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What is an allergic reaction?




Normally, the immune system functions as the body's defense against invading agents such as bacteria and viruses. In most allergic reactions, however, the immune system is responding to a false alarm. When an allergic person first comes into contact with an allergen, the immune system treats the allergen as an invader and mobilizes to attack. The immune system does this by generating large amounts of a type of antibody (a disease-fighting protein) called immunoglobin E, or IgE. Each IgE antibody is specific for one particular allergenic (allergy-producing) substance. In the case of pollen allergy, the antibody is specific for each type of pollen: one type of antibody may be produced to react against oak pollen and another against ragweed pollen, for example.

These IgE molecules are special because IgE is the only class of antibody that attaches tightly to the body's mast cells, which are tissue cells, and to basophils, which are blood cells. When the allergen next encounters its specific IgE, it attaches to the antibody like a key fitting into a lock, signaling the cell to which the IgE is attached to release (and in some cases to produce) powerful inflammatory chemicals like histamine, cytokines, and leukotrienes. These chemicals act on tissues in various parts of the body, such as the respiratory system, and cause the symptoms of allergy.

Some people with allergy develop asthma. The symptoms of asthma include coughing, wheezing, and shortness of breath due to a narrowing of the bronchial passages (airways) in the lungs, and to excess mucus production and inflammation. Asthma can be disabling and sometimes can be fatal. If wheezing and shortness of breath accompany allergy symptoms, it is a signal that the bronchial tubes also have become involved, indicating the need for medical attention.

Symptoms of Allergies to Airborne Substances

The signs and symptoms are familiar to many:

Sneezing often accompanied by a runny or clogged nose

Coughing and postnasal drip

Itching eyes, nose, and throat

Allergic shiners (dark circles under the eyes caused by increased blood flow near the sinuses)

The "allergic salute" (in a child, persistent upward rubbing of the nose that causes a crease mark on the nose)

Watering eyes

Conjunctivitis (an inflammation of the membrane that lines the eyelids, causing red-rimmed, swollen eyes, and crusting of the eyelids).

In people who are not allergic, the mucus in the nasal passages simply moves foreign particles to the throat, where they are swallowed or coughed out. But something different happens to a person who is sensitive to airborne allergens.

As soon as the allergen lands on the mucous membranes lining the inside of the nose, a chain reaction occurs that leads the mast cells in these tissues to release histamine and other chemicals. These powerful chemicals contract certain cells that line some small blood vessels in the nose. This allows fluids to escape, which causes the nasal passages to swell, resulting in nasal congestion.

Histamine also can cause sneezing, itching, irritation, and excess mucus production, which can result in allergic rhinitis (runny nose). Other chemicals made and released by mast cells, including cytokines and leukotrienes, also contribute to allergic symptoms.

Pollen Allergy

Each spring, summer, and fall, tiny particles are released from trees, weeds, and grasses. These particles, known as pollen, hitch rides on currents of air. Although their mission is to fertilize parts of other plants, many never reach their targets. Instead, they enter human noses and throats, triggering a type of seasonal allergic rhinitis called pollen allergy, which many people know as hay fever or rose fever (depending on the season in which the symptoms occur). Of all the things that can cause an allergy, pollen is one of the most widespread. Many of the foods, drugs, or animals that cause allergies can be avoided to a great extent; even insects and household dust are escapable. Short of staying indoors when the pollen count is high--and even that may not help--there is no easy way to evade windborne pollen.

People with pollen allergies often develop sensitivities to other troublemakers that are present all year, such as dust mites. For these allergy sufferers, the "sneezin' season" has no limit. Year-round airborne allergens cause perennial allergic rhinitis, as distinguished from seasonal allergic rhinitis.

What is pollen?

Plants produce microscopic round or oval pollen grains to reproduce. In some species, the plant uses the pollen from its own flowers to fertilize itself. Other types must be cross-pollinated; that is, in order for fertilization to take place and seeds to form, pollen must be transferred from the flower of one plant to that of another plant of the same species. Insects do this job for certain flowering plants, while other plants rely on wind transport.

The types of pollen that most commonly cause allergic reactions are produced by the plain-looking plants (trees, grasses, and weeds) that do not have showy flowers. These plants manufacture small, light, dry pollen granules that are custom-made for wind transport. Samples of ragweed pollen have been collected 400 miles out at sea and 2 miles high in the air. Because airborne pollen is carried for long distances, it does little good to rid an area of an offending plant--the pollen can drift in from many miles away. In addition, most allergenic pollen comes from plants that produce it in huge quantities. A single ragweed plant can generate a million grains of pollen a day.

The chemical makeup of pollen is the basic factor that determines whether it is likely to cause hay fever. For example, pine tree pollen is produced in large amounts by a common tree, which would make it a good candidate for causing allergy. The chemical composition of pine pollen, however, appears to make it less allergenic than other types. Because pine pollen is heavy, it tends to fall straight down and does not scatter. Therefore, it rarely reaches human noses.

Among North American plants, weeds are the most prolific producers of allergenic pollen. Ragweed is the major culprit, but others of importance are sagebrush, redroot pigweed, lamb's quarters, Russian thistle (tumbleweed), and English plantain.

Grasses and trees, too, are important sources of allergenic pollens. Although more than 1,000 species of grass grow in North America, only a few produce highly allergenic pollen. These include timothy grass, Kentucky bluegrass, Johnson grass, Bermuda grass, redtop grass, orchard grass, and sweet vernal grass. Trees that produce allergenic pollen include oak, ash, elm, hickory, pecan, box elder, and mountain cedar.

It is common to hear people say that they are allergic to colorful or scented flowers like roses. In fact, only florists, gardeners, and others who have prolonged, close contact with flowers are likely to become sensitized to pollen from these plants. Most people have little contact with the large, heavy, waxy pollen grains of many flowering plants because this type of pollen is not carried by wind but by insects such as butterflies and bees.





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