Allergies

Allergy is an abnormal reaction to a substance foreign to the body that is acquired, predictable and rapid.

In the strict sense of its meaning, it is the first (type 1) of five forms of hypersensitivity described by Gell and Coombs in their 1963 classification. However, by extension, the term " allergy " is often used for other abnormal reactions to substances.

History
The term 'allergy' was coined by the Viennese pediatrician Clemens von Pirquet in 1906 after noting that some of his patients were hypersensitive to normally innocuous entities such as dust, pollen, or certain foods. Pirquet called this phenomenon " allergy ", from the Greek words allos meaning "other" and ergon meaning "work".

Type I hypersensitivity is characterized by excessive activation of mast cells and basophils by IgE, resulting in a systemic inflammatory response that can result in symptoms as benign as a runny nose, to life-threatening anaphylactic shock and death . Knowing any allergies that a patient may have is important in a clinical setting. Full allergy history is taken down when obtaining a medical history of a patient. This ensures that no contradictory treatments are prescribed to the danger of the patient. In the United States physicians who hold certification by the American Board of Allergy and Immunology (ABAI) have successfully completed an accredited educational program and an evaluation process, including a secure, proctored examination to demonstrate the knowledge, skills, and experience to the provision of patient care in allergy and immunology[ Allergy is a local or systemic inflammatory response to allergens .

Local symptoms
Nose: swelling of the nasal mucosa (allergic rhinitis)
Eyes: redness and itching of the conjunctiva (allergic conjunctivitis)
Airways: Sneezing, broncho-constriction, wheezing and dyspnoea, sometimes outright attacks of asthma , in severe cases the airway constricts due to swelling known as anaphylaxis.
Ears: feeling of fullness, possibly pain, and impaired hearing due to the lack of eustachian tube drainage.
Skin: various rashes, such as eczema and hives (urticaria)

Hay Fever
Allergic rhinitis afflicts 20% of the U.S. population. [7] Also known as hay fever , symptoms can be in response to airborne pollen. Asthmatics are often allergic to dust mites. Apart from ambient allergens, allergic reactions can result from foods, insect stings and reactions to medications. Systemic allergic response is also called anaphylaxis; multiple systems can be affected including the digestive system, the respiratory system, and the circulatory system. Depending of the rate of severity, it can cause cutaneous reactions, bronchoconstriction, edema, hypotension, coma and even death . This type of reaction can be triggered suddenly or the onset can be delayed. The severity of this type of allergic response often requires injections of epinephrine, sometimes through a device known as the Epi-Pen auto-injector. The nature of anaphylaxis is such that the reaction can seemingly be subsiding, but may recur throughout a prolonged period of time.

TREATMENTS AVAILABLE
Immunotherapy -once called hyposensitization or desensitization, is a treatment in which the patient is gradually vaccinated with progressively larger doses of the allergen in question. This can either reduce the severity or eliminate hypersensitivity altogether. It relies on the progressive skewing of IgG ("the blocking antibody") production, as opposed to the excessive IgE production seen in hypersensitivity type I cases. In a sense, the person builds up immunity to increasing amounts of the allergern in question. A second form of immunotherapy involves the intravenous injection of monoclonal anti-IgE antibodies. These bind to free and B-cell IgE, signalling such sources for destruction. They do not bind to IgE already bound to the Fc receptor on basophils and mast cells as this would stimulate the allergic inflammatory response. The first agent in this class is omalizumab. While these shots are very effective in curing most allergies , they should not be used in treating the majority of people with food allergies . Strict avoidance of the food in question appears to be a better form of treatment in these allergies . Sublingual immunotherapy is an orally-administered therapy which takes advantage of oral immune tolerance to non-pathogenic antigens such as foods and resident bacteria. This therapy currently accounts for 40 percent of allergy treatment in Europe. In the United States, sublingual immunotherapy is gaining support among traditional allergists and is endorsed by otolarygologists who practice allergy treatment.

Unproven or ineffective treatments
An experimental treatment, enzyme potentiated desensitization (EPD), has been tried for decades but is not generally accepted as effective.[20] EPD uses dilutions of allergen and an enzyme, beta-glucuronidase, to which T-regulatory lymphocytes are supposed to respond by favouring desensitization, or down-regulation, rather than sensitization. EPD has also been tried for the treatment of autoimmune diseases but again is not FDA approved or of proven effectiveness.

Pharmacotherapy
Several antagonistic drugs are used to block the action of allergic mediators, or to prevent activation of cells and degranulation processes. They include antihistamines, cortisone, dexamethasone, hydrocortisone, epinephrine (adrenaline), theophylline and cromolyn sodium. Antileukotrienes, such as montelukast (Singulair) or zafirlukast (Accolate), have also been FDA approved for allergic diseases. Anticholinergics, decongestants, mast cell stabilizers, and other compounds (some of which might impair eosinophil chemotaxis) are also commonly used. These drugs help alleviate the symptoms of allergy but play little role in chronic alleviation of the disorder. They can play an imperative role in the acute recovery of someone suffering from anaphylaxis, which is why those allergic to bee stings, peanuts, nuts, and shellfish often carry a device for giving an emergency injection of epinephrine with them at all times.

Alternative therapies
In alternative medicine, a number of treatment modalities are considered effective by its practitioners in the treatment of allergies , particularly naturopathic, herbal medicine, homeopathy, traditional Chinese medicine and kinesiology.. These modalities are frequently offered as treatment for those seeking additional help. Often the aromatherapists approach to allergy is to use essential oils in massage which are calming and soothing. Quite often a person who develops certain allergies can do so when suffering from stress so oils which can help relax and soothe are often popular. Chamomile German , Chamomile Roman , Lavender and Melissa are the most popular oils used by aromatherapists whilst Bergamot , Clary Sage , Neroli, Jasmine , Rose , Sandalwood and Ylang Ylang are also oils which are deemed to be relaxing and calming. Massage with these oils is very valuable but they can also be used to good effect in a warm bath.

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