allergic attacks with sometimes serious general symptoms such as laryngeal oedema, bronchial asthma, urticaria and even anaphylactic shock. In the sensitization against animal allergens, it must not be forgotten that the most powerful immunogens are to be found, for example, in the urine of small rodents (mice and rats). In the manufacture or application of fish food with red gnat larvae, people who are disposed to this will often react with an attack of bronchial asthma.     Gluck U .

This study, in Skovde, Sweden,  was performed in patients with allergic rhinitis/conjunctivitis to birch pollen to determine whether patients with additional hypersensitivity to nuts and apples differed from patients without such hypersensitivity. Forty-seven patients with birch pollen allergy were investigated by RAST against  birch and hazel pollen and by skin prick test. They were treated in a randomized, double-blind, placebo-controlled study. The area of the skin prick tests was larger and the specific IgE values higher in patients with hypersensitivity to nuts and  apples. These patients also had more symptoms during the pollen season. We conclude that hypersensitivity to nuts is an indication of a more  severe allergy in

patients with birch pollen allergic rhinitis. .Fogle-Hansson M

A study was carried out in the southern part of Switzerland (Canton Ticino) in 1990-1993 to determine the spectrum of cutaneous sensitivity to a large amount of pollens and several perennial allergens (50), using skin prick tests in a sample of 503 consecutive patients suffering from hay fever. The results of the study indicate that  in this region the patients have symptoms of hay fever almost 10 months a year Asthmatic symptoms were found in about 23% of the patients. At the top of the allergen list were grass-pollens (72% of the patients had sensitivity); rye (69%); olive tree (54%); birch (46%); chestnut (37%); ash tree (36%); alder tree (33%); ragweed (17%); parietaria (18%). Of  real interest in this study area are, besides the classical allergy-inducing pollens, those of chestnut, parietaria, olive tree, ash tree and    

cupressaceae (for example cypress). Chestnut pollens represent about 30% of the airborne pollens in this region. 30% of the patients had  sensitivity against dust mites (Dermatophagoides pteronyssinus und D. farinae), and 20% against cats. Sensitivity against 8 mould spores was 2-9%. Gilardi S. and others

To determine the importance of silkworm moth allergens, a study from Japan tested 267 patients with allergic rhinitis with CAP-RAST, a new assay system for detecting specific IgE in sera. We used the following allergen sources: house-dust mite, Candida, Alternaria, cat dander, orchard grass, ragweed, mugwort, Japanese hops, Japanese cedar, Japanese cypress, cotton, silk, larval chironomid midge, adult chironomid midge, and silkworm moth. As expected, the highest positive rate of reaction, as determined by CAP-RAST, was 73.8% for Japanese cedar, followed by 53.2% for mite and 50.6% for Japanese cypress. Although the positive rate for silkworm moth was not as high as for cedar pollen, one-third of patients had

specific IgE against silkworm moth. The positive rate of reaction to silkworm moth was much higher than that to chironomid. It was interesting to note that the patients reported had not been documented as having frequent contact with silkworm moth allergen. Correlations between silkworm moth and silk, and silkworm moth and chironomid midge were found to be significant. Silkworm moth allergen showed the third highest reaction rate in patients with severe symptoms. These results suggest that silkworm moth allergen should be considered to be important in patients with allergic rhinitis in Japan.  Suzuki M and others   

Hypersensitivity to cockroach antigen has been recognized as an important cause of perennial allergic rhinitis and asthma. To assess the frequency of cockroach hypersensitivity in our country, 150 asthmatic atopic subjects were studied using skin testing and in vitro assays for cockroach-specific IgE antibodies (Oriental and German cockroaches) in a study from Madrid, Spain. Twenty-two of 61 patients who had a positive history of cockroach exposure had positive skin tests, and only 3 of 89 patients who had no history of exposure had positive skin reactions. Of 25 patients with positive skin tests, 23 showed specific IgE antibodies against oriental and German cockroaches using RAST and EIA techniques. In summary, approximately 15% of asthmatic atopics in Madrid area are sensitive to cockroaches (positive

