Dr. Carole Youakim: All Kinds of Allergies are Curable through Immunotherapy!

According to the World Allergy Organization, approximately one billion people around the world suffer from allergies, which are reactions of the body’s immune system toward unfamiliar substances called allergens. Consequently, immunoglobulins (IgE) are produced as a countermeasure to protect the body from this substance. And, this leads to the secretion of histamine, the leading cause of allergies.

Is it possible to cure allergies or are patients forced to live with them? Dr. Carole Youakim, President of the Lebanese  Pulmonary Society (LPS) and Head of the Pulmonary Department at Mount Lebanon Hospital answered hereafter these questions.

The Development of Allergies in Children

It is important to note that children are exposed and prone to develop a series of allergy. First of all, the child may suffer from eczema, then food allergies, then allergic rhinitis and asthma, leading to respiratory system hypersensitivity. (Allergic March)  This sequence is not consistent for every child. However, if a child suffers from skin allergies, he/she is more prone to have food allergies, allergic rhinitis, and asthma. When it comes to food allergies, one must differentiate between food intolerance and actual food allergies. If a child has intolerance to milk for example, when the type of milk is changed, the intolerance will disappear. Whereas, a child suffering from milk allergies must be forbidden from drinking milk.

An allergy can cause a sever shock (called anaphylactic shock) when re-exposed to the allergen, while intolerance does not lead to serious complications.

When children develop respiratory system hypersensitivity, it could be genetic or due to the exposure to a particular allergen. As mentioned earlier, whoever suffers from asthma will most likely suffer from allergic rhinitis. A qualitative treatment of allergies must hence be provided in order to have proper healing.

The Treatment of Allergies in Children

One of the most common false-believes related to children allergies is that as they get older, the allergies will disappear without treatment. This is completely false! In the absence of treatment, the allergies can generate serious complications. Therefore, treatment is mandatory and should start through accurate diagnosis helped by a blood test to determine the presence of allergies and their cause (Total IgE and specific IgE  for respiratory and food allergens). Through a blood test, food allergies can be highlighted such as milk, peanut butter, and sesame oil allergies. Other types of allergies such as moisture, house, dust, mite or pollen can also be determined by the test and by Prick Testing : (Skin test). Children can undergo this test starting from the age of four years.

After an accurate diagnosis comes the treatment phase. All kinds of allergies can be treated based on immunotherapy whereby the child is given small doses of allergens (such as pollen) in order for the body to produce antibodies that will fight this allergy. This treatment extends for a period of three years, but its effectiveness lasts a lifetime. In addition, eczema is treated by the use of localized creams, whereas allergic rhinitis’ treatment is based on inhaled corticosteroids, without any negative repercussions. This also is the case with asthma where Inhaled corticosteroids spray is utilized in addition to a special medicine that opens up the respiratory airways (bronchodilator). Parents should not worry about the side effects (such as obesity) of these Inhaled corticosteroids cause they act locally and do not cause systemic side effects. Only systemic  steroids taken for a long period of time and at high doses can cause serious side effects.

Adult Allergies

The most prevalent type of allergies in adults is the allergy to mites. First of all, it is important for the person who suffers from this allergy to aerate his/her room every day and clean the bed sheets properly by washing them at high temperature (70°C) once a week. As mites love humidity and darkness, therefore doing so will help to  get rid of them. However, these preventive measures should be integrated along with treatment. In Lebanon, another common allergy result from hypersensitivity to parietaria, trees and plants. Allergies do not require touching the allergen to develop, as the allergen can be carried through the air (airborne). However, immunotherapy has an active role in healing the various types of allergies with noted progress as early as the first 6 months of the three-year treatment.

Adults who suffer from asthma can be easily treated with inhaled corticosteroids and bronchodilators. After 3 months of treatment, the doctor will reassess the situation and may decrease the dosage of the medication to ultimately stop it altogether. It is a must to note that the bronchodilator is not a cure by itself, because it relieves symptoms and it does not treat the underlying inflammation. Inhaled corticosteroids are the mainstay treatment of asthma.

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