In France, one in four people suffers from allergic rhinitis. Among these patients suffering from hay fever, 41% give up social, sports, leisure or professional activities. Clearly, a respiratory allergy can be a real handicap on a daily basis. But what are the most effective methods to relieve the sick? Dr. Catherine Quéquet, allergist and author of the book “New allergies: How to recognize them? How to fight them?”, takes stock of the treatments that exist today.
– Why Doctor: According to a report published by the association Asthma & Allergies on March 22, one in three adults born after 1980 is currently affected by an allergy. In 2050, half of the world’s population will be affected by at least one allergic pathology, according to projections. Do you confirm that these conditions constitute a major public health problem?
Catherine Quequet: Unfortunately yes ! For years, the allergy community has been advocating with policy makers on the need to make allergies a great national cause. This is such a problem that the French Federation of Allergology (FFA) and patient associations have drawn up a five-year plan to combat these diseases, which has been submitted to all candidates for the presidential election. The aim of this project is to raise the authorities’ awareness of the rise in importance of allergies, poly-allergies, cross allergies and the cruel lack of allergists to improve the management of these pathologies.
– In France, the frequency of hay fever has quadrupled over the past three decades. It now affects more than 25% of the general population in France. How to explain this boom in allergic rhinitis?
In France, a small increase in respiratory allergies, the main causes of which are grass pollen, dust mites, pets, has been observed in recent years. This slight increase is caused by the lag in flowering. For some time now, the pollens have been appearing earlier and the season is getting longer. In addition, atmospheric pollution modifies the composition of pollens, which makes them more allergenic.
– Has the Covid-19 epidemic favored the occurrence of respiratory allergies?
The pandemic has had no impact on the prevalence of allergies. During the first lockdown in 2020, an increase in symptoms was observed, as grass pollens were not cut on roadsides and temperatures were higher.
– The allergy community has noted an increase in cross allergies. But what is it?
Cross allergies are caused by the presence of similar or similar structures in substances as different as pollen, food or animal hair.
The most frequent are between pneumallergens, namely a substance in suspension in the air such as pollen, between trophallergens, ie a substance present in food, or between pneumallergens and trophallergens. For example, a person allergic to dust mites may also be allergic to snails, or a patient with an allergy to birch pollen is more likely to be allergic to raw apples or pears.
In general, adults allergic to pollens do not immediately understand that they are allergic to particular foods. They go to an allergist for a pollen allergy. The practitioner will have them do tests and ask them questions about the consumption of certain foods. Another possible case: people notice that their tongue itches or that their lips swell after eating a fruit or vegetable. During the consultation, the specialist will try to understand if each year at the same period, the patient suffers from rhinoconjunctivitis and will confirm that he is suffering from a cross-allergy.
– Currently, what techniques can effectively manage respiratory allergies and improve the daily lives of patients?
In the event of respiratory allergy, it is advisable, initially, to limit the contact with the allergen. Avoidance, depending on the responsible allergen, consists of not sleeping with pets, bathing your cat to reduce the presence of allergen for at least 24 hours, opting for a featherless pillow, a mattress without wool and to use electrostatic cloths. Other recommendations: do not play sports when the weather is nice and windy, wash your hair in the evening, ventilate your house early in the morning and late in the evening outside of pollution peaks.
The medical treatment of respiratory allergies is based on taking antihistamines, using eye drops and local corticosteroids in the nose. Allergic rhinitis can also be treated with sublingual desensitization in the form of drops or tablets, the purpose of which is to make the patient tolerant to the allergen. People allergic to dust mites must follow this treatment every day for three to five years and those allergic to grass pollen use this method for five years, before and during the pollen season.
– What are the latest news on allergy treatments?
It is now possible to use monoclonal antibodies, by injection, to fight against severe allergic asthma. The use of this treatment has very recently been extended to treat chronic urticaria, including cold urticaria. These occur on areas of skin exposed to cold through direct contact with cold substances or cold drafts or cold water.
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