Allergy to pollen

Allergy to pollen is a disease associated with seasonal natural phenomena, the flowering of cereals, trees, various herbs. The disease develops as a response to the secondary invasion of the allergen in those who already have a predisposition to allergies. There are several synonyms that determine the disease, which sometimes deceive the allergy sufferers themselves.

Allergy to pollen - it's pollinosis, and hay fever, and seasonal allergic conjunctivitis, rhinoconjunctivitis. All the variety of concepts is reduced to one term, designated in the classifier of diseases, ICD-10, where the pollen allergy is code J30.1 - allergic rhinitis caused by pollen of plants.

1. Among all types of allergy pollinosis is considered the most common and is diagnosed in 20-25% of the world's inhabitants.
2. For the first time pollen allergy was recognized as an independent disease only in 1819 year.
3. Initially, it was believed that the allergic reaction was provoked by dry grass, hay, hence one of the names of allergies - hay fever occurred.
4. Of the great number of plants found on the planet, only a little over 50 families can cause allergies. These include the so-called carnivorous flora, that is, plants that produce pollen, which is carried for several kilometers by the wind.

[1], [2]

Causes of pollen allergy

The etiology of pollinosis, that is, the cause of pollen allergy, is a series of biochemical reactions when histamine, other substances provoking the inflammatory process and secretion of mucous secretions from the eyes and nose, enter the blood. The factor responsible for the hypertrophied immune reaction is the male constituents of pollen, which can excrete cereals, certain tree species, weeds and grasses. Allergy provokes only such pollen, which corresponds to certain parameters, indicated in the studies of the famous allergist Tommen: 

• A large amount of pollen.
• Volatility and the property quickly spread to the surrounding area (usually such pollen produces anemophilous plants).
• Immunogenic properties of male pollen particles due to the presence of polypeptides and glycoproteins.
• Prevalence of the plant in the territory.

The causes of pollen allergy in the spring are explained by the allocation of allergens by birch, oak, maple, hazel, plane tree, poplar (fluff adsorbs and carries pollen of other trees).

The second peak of incidence is associated with the summer period, when wild plants (grasses) and cereals start to bloom - corn, rye, buckwheat.

The third period of pollen allergy is autumn, which is known for the sad statistics of violent allergic reactions to ragweed, starting to blossom since August. The number of diagnosed asthmatic attacks, Quincke's edema and anaphylactic shocks in late summer and fall sharply increases and is due to the bloom of ambrosia, which is considered the most aggressive plant in the sense of provoking allergies.

Also a lot of trouble delivers to allergic people flowering wormwood and quinoa.

In addition, the etiology of pollinosis is characterized by the fact that many plants have antigenic commonness with each other, with fruits, vegetables, melons and melons, and cause a polyvalent allergy that does not have one particular pathogen.

Factors that can provoke cross-pollination: Pollen Related plants, trees, flowers, meadow grasses Fruits, vegetables, melons, nuts, products Medicinal herbs Pollen of blossoming birch Apple, hazel-hazel, alder Hazelnut, carrots, apples, plums, potatoes, cucumbers, celery, tomatoes, onions, kiwi, peaches Birch buds, cones of alder, hazel leaf Cereal crops - buckwheat, rye, corn, wheat, oats, barley Not detected Not detected Not detected Flowering of wormwood Sunflower pollen, dandelion Sunflower vegetable oil, its products, citrus fruits, honey and chicory Chamomile, elecampane, mother-and-stepmother, calendula, string, celandine Ambrosia Sunflower Bananas, sunflower seed oil, sunflower seeds, melon Dandelion Lebed Not found Beets, rarely - carrot, spinach Not detected

The reasons for pollen allergy in the sense of aggressiveness of provocative factors are distributed as follows: 

1. Weeds, herbs.
2. Cereals.
3. Pollen trees.

[3]

How does the allergen penetrate the body?

