The respiratory allergies have the wheel in motion!

The respiratory allergies have the wheel in motion!
For more than thirty years, the respiratory allergies have been in full expansion. Whereas various assumptions try to explain this increase, the assumption of responsibility evolves/moves taking more into account quality of life of the patients.

In the industrialized countries, the number of people victims of allergic rhinitis is in constant increase. A study published in 1995 showed that nearly 30% of the population is touched today against 3,8% in 1968…

First culprit: changes of lifestyle
“So that an allergy appears, several elements are needed: a favorable genetic ground and in the environment, one (seldom) or several allergens” explains Dr. Isabella Annesi Maesano, of the national institute on health and the medical research (Inserm).

But an evolution of genetic susceptibility in a few years seems not very probable, it is thus the environmental assumption which seems most plausible. “It is true that new allergens appeared (plants and fruits exotic, unquestionable polluting) and that the frequency of some others increased. But the principal persons in charge are the same ones: acarina, pollens, hairs and squames of cat are in question nine times out of ten. Moreover, their concentration in the air does not seem higher than formerly according to the studies having measured it” Dr. Maesano specifies. In addition to the improvement of the diagnosis, this doctor estimates that the lifestyle is the principal culprit: geographical mobility towards areas rich in pollens, enfermement prolonged in nonventilated dwellings, automobile pollution, passive smoking, stress, lack of vitamins and obesity playing like as many worsening factors… 

The thesis hygienist: a reality?
The assumption hygienist brings another explanation. At the newborn, the immune system has a prevalence of Th2 lymphocytes which support the production of proteins implied in the allergy, before being directed towards an activity adapted to the fight against the infections. But so that this rocker operates, the organization could need in the first months for the life to react in contact with infections. Although not-proven, several studies militate in favor of this assumption hygienist: the children placed in crib have more infections but less allergy, the babies born by Cesarean not having been in contact with the vaginal germs have more allergies…

In addition, the increasingly many premature children with being saved could have more important susceptibilities: there exists thus a bond between asthma and prematurity. Several events of life in utero could also act on the development of individual susceptibility (taken hormones and drugs, fetal suffering…). Thus, of many causes could explain the boom of the allergies.

A real deterioration of quality of life
Recently, the allergists are concerned with impact of the symptoms of the allergic rhinitis on the quality of life of the patients. “This concept is particularly useful vis-a-vis the perannuelle rhinitis in which the permanent exposure to the environmental factors like the acarina, makes that the rhinitis takes the form of a chronic disease. Thus in addition to the traditional symptoms (sneezes, nose which runs, itchings…), the interrogation of the patient must make it possible to judge repercussions and thus of the severity of the disease” professor Alain Didier comments, of the service of pneumology of the hospital of Rangueil (Toulouse).

It is in this spirit that the World Health Organization worked out the report/ratio ARIA (Allergic Rhinitis and its Impact one Asthma) who proposes a classification and an assumption of responsibility based on symptomatology and quality of life (deterioration of the sleep, difficulty of concentration, lowers intellectual ability on the school or professional level, disorders of mood…). 

Effective cures
To reabsorb the symptoms, the antihistamines by oral way or corticoids by nasal way are the therapeutic classes most effective vis-a-vis a light allergic rhinitis. For more severe symptoms, corticoids by general way can be prescribed. But the antihistamines remain the principal treatment.

After the projection of the antihistamines of 2nd generation which had allowed a reduction in the side effects (somnolence, deterioration of vigilance…), of new compounds arrive on the market. More slightly proportioned, they for the moment are reserved for the medical regulation.

To modify the course of the allergic rhinitis durably, only desensitizing, if possible early, is effective. It makes it possible to limit the acquisition of new sensitizings and to reduce in the children reached of allergic rhinitis the risk of later development of asthma.