Allergic Rhinitis Health Article

Immunotherapy

Immunotherapy, also known as desensitization or allergy shots, alters the balance of antibody types in the body, thereby reducing the ability of IgE to cause allergic reactions. Immunotherapy is preceded by allergy testing to determine the precise allergens responsible. Injections involve very small but gradually increasing amounts of allergen, over several weeks or months, with periodic boosters. Full benefits may take up to several years to achieve and are not seen at all in about one in five patients. Individuals receiving all shots will be monitored closely following each shot because of the small risk of anaphylaxis, a condition that can result in difficulty breathing and a sharp drop in blood pressure.

Alternative treatment

Alternative treatments for AR often focus on modulation of the body's immune response, and frequently center around diet and lifestyle adjustments. Chinese herbal medicine can help rebalance a person's system, as can both acute and constitutional homeopathic treatment. Vitamin C in substantial amounts can help stabilize the mucous membrane response. For symptom relief, western herbal remedies including eyebright (Euphrasia officinalis) and nettle (Urtica dioica) may be helpful. Bee pollen may also be effective in alleviating or eliminating AR symptoms.

Prognosis

Most people with AR can achieve adequate relief with a combination of preventive strategies and treatment. While allergies may improve over time, they may also get worse or expand to include new allergens. Early treatment can help prevent an increased sensitization to other allergens.

Prevention

Reducing exposure to pollen may improve symptoms of seasonal AR. Strategies include the following:

• stay indoors with windows closed during the morning hours, when pollen levels are highest
• keep car windows up while driving
• use a surgical face mask when outside
• avoid uncut fields
• learn which trees are producing pollen in which seasons, and avoid forests at the height of pollen season
• wash clothes and hair after being outside
• clean air conditioner filters in the home regularly
• use electrostatic filters for central air conditioning

Moving to a region with lower pollen levels is rarely effective, since new allergies often develop

Preventing perennial AR requires identification of the responsible allergens

Mold spores:

• keep the house dry through ventilation and use of dehumidifiers
• use a disinfectant such as dilute bleach to clean surfaces such as bathroom floors and walls
• have ducts cleaned and disinfected
• clean and disinfect air conditioners and coolers
• throw out moldy or mildewed books, shoes, pillows, or furniture

House dust:

• vacuum frequently, and change the bag regularly. Use a bag with small pores to catch extra-fine particles
• clean floors and walls with a damp mop
• install electrostatic filters in heating and cooling ducts, and change all filters regularly

Animal dander:

• avoid contact if possible
• wash hands after contact
• vacuum frequently
• keep pets out of the bedroom, and off furniture, rugs, and other dander-catching surfaces
• have your pets bathed and groomed frequently

BOOKS

Allergic and Non-Allergic Rhinitis: Clinical Aspects. Ed. N.Mygund and R. M. Naclerio. Philadelphia: W. B. Saunders Co., 1993.

Lawlor, G. J. Jr., T. J. Fischer, and D. C. Adelman. Manual of Allergy and Immunology. Boston: Little, Brown and Co., 1995.

Novick, N. L. You Can Do Something About Your Allergies. New York: Macmillan, 1994.

Weil, A. Natural Health, Natural Medicine: A Comprehensive Manual for Wellness and Self-Care. New York: Houghton Mifflin, 1995.

Richard Robinson

KEY TERMS

Allergen—A substance that provokes an allergic response.

Anaphylaxis—Increased sensitivity caused by previous exposure to an allergen that can result in blood vessel dilation (swelling) and smooth muscle contraction. Anaphylaxis can result in sharp blood pressure drops and difficulty breathing.

Antibody—A specific protein produced by the immune system in response to a specific foreign protein or particle called an antigen.

Antigen—A foreign protein to which the body reacts by making antibodies.

Granules—Small packets of reactive chemicals stored within cells.

Histamine—A chemical released by mast cells that activates pain receptors and causes cells to become leaky.

Mast cells—A type of immune system cell that is found in the lining of the nasal passages and eyelids, displays a type of antibody called immuno-globulin type E (IgE) on its cell surface, and participates in the allergic response by releasing histamine from intracellular granules.