The immunogenicity of pollen depends on its structure and properties, especially on the ability to solubility. Since the molecular mass of the pollen elements is large enough to reach 40,000 Daltons, the immune system quickly recognizes pollen as an alien component and actively fights against it. It should also be taken into account that most of the pollutant structural substances are not able to dissolve and do not pass the mucosal barrier, however, the smallest pollen proteins well overcome mucosal protection and enter into aggressive interaction with human lymphocytes, provoking an allergic reaction. The intensive activity of the immune system, its instant response to the invasion of the allergen leads to the fact that the release of histamine contributes to a sharp narrowing of the bronchi, the blood rushes to the mucous membranes - so there is a typical persistent allergic cough, often resulting in an asthmatic attack, itching, allergic lacrimation and discharge from the nose .

Symptoms of pollen allergy

Clinical manifestations of pollen are typical, although some variants of hay fever may be similar to manifestations of acute respiratory diseases.

Symptoms of pollen allergy are characterized by a clinical triad:

1. Nasal and ophthalmic (rhino-conjunctival) symptoms - difficulty with breathing, stuffy nose, tearing.
2. Untypical for ARI nasal discharge - they are more rare in consistency and frequent.
3. Persistent sneezing, seizures can total up to 20-25 times per minute.

In addition, the pollinosis clinic includes such signs:

• Strong itching, most often in the nasopharynx, in the eye area.
• Purulent conjunctivitis associated with a secondary bacterial infection (rubbing of inflamed eyes).
• Rez, "sand" in the eyes, photophobia, puffiness of the eyes.
• Noise, stuffiness in the ears.
• Attacks of bronchial asthma associated with the seasonal factor (diagnosed in 20% of allergy sufferers).
• Allergic dermatitis.

It should be noted that the symptoms of pollen allergy only occur during the flowering period of trees, plants and grasses. As soon as the season provoking the reaction ends, the main symptomatology disappears. The degree of severity of clinical manifestations depends on the level of concentration of the allergen, that is, the pollen, and also on the degree of predisposition of the person to allergies. In sensitive people, symptoms can persist for a long time even after the end of the flowering season.

In severe cases, inflammatory processes of the genito-urinary organs can develop - cystitis, vulvitis, but these diseases also quickly go along with the basic symptoms of hay fever. The most serious manifestation of allergy to pollen is considered to be Quincke's edema and anaphylactic shock.

Allergy to birch pollen

Allergic reaction to blossoming of a birch in the period from the middle of April till the end of May is a real calamity for allergy sufferers. According to statistics provided by WHO, an allergy to birch pollen affects more than 100 million people annually.

Birch is associated with health, indeed its kidneys, leaves and even pollen for people who are not allergic can become a medicine. Kidneys help the urinary system work, pollen is an effective adaptogen that stimulates immunity and cleanses the blood. However, due to its composition, which includes more than forty protein substances, birch pollen is the strongest allergen. Especially aggressive are protein compounds similar in structure to glycoproteins, it is they that in 90% of cases provoke an allergic reaction - itching, nasal discharge, tearing. In addition, the allergy to birch pollen can become crossed and combine with the reaction to alder and hazel blossom (hazel), as well as cherry, apples, apricots and peaches.

There is a definite and well-studied system of crossing birch pollen with such plant species:  

• Birch pollen and composite plants, flowers.
• Birch pollen and umbellate cultures.
• Birch pollen and rosaceous plants.
• Treatment of allergy to pollen.

The therapeutic strategy of any kind of allergy, including pollinosis, consists of such steps: 

1. Elimination, that is, the maximum exclusion of contact with a provoking allergen.
2. Drug treatment for allergy to pollen.
3. Prevention of recurrence of hay fever.

Drug treatment of pollen allergy is the appointment of certain groups of drugs depending on the clinical picture of the disease. Drugs against pollinosis include the following: 

• Antihistamines.
• Glucocorticosteroids.
• Vasoconstrictors.
• Stabilizers of membranes of mast cells (cromoglycates).
• Cholinolytics or AHP - anticholinergic drugs.

In addition, the treatment of pollen allergy includes a sparing diet and the observance of certain rules of conduct, to which, in the first place, minimizes contact with a flowering plant or tree. In some cases, special therapy is effective - ASIT. Allergists recommend conducting courses of allergen-specific immunotherapy, which significantly moves the boundaries of remission, sometimes up to five years, which helps the patient to forget about the use of antihistamines and seasonal allergic reaction. However, ASIT (allergen-specific immunotherapy) is indicated only in cases with a specific pathogen of allergy, which, unfortunately, is not common in albino cases.

