Allergy in Mediterranean Area

 

Marcello Zambito, MD (Marcello.zambito.@infinito.it  tel. 0039-091332303) was born in Palermo in 1960 on Ianuary 20th, graduated at Palermo’s University in 1985, he specialized at Bari’s University in Allergology and Clinical Immunology in 1989. He has worked as allergologist from 1999 to date for the Italian NHS (ASL 6).  From 1990 fellow of the Italian and European Society of Aerobiology and of the Italian Allergology and Clinical Immunology Society; He has publisced many articles and abstracts on national and international scientific journals. He has attended as chairman to several meetings on allergology

 

What is allergy?

With the scientific term allergy we intend an abnormal reaction of our organism towards exogenous nature goads ( allergens ) that do not indulge to any reaction in normal people.

The allergic patient represents an exalted and protract synthesis during a period of time of Class E immunoglobuline, that are antibodies responsible of allergic syndromes, responding to a stimulation of its owh immune –system.

The principal allergys in Mediterranean area are represented by respiratory allergy ( conjunctivitis, rhinitis and asthma ).

In the determinism of such allergys perennial allergens ( house dust mite, environment fungi, and dog and cat epithelium ), and seasonal allergens are implicated as far as pollen regards, they vary depending on the kind of vegetation and climatic conditions present in different  places. Through the elaboration of pollen calendars it’s possible to know which pollinic species are present in each region.

The most diffused pollinic species in Europe is represented by grass pollen, infesting weeds present everywhere; in Northern Europe Birch is the most frequent pollinic species present; instead in Mediterranean regions, due to mild winters and dry summers, Urticacee (Parietaria Judaica ), Olea ( Olea européa ), Grass Pollen, Cupressus (Cypress, Thuja, Juniperus ) are the major pollinic species present.

In Spain, besides the above mentioned there is also Chenopodium-Amarantacee ( Amaranthus, Salsola Kalj ). In France, like in Northern Italy, Austria and Hungary we assist to an increasement of Ambrosia pollen allergy ( the most common allergy in America ), this is due to the much more frequent cultural exchange and also for the plants imported for parks.

 

Which  theraphy in allergy?

For what concerns respiratory pathology therapy it can be sub-divided into two types: symptomatic and curative.

The symptomatic therapy comprehend medicine capable to neutralize allergy symptoms: beta-2 adrenergic agents, steroids, anticholinergic agents; medicine addressed to neutralize the negative effects of infiammation mediator like antihistamines and antileokotrienes.

The curative therapy is given by substances that are able to modify the basical mechanism of allergic reactions like immunotherapy

The only therapy able to modify the natural course of allergic reactions is immunotherapy, it prevents that allergic rhinitis evolves to asthma.

Remembering that antihistamines assumption must be always guided by medical prescription due to its side-effects as: sedateness and throat dryness, dysury by prostatic congestion ( side-effects reduced by the latest antihistamines ).

Antihistamines that give less side-effects are loratadine and fexofenadine, the only ones used by air-line pilots and flight controllers admitted by USA federal aviation.

The future prospective of therapy is represented by Anti-IgE , that have given very good results with allergic asthma and rhinitis; dealing with like human monoclonal mouse antibody that links with IgE globulins, and by DNA vaccines that represents a sort of inside vaccination to the immunitary system.

To signalize, furthermore, the next coming out in commerce of two new antihistamines molecules , the desloratadine and the levocetirizine.

 

Which prevention in allergy?

As far as preventive therapy concerns, we can follow the next advice for the environmental perennial allergys:

-Remove all dust repository from bedroom ( tapestry, carpet, rugs, toys, plush, books, magasizes, etc;

-Use allergen-impermeable mattress and special pillow covers;

-Do not use latex mattress and pillow because it is a very high allergic source;

-Change frequently bedroom sheets;

-While cleaning use special electrostatic dust clothes and vacumcleaners with high Hepa filters;

-Remove animals from the bedroom;

-Use acaricides to reduce house dust mite population;

-Control environment humidity , to reduce humidity it should be sufficient a good ventilation

  or where it is not possible place a dehumidificator .

 

As far as pollen allergy concerns you should conform the following advises:

-Avoid in springtime all places with birch, hazel and poplar trees: in summertime avoid cultivated  

 meadows and fields  in late summertime avoid uncultivated lands;

-Take care to go on holidays during the right period of plants pollination for you;

-For holydays prefer sea or mountain areas;

-Sleep with closed windows or you can open the windows only from 10,00 P.M. to 4.00 A..M. ;

-While in car use Hepa air-conditioner filters or keep windows closed;

-Do not trim grass while illness or don’t stand near while others are trimming grass;

-Practise sports in close areas like a gymnasium, covered swimming pools.

 

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