Pollen allergyNot long ago, doctors referred to hay fever as seasonal allergic rhinitis. In the meantime, this has been abandoned, since many people react to the pollen of several flowering plants and suffer from symptoms not only in spring or summer, but almost all year round.
For years, researchers have observed that the pollen count has shifted forward by several days and lasts somewhat longer in autumn. In mild climates, the last grass or herb pollen may fly in November and the first hazel pollen may be on the way in December. There is no question of an early summer hay fever (which was originally called so because one amed a connection with hay and grass).
Underestimated are also the Effects of pollen allergy (also: hay fever, allergic rhinitis, pollinosis). Sneezing attacks, runny nose and itchy eyes are not the only complaints that torment those affected. Many are during the pollen flight not fully efficient, sleep badly and are exhausted. In addition, after years, some allergy sufferers experience a so-called floor change (from the upper to the lower respiratory tract): Suddenly, the bronchial tubes also react hypersensitively, bronchial asthma can develop.
A basic explanation of pollen allergy can also be found as a comic strip.
About 12 million people in Germany suffer from hay fever (14.8 percent). Scientists at the Robert Koch Institute came to this conclusion by evaluating medical interviews with about 8000 people.
Hay fever typically becomes noticeable before the age of 25. Pollen allergy occurs between the ages of 8 and 16, mostly in children. and 16. year of life. In the meantime, more and more people beyond the age of 50 develop a pollen allergy for the first time.
The pollen is the cause of the allergy or the. The pollen of wind-pollinated plants. It consists of individual pollen grains that contain the male genetic material. While insect-pollinated plants produce less pollen at flowering time, wind-pollinated plants have to release a lot of pollen to ensure pollination. The light pollen can fly several hundred kilometers. The windier it is, the further and more numerous the pollen is dispersed; if it rains, it is more likely to sink to the ground and cause less discomfort (thunderstorms, however, can be exacerbating).
In some allergies, just a few pollen grains are enough to trigger a severe reaction. For example, six rye pollen grains per square meter of air are enough to provoke an allergic reaction in sensitized people (For comparison, a single ear of rye emits several million pollen grains).
The most important allergenic pollen comes from trees, grasses and herbs.
TreesEspecially the pollen of the "early bloomers" birch, hazel, alder and ash are allergenic. Birch pollen allergies are particularly common. GrassesIn the case of allergy to grass pollen, the so-called sweet grasses play a major role. HerbsMugwort and ragweed in particular are highly allergenic.
The pollen contains water-soluble proteins (proteins) that are released on contact with the mucous membranes. In the case of an allergy, the immune system reacts to what are actually harmless proteins by forming IgE antibodies. These bind to the body's defense cells, known as mast cells, which then release substances that trigger inflammation, such as histamine. The histamine and other messengers stimulate glands to release secretions, irritate nerves causing itching and sneezing, and cause vasodilatation leading to redness and swelling of mucous membranes.
The symptoms occur mainly where the pollen allergens directly hit – the mucous membranes of the nose, eyes and mouth. Thus the following symptoms are possible:
NoseRunny nose with watery secretion, nasal congestion, nasal itching, sneezing Eyes: reddening of the conjunctiva, itching, tearing Mouth/throat: Burning, itching Ears: itchy ear canals Lungs: dry cough (especially at night), whistling breathing, shortness of breath (asthma) Skin: worsening of neurodermatitis, rarely wheals, redness General symptoms: fatigue, sleep disturbances, headaches
Often people with pollen allergy also suffer from allergy to certain foods. For example, raw apples or hazelnuts can cause itching in the throat or swelling in the mouth of birch pollen allergy sufferers. These so-called pollen-associated food allergies occur because the proteins of some foods resemble certain pollen proteins. The already sensitized immune system of the hay fever sufferer then classifies not only the pollen but also certain fruits or vegetables, nuts or spices as "dangerous" and triggers an allergic reaction. For more information on these cross-reactions to foods, see Allergies to celery, cherry& Co – cross reactions to food.
Whether it is hay fever, the doctor clarifies first in a Talk to about the symptoms. Among other things, it is asked in which places and at what time of day and year the symptoms occur, how long they last and whether allergic diseases are present in the family. A physical examination is followed by skin and/or blood tests, to further confirm the suspicion. These tests indicate a susceptibility to certain pollen allergens, but they cannot prove an allergy.
In unclear cases, therefore, a Provocation test be necessary. Small amounts of the suspected pollen allergen are applied to the nasal mucosa (rarely to the conjunctiva of the eyes) under medical supervision. The extent to which the nose swells up is then measured. whether sneezing or tearing occur. If affected persons suffer from respiratory problems, a so-called Lung function test useful. In this procedure, the doctor measures the volume of air that the affected person inhales and exhales, as well as the speed at which the air is exhaled. The results allow conclusions to be drawn about changes in the respiratory tract.
By the way, dust mites, animal hair or molds can also cause symptoms similar to those of hay fever. Therefore, allergies to these substances should be excluded.