[4], [5], [6], [7], [8]

Allergy to pollen of trees

Pollinosis on the pollen, allocated by the trees, begins in the middle of spring, when the alder blossoms, and then the birch. Allergy to pollens of coniferous trees is rare, although spruce, fir and pine produce much more pollen than deciduous tree species. This is due to the fact that the size of molecules of coniferous pollen is great, they linger in the mucosa and rarely penetrate into the bronchi, hence, its immunogenicity is lower and the allergic reaction is much weaker. Of all tree species, the most allergenic is birch and species of its family, on the second place is hazel (hazel) and ash. Considering that birch grows everywhere, practically in all countries of the world, except Australia and South Africa, an allergy to the pollen of trees of birch family annually affects millions of people.

List of trees, the pollen of which can provoke an allergy: 

• Betula is the birch that leads the list. The chemical composition of birch pollen includes about 40 albumin-like proteins, of which 6 are the most aggressive (immunogenic). The flowering season in different countries and territories starts from the end of March and ends at the beginning of June (in the northern regions).
• Alnus - alder, which belongs to the family Betulaceae (birch). Alder begins to bloom before the birch, roughly from late February to mid-April. Alder releases slightly fewer pollen substances, but it is also considered the main provoking factor of allergic reaction to pollen of trees.
• Corylus is a hazel or hazel, which is also a subspecies of a birch family, and its pollen causes a strong allergy, including a cross. Blossom hazel early - from mid-February to mid-March, in some southern countries, it can bloom and secrete pollen even in winter, for which it suffices moisture and temperatures from 5 to 10 degrees Celsius.
• Fraxinus - ash from the family of olive. In addition to pollen from ash, it can cause severe contact dermatitis. Ash blooms in April and ends up producing pollen in May.
• Salix - a willow, a willow, a willow, which grows everywhere where there are ponds. An allergy to the pollen of trees of the family of willow trees is less common than the hay fever caused by birch, but the reaction to the willow often results in asthmatic attacks.
• Populus - poplar. Such a popular tree, which is customarily blamed for almost all allergic troubles, is not really the culprit of an allergy. The fact that the period of its flowering fluff as an adsorbent absorbs the pollen of blooming grasses and other allergic-provoking trees. Thus, poplar fluff itself is not allergic, rather it can be considered a vehicle for the spread of plant and plant allergens.

[9], [10], [11], [12]

Allergy to pollen of plants

Pollinosis (allergy to pollen of plants) is clearly associated with the seasonal flowering of certain trees, cereals, meadow and weeds. To date, allergists have identified more than 750 plant species that provoke pollinosis. Most often, an allergy occurs if a person contacts the pollen in the morning hours, since it is in the morning that most plants have a favorable time for panning (allocation of pollen). Also, conditions that help to produce pollen are a certain level of humidity and sun. Allergy to pollen of plants in the rainy or droughty period is much less common for understandable reasons - there are no conditions for ripening and pollen production. In addition, seasonal allergies are clearly associated with the schedule and regional distribution of flowering. For allergies in many developed countries, plans, maps indicating the periods of pollen production and a list of provoking plants are developed.

The clinic, which is typical for pollinosis, is several forms of symptoms: 

• Allergic rhinoconjunctivitis.
• Allergic tracheitis.
• Allergic laryngitis.
• Bronchial asthma.
• Bronchitis with asthmatic component.

Allergy to pollen of plants has been studied for a long time, and the factors that provoke the hay fever are systematized in this way: 

1. Pollinosis caused by trees and shrubs. The allergy can begin from March and last till the end of May.
2. Allergy to cereals and herbs, the reaction period is from the middle of May to the end of June.
3. Pollinosis associated with flowering weeds. The aggravation begins in June and ends in late autumn.

