What is allergy?

The exaggerated response of the immune system to certain antigens present in the
environment is called allergy

Allergen
The substances to which immune responses to produce are called allergens

Common examples of allergens are mites in dust, pollens, animal dander’s etc..
Allergic Reaction:
An allergic reaction occurs when cells in the immune system interpret foreign substance or
allergen as harmful . The immune system overreacts to these allergens and produces
histamine, which is a chemical that causes allergy symptoms, such as inflammation,
sneezing and coughing
Symptoms of allergic reactions:
Symptoms of an allergic reactions usually develop within a few minutes of being exposed
exposed to something you’re allergic to, although occasionally they can develop gradually
over a few hours.

Although allergic reactions can be nuisance and hamper your normal activities, most are
mild

Very occasionally, a severe reaction called anaphylaxis can occur

Common symptoms of an allergic reaction include:

 Sneezing and an itchy ,runny or blocked nose
 Itchy, red, watering eyes
 Wheezing, chest tightness ,shortness of breath and a cough
 A raised ,itchy red rash
 Swollen, lips, tongue, eyes or face
 Tummy pain, feeling sick, vomiting or diarrhoea
 Dry, red and cracked skin

TYPES OF ALLERGY
1. Dust and Pollen Allergy
Symptoms:
 A blocked or congested nose
 Itchy eyes and nose
 A runny nose
 Swollen and watery eyes
 A cough

2. Food Allergy
Symptoms :
 vomiting
 a swollen tongue
 tingling in the mouth
 swelling of the lips, face, and throat
 stomach cramps
 shortness of breath
 rectal bleeding, mainly in children
 itchiness in the mouth
 diarrhoea
 3.Insect stings
Symptoms
 Wheezing
 significant swelling at the site of the sting
 a sudden drop in blood pressure
 itchy skin
 shortness of breath
 restlessness
 dizziness
 a cough
 chest tightness

4. MEDICATION
Symptoms

 wheezing
 swelling of the tongue, lips, and face
 a rash
 itchiness

If symptoms become severe, anaphylaxis can develop.

 ANAPHYLAXIS
Anaphylaxis is the severest form of allergic reaction. Its a medical emergency and can be life
threatening. Anaphylaxis can develop quickly, with symptoms appearing within minutes or
hours of exposure to allergen. Research suggests that anaphylaxis most commonly affects the
skin and respiratory system
SOME SYMPTOMS INCLUDE:
 hives, flushing, and itchiness
 difficulty in breathing
 wheezing
 swelling
 low blood sugar
 changes in heart rate
 dizziness and fainting
 loss of consciousness

Recognizing these symptoms can be crucial to receiving timely treatment

 PATHAPHYSIOLOGY
Acute response
In the early stages of allergy, a type 1 hypersensitivity reaction against an allergen
encountered for the first time and presented by a professional antigen-presenting cell causes
a response in a type of immune cell called a TH2 lymphocyte; a subset of T cells that
produce a cytokine called interleukin-4 (IL-4).These TH2 cells interact with other
lymphocytes called B cells, whose role is production of antibodies. Coupled with signals
provided by IL-4, this interaction stimulates the B cell to begin production of a large amount
of particular type of antibodies. Coupled with signals provided by IL-4, this interaction
stimulates the B cells to begin production of a large amount of a particular type of antibody
known as IgE. Secreted IgE circulations in the blood and binds to an IgE- specific receptor (a
kind of Face receptor called FC RI) on the surface of other kinds of immune cells called mast
cells and basophiles, which are both involved in the acute inflammatory response. The IgE-
coated cells, at this stage, are sensitized to the allergen.

If later exposure to the same allergen occurs, the allergen can bind to the IgE molecules held
on the surface of the mass cell pr basophiles. Cross linking of the IgE and Face receptors
occurs when more than one IgE receptor complex interacts with the same allergic molecule,
and activates the sensitized cell. Activated mast cells and basophiles undergo a process
called degranulation, during which they release histamine and other inflammatory chemical
mediators (cytokines, interleukins, leukotriene, and prostaglandins) from their granules into
the surrounding tissue causing several systemic effects, such as vasodilatation, mucous
secretion, stimulation, and smooth muscle contraction. This results in rhino rhea , itchiness,
dyspnoea, and anaphylaxis. Depending on the individual, allergen, and mode of introduction,
the symptoms can be system –wide (classical anaphylaxis), or localized to particular body
systems; asthma is localized to the respiratory system and eczema is localized to the dermis.

