"Allergy" is perhaps the most widespread chronic health condition in the world,
according to the Encyclopedia Britannica, and it is estimated that one out of every four people is a CHRONIC allergy sufferer. An allergy is a hypersensitivity, or an abnormal reaction, to a substance that is harmless to most people. Allergy is an extremely serious health problem, which continues to grow rapidly in the developed world. The substances that cause allergies are called allergens or antigens . It is the fact that the immune system always becomes involved to try to defend us from these ordinarily harmless substances which differentiates an allergic reaction from any other type of reaction.
The basic biological mechanism behind each of the allergic illnesses is almost identical. Allergies may be taken into the body in four different ways: 1) through the nose, throat, and lungs (such as in airborne substances we inhale); 2) through the mouth and digestive system (such as in the food, liquids or drugs that we ingest); 3) through the substances and chemicals that come in contact with our skin (such as plants, cosmetics, cleaning detergents, etc.); and 4) through the tissues under the skin (such as injected vaccines, medicines, animal bites or insect stings).
Repeated exposure to an allergen causes the body to release antibodies, which attach themselves to the surface of special cells called mast cells.
The mast cells respond by releasing a range of chemicals which cause blood vessels to expand and leak fluid, and the tubes (or airways) in the lungs to contract.
This type of immune response then summons up attacking cells to destroy the substance that is "invading" the body, which is, in fact, NOT doing any real harm to the body at all.
An inflammation is then set up by the most important of the attacking cells, to try to defend the body from the allergen, or the perceived "invader". This response works quite well when the invading substance is actually harmful, but is very counter-productive when dealing with an allergen that is quite harmless to non-allergic individuals.
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HOUSE DUST MITES: It is actually the droppings from the millions of these tiny creatures that share our homes that can cause problems for allergic people, as well as be a major trigger for asthma. These mites especially flourish in bedrooms and sitting rooms, as they like warm, humid conditions and live on the abundant skin cells which we shed each day.
MOLDS: Indoor or outdoor growths which release spores into the atmosphere, molds can also be implicated in asthma or explain why some people experience hay fever symptoms after the pollen season is over.
POLLENS: Hay fever is the condition most likely to be caused by pollen allergy. From Spring through Autumn, grasses, trees and weeds release hundreds of varieties of pollens. Geographical considerations play an important role in pollen allergies, as well as environmental factors, such as global warming.
FOODS: Food allergies are actually much less common than you might expect; however, they can cause very severe reactions in some people. Peanuts, eggs, milk and fish, in particular, are known to have caused problems for allergic people.
PETS: All warm-blooded creatures, including hamsters, birds, ferrets and gerbils (as well as cats and dogs), shed allergens which may be more likely to provoke asthma and rhinitis symptoms.
ADDITIONAL TRIGGERS: A very small percentage of people have become so highly sensitized to certain bee and wasp stings that they can have life-threatening reactions, and they have to change their lifestyles accordingly. Other possible allergens for allergy-prone people are certain medications, chemicals, rubber, metal jewelry, plants, and even sunlight.
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The primary determining factors as to whether a person will develop allergies or not seem to be both genetic and environmental. If you have close relatives that suffer from allergies of any kind, the likelihood is greater that you come from an "atopic" family. This means that you may have inherited the potential to produce higher than normal levels of IgE in response to contact with an allergen.
The only way for you to become allergic to a particular substance is to be exposed to this substance.
It is often thought that the first few months of life may be particularly important in this respect, as well as where you grow up. An example sometimes cited is that people born in the United States are more likely to be allergic to peanuts, because peanut butter is a very common food in this country, while people born in Sweden are more likely to be allergic to salmon, which is eaten in large quantities in that country. There is also evidence that genetically susceptible people born in the pollen season are more likely to suffer from hay fever. It is especially important for babies from "atopic" families to be breast-fed, as breast milk protects against the development of allergy.
There is a recognized difference in the scientific community between an allergy source and an irritation source. No one yet knows the full story as to why each develops and the various forms that they take.
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Sensitivities to animals is one of the most frequently seen allergies. Cats actually cause the most allergic reactions, but any animal with fur or feathers could also become a trigger for such symptoms as red, itchy, watery eyes; nasal congestion; itchy nose; sneezing; difficulty breathing; chronic sore throat and/or scratchy throat; coughing, wheezing, or itchy skin.
It is the Fel d 1 substance, produced in the sebaceous glands of the cat's skin and in cat saliva, which is believed to be the major allergen that most people who are allergic to domestic cats are actually reacting to. The dander (old skin cells) which animals shed constantly into the environment, are tiny micron-like particles that cling to furniture, draperies and wall coverings, and can cause problems for allergic people. The Fel d 1 airborne particles are the same size as bronchial medication droplets designed to penetrate into bronchial membranes...so, no wonder cat allergy can lead to asthma!! And, Fel d 1 (short for "Felis domesticus, i.e., the domestic house cat), which comes from the fatty secretions called sebum, can live for months or even years even after the cat is removed from the environment. Interestingly, female cats shed substantially LESS amounts of allergen than males, and a neutered male sheds significantly less than a full male tom. Other recent studies have shown that, regardless of the breed or sex of the cat, far more people have allergic reactions to darkly colored and pigmented cats versus lighter colored cats with less pigment.
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Having pets is supposed to be good for you...after all, studies have proven that pet owners tend to live longer than non pet owners, presumably because caring for a pet eases the stress of daily living. There have been some dramatic advances by scientists and researchers in the understanding and management of airborne animal allergens. It is important to remember that ALLERGIES ARE CUMULATIVE ; that is, they build up. People also can have varying degrees of sensitivities to different allergens. Dust, mold, mildew, pollens, paint, perfumes, cosmetics, and many, many other substances can trigger allergic reactions, and whether or not a person has symptoms depends upon HOW MANY of these allergens are IN HIS ENVIRONMENT at a particular time. Remember that this is a constantly changing factor, depending upon a wide variety of conditions that occur in the home environment.