A rhinitis caused by bacteria or viruses can also resemble a hay fever at first. However: a cold subsides after about ten days. It is not accompanied by eye itching, the secretion can also become greenish-yellow and viscous, unlike the watery hay fever secretion. Elevated temperature or swollen lymph nodes in the neck also indicate a cold.
The most important thing in case of allergy is to avoid the trigger. In the case of hay fever, this is only possible to a limited extent, but there are a few tips that may help. In addition, various medications alleviate the symptoms – but cannot cure the allergy. Helpful are possibly. also some non-drug measures. Specific immunotherapy (also called hyposensitization or desensitization) is a treatment option that addresses the causes of hay fever.
Cortisone sprays or newer antihistamines are considered the drugs of choice. For rather mild symptoms, cromones can be used as eye drops and nasal sprays. Complaints such as occasional sneezing, itching eyes and runny nose can be alleviated by newer antihistamines in eye drops, nasal sprays or also in tablet form. If the symptoms are more pronounced, cortisone nasal sprays are the drug of choice (possibly combined with newer antihistamines). For eye and nasal sprays, preservative-free products should be preferred, as preservatives can also be allergenic.
Cromones (cromoglicic acid):
The substances prevent the release of histamine from the mast cells and thus reduce inflammation. However, they do not have an immediate effect. They are therefore used more as a preventive measure. Their effect (especially on the nasal symptoms) is not pronounced, but they are usually well tolerated. Possible side effects are irritation of the nasal mucosa. Block the docking sites of histamine in the body. Thus reduce the allergic reaction. The substances act relatively quickly (tablets within an hour, nasal sprays within 15 minutes) and can therefore be used for acute symptoms. First-generation antihistamines also act in the central nervous system and can cause fatigue and drowsiness. The newer antihistamines do so to a lesser extent and have a more favorable side effect profile: fatigue and headaches occur less frequently than with the older agents. Nose sprays containing cortisone have an anti-inflammatory effect. Suppress symptoms such as a runny or stuffy nose. The preparations usually start to act after 12 to 24 hours and develop their full effect after three to seven days. Modern cortisone-containing nasal sprays have no systemic side effects, i.e. no side effects in the rest of the body. The undesirable effect may be dryness of the nasal mucosa, nosebleeds or headaches. However, the risk of growth retardation in children has also been. Adolescents described (for the active ingredient beclomethasone dipropionate). Although the likelihood is considered low, regular medical checks are advisable with long-term administration.
Nasal sprays or drops containing these active ingredients constrict the vessels of the nasal mucosa and thus have a decongestant effect. However, it should only be used for colds in the context of a cold. Then also only for a maximum of one week, since longer use can lead to dependence with the development of a drug-induced rhinitis.
The substances inhibit the action of leukotrienes, messenger substances which, like histamine, play an important role in (allergic) inflammation. They are used to treat asthma. As they are also effective in allergic rhinitis (less so than antihistamine tablets), they are used as a second-line treatment when people suffer from both asthma and hay fever. Side effects may include headaches, gastrointestinal disorders and respiratory infections.
A causal form of treatment for hay fever is specific immunotherapy with allergens (SIT). They are intended to accustom the immune system to the allergy-causing pollen over a longer period of time. The pollen allergens that cause the patient's symptoms must first be identified. Then one or two appropriate preparation(s) is (are) selected. The drug is injected in increasing doses into the subcutaneous fat tie of the upper arm once a week (subcutaneous immunotherapy, SCIT for short). The maximum dose is reached after about three months, after which the injection is given only once a month. However, those affected need good stamina and a willingness to cooperate, as the therapy must be continued for about three to five years. There is no guarantee of success that the allergy will "disappear" afterwards. However, studies show that completed SCIT can reduce symptoms and medication consumption in the longer term. In addition, the treatment reduces the risk of a floor change, so it can prevent asthma. The likelihood that sufferers will react to additional, new allergens is also reduced.
Immunotherapy for hay fever is considered when symptoms are pronounced and have been present for more than two years. The best chances of success are in young patients who do not react to too many different allergens.
Besides SCIT there is also the possibility to take the pollen allergens in tablet or drop form. The preparations are given under the tongue (Sublingual immunotherapy, SLIT for short). Either drops are dribbled under the tongue. Swallowed after a certain exposure time. Or a special self-dissolving tablet is placed under the tongue. The effectiveness has been proven especially in grass pollen allergy. The advantage is that the treatment can be done daily at home, but SLIT also lasts at least three years.
Whether the two forms of treatment are equally effective cannot yet be conclusively assessed. The results of comparative studies suggest that specific immunotherapy with injections (SCIT) relieves symptoms somewhat better than therapy with tablets or drops (SCIT). But since SCIT and SLIT are similarly effective in any case, sufferers can decide together with their allergist which treatment is appropriate.
Some doctors use homeopathy or acupuncture to relieve hay fever symptoms. However, no clear picture emerges regarding its effectiveness. To date, there are too few conclusive studies.