Hay fever

What Is Hay Fever/Rhinitis: Symptoms & Treatment

The term “hay fever” refers to allergic rhinitis caused by pollinosis : it is a very common allergopathy, tending to recur seasonally or periodically in sensitive subjects. Hay fever affects the nasal mucosa , eyes and respiratory tract, and is caused above all by pollen; some individuals also manifest the allergy following contact with dust, feline fur and other possible irritants .
However, a clarification is necessary: ​​pollen it does not represent the actual allergen responsible for hay fever; only by convention is it usually said that it is responsible. In reality, some proteins contained within the pollen trigger hay fever : for example profilins, reserve proteins, pathogenesis related proteins, etc.


Triggering Factors And Predisposing Factors For Hay Fever

It is clear that, being an allergic rhinitis caused by pollen, hay fever tends to worsen in spring, near flowery parks and countryside. Regardless of the seasonality of the allergy, it has been shown that hay fever can also be influenced by strong emotional stress and excessive intake of alcoholic substances .
Over 20 different types of hay fever have been identified, triggered by more than 3,500 plants: the most “dangerous” are birch , ash and grasses in general.

Biochemical Causes

Pollen proteins represent the main causes of hay fever: as they are allergens, the first time they come into contact with a sensitive organism , they induce the production of antibodies. Subsequently, in the event of a new contact between the allergen and the organism, the pollen proteins are perceived more quickly as potentially dangerous (sensitization), so the organism responds with more or less intense allergic phenomena , based on the sensitivity and reactivity of the subject.
In allergic subjects, continuous sneezing is mainly due to the release of histamine , operated by mast cells : histamine spills over the receptors , triggering a vicious circle that inevitably generates sneezing, nasal itching and edema .



What Symptoms Does Hay Fever Cause?

Typical symptoms of hay fever are continuous sneezing , nasal itching , red eyes and the constant sensation of a stuffy nose , often due to rhinorrhea (abundant watery nasal secretion); among the most common symptoms, we also remember breathing difficulty, mainly caused by rhinorrhoea .
Furthermore, hay fever can also cause an annoying itch on the palate , eyes and, more rarely, ears .
It is very frequent that the typical signs of allergy are also associated with headaches and tiredness general, symptoms are even more marked in those subjects suffering from chronic forms of hay fever, with repeated exacerbations over the course of the year regardless of the presence of pollen or irritating agents.
The most problematic symptoms of hay fever are edema and congestion of the nasal mucous membranes: for these reasons, the subject is unable to breathe through the nose , since the nostrils are blocked by mucus and the passage of oxygen is denied .
Sometimes, hay fever also causes pharyngitis and conjunctivitis ; in some people, continuous sneezing and nasal congestion they induce stress, so much so as to generate a certain nervous irritability. When hay fever is also related to inflammatory processes at the level of the bronchial mucosa , the conditions of the affected person could degenerate, to the point of developing a real asthmatic crisis .



How is Hay Fever Diagnosed?

Three common procedures are needed to diagnose hay fever; medical history , physical examination and laboratory tests . The patient’s medical history is based on the collection of information relating to the symptoms he or she complains of, followed by the search for a possible familiarity with the allergy to investigate the genetic predisposition. The physical examination consists in the investigation of the common and classic symptoms of the hypothesized allergopathy; while laboratory tests – including blood tests and the search for type E immunoglobulins – represent further confirmation of hay fever, although not always essential.
Again, to complete the diagnostic picture, RAST-test , RAST-similar, intradermal tests and prick-tests , useful for isolating the allergen, therefore implementing a seasonal prophylaxis plan.



What Are the Cures and Treatments for Hay Fever?

The administration of antihistamine drugs , which hinder histamine action, reduce the symptoms generated by hay fever; the use of decongestants and substances with a vasoconstrictor action can also be very useful.
In allergic and asthmatic patients, in whom the symptoms appear particularly intense, the doctor generally prescribes corticosteroids , capable of exerting a strong anti-inflammatory action , therefore calming the allergic symptoms and asthma in a short time.
When isolating the allergen responsible for the allergic reaction from hay, a desensitization intervention is possible: it is an immuno-therapeutic approach which consists in the administration of specific doses of the allergen itself, subcutaneously . By doing so, the immune system is gradually accustomed to the presence of the antigen, like a sort of habituation to the allergen . This therapy, unfortunately, does not prove useful in all patients, since each subject reacts to the treatment in his own way.
Another alternative therapy comes from the medical school of Sapporo (Japan): hay fever seems to react positively to the inoculation of vitamin E , thanks to its alleged antihistamine properties. Tocopherol _In fact, it seems to reduce blood pressure , numbness and some typical symptoms of hay fever. However, this alternative therapy for the treatment of hay fever has yet to be effectively proven.



Hay fever in brief

Hay fever Allergic rhinitis due to pollinosis: very common allergopathy, tending to recur seasonally or periodically in sensitive subjects
Hay fever: causes Contact/inhalation of pollen, feline fur, dust, irritants.
Possible correlation between pollinosis, excessive alcohol intake and stress
Hay fever: incidence Hay fever tends to get worse in spring, near parks or countryside
Hay fever: symptomatic picture
  • Common symptoms: continuous sneezing,  nasal itching , red eyes, constant feeling of stuffy nose often due to rhinorrhea, annoying itching of the palate, eyes and, more rarely, ears, difficulty breathing .
  • Signs associated with pollinosis: headache, general tiredness, irritability, stress
  • Less frequent symptoms: pharyngitis, conjunctivitis
  • Most dangerous symptoms: edema, congestion of the nasal mucosa, inflammation of the bronchial mucosa, asthma
Hay fever: the biochemical explanation Allergens = antigens = pollen proteins: profilins, reserve proteins, pathogenesis related proteins etc. Contact with the allergen → mast cell activation → histamine release → sneezing, nasal itching, edema
Hay fever: diagnosis
  • Medical history
  • Physical examination
  • Laboratory tests: blood tests and detection of type E immunoglobulins
  • RAST-test, RAST-like, intradermal tests and prick-tests: to isolate the allergen
Hay fever: therapies
  • Administration of antihistamine drugs
  • Use of decongestants
  • Substances with vasoconstrictor action
  • Corticosteroids (particularly intense symptoms)
  • Desensitization intervention: consists of the administration of specific doses of the allergen itself, subcutaneously
  • Alternative therapy: vitamin E inoculation (alleged antihistamine properties, useful in the prevention of hay fever, practice not yet demonstrated and not approved)


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