Allergy Drops

July 30, 2006 Respiratory Allergies An allergy is an inappropriate over-reaction of the bodys immune system to a normally harmless substance (called an allergen). Respiratory allergies are caused by inhaling an allergen. They are also referred to as allergic rhinitis, or "hay fever." The American College of Allergy, Asthma and Immunology estimates about 40 million Americans have allergic rhinitis. The most common offenders are tree pollen, grass pollen, weed pollen (especially ragweed, which affects 75 percent of those with hay fever), mold spores and dust mites. Exposure to an allergen can produce a number of symptoms, like sneezing, coughing, itching or watery eyes, runny or clogged nose and postnasal drip. Some patients develop dark circles under the eyes (nicknamed "allergic shiners"). In susceptible people, exposure to an allergen can trigger an asthma attack, leading to coughing, wheezing and shortness of breath. Dealing with Allergies The best way to deal with allergies is to avoid the allergen. However, in most cases, thats impossible. But there are ways to at least reduce exposure. Stay indoors when pollen levels are highest (usually in the morning or on very windy days). Use air conditioners on warm days to prevent pollens from entering through the window (dont forget to clean the filter!) When working outdoors, wear a face mask with a filter designed to keep out pollen. Replace wall-to-wall carpeting with washable throw rugs. Most people dont want to give up pets. But at least keep the animals out of the bedroom to reduce allergen exposure at night. When symptoms occur, there are a number of different options to choose from. Allergy medications are available over-the-counter and by prescription. Eye drops can reduce itching and tearing. Nose sprays reduce inflammation causing nasal congestion. Another option for people with allergies is allergy shots (immunotherapy). Doctors give a very small amount of the substance that causes the allergy through an injection under the skin. Gradually, the dose of the allergy shot is increased. The shots increase production of a protective antibody, enabling the body to develop a tolerance to the allergen, reducing allergy symptoms. The American Academy of Allergy, Asthma and Immunology reports allergy shots are successful in 90 percent of people with seasonal allergic rhinitis (i.e., symptoms regularly occur at a certain time of the year) and in 70 to 80 percent of those with perennial (year-round) allergic rhinitis. Oral Immunotherapy for Allergies Although allergy shots are very effective, some people dislike having to get regular injections. They are also inconvenient because the shots must be given in a doctors office. Thats because some people develop a severe reaction after an allergy shot and may require immediate medical intervention. Allergy patients may soon have another option. Its called sublingual immunotherapy (SLIT, or allergy drops). Robert Anolik, M.D., Allergist with Vireo Allergy Center, says the oral drops are made from the same extracts used to produce allergy shots. The concentrations are adjusted, just as with shots, starting with a very low dose and gradually increasing it. Once each day, patients place six drops under the tongue, hold them there for two minutes and then swallow. The drops are safer than injections because they dont appear to cause severe reactions. Thus, the drops can be used by the patient at home. With drops being more convenient and less painful, patients are more likely to comply with therapy. Anolik says oral immunotherapy has been used in Europe and South America for about 30 years, but is still a relatively new technique here in the U.S. He recommends patients start treatments about three to six months before expected onset of symptoms because it takes time for the body to develop a response to the therapy. Estimated cost of the sublingual immunotherapy is about $100/month. Currently, the extracts used to produce the oral allergy drops are only approved for injections. However, clinical trials are now underway to confirm the safety and effectiveness of the drops for oral administration. Once the drops are FDA approved, Anolik is hopeful insurance companies will cover the cost. AUDIENCE INQUIRY For general information on allergies: American Academy of Allergy, Asthma and Immunology, http://www.aaaai.org American College of Allergy, Asthma and Immunology, http://www.acaai.org Asthma and Allergy Foundation of America, http://www.aafa.org National Institute of Allergy and Infectious Diseases, http://www.niaid.nih.gov BIBLIOGRAPHY "Airborne Allergens," Bethesda: National Institute of Allergy and Infectious Diseases, downloaded from website (http://www.niaid.nih.gov), July 6, 2006. 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Miceli, et al., "Sublingual Immunotherapy in Asthma and Rhinoconjunctivitis," Archives of Disease in Childhood, July 2004, Vol. 89, No. 7, pp. 620-624. Walls, Ronald, et al., "Optimising the Management of Allergic Rhinitis," Medical Journal of Australia, January 3, 2005, Vol. 182, No. 1, pp. 29-33. Wilson, D., et al., "Sublingual Immunotherapy for Allergic Rhinitis," The Cochrane Database of Systematic Reviews, 2006, Issue 2. Research compiled and edited by Barbara J. Fister