Allergies
Atopic dermatitis is often the beginning of the atopic march, which typically starts very early in childhood with eczema and food allergies and continues into adulthood with allergic asthma or allergies to inhaled allergens and allergic rhinitis (hay fever). At the same time, the level of IgE antibodies increases in the blood.
Research from the past years has shown that allergies in atopic dermatitis are due to the failure of skin barrier (the patients lack the gene for the production of the filaggrin protein), which is why allergens can penetrate into the deeper layers of the skin, activating the immune cells. A number of reactions follow the penetration that lead to heightened sensitivity to allergens. The response to allergens differs with respect to the genetic makeup of the immune system of different individuals. Some allergens have similar structures. Our body treats them as one and the same substance and reacts to them equally strongly. This phenomenon is known as cross-reactivity. This is the reason why a person can be allergic to inhaled and food allergens at the same time.
A person who lacks filaggrin will develop atopic dermatitis, allergies and asthma sooner if exposed to environmental allergens (e.g. cat hair, pollen) as a baby.
Allergy problems are widespread amongst the population. They include:
- Allergic rhinitis, sinusitis or conjunctivitis.
- Allergic asthma.
- Contact dermatitis.
- Allergies to certain food or medicine, bug bites, etc.
- Urticaria or hives.
- Anaphylaxis.
Cross-reactivity table
Inhaled allergens | Food allergens |
|---|---|
tree pollen: common hazel, alder, birch | apple, cherry, armenian plum, common plum, hazelnut, almond, raw carrot, potatoes, celery, tomatoes, paprika |
grass pollen | cereals, celery, tomatoes, potatoes, soy, peanuts, parsley, thyme, curry |
weeds pollen: mugwort, annual ragweed, plantago, chamomile, lichwort | celery, soy, carrot, fennel, anise, caraway, garlic, coriander, paprika, parsley, artichoke, dandelion, pelinkovac, vermouth |
mitten | sea food |
latex | banana, avocado, papaya, kiwi, chestnut |
cat hair | pork |
bird feathers | chicken eggs |
IgE antibody levels
We measure specific and total IgE antibody levels, the latter being the value of all specific IgE antibodies. The levels are obtained through the immunochemical method (ECLIA, CMIA) after taking the patients’ peripheral blood from the veins. Raised levels of IgE mean that the person is sensitive to a certain substance (he or she is sensitized), which doesn’t necessarily mean he or she is also allergic to the substance. For an allergy diagnosis, signs and symptoms of an allergic reaction need to be present, such as itching, rashes, sneezing, eye watering, runny or stuffy nose, difficult breathing and the anaphylactic shock (in the severest cases). The problem with atopic dermatitis, especially the severe type, is that the eczema is more or less constantly present, as is the accompanying itch. This makes it difficult to know whether we are actually allergic to a substance or the itch is simply the result of our illness. The table below shows the reference values for the specific and total IgE antibody counts.
Analyte | Unit | Age | Reference value (for both sexes) |
|---|---|---|---|
Total IgE | IU/mL | up to 5 weeks | up to 2.3 |
up to 3 months | up to 4.1 | ||
up to 6 months | up to 7,3 | ||
up to 9 months | up to 10 | ||
up to 1 year old | up to 13 | ||
up to 2 years old | up to 23 | ||
up to 3 years old | up to 32 | ||
up to 4 years old | up to 40 | ||
up to 5 years old | up to 48 | ||
up to 6 years old | up to 55 | ||
up to 7 years old | up to 53 | ||
up to 8 years old | up to 71 | ||
up to 9 years old | up to 78 | ||
up to 10 years old | up to 85 | ||
Adult | up to 114 |
Analyte | Unit | Class | Reactivity |
|---|---|---|---|
Specific IgE: in the presence of food, inhaled and medicine allergens | IU/mL | 0 | < 0,10 – 0,34 |
I | 0,35 – 0,69 | ||
II | 0,70 – 3,49 | ||
III | 3,50 – 17,49 | ||
IV | 17,5 – 52,49 | ||
V | 52,5 – 99,99 | ||
VI | >100 |
Hay fever
Allergic inflammation of conjunctiva, mucus membrane in the nose or both is known as hay fever. The conjunctiva becomes red and the eyes are itchy and watery. The nose becomes very runny and stuffy because of the swollen mucus membrane. Itch and excessive sneezing are also present. Uncontrolled allergic inflammation in hay fever can spread to the lower respiratory tract and triggers the development of allergic asthma. Signs and symptoms are similar to those of the common cold. The difference lies in the duration – the common cold never lasts more than a week, while hay fever symptoms can persist for months and appears in the same period in the year, each year. Sensitisation to a certain allergen is confirmed with skin prick and serological tests, which are used to determine the specific IgE antibody levels.
Symptoms of hay fever occur during the blooming season of the plan to which the person is allergic. Common hazel and alder bloom in February (or January, during mild winters). The end of March and April is the blooming season of the birch. Due to cross-reactivity, symptoms occur also during the blooming period of related plant species. Common hazel is related to alder, birch and other members of the birch family. Birch is related to European hornbeam and beech family trees (European beech, oak, chestnut).
How much pollen is currently present in the air for a specific plant species can be viewed on the following pages:
- http://silam.fmi.fi/pollen.html?parameter=birch®ion=Europe&height=0
- https://www.nijz.si/sl/napoved-o-obremenjenosti-zraka-s-cvetnim-prahom-0
- https://www.polleninfo.org/SI/en.html
Viri
- Križišnik C. et. al. 2014. Pediatrija. 1. Izdaja. Ljubljana: DZS
- Hlušička, C. E. Ublažimo simptome alergij. Naša lekarna. Št. 62, april 2012. (online) https://www.nasa-lekarna.si/clanki/clanek/ublazimo-simptome-alergij/ (prevzeto: 12.4.2020)
- Schneider, L. Eczema, Atopic Dermatitis and Allergies: What Is The Connection?. National Ezcema Association. 2020 (online) https://nationaleczema.org/atopic-dermatitis-and-allergies-connection/ (prevzeto: 12.4.2020)
- Splošna bolnišnica Jesenice. Referenčne vrednosti preiskav za otroke. (online). https://www.sb-je.si/uploads/jesenice/public/_custom/Referencne_vrednosti_otroci_2.pdf (prevzeto: 12.4.2020)
- Faber M.A. et. al. 2018. Cross-Reactive Aeroallergenes: Which need to cross our mind in food allergy diagnosis?J Allergy Clin Immunol pract, 813-1823.