It makes sense, then, to minimize your exposure to other allergens that trigger attacks, for people allergic to their pets. Every allergic person has a tolerance level that is unique to them, and above which an acute allergic reaction takes place. As long as your total exposure is below your allergy threshold, you will not have a reaction. Sometimes, just by having a female or a neutered male cat will be enough to keep your allergen exposure below your threshold level. Many people highly allergic to cats have, over time, become "immune" to allergic symptoms from THEIR OWN CATS; however, they most often will still have allergic reactions of varying intensity to OTHER cats.
Other things to do around your home to lower your exposure: Since the allergens from cats are airborne and get into everything in the house, you can do several things to help reduce the number of cat-allergen reservoirs. Reduce the amount of carpet in your home, especially in the bedrooms and sitting rooms...learn to love hard wood floors!! Cover your mattresses and pillows with air-tight encasings, and reduce the number of upholstered furnishings, especially in the bedrooms. Have someone else do your vacuuming, or use vacuums with the built-in high efficiency (HEPA) filters. In our home, we use Indoor Air Purification Units (those which use ozone as well as ionization), which greatly reduce the number of allergens in the air of our home, as well as virtually eliminating pet odors, cooking odors, and other unpleasant, lingering odors in a home.
What about allergy medications? There are many new medications (without unpleasant side effects) such as nasal steroid sprays, which reduce allergic inflammation in the nasal area and help reduce the bronchial inflammation that leads to coughing, wheezing and chest tightness. Plus, there are now several different "over the counter" products for applying directly to the cat, which are supposed to help reduce their dander and keep them from shedding their allergens.
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While not for everyone, significant improvement is seen in about 80% of people who follow immuno-therapy. The biggest drawback to having allergy shots is that they can be inconvenient, as typically, the tiny injections are given twice weekly for six months, then every three to four weeks for three to five years. And, unfortunately, because of the nature of the therapy, adverse reactions are common, although serious adverse reactions are very rare. This is because the serum you are given in the injections is made from extracts of the items you are actually allergic to. And, while immuno-therapy is not a cure for allergies, it is considered more effective than medication alone because it treats the cause of your allergic reactions, not just the symptoms. And, every day, newer, more accurate, and safer forms of immuno-therapy are being developed.
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Washing your cat!! A recent study done at the University of Virginia Asthma and Allergic Diseases Center in Charlottesville has suggested that frequently washing your feline could reduce the shedding of allergy-irritating proteins (Fel d 1). "The major findings of the paper are that even though the (allergen) levels are reduced, they are not maintained at low levels for long periods of time so you would have to repeatedly wash the cat - which may not be that feasible for the patient," said senior investigator Dr. Judith Woodfolk. "The findings were not negative - and that is important - but it was just that you would have to (continue) to wash the cat, maybe every two to four weeks," she continued. Cats washed with soap, water and a hose had a 44% decrease in an allergy-causing protein, while those totally immersed in tap water had a 79% reduction in allergen level in the week after the washing. There are more and more products coming onto the market to deal with this problem, including special wipes to help you reduce the allergens on your pets. Some people have found these products highly effective.
Synthetic Epitope Vaccine: Researchers at the John Hopkins University School of Medicine were recently conducting trials with an epitope vaccine developed from the cat dander allergen Fel d 1. The vaccine consisted of two 27 amino acid peptides derived from Fel d 1. A majority of the patients in the study (71%) receiving four weekly injections of 750 ug, showed improvements, and a follow-up study of the participants showed that 75% of those who had received that regimen continued to maintain some or all of their improvement after seven and a half months.
The study came about because molecular biologists have cloned many major allergens and have identified the specific T-cell epitopes associated with the human immune response. These developments coincided with an increased understanding of allergic response, and the role that T-cells play in that response. The vaccines were injected subcutaneously in very small doses. While the early indications were that a single injection could provide prolonged protection against a specific allergen, the long-term hope if this project is ever resumed and further testing done, is that one or two injections would provide year round protection.
The epitope vaccine represents a new direction and hope in allergy therapy. If this therapy continues to prove successful, it would allow custom designed anti-allergy treatments for a variety of the common allergens, perhaps all within a single under-the-skin injection. The vision for the vaccine result is prolonged T-cell down regulation, which would result in the suppression of the late phase allergic inflammation and the IgE antibody synthesis. (Note: As of 2001, we were unclear as to whether or not this vaccine or a follow-up study was still in development.)
The idea of using allergen extracts to treat allergies is not a new one... It was in the year 1911 that this idea was first reported. In the 1970's, this idea evolved into an immuno-therapy with allergen extracts that worked by increasing suppressor T-cells (which then controlled the production of the IgE antibody). It has only been in the past ten years that researchers have created T-cell epitopes to actually block IgE receptors, which then block the allergic cascading reaction. One of the most interesting and most recent discoveries in the field is the relationship, cause unknown, between GERD (acid reflux disease, which may or may not be causing symptoms) and certain allergy responses such as asthma, chronic dry cough, wheezing, etc. For some reason, allergists are finding that people who experience medium to severe allergy symptoms are often helped by taking a medication such as Pepcid AC nightly to reduce the amount of stomach acid refluxing during the night (regardless of whether or not they are experiencing actual episodes of heartburn). As always, consult your own physician and allergist before starting any new medication, including over-the-counter drugs.
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