Allergology & Immunology

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Introduction

Allergy-mediated disorders encompass the treatment of immune-related disorders. These disorders range in severity from very common to very rare in individuals of all ages and involve various organ systems. This article aims to provide a simple and comprehensive guide for the common man to understand allergy-mediated disorders, their causes, symptoms, and available treatments.

What are Allergy-Mediated Disorders?

Allergy-mediated disorders encompass a broad spectrum of conditions triggered by the body's immune response to typically harmless substances. Allergens such as pollen, dust mites, foods, and pet dander can provoke exaggerated immune reactions, leading to various symptoms. Common manifestations include hay fever, asthma, eczema, and anaphylaxis, with symptoms ranging from sneezing and itching to severe respiratory distress.

These disorders arise from an individual's genetic predisposition and environmental factors. Identifying specific allergens through tests like skin prick tests or blood tests are crucial for managing and mitigating these disorders, often through allergen avoidance, medications, or immunotherapy.

Types of Allergy-mediated Disorders

Allergic rhinitis

It is commonly known as hay fever and is an allergic disorder characterized by inflammation of the nasal passages.

Atopic dermatitis

It is also referred to as eczema, a chronic skin condition characterized by red, itchy, and inflamed patches on the skin.

Asthma

It is a chronic respiratory condition that affects the airways, causing them to become inflamed and narrow.

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Common Symptoms of Allergy-Mediated Disorders

Runny or Stuffy Nose

Allergies can cause nasal congestion or a clear, watery discharge from the nose

Sneezing

An abrupt, forceful exhalation through the nose, often triggered by allergens like pollen, dust, or pet dander.

Coughing

Allergies may lead to persistent coughing, particularly in response to irritants in the air.

Wheezing

Constricted airways due to allergens can cause a high-pitched whistling sound while breathing.

Itchy, Watery Eyes

Allergic conjunctivitis can lead to intense itching, redness, and excessive tearing.

Swelling

The eyelids or the skin around the eyes may swell due to an allergic reaction.

Hives

Raised, itchy welts on the skin, often with redness. These can occur in response to allergens like certain foods or insect stings.

Fatigue

Allergic reactions can lead to a general feeling of tiredness and lethargy.

Headache

Some people experience headaches as part of their allergic response.

Anaphylaxis

It is a severe, life-threatening allergic reaction that can lead to a sudden drop in blood pressure, difficulty breathing etc., which require immediate medical attention.

Causes of Allergy-Mediated Disorders

Immune System Response

Allergies occur when the immune system mistakes allergens as harmful invaders.

Histamine Release

Upon re-exposure to the allergen, IgE antibodies trigger mast cells and basophils to release histamine and other chemicals. These substances cause classic allergy symptoms like itching, swelling, and inflammation.

Immediate and Delayed Reactions

Allergic reactions can be immediate (IgE-mediated), occurring within minutes of exposure, or delayed (T-cell-mediated), taking hours or even days to develop.

Environmental Exposures

Exposure to allergens in the environment plays a key role. Common allergens include pollen, dust mites, pet dander, mould spores, and certain foods.

Occupational Allergies

Some individuals develop allergies to substances encountered in the workplace, like latex, flour, or chemicals.

Genetic Predisposition

Allergies often run in families. If one or both parents have allergies, a child is more likely to develop them.

Understanding Allergy-Mediated Disorders in Ayurveda

In Ayurveda, allergy-mediated disorders are understood as a result of an imbalance in the body's doshas (Vata, Pitta, Kapha). Allergies are believed to occur when an individual's immune system is compromised, allowing allergens to trigger reactions. Excess Pitta dosha, often influenced by diet and lifestyle, can make individuals more susceptible to allergies. Poor digestion, toxins (Ama) accumulation, and impaired immune function contribute to these disorders.

Kapha Dosha

Kapha governs bodily fluids, stability, and strength. High Kapha in the body could result in increased cholesterol and heart blockages.

Treatment and Management

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Allergen Avoidance

Identify and minimize exposure to allergens that trigger your symptoms. This may include using allergen-proof covers on bedding, cleaning your home regularly, and avoiding outdoor activities during peak pollen seasons.

Over-the-counter (OTC) Medications

Antihistamines, decongestants, and nasal corticosteroid sprays can provide relief from symptoms.

Prescription Medications

If OTC medications do not provide adequate relief, your doctor may prescribe stronger antihistamines, nasal corticosteroids, or other medications to manage your symptoms.

Immunotherapy

In cases of severe or persistent allergies, allergen immunotherapy (allergy shots) may be recommended to desensitize your immune system to specific allergens.

Lifestyle Changes

Managing stress, maintaining good hygiene, and staying well-hydrated can help alleviate symptoms and improve your overall well-being.

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Symptom Management

Providing relief from symptoms such as nasal congestion, itching, wheezing, or skin irritation through medications, environmental control measures, or allergen avoidance.

Emotional Support

Addressing the psychological impact of living with chronic respiratory or allergic conditions through counselling, education, and support groups.

Education and Self-Management

Empowering individuals with knowledge about their condition, proper medication use, asthma action plans, and allergen avoidance strategies to better manage their symptoms.

Quality of Life Enhancement

Promoting strategies to maintain optimal respiratory function, manage triggers, and improve overall well-being for individuals with chronic respiratory or allergic diseases.

Conclusion

Allergy-mediated disorders represent a complex interplay between genetic predisposition and environmental factors, eliciting exaggerated immune responses to harmless substances. While conventional medicine focuses on symptom management and allergen avoidance, Ayurveda offers an alternative perspective, attributing these disorders to dosha imbalances and compromised immunity.

Both approaches emphasize the importance of understanding triggers and adopting preventative measures. In essence, the management of allergy-mediated disorders requires a holistic approach, addressing both the underlying causes and symptomatic relief to enhance an individual's quality of life and overall well-being.

Frequently Asked Questions

Can allergies develop later in life even if a person had no allergies as a child?

Yes, allergies can develop at any age, even if someone had no allergies as a child. This phenomenon is known as adult-onset allergies and can be diagnosed and managed by allergists.

Do all allergies persist throughout a person's life?

No, not all allergies persist throughout life. Some childhood allergies, like milk or egg allergies, may resolve with age. However, allergies to substances like pollen or pet dander can persist or develop later in life. Allergies vary in their lifelong impact.

What are the complications of untreated allergies?

Untreated allergies can lead to complications, including chronic sinusitis, respiratory infections, ear infections, asthma exacerbations, sleep disturbances, impaired quality of life, and, in severe cases, anaphylactic reactions that can be life-threatening.

Why are allergies worse at night?

Allergies can worsen at night due to increased exposure to indoor allergens like dust mites and pet dander in enclosed spaces. Additionally, lying down can lead to postnasal drip and congestion, intensifying night-time allergy symptoms.

Can allergies be prevented entirely?

Allergies cannot be entirely prevented, but their severity and frequency can be reduced. Avoiding allergens, maintaining a healthy lifestyle, and immunotherapy (for some) can help manage symptoms.