Late –Phase Response

After the chemical mediators of the acute response subside, late-phase responses can often
occur. This is due to the migration of other leukocytes such as nuetrophils, lymphocytes,
eosinophils and macrophages to the initial site. The reaction is usually seen 2-24 hours after
the original reaction. Cytokines from mast cells may play a role in the presence of long term
effects. Late phase responses seen in asthma are slightly different from those seen in other
allergic responses, although they are still caused by release of mediators from eosinophils
and are still dependent on activity of TH2 cells.
 DIAGNOSIS

Effective management of allergic diseases relies on the ability to make an accurate

diagnosis. Allergy test can help confirm or rule out allergies. Correct diagnosis,
counselling, and avoidance advice based on valid allergy test results reduces the
incidence of symptoms and need for medications, and improves the quality of life. To
assess the presence of allergen-specific IgE antibodies, two different methods can be
used: a skin prick test, or an allergy blood test. Both methods are recommended, and
they have similar diagnostic value.

Skin-prick Testing:
It involves putting a drop of liquid onto the affected individual’s forearm that contains
a substance he may be allergic to. The skin under the drop is then gently pricked. If he
allergic to the substance, an itchy, red bump will appear within 15 minutes. Most
people find skin prick testing not particularly painful, but it can be a little
uncomfortable. It’s also very safe

Patch Testing:
Patch tests are used to investigate a type of eczema known as contact dermatitis, which
can be caused by your skin being exposed to an allergen. A small amount of the
suspected allergen is added to special matal discs, which are then taped to the person’s
skin for 48 hours and monitored for a reaction

Blood Testing:
 Blood test may be used instead of, Or along side, skin prick tests to help diagnose
common allergies. A sample of the affected person’s blood is removed and analysed
for specific antibodies produced by his immune system in response to an allergen

Elimination Diet
If a person has a suspected food allergy, he may be advised to avoid eating a particular
food to see if his symptoms improve. After a few weeks, he may be asked to eat the
food against to check if he has another reaction.

Challenge Testing:
In a few cases, a test called a food challenge may also be used to diagnose a food
allergy. During the test, the patient is given the food that he think he is allergic to in
gradually increasing amounts to see how he react under close supervision. The test is
riskier than other forms of testing, as it could cause a severe reaction, but it is the most
accurate way to diagnose food allergies. Challenge testing is always carried out in a
clinic where a severe reaction can be treated if it does develop.

Allergy testing kits:

The use of commercial allergy testing kits isn’t recommended. These tests are often of
a lower standard then those provided by the NHS pr accredited private clinics, and are
generally considered to be unreliable. Allergy tests should be interpreted by a qualified
professional who has detailed knowledge of symptoms and medical history

PREVANTION AND PRECAUTIONS

The best way to prevent an allergic reaction is to avoid the substance that a person is allergic
to.

Those at risks of allergic reactions should:

 Take measures to avoid exposure to known allergen.

 Carry two auto-injectors and know how to use them correctly.
 Inform friends, relatives, colleagues, and others about the allergy and how to use the auto-
injector.
 Seek allergy testing to know which substances to avoid
 Consider wearing a medical identification bracelet with details of allergy.
 PSYCHOLOGICAL ASPECTS OF ALLERGY

Allergies affected children’s health as well as their quality of life, stress levels and family
budget. The available literature suggests that family, social and psychological factors are
affected by allergic pathologies such as rhinitis, asthma and atopic dermatitis.

It has been documented that anxiety and depression are prevalent in patients with asthma and
are associated with greater frequency of exacerbations, increased use of health resources, and
poor asthma control.

Psychological stress is recognized as a key factor is the exacerbation of allergic asthma,

whereby brain responses to stress act as immune modulators for asthma. In particular, stress
induced enhanced type 2T helper – type lung inflammation is strongly associated with
asthma pathogenesis. Psychological stress leads to eosinophillic airway inflammation
through the activation of the hypothalamic pituitary adrenal pathway and automatic nervous
system. This is followed by secretion of stress hormones into the blood, including
glucorticoids, epinephrine, and nor epinephrine, which enhance Th2 and type 17 T-helper
(Th17) type asthma profiles in humans.

Over the past few years, the rates of food allergies have dramatically increased. As a result,
the lives of patients and their caregivers have been dramatically altered. While most attention
surrounding food allergies has focused on treatment, less consideration has been given to the
mental health ramifications

Of living with this condition, among them depression, anxiety, post traumatic stress, being
bullied, and an overall poor quality of life. At the same time, patient’s family lives are often
disrupted. Parents of food allergic children, especially mothers, report anxiety, depression,
and a decreased quality of life. Indeed, mental health issues associated with food allergies
are likely under –recognized.

BIBILOGRAPHY
 https://www.docoline.com/what-we-treat/allergies

 https://www.healthline.com/health/anaphylaxis
 https://en.wikipidia.org/wiki/Allergy\

 https://www.healthline.com/health/allergies#causes