Allergies, it’s not always the pollen’s fault

Stuffed nose, sneezing, tingling in the throat. But also red eyes and tears. All this, sometimes, accompanied by the feeling of not being able to breathe well. The season of awakening of nature – and allergies -, for many, it does not coincide with a good morning day. Worry not to become the target of the first blooms you stay away from pollencome on buds and give it treesliving with the handkerchief in his hand and the antihistamine in his pocket.

But it’s not all their fault – the pollen. And not even mites. In most cases, blooms and powders work like the classic straw that breaks the camel’s back. A jar full of conditions that predispose to allergies. He explains it Attilio Specianiclinical immunologist and allergy specialist, GEKLab scientific director and lecturer in the nutrition master’s degree at the University of Pavia.

“Once there was talk of ‘hay fever’ and few had it. Today we prefer to use the expression ‘allergic rhinitis‘and the majority of the population suffer from it, some more, some less. When hay fever began to be discussed at the beginning of the 19th century, it was hard to find even one case “.

So, isn’t there a genetic predisposition to allergies?

“There is but it is not decisive. Let’s take a step back. For us immunologists, the discovery of Japanese spouses Ishizaka which, in 1966, clarified the allergic phenomena together with the role of particular antibodies, the IgE immunoglobulins. In response to repeated exposure to allergens, respiratory or food (such as dust and pollen or nutrients), allergy sufferers produce numerous IgE that bind to specific cells (mast cells) that release histamine. The latter is responsible for inflammatory reactionsfrom the most modest, such as rhinitis, to the most severe such as anaphylactic shock “.

And it has become easy to spot allergy sufferers.

“Exactly, blood is sought for antibodies. Hence the cure: specific drugs also correspond to a specific disorder (from generic antihistamines to modern and precise biologics). However, we see that it is not always possible to resolve the symptoms of allergy sufferers. So the research had to look further. Beyond the particular, IgE and histamine “.

And where did it land?

“In 2006 a German researcher published, in one of the most important magazines, the Journal of Allergy and Clinical Immunologyone study on non-allergic mice (without IgE antibodies) but suffering from intestinal inflammation. The rodents were exposed to mold and pollen and exhibited allergy symptoms for 12 days while not developing IgE. This case shows that, in a diffuse inflammatory condition, contact with the molds or with i pollen it can become the element that triggers the allergic reaction but both, mold or pollen, are not the real culprit. We find a similar situation in those who have a sensitivity to gluten (not of the celiac type which is another matter), that is, the repeated intake of foods with gluten can lead to systemic inflammation and the allergic reaction can depend on the inflammation and not on the pollen. Likewise, whoever has a reaction to grassesif he intervenes on the diet by reducing the prevailing cereal in his meals (pasta and bread for Italians, or rice for Asians who are food grasses) he will observe a reduction in symptoms “.

Is this why allergies can also be treated by changing the diet?

“In our centers we teach which is the personal and anti-inflammatory diet which helps to reduce and often stop the use of specific drugs “.

Could the contrary be true, that IgE develops without manifesting the symptoms of allergies?

“Many people have IgE for some specific substance without having allergies. For example, I am very close to my cats, I am ‘sensitized’ to cats but I have no allergy to my cat. Also, from the IgE tests we see people apparently reactive to everything, or almost everything, but without disturbances “.

And are there any food situations that explain the appearance of an allergy or similar symptoms?

“That’s right, in 2017 always on the authoritative Journal of Allergy and Clinical Immunologytwo papers came out which discussed the fact that allergic and allergic-like reactions, in 38% of casesare identified by a trigger and by one immediate response (e.g. shortness of breath under the effect of grasses, nickel contact dermatitis as required by the IgE logic) but in the 62% of cases – two thirds – the inflammatory response is multifactorial. I have happened to observe patients who seem allergic to mites, a hypothesis excluded from the tests. Then, for example, by reducing the amount of sugar in the diet, we achieved changes. Reactions such as asthma or rhinitis are identical in those who have IgE or are inflamed, but the inflammatory state is not yet taken into account. From the tests we see people reactive to everything, or almost everything, but without disturbances “.

How much does a diet with a lot of sugar affect?

“A lot. The phenomenon of glycation (effect of glucose and fructose residues that bind to some proteins leading to metabolic alteration) induces a reaction similar to that of mice with intestinal inflammation. Adequate dietary control is essential for the prevention of the most severe diseases of our times. According to the CDC in Atlanta, 54% of the population in the US is living with diabetes or a pre-diabetic state, without considering the obese. “

Is there also an emotional correlation in allergies?

“Of course. Rita Levi Montalcini at a congress in Berlin in 2001, illustrating the effects of his findings on nerve growth factor, NGF (Nerve Growth Factor), for which he obtained the Nobel in 1986, he showed that when the human organism is in a dangerous condition it produces large quantities of neurokines, substances that pass through the brain and the immune system that stimulate the reactivity of the cells that deal with allergy (mast cells). The allergy could therefore be an alarm signal for the whole organism. I often talk about it to my patients remembering that pollen allergy can express a certain fear of living“.

In this period, with the nearby war and the post Covid, have allergies increased?

“Who has one systemic vision he cannot fail to notice the phenomenon. Every emotional turbulence has an effect on allergic symptoms. Moreover, today more conjunctivitis are observed than nasal congestions, the stuffy nose refers to lockdown, conjunctivitis to tears and perhaps even to repressed crying “.

However she prescribes antihistamines.

“Sure. Inside a proper nutrition, with a good one supplementation of minerals and vitamin D – the latter is to be considered an excellent antiallergic substance – it happens that the antihistamine can be used only occasionally. In that case the drug helps to alleviate the symptoms, if they appear, only when you go to the countryside or want to do outdoor sports “.


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