[13]

Allergy to flower pollen

Pollen colors, both field and room, can cause an allergic reaction, however, most often it is a consequence of cross-pollination. It should also be noted that the allergy to pollen can develop only if the flower belongs to wind-pollinated plants. Usually it's all my favorite meadow, field flowers, having large leaves and small, faint inflorescences, as well as plants of the family of ferns. All other plants with fragrant, large flowers are subject to "processing" by bees and other insects, so their pollen simply does not have time to be carried by the wind and provoke an allergy. Indoor flowers, as a rule, do not have pollen, since they reproduce in a different way, so all allergic reactions to them are more likely associated with plant-derived volatile volatile compounds or lacteal juice that causes contact dermatitis. The remaining cases, when there is an allergy to pollen, are due to the general antigenicity between the flower and the related plant, which is the main culprit of pollinosis. Cross-reactivity (cross-allergy) is possible between cereal crops and rosaceous, lily families, between pollen pollen, ragweed and camomile flowers, daisies, asters or chrysanthemums. Doctors do not recommend people with increased allergenic sensitivity to plant or contact with these kinds of flowers: 

• Perennial flowers - chrysanthemum, aster, buttercups, hellebore, rudbeckia, koreopsis, zinnia.
• Annual plants - cornflower, geranium, primrose, lemon, calendula, daisies, marigolds, lily of the valley.
• Curly flowers - wisteria, clematis, morning glory.

[14], [15]

Allergy to pollen of weeds

Everyone knows that weeds, that is weeds grow everywhere. Obviously, there is no corner on the planet where this or that species of weed does not occur, except for mountain areas, deserts and glaciers. Weeds are the most common type of carnivorous plants, their pollen is carried by winds for many kilometers, so even the townspeople of huge megacities feel the influence of pollen plant allergens from time to time. It is believed that the most typical allergy to pollen of weeds is a reaction to ragweed. The food of the gods - this is how the plant from the family Asteraceae, astroids imported from America, was named. Today this plant is recognized worldwide as a quarantine, that is, subject to destruction: first, because of the provocation of allergies in millions of people, and secondly, because ragweed is able to drain the earth and create around itself a mini-desert in just two weeks. Ambrosia is not accidentally called a live pump, "it drinks" moisture from the soil with such speed and power that even the most hardy plants die around it.

In addition, of all weed grasses it is Ambrosia that can cause the strongest allergy up to Quincke's edema and anaphylaxis. This is due to the composition of the ragweed pollen, which includes a low molecular weight protein - profilin, which overcomes all the barriers of the mucous membranes of the nasopharynx. However, profilin (a protein compound) is found both in wormwood and in quinoa, which are also common almost throughout Eurasia. The flowering of these herbs begins in August and lasts until the first October colds. Recent studies of allergists have shown that over the past 10 years, the number of diagnosed pollinosis has increased in the dandelion, which is part of the family of astroids. Thus, a dandelion can be considered a "relative" of ambrosia, although it is not considered a weed plant. Less often the allergy to pollen of weeds is associated with the flowering of nettle or sorrel, almost all cases of pollinosis on these plants are diagnosed as crossed.

In the list of allergen-provoking weeds, in addition to the notorious ragweed and wormwood, the following plants are included: 

• Family of Mind: 
  • Quinoa, marsh, beetroot, hodgepodge, spinach, desert dwarf saxaul, Kohia.
• Complex weed grasses: 
  • Belokopytnik, tansy, chicory, turn, tarhun, elecampane, mother and stepmother dandelion, burdock.

It should be noted that the allergy to the pollen of weeds often intersects with the reaction to pollen of birch and alder, as well as sunflower, wheat, oats, rye. In addition, it is possible to cross-allergy to food plant products - tomatoes, apples, plums, pears, onions, melons, peaches and rice. Considering the long flowering period of weed grasses (from the beginning of May to October), their widespread prevalence, pollinosis of pollen of weeds is considered one of the most severe allergic diseases, the only relative plus of which is seasonality.

[16], [17]

Pollen allergy in children

The spring-summer period is not only a revival of nature and an increasingly sun-baking sun, but also a season of typical diseases, which include allergy to pollen in children. The peculiarity of pediatric pollinosis is that at the first stage it is similar in symptoms to manifestations of acute respiratory disease. Often, caring parents are sincerely convinced that their child continues to ache like in winter, and complain about the excessive soreness of the baby, his reduced immunity. Trying independently to cope with a runny nose, mothers zealously bury and warm up the child's nose, not getting the proper result. Neither hot milk with honey, nor infusions of herbs help, moreover, the symptoms can even worsen. Thus, the pollen allergy in children is masked for a long time, until the parents turn to the doctor, where it turns out that the child does not suffer from a cold at all, but seasonal pollinosis - a type of respiratory allergy.

