The potency of an allergen vaccine is the total allergen activity (that is, the sum of the contribution to allergenic activity from any individual IgE molecule specific for any t-cell epitopes on any molecule in the allergen vaccine). It follows that potency measures always will depend on the serum pool or patient panel selected as well as the methodology used. Methods used for the assessment of allergen vaccine potency may be divided into in vitro or in vivo techniques. (more…)

Being an immunological disease, the characteristics of allergy are those of specificity and memory. Regardless of whether the clinical manifestation is rhinoconjunctivitis, rhinitis, or asthma, the underlying immunological response disorder is based on the adverse reactions of cells in the immune system upon contact with allergens. These cells are specific for epitopes that are structural parts of allergens present in the allergenic source material. Two types of cells (i.e., T cells and B-cells) produce receptor molecules (i.e., T-cell receptors and immunoglobulin [IgE] antibodies) that, through high-affinity interactions with the allergen, efficiently catalyze the presence of even minute amounts of allergens into clinical symptoms, the extreme consequence of which may be life-threatening to the patient. (more…)

An allergic patient’s history may point the clinician’s assessment to a specific area or organ system during allergy testing. In general, physical examination may be standard; shortage of findings isn’t going to rule out allergy.

Essential indicators are a starting point in any physical examination of allergic patients. Respiratory rate is essential as well, but hyperventilation is more a representation of minute ventilation (respiratory rate × tidal volume) than respiratory rate on it’s own. (more…)

By definition, allergy is a condition where a person has hypersensitivity to an environmental, drug, or food antigen (allergen) caused by an altered or unusual immune system reaction to the antigen.

Allergenic foods can impact the lungs when an allergic reaction individual inhales food particles that may have been released when the food was cooked or that were dispersed in aerosol form. Allergy to the allergens in cooked food has been reported by highly allergic patients who were exposed to their allergenic foods (say, fish, shellfish, or eggs) in an enclosed area (for example, a restaurant dining room) or during meal preparation. Most cases of asthma triggered by aerosolized food allergens involve adults engaged in specific occupations that regularly expose them to the allergens. In contrast, most cases of asthma in children are triggered when the allergen is eaten, not inhaled.

Many experts believe that if a baby can be protected from becoming sensitized to the most highly allergenic foods when their healthy immune system and the digestive tract are in the most vulnerable stage for allergy to develop, the incidence of lifelong food allergy and potentially life-threatening anaphylactic reactions to foods will be reduced and hopefully entirely prevented. When a baby has been identified to be at risk for developing allergy, measures to reduce allergic sensitization might be implemented at birth and the problems associated with future food allergy may be significantly reduced. However, as we shall see in later discussions, experts disagree on the best way to avoid this early allergic sensitization.

The reaction of asthmatics to these chemical compounds is not an allergy, but is more correctly described as allergy intolerance because the initial response is not a triggering of the immune system. The process involves an increase in the level of the inflammatory mediators that are responsible for the bronchospasm of asthma. These mediators include histamine and leukotrienes. They are released during the reaction to an allergen, and cause the muscular contractions that result in the difficulty in breathing and wheezing that are typical of asthma. By inhibiting (or turning off) other types of mediators, the chemicals in the food additives cause an increase in the level of antihistamine and leukotrienes. This results in increased bronchospasm, and a definite worsening of the asthma symptoms.

Oral allergy syndrome is an allergic reaction to food that is confined to the oral cavity (i.e., to the lips, and around the lips, roof of the mouth, tongue, hard and soft palate, and uvula) and adjacent structures. It differs from other food allergy in that its symptoms do not appear in any other location in the body, and always accompany respiratory allergy to inhaled allergens of plants, particularly plant pollens. Of course, symptoms in the mouth, throat, and upper respiratory tract can be part of a generalized reaction to foods, but in this case they are more accurately described as oral allergy symptoms. The term oral allergy syndrome applies specifically to pollen allergy (pollinosis) accompanied by reactions to certain raw foods when they are in direct contact with oral tissues. Individuals with Oral allergy syndrome typically have hay fever symptoms caused by allergies to trees, grasses, and weeds. They experience irritation in the mouth (lips, tongue, roof of the mouth) and sometimes the throat after eating specific types of raw fruits, vegetables, and sometimes nuts.

About twenty percent of patients who have common allergic rhinitis are also having perennial allergic rhinitis symptoms. This fact is also reflected in their patterns of drugs and medication use. Compare to seasonal allergic rhinitis, perennial allergic rhinitis patients have significantly higher health care costs and rates of comorbidities and greater use of concomitant medical treatment. (more…)