skin test + specific IgE antibodies). These results indicate that cockroach hypersensitivity should be considered in every patient with perennial asthma. Pola and others Airborne pollutants may cause a wide spectrum of immunologically mediated disorders. Interaction with the immune system may result in local and systemic responses, and studies have shown examples of disease occurring from both overactive immune responses and immunosuppression. For the most part, airborne pollutants (small molecular weight chemicals) have to be coupled with other substances (proteins or conjugates) before they can be recognized by the immune system and exert their effects. Fortunately, this encounter rarely causes immunologically mediated human disorders. Albright JF

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REFERENCES

Albright JF. Goldstein RA     Airborne pollutants and the immune system. [Review]     

Otolaryngology - Head & Neck Surgery. 114(2):232-8, 1996 Feb. 96225847

Eriksson NE . Allergy screening in asthma and allergic rhinitis. Which allergens should be used? Allergy. 42(3):189-95, 1987 Apr. 87239285

Eriksson NE.  Food sensitivity reported by patients with asthma and hay fever. A relationship between food sensitivity and birch pollen-allergy and between food sensitivity and acetylsalicylic acid intolerance. Allergy. 33(4):189-96, 1978 Aug.   79060167

Florido-Lopez JF. Gonzalez-Delgado P. Saenz de San Pedro B. Perez-Miranda C. Arias de Saavedra JM. Marin-Pozo JF.  Allergy to natural honeys and chamomile tea.  International Archives of Allergy & Immunology. 108(2):170-4, 1995 Oct. 96021100

Fogle-Hansson M. Bende M . The significance of hypersensitivity to nuts in patients with birch pollen allergy. Allergy. 48(4):282-4, 1993 May. 93319092

Gilardi S. Torricelli R. Peeters AG. Wuthrich B. Pollinosis in Canton Ticino. A prospective study in Locarno. [German]  Schweizerische Medizinische Wochenschrift. Journal Suisse de Medecine. 124(42):1841-7, 1994 Oct 22. 95063777

Gluck U . Neglected allergens. [German] Therapeutische Umschau. 49(10):669-73, 1992 Oct.

93069018

Guerin B. Levy DA. Lemao J. Leynadier F. Baligadoo G. Fain A. Dry J.   The house dust mite Dermatophagoides pteronyssinus is the most important allergen on the island of Mauritius Clinical & Experimental Allergy. 22(5):533-9, 1992 May.  92331003

 McEvoy R, Allergies and other Environmental Illnesses: A Practice Handbook for

Doctors, 1992.

Merck Manual, Merck Sharp & Dohme Research Laboratories, Rahway, N.J.

Middleton E, Jr, Reed CE, Ellis EF, Allergy Principles and Practice, Mosby St Louis, 1978

Ortolani C. Ispano M. Pastorello EA. Ansaloni R. Magri GC Comparison of results of skin prick tests (with fresh foods and commercial food extracts) and RAST in 100 patients with oral allergy syndrome.  Journal of Allergy & Clinical Immunology. 83(3):683-90, 1989 Mar89175910

Pola J. Valdivieso R. Zapata C. Moneo I. Duce F. Larrad L. Losada E. Cockroach

hypersensitivity in asthmatic patients. Allergologia et Immunopathologia. 16(2):105-7, 1988 Mar-Apr. 88279298

Suzuki M. Itoh H. Sugiyama K. Takagi I. Nishimura J. Kato K. Mamiya S. Baba S. Ohya Y. Itoh H. et al. Causative allergens of allergic rhinitis in Japan with special reference to silkworm moth allergen. Allergy. 50(1):23-7, 1995 Jan. 95259751

Wuthrich B. Annen H.   Pollinosis:1.  Findings on the clinical aspects and the pollen spectrum in 1565 pollen-sensitive patients.  Schweizerische Medizinische Wochenshrift. Journal Suisse de Medecine. 109 (33):1212-8,1979 Sep. German

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