Allergic diseases: symptoms, types and treatment.
We talk about allergies when, as a result of the body’s contact with substances that are harmless to most people, disease reactions occur in people who are allergic. It is an excessive, specific immune response to external factors that leads to disease symptoms. Usually the allergy is acquired as a result of repeated contact with the sensitizing substance. According to data, 40% of Poles suffer from allergies that manifest themselves in various forms. In about 9 million of them it is allergic rhinitis, and in about 2.5-3 million it is atopic dermatitis.
Depending on the immune pathomechanism, there are the following divisions of allergic disease reactions:
- Type I – immediate reaction. It usually appears from a few minutes to one hour after contact with the allergen. An allergic reaction occurs when an antigen (e.g. pollen, animal hair, house dust mite, nutrient, insect venom) binds to a specific IgE antibody on the surface of mast cells and basophils. This reaction triggers many enzymatic mechanisms, which lead to the release of active compounds, the so-called mediators of allergic reactions (histamines, leukotrienes, prostaglandins, cytokines). Depending on the organ in which this mechanism occurs, we deal with different clinical units. If the antigen-antibody reaction takes place in the bronchopulmonary system, the clinical picture of this reaction is an attack of bronchial asthma. If the shock site is the nasal mucosa, this will result in an allergic rhinitis. When the allergic reaction is in the skin, there is hives or some other form of skin allergy.
- Type II – cytotoxic reaction. It occurs after the binding of IgG or IgM antibodies to the antigen present on the cell surface, which leads to cell damage by activating the complement system. Examples of this type are: blood group incompatibility after transfusion or drug reaction.
- Type III – antigen-antibody complexes are formed. Deposition of immune complexes in, for example, the glomeruli, joints, vascular endothelium, causing inflammation at these sites. We observe this type of reaction in serum sickness, in drug-induced reactions, and recently also in some forms of bronchial asthma.
The most common allergic diseases:
The most common allergic diseases currently include bronchial asthma, allergic rhinitis, pollen catarrh, childhood eczema, allergic dermatitis, and gastrointestinal disorders. Allergens are substances that cause allergic symptoms upon contact with the body. By convention, they can be divided into inhalation allergens, which include house dust, feathers, plant pollen, molds and fungi, and epidermal substances of domestic animals. Particularly frequent is allergy to house dust allergen, the main allergenic component of which is dust mites. They are the main cause of asthma.
Food allergens lead to frequent allergies in the form of urticaria, eczema, migraines. It is much more common in childhood and may disappear completely within a few years. The most common food allergens include: cow’s milk, egg white, and also yolk, fish, oysters, shrimps, wild strawberries, nuts, citrus fruits, and chocolate.
Contact allergens are chemical compounds that enter the body as a result of contact with the skin. The most dangerous allergy is an allergy to the venom of insects, bees, wasps and others. Increasingly, there is a situation in which patients are allergic to drugs, in particular to antibiotics, salicylates and sulfonamides.
The causes of allergic diseases or their development is largely due to the patient’s living and working conditions, as well as environmental factors, living conditions and diet.
Treatment of allergic diseases:
Antihistamines – blocking histamine receptors.
First-generation drugs that block histamine H1 receptors
– they are used in seasonal and perennial atopic rhinitis, in allergic dermatoses, in allergic itching of the skin, in angioedema, in allergic bronchial asthma,
– in allergic diseases, the symptoms of which are aggravated by severe stress, their inhibitory effect on the CNS has a beneficial effect,
– in symptomatic treatment of upper respiratory tract rhinitis, nasal drops containing the 1st generation antihistamine and alpha-adrenomimetic drug, as well as oral medications containing the 1st or 2nd generation antihistamine and sympathomimetic drugs (pseudoephedrine, phenylephrine) are used. The sympathomimetic agent causes vasoconstriction of the nasal mucosa and a temporary improvement in patency.
– side effects: fatigue, drowsiness, dementia, impaired motor coordination; due to their cholinolytic effects, they cause dry mouth, visual disturbances, and difficulty urinating. They can cause heart rhythm disturbances, digestive tract disorders, skin allergic symptoms, headache, dizziness, bone marrow damage.
CLEMASTIN – has antiallergic and antipruritic properties and inhibits swelling caused by an allergic reaction. Used to treat urticaria and drug reactions.
DIFENHYDRAMIN (Aviomarin) – used only topically to treat allergic reactions of the skin, nasal mucosa, conjunctiva of the eye.
ANTAZOLIN – treatment of angioedema, urticaria, persistent pruritus, in inflammatory and allergic conditions, strong allergic reactions to drugs and insect bites, inhibits supraventricular arrhythmias. In combination with vasoconstrictor drugs, it is used externally in the treatment of allergic changes in the nasal mucosa or the conjunctiva of the eyes.
