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What's the problem?

Mark E. Reiber, MD, FACS, FAAOA

Understand the enemy:

"Antigen" is the smallest protein molecule causing allergic symptoms. When we say you are allergic to cats, it’s not the whole cat, just the Fel protein in saliva that gets on it's hair when licked. Antigens are found in pollens, molds and all allergic substances.

The two ingredients of allergies:

To be allergic, you must possess both an allergy gene to each antigen, and repetitive exposures to that antigen.

Mom and Dad are to blame:

You get 23 pairs of chromosomes, one from each parent. Within the chromosomes of immune cells are the allergy genes.

All genes are not alike:

If one parent has allergies, you have a 1 in 3 chance of developing allergies, and 1 in 2 if both parents are affected. Patients with the same “allergy gene” can show mild, moderate or severe symptoms.

Genes alone won’t do it:

Repetitive exposures are also required. With first contact, your system detects, processes, and reacts without symptoms. Subsequent exposures cause increasingly greater responses.

How and why do allergic reactions happen?

Our immune system is a complex array of chemical reactions designed to protect us from the outside world. It recognizes foreign from self and eliminates or isolates invaders.

The military for the body:

Common invaders include bacteria, viruses, chemical irritants, toxins, and allergens. The symptoms we experience are the result of our immune response. The itchy, watery nose and sneezing you experience during an allergic attack is from histamine and congestion is a result of a chemical called Leukotrienes.

The highway system:

Immune reactions are complex and intertwined like an elaborate system of branching roads. Medications work to block various points along these roads.

There can be many triggers (viruses, bacteria, toxins, pollutants, and allergens) eliciting responses. There are at least four unique types of allergic reactions. A poison ivy reaction is a delayed hypersensitivity, taking hours to develop. A peanut allergy reaction is immediate and life threatening.

A powder keg, waiting to explode:

Once the immune system has been primed by exposures, it is set to react more easily and severely, like an explosion erupting through a fireworks factory. When allergies are bothering you, it may seem like anything will trigger symptoms. Concentrate on prevention and early intervention before things get out of hand.

Two major types of allergy patients:

My nearly 20 years of treating allergies have shown me two major divisions in sinus allergy patients. The traditional patient has the wet symptoms of allergies: runny nose, sneezing, itching and eye watering. These are histamine related problems. The other patient has nasal congestion, blockage, headache and pressure, and recurrent sinus infections. These are predominantly leukotriene effects. It requires different medications and treatments for each of these patients.