Respiratory allergies are on the rise!
For over thirty years, respiratory allergies are growing. While various hypotheses attempting to explain this increase, the management changes taking greater account of quality of life of patients.
In industrialized countries, the number of people suffering from allergic rhinitis is increasing steadily. A study published in 1995 showed that nearly 30% of the population is now affected as against 3.8% in 1968 ...
First culprit: the changes in lifestyle
"For an allergy appears, it takes several factors: a favorable genetic background and environment, one (rarely) or more allergens" said Dr. Isabella Annesi Maesano of the National Health and Medical Research (Inserm).
But a change in the genetic susceptibility in a few years seems unlikely, therefore, is that the environmental hypothesis seems the most plausible. "It is true that new allergens have emerged (plants and exotic fruits, some pollutants) and the frequency of some others has increased. But the main culprits are the same: mites, pollen, dander from cats are involved nine times ten. In addition, their concentration in the air do not appear higher than in the past from studies having measured". In addition to improved diagnosis, the doctor believes that the lifestyle is the main culprit: geographical mobility to regions rich in pollen, prolonged confinement in unventilated homes, automobile pollution, passive smoking, stress, lack of vitamins and obesity playing as factors aggravating ...
The thesis hygienist: a reality?
The hygiene hypothesis offers another explanation. In newborns, the immune system has a predominance of Th2 lymphocytes that promote the production of proteins involved in allergy, before turning to an activity suited to the fight against infections. But for this switch operates, the agency may need in the first months of life react to infections. Although not proven, several studies argue in favor of the hygiene hypothesis: children in day care have more infections but fewer allergies, babies born by caesarean section had not been in contact with germs have more vaginal allergies ...
Furthermore, premature infants more likely to be saved could present sensibilities more important: there is a link between asthma and prematurity. Several life events in utero could also affect the development of individual susceptibility (taking hormones and drugs, fetal distress ...). So many reasons could explain the boom of allergies.
Real alteration of the quality of life
Recently, allergists are concerned about the impact of symptoms of allergic rhinitis on quality of life of patients. "This concept is particularly useful, given the perennial rhinitis in which the permanent exhibition to environmental factors such as mites, that rhinitis is the appearance of a chronic illness. So also the classic symptoms (sneezing, runny nose, ... itching), the interrogation must allow the patient to judge the impact and therefore the severity of the disease.
It is in this spirit that the World Health Report prepared ARIA (Allergic Rhinitis and Its Impact on Asthma) which proposes a classification and management based on symptoms and quality of life (impaired sleep, difficulty concentrating, decreased intellectual capacity on the academic or professional, mood disorders ...).
Effective treatments
To reduce symptoms, Antihistamines oral or nasal corticosteroids are the therapeutic classes most effective against a mild allergic rhinitis. For more serious symptoms of corticosteroids may be prescribed. But antihistamines are still the main treatment.
After the advance of 2nd generation antihistamines that had led to fewer side effects (sleepiness, impaired vigilance ...), new compounds coming onto the market. Lower doses, they are currently reserved to medical prescription.
To permanently change the course of allergic rhinitis only desensitization, possibly early works. It can restrict the acquisition of new sensitizations and reduced in children with allergic rhinitis risk of subsequent development of asthma.