HYDROXYINE – has a strong sedative, anxiolytic, spasmolytic effect, and has a low blood pressure reduction. Used in states of nervous tension, in psychoneurosis, to control anxiety and anxiety, as an aid in the treatment of allergic reactions and psychiatric dermatoses, and in the treatment of pruritus. It is an adjuvant drug in the treatment of chronic pain. It is used in premedication to inhibit vomiting. Side effects include symptoms of fatigue and a dry mouth.
DIMETINDEN – stabilizes mast cells. It has a moderate calming and antimuscarinic effect. Prescribed for the symptomatic treatment of allergic diseases associated with urticaria, vascular edema, allergic rhinitis, allergic conjunctivitis, and for the treatment of cold symptoms.
KETOTIFEN – long-term prevention of bronchial asthma, allergic bronchitis, asthmatic symptoms related to hay fever. Prevention and treatment of urticaria, atopic dermatitis, rhinitis and allergic conjunctivitis.
PROMETHININE – has a strong calming effect. It is used in the symptomatic treatment of bronchial asthma, allergic reactions occurring in urticaria, vascular edema, allergic rhinitis, allergic conjunctivitis, and treatment of itchy skin diseases. It is administered intravenously to treat shock. It can be used in motion sickness, in inhibiting vomiting occurring after surgery, treatment of Meniere’s disease, in disorders of the vestibular function.
FENSPIRID – has anti-inflammatory properties, relaxes the bronchi, reduces the production of inflammatory mediators. Prescribed for the treatment of asthma.
2. Second-generation drugs that block histamine H1 receptors
– practically no non-receptor cholinolytic activity
– only some medications can have a weak sedative effect
– are not used parenterally
– treatment of chronic allergic conjunctivitis of the eyes and nasal mucosa
– their action starts later and lasts longer than the first generation drugs
ACRIVISTIN – symptomatic treatment of chronic allergic rhinitis and treatment of various forms of chronic urticaria
LEVOCBASTIN – used only topically in the form of eye drops in the treatment of allergic conjunctivitis and in the form of nasal drops in allergic rhinitis
LORATADINE (Claritine, Aleric, Loratan, Flonidan) – works for a long time, does not have a sedative and antimuscarinic effect. Used in the symptomatic treatment of chronic allergic rhinitis and in the treatment of chronic urticaria.
DESLORATADINE – has an effect longer than loratadine
CETIRIZINE (Zyrtec, Letizen, Allertec, Cirrus) – a long-acting drug, shows the property of stabilizing mast cells. It is administered for the symptomatic treatment of chronic allergic rhinitis and for the treatment of chronic urticaria. Medicinal activity is shown by levocetirizine.
LEVOCETIRISINE (Contrahist, Xyzal, Lirra, Zyx, Cezera) – treatment of symptoms related to allergic diseases, such as allergic rhinitis and urticaria.
FEXOPHENADINE (Telfast, Telfexo, Allegra) – seasonal allergic rhinitis, idiopathic urticaria.
AZELASTIN (Allergodil) – mainly used topically in the treatment of allergic conjunctivitis of the eyes and nasal mucosa.
Second-generation antihistamines are more selective in relation to the first generation, and thus show significantly fewer side effects, especially in the nervous system.
Among the over-the-counter medications that are used in the treatment of allergic rhinitis are oral preparations, the active ingredients of which may be loratidine, cetirizine, fexofenadine. Nasal medications consisting of anthazoline, diphenhydramine, dimethindene or nasal decongestants phenylephrine, xylometazoline, naphazoline, oxymetazoline. Application should not exceed 7 days, due to the risk of drug-induced rhinitis. Hypertonic and isotonic sea salt solutions used to open and clean the nasal cavity can also be proposed.
It happens that patients often confuse allergic diseases with a common cold, so it is extremely important to diagnose it properly, if only the first symptoms of allergy appear, consult a doctor for a referral for appropriate tests.
Literature:
- A. Ożarowski, Herbal medicine – A guide for doctors, PZWL,
- R. Korbut, “Pharmacology”, PZWL Medical Publishing House,
- E. Dadas-Stasiak, B. Kalicki, A. Jung, The most common causes and types of allergies in children in the light of current epidemiology, Department of Pediatrics, Pediatric Nephrology and Allergology, Central Clinical Hospital of the Ministry of National Defense, Military Institute of Medicine in Warsaw,
- E. Mutschler, G. Geisslinger, H. K. Kroemer, P. Ruth, Mutschler Pharmacology and Toxicology,
- A. Szczeklik, P. Gajewsk, Interna Szczeklik,
- Pharmacodynamics, Volume 2, a textbook for Students of Pharmacy.
