Millions of Americans Spend weeks each year sneezing and smelling because Allergies to seasonal triggers Such as tree, grass or ragweed pollen. For a subset of people who are allergic to year-round household irritants like dust mites, mold, and cockroaches, any season can turn into allergy season.
Allergy symptoms occur when your immune system interprets what should be a relatively benign substance as a threat. The severity of symptoms and the difficulty of treating them can vary depending on your genes, the amount of substances you are allergic to, and your exposure levelJames Widener, an allergist and immunologist at Washington University in St. Louis.
For many people with mild symptoms, the misery of seasonal or environmental allergies can be tamed by over-the-counter medications — but for others, not all the pills and nasal sprays in the world seem to make a difference. Some allergy sufferers don’t really respond to treatment, Widener says, and researchers are still studying why this is. But others may be able to find relief with the right treatment.
“I feel like we’re normalizing allergies” to the point where people think they have to live with it, says Dr. Carolyn Sokol, principal investigator in the Center for Immunology and Inflammatory Diseases at Massachusetts General Hospital. But “we have tools in our belt to really help people.” This is the best efficacy, and what is on the horizon.
Antihistamines and corticosteroids
For many people, antihistamines (which block the effects of a chemical produced by your immune system) and/or corticosteroids (anti-inflammatory drugs) are Enough to control allergies. These medications can be taken by mouth or nasal sprays, and are usually available in over-the-counter forms and in prescription strengths.
Widner recommends introducing medications several weeks before the peak of allergy season to relieve symptoms before they start. It’s also important to take these medications exactly as directed. Sokol notes that some sprays take about a week to work.
If your medication is not effective, you may not be using the correct medication. Sokol says antihistamines are great for symptoms like itchy eyes, but corticosteroids are better for congestion. You may need to mix and match to find the right regimen for your symptoms.
“Nobody is allergic to something that isn’t,” says Widener, so reducing exposure to an allergen is sometimes the best way to relieve symptoms (although it’s often easier said than done). Moth prevention wraps Sokol says bedding can be helpful for those with dust allergies, and replacing carpeting with tile or hardwood can eliminate allergens’ hiding places. HEPA air purification systems can help, too, she says, as long as they’re the right size for your space.
Widener says that pet allergies can be the most difficult to control at source, because pet owners often refuse to bring their animals home even if they are allergic to it. For years, Widener’s lab tried to reduce cat allergies by washing them, something that wasn’t terribly effective and that both people and cats hated, he says. That effort didn’t work, but his team recently tested a special food It neutralizes allergens in cat saliva – which spread in cats’ coats as they clean themselves – and I found it effective. Sokol adds that keeping pets out of your bedroom can also reduce symptoms.
People with chronic environmental allergies may want to try ImmunotherapyThe body gradually adapts to the allergen through a series of injections. “It’s one of the few ways we as physicians can change your immune system,” Widener says. But immunotherapy is not a quick and easy solution. It requires weekly shots for about six months, followed by years of less frequent maintenance shots.
Studies show that about 85% of people get at least Some relief from immunotherapybut Some patients eventually relapse Others do not respond at all. Researchers aren’t entirely sure why, but it’s partly possible that there’s no commercially available test to determine what type of protein in an allergen is causing someone’s symptoms, says Dr. Gabriel de Vos, associate professor of allergy and immunology at Albert Einstein. New York City College of Medicine.
“Even if you have 10 people who all have allergies to dust mites, their allergies may be completely different,” says de Vos.
Without granule testing, de Vos explains, it’s impossible to create an individually customized immunotherapy regimen. De Vos says such tests are in development, but it’s not clear if they will be used clinically.
Immunotherapy using pills that dissolve under the tongue, rather than injections, is now available dust mites And the grass allergyStudies have shown that this method can be effective. The caveat, Sokol says, is that people who are sensitive to many things may still have symptoms, because the grains are specific to dust or grass. As research has shown Injecting the allergen directly into the lymph nodes can be effective.
biologyProtein-based drugs that, in the case of allergies, neutralize the parts of the immune system that cause inflammation – are a new treatment option. These drugs can be used to enhance the “long-term tolerance of our environment,” or combined with allergy injections to speed up their effectiveness, Sokol says. Biologics are still a subject of active research, but some of them can actually be prescribed to patients who need something more powerful than over-the-counter treatments.
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