Diagnosis of pollen allergy

Diagnosis of allergy to pollen, as a rule, does not cause difficulties for allergists, which is due to an obvious causal relationship - allergen - response and seasonality of the disease. However, there is also a problem - the detection of a specific allergen, since seasonal pollinosis has recently been characterized by cross-combinations (cross-allergy).

To determine the true pathogens of allergies, the following measures are taken:

• Anamnesis, including family, household. This helps to more accurately identify the triggering factor, differentiate it (trees, grasses or grasses), find out the possible hereditary etiology of the disease.
• Carrying out allergens, tests. Tests can be carried out in various ways - dermal (scarification), intradermal (injectable), nasal and so on. Tests help to specify the type of allergen to an accuracy of 100%.
• Laboratory blood tests for determining the level of eosinophils. If their amount rises, this indicates that, at a minimum, the body is predisposed to pollen.
• Immunofermentogram is a blood test for the detection of specific immune proteins (IgE), which are a marker of the presence of an allergen in the body.

[18], [19], [20], [21], [22], [23]

How to distinguish ORZ from signs of seasonal allergy?

Firstly, pollinosis is a typical seasonal disease, it can not develop in the cold season, in winter, like colds. The pollen allergy is caused precisely by pollen molecules that overcome the barrier of the mucous membrane of the nasopharynx of the child, penetrate the bronchopulmonary system and cause the strongest allergic reaction. Accordingly, seasonal pollinosis is a disease that develops during the flowering period, that is, in spring and summer.

Secondly, ARD usually pass for 10-14days, in contrast to pollinosis, which without proper treatment, can continue the entire flowering period of trees, plants or herbs.

Thirdly, the mucus secreted from the nose for colds is more dense and colored (greenish-yellow hue) than with allergies. The allergy to pollen in children is manifested by the secretion of a nasal secretion of a liquid consistency of a transparent color, the mucus almost never thickens.

Characteristic symptoms of pollinosis in children: 

• Hyperemia of the skin (face).
• The constant release of mucus from the nose of a transparent color and a rare consistency.
• A fever may occur.
• Conjunctivitis, increased lacrimation, photophobia.
• Dry, frequent, superficial cough.
• Frequent sneezing.
• Rashes on the skin, itching (dermatitis).
• Changing the timbre of the voice, hoarseness.
• Shortness of breath, attacks of asthmatic coughing are possible.
• Irritability, capriciousness

Provocators of spring pollinosis in children can be blooming birches, alder, ash, maple. In summer, the factor that causes pollen allergy is almost all carminative herbs, flowers. In the autumn - it's all known ragweed, wormwood, some types of cereal crops. Among the internal reasons explaining the development of seasonal allergies in children, heredity is first of all in the lead, followed by reduced immunity and latent inflammatory processes in the nasal or broncho-pulmonary system.

Parents should remember that seasonal pollinosis in a child requires timely diagnosis, treatment and compliance with certain dietary rules. Exciting components are excluded from the menu: 

• Limitation of protein foods (meat, fish).
• Spicy, smoked, pickled dishes.
• By-products (liver, lungs, heart).
• Chocolate.
• Citrus.
• Nuts.
• Strawberries, raspberries, currants, strawberries.
• Cherry, plum, peach, apricot.
• Oatmeal, wheat, barley porridge.

Of course, all these products can not be completely excluded from the diet of the child, they must be limited and monitor the body's response. In addition, frequent washing, excluding airing, the exclusion of synthetic detergents and synthetic clothing, walking only in places where there are no provoking plants, hardening and activation of immunity are those simple measures that help to prevent, stop or minimize the manifestations of seasonal allergies.

Statistics say that the obvious signs of seasonal allergies are most often manifested in boys before reaching pubertal age, while girls suffer from pollinosis more often after 14-15 years. Seasonal allergy is diagnosed in 25% of cases from the total number of childhood allergies.

How to treat allergy to pollen?

