The blooming spring flowers mark the beginning of spring, but for millions of people, they also indicate the beginning of misery: season of allergies and asthma. Itchy and watery eyes; sneezing, runny nose; coughing and wheezing are triggered by an excessive reaction of the body to pollen.
Every spring, trees and grasses release billions of pollen granules floating in the air, using the wind to disperse through the countryside for the purpose of breeding. Everything is a question of survival. plants that release more pollen have the advantage of surviving.
As an adult and pediatric allergist-immunologist in the Midwest, the early spring marks my busy season treating hundreds of patients for their seasonal allergy and asthma symptoms. If you suffer all season, know that you are not alone. During the course of history, pollen has been a source of pleasure for spring. In modern times, however, medical science has identified practices and treatments that help.
Older than dinosaurs, as wide as the world
Fossilized specimens of pollen granules were discovered before the dinosaurs and alongside the Neanderthals.
And, the symptoms and treatments of sinuses and asthma are documented throughout history and around the world. People simply did not know how to treat the symptoms or what caused them.
For example, more than 5,000 years ago, the Chinese used the berries of the horse-tail plant, ma huang (Ephedra distachya), to relieve congestion and reduce the production of mucus associated with "plant fever" – a disease that affects people during the fall.
In Egypt, the "Papyrus Ebers", written around 1650 BC BC, recommends more than 20 treatments for coughs or breathing difficulties, including honey, dates, juniper and beer.
Although Homer's "Iliad" describes the muffled sound of breathing during combat as "asthma," Aretaeus of Cappadocia in the second century AD is credited with the first clinical description more consistent with modern understanding of this disease . He wrote of those who suffered this:
"They open their mouths because no house is enough for their breathing, they are standing, breathless, as if they aspired to suck all the air that they could possibly breathe … the neck swells up." with the swelling of the breath, the precordia (chest wall) retracted, the pulse becomes small and dense, "and if the symptoms persist, the patient" may cause suffocation after the form of epilepsy ".
At the time of Columbus's arrival, the indigenous peoples of Central America and South America were using ipecacuanha, a root found in Brazil with expectorant and emetic properties and balm, which is still used in some cold remedies. The coca leaves and tobacco, used in medicine by the Incas, were then exported to Europe for further experimentation for the treatment of rhinitis and asthma.
In addition to the "plant fever" described in China, the earliest written description of seasonal respiratory symptoms is attributed to Rhazes, a Persian scholar, circa AD 900. He described nasal congestion that coincided with the flowering of the plants. roses, called "pink fever".
Symptoms observed, but no identified cause
As scientific progress was stifled in the Middle Ages, largely because of the plague, it was only 900 years later, in 1819, that Dr. John Bostock published a description of his own seasonal allergies. But he did not know what was causing them.
Suffering from "summer caricatures" since childhood, Bostock has continued his study of the disease, despite a mediocre response from the medical profession.
In the nine years between his first and second publications, he found only 28 additional cases, which is consistent with his own seasonal allergy symptoms, which may indicate the lowest prevalence of disease at this time. He noted that the nobility and privileged classes were more often affected by seasonal allergies. It was thought that this was a consequence of wealth, culture and a life inside.
Societal changes that have their roots in the industrial revolution, including increased exposure to air pollution, reduced outdoor time, increased pollen and improved hygiene, have probably contributed to the increased prevalence of allergies that we continue to see today. They also contributed to the formulation of the hypothesis of hygiene, according to which partially reduced exposure to certain bacteria and infections could lead to an increase in allergic and autoimmune diseases.
It was also thought that the source of the seasonal symptoms at the time was the smell of new hay. This led to the formulation of the term "hay fever".
Bostock suspected instead that the recurring symptoms were due to the heat of summer, his symptoms being alleviated when he was spending the summer on the coast. It later became common for nobility and aristocrats to spend the allergy season at resorts or hill stations to avoid annoying symptoms.
Identify the real culprit
Through methodical study and self-experimentation, Dr. Charles Blackley determined that pollen was at the origin of allergy symptoms. He collected, identified and described various pollens and then determined their allergic properties by rubbing them in the eyes or scratching them on the skin. He then noted those that caused redness and itching. This same technique is used in skin tests by allergists today.
Inspired by the discoveries related to vaccination, Dr. Leonard Noon and John Freeman prepared doses of pollen extracts by injection in order to desensitize patients with allergic rhinitis in the early 1900s. This effective treatment, called allergen immunotherapy, is also used today.
Antihistamines became available in the 1940s, but they caused significant sedation. Formulations with fewer side effects used today are only available since the 1980s.
Pollen may grow
Although recognized by ancient civilizations, the prevalence of seasonal allergic rhinitis and allergic asthma has only increased in recent years; it now affects 10 to 30% of the world's population.
Fueled by warmer temperatures and increased levels of carbon dioxide, the pollen seasons are longer and their numbers higher. Many experts believe that this will worsen in the coming years, largely because of climate change.
What can you do? Allergy sufferers often need a multidimensional approach.
- Find out which allergens are causing your symptoms.
Take note of when your symptoms begin by making a note in a calendar or diary.
- Minimize exposure to allergens.
Follow the pollen counts. When the pollen count is high, keep the windows closed at home and in the car. After spending time outside, take a shower and change clothes to avoid continuous exposure to pollen.
- Take a proactive approach to treating symptoms.
Taking medication before the onset of symptoms can prevent the symptoms from becoming uncontrollable. This can also decrease the amount of medications needed overall. Non-sedating long-acting antihistamines are useful for itching and sneezing. Aerosols of nasal corticosteroids are more useful for stuffy noses.
- Consider a visit to a certified allergist / immunologist. He or she can help you determine which pollens in particular can be the source of your symptoms.
- Explore the role of immunotherapy with your doctor. Immunotherapy alters the immune response by administering small doses of allergens over time. This induces a state of tolerance, ultimately helping people become less allergic over time.
As the pollen season approaches, a multifaceted approach can provide much needed relief to the symptoms that have affected humanity throughout the millennia.
Kara Wada, Assistant Professor of Allergy / Immunology Clinic, State University of Ohio
This article is republished from The Conversation under a Creative Commons license. Read the original article.