Hay fever season: Are allergies a form of chronic inflammation?

Isn't spring wonderful? With the early bloomers, the first splashes of color return to the winter-gray landscape, and the trees slowly begin to sprout again. If you can only enjoy this to a limited extent, you are probably one of the approximately 15 percent of the population who suffer from a pollen allergy. Irritated eyes and respiratory tract are just the beginning; flu-like symptoms (such as severe aching limbs) are also among the unpleasant side effects of the disease, which is affectionately known as "hay fever." Why are allergies becoming more and more widespread? Is allergy also one of the chronic inflammatory diseases?

What exactly is an allergy?

An allergy is an excessive reaction of the immune system to a normally harmless environmental substance. These foreign substances are then referred to as allergens. They can be food, chemicals, certain metals, animal hair or pollen. According to the RKI, around one in four people in Germany will suffer from an allergy in their lifetime. The most common allergens are pollen, house dust and food, with pollen making up the lion's share at 15 percent of adults. Allergies occur repeatedly and over a long period of time. They are therefore a chronic inflammatory disease and should therefore not be taken lightly. A pollen allergy that is not adequately treated can spread from the upper to the lower respiratory tract. The sinusitis that often accompanies the allergy can also take a chronic course. In addition, the constantly excessive immune reaction can also affect other sources of inflammation in the body. This can possibly lead to an increased occurrence of silent inflammation .

How does an allergic reaction occur?

The allergens enter our body via the mucous membranes of the respiratory tract or intestines - or directly via the skin in the case of contact allergies - and there they meet the immune system. In the case of an allergy, the immune system overestimates the allergen and thinks it is more dangerous than it is. Certain antibodies of the immunoglobulin E type, or IgE for short, are presumably responsible for this. At some point in life, usually in early childhood, these antibodies have "targeted" the allergens. The IgE then spread throughout the body and form strong bonds with the so-called mast cells. Mast cells have the task of releasing certain inflammatory mediators, i.e. substances that trigger an inflammatory reaction . This is particularly histamine. This then leads to the typical signs of inflammation: redness and swelling of the mucous membranes, secretion production, sneezing, and sometimes even fever. Accordingly, antihistamines and cortisone are mainly used to treat allergic reactions. Antihistamines directly inhibit the effects of histamine, while cortisone has a general anti-inflammatory effect.

More allergies due to too much hygiene?

It is still unclear why IgE antibodies are predominantly formed in the initial phase of an allergy, the sensitization phase. The original task of IgE is probably to defend against parasites. Allergies are becoming more and more common, especially in industrialized nations. One theory is that we hardly come into contact with parasites anymore and that the increasingly idle IgE is therefore specializing in other invaders. In countries with a higher parasite infestation within the population, comparatively fewer allergies occur. Since these countries generally have lower hygiene standards, this also leads to the widespread theory that excessive western hygiene is to blame for the occurrence of allergies. Where people clean more, the immune system comes into contact with foreign substances less often and is therefore less able to adapt to them - or so the assumption goes. This hypothesis is fueled by the fact that city children suffer from allergies more often than children who grew up in villages.

Does my allergy get worse every year?

But increased contact with allergens could also be responsible for the increased occurrence of allergies. Climatic changes lead to phases with significantly higher pollen levels. The last pollen is increasingly flying until December and the first grasses start to appear in January. It is also suspected that the pollen is also contaminated with pollutants (for example from exhaust fumes) and thus triggers more severe reactions in the immune system. This means that allergies would not only occur more frequently, but the symptoms would also become more severe. As plausible as these theories may sound, it has not yet been conclusively determined which factor is actually responsible for the increasing occurrence of allergies. An interaction of the various factors is also conceivable.

Do allergies get worse with age?

This also applies to allergies that only develop over time. Most allergies develop in childhood. But allergies are also becoming increasingly common in older people. If allergies only develop in adults, this could be an indication of a disturbed barrier function of the skin or intestines. As we get older, our skin becomes thinner and produces fewer of the protective fats. Without appropriate care, the skin can become brittle, dry and flaky. This also means that the skin microbiome loses living space and is therefore less able to fight off foreign substances. The diversity of species in the intestinal microbiome also decreases with age. This could have an impact on the barrier function of the intestinal mucosa and promote diseases such as leaky gut syndrome . Researchers see this as a possible risk factor for the development of allergies. But the microbiome can be easily supported. For the skin, this means not only drinking enough fluids but also using moisturizing lotions. The intestinal microbiome benefits from a varied diet and, in particular, from fiber. This is because the bacteria can extract short-chain fatty acids from them and thus supply themselves with energy.

What to do if you have an allergy? Five simple tips

Since the microbiome is part of our immune system, it should always be well cared for. But how else can the body be supported in the event of an allergy? We have put together the best tips for you:

• As banal as it may sound, the best tip for preventing an allergic reaction is to avoid contact with the allergen. However, this is particularly difficult with pollen. Washing your hair before going to sleep can still be helpful.
• While in the countryside most pollen is found in the morning, in the city it is the other way round. You should therefore ventilate at times when the pollen load is low.
• Vacuum cleaners with so-called HEPA filters can capture even the finest airborne particles and thus reduce the allergen load.
• The beloved mouth and nose protection can also provide relief during pollen season. A nasal douche can provide additional relief from symptoms.
• Plan your vacation in pollen-free regions. Coasts, islands and high mountains are considered to have particularly low levels of pollution.