Treating seasonal pollinosis is quite difficult, because most often the patient seeks help at the time when sensitization occurred, that is, "familiarity" of the body with the allergen. Therefore, the first thing that allergists advise is to limit as much as possible contact with provoking factors - pollen of trees, grasses and cereals. Further to the question - how to treat an allergy to pollen helps to answer a long, carefully chosen individual therapeutic strategy. As a rule, relief of symptoms is carried out by the following drugs, which are prescribed both in a complex and as a monotherapy depending on the severity of the allergy: 

• The drugs are antihistamines.
• Vasculature nasal preparations.
• Cromoglikaty (kromoglikat sodium) - stabilizers of mast cells.
• Glucocorticosteroids.

How to treat allergy to pollen with antihistamines? Antihistamine group - a drug that can effectively break the pathological connection of the antigen and the substances produced by the immune system (histamine and others). Usually, antihistamines are given in tableted form, but during an exacerbation intravenous administration of such agents is indicated. Among the drugs of the latest generation, not causing drowsiness, addiction and other side effects, you can note Cetirizin, Cetrin, Zodak, Zestra, Claritin.

Treatment with vasoconstrictive drugs helps significantly alleviate nasal symptoms by acting on the adrenoreceptors of the nasal mucosa. The patient starts to breathe normally, the mucus is stopped for a while. As a rule, vasoconstrictors are administered intranasally in the form of drops, sprays. In addition, with ophthalmic manifestations of allergies, which often happens, the use of eye drops, which includes cromoglycate sodium, is indicated.

Treatment of pollen allergy with glucocorticosteroids is carried out strictly according to indications, with severe symptoms. As a rule, such therapy is indicated to people who already have an anamnesis of an allergic disease of another, not pollen etiology. 

One of the most effective methods in the treatment of allergies, including pollinosis, is considered ASIT - allergen-specific immunotherapy. To date, ASIT is a way to help translate seasonal allergy into a stage of persistent remission that lasts for many years. In addition, immunotherapy can prevent the transition of the initial stage of pollinosis into a heavier form, accompanied by Quinck's edema and anaphylactic shock. The meaning of the method is to gradually "accustom" the body to react normally to the pollen allergen by means of a microdosed antigen injection. The characteristics of ASIT are as follows: 

• Immunotherapy is not administered to children under seven years of age.
• ASIT is performed only during a period of long remission, usually in the winter.
• ASIT is a long-term therapy, which is conducted by several courses.
• Such hypo-sensitization helps to achieve a stable therapeutic effect and remission for at least 2 years.

Prevention of allergy to pollen

Both in the fight against many diseases and in the treatment of pollinosis, the prevention of allergy to pollen is the only reliable method that helps if you do not avoid the reaction and complex of symptoms, then significantly reduce their severity. Preventive measures are a complex of actions, the fulfillment of which is not difficult, the only thing that is required from an allergic person is to remember the rules and systematically adhere to them. 

• Elimination of the provoking factor. Eliminate, this means removing the allergen or avoiding contact with it. In the sense of seasonal pollinosis, elimination consists in changing the regime and time spent in the fresh air. Morning period, windy weather, groves, forests planted with allergens provoking trees, cereal fields, clearings with meadow grasses is a "taboo" for an allergic person. Walking in damp, rainy weather is allowed in the territories where there are no birches, ash, maple, alder and weeds. 
• Conduct regular wet cleaning at home, in office buildings, however, airing should be done in the absence of a person suffering from allergies (the wind can bring pollen).
• When traveling, do not open the windows of the car, vehicle. It is desirable to avoid the accumulation of a large number of people who can also carry on the clothes particles of pollen.
• During the flowering of trees, grasses, grasses, you must regularly take a shower (not a bath), with which you can wash off the smallest particles of pollen.
• All suffering pollinosis should carefully read information on the cross-reaction to food, and if possible make a sparing menu.
• Suffering pollinosis is the entire summer season to wear sunglasses that help not only to resist harmful ultraviolet, but also partially protects the face (eyes) from contact with pollen.
• Going on a trip, for a walk, you should have an emergency kit - an antihistamine, preferably in a soluble, nasal or inhalation form for rapid relief of a possible allergic attack.
• A good helper for people suffering from seasonal allergies is a special calendar for the flowering of the carnivorous flora, which indicates the timing of the palination, the territorial location and the types of trees, plants and herbs.

Reliable and tested by many allergy prevention of pollen allergy are preventative courses of ASIT (allergic-specific immunotherapy), which must be carried out in advance, before the flowering season.