Diagnostics And Immunotherapy Allergic Reaction Biology Essay

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The disorder of immune system when there is an atypical reaction to normal substances in the environment is called allergy (or atopy) which is one of the 4 forms of hypersensitivity, immediate (type I) hypersensitivity. Those substances calling allergic reactions are called allergens. When the stimulus works, white blood cells called basophills and mast cells are excessively produced by antibody of immunoglobulin E and the extreme inflammatory response begins. Hay fever, chicken-poxes, eczema, food allergy, attacks of asthma, and reactions to poison of caustic insects like wasps and bees are among the general allergic reactions.

A mild allergy like a hay fever is extraordinarily prevailing in human population and defiant symptoms such as allergic conjunctivitis, thirst, and snivel. The reactions affect many organs: it becomes difficult to breathe and smell (allergic rhinitis and sinusitis); eyes become red and itching (allergic conjunctivitis); one begins to sneeze and cough from laryngeal edema; ears can hurt too, feel full and hearing impairs (lack of Eustachian tube); rashes attack skin, and problems with gastrointestinal tract like bloating, abdominal pain, diarrhea, and vomiting can happen as well. As it is widely covered in Frequency of infections and risk of asthma, atopy and airway hyperresponsiveness in children, an allergy can be the main factor in asthma, while the airways are narrowing (it is called bronchoconstriction) and mucus is excessively produced in the lungs, breath gets short (i.e. dyspnea), one begins to cough and wheeze. For some people, severe allergy to the environmental allergens, medications or dietary allergens can cause anaphylactic reaction and eventually result in death even (Von Mutius et al. 1999, p. 4). That is why it is so important to study this type of disorder, and search for remedies to prevent it and to make the patients fell easier, there is medical specialty allergology the tradition of which dates back to the beginning of the 20th century. In was then, in 1906 when pediatrician from Vienna Clemens von Pirquet introduced the concept of allergy. It is important to signify that firstly all types of hypersensitivity were regarded as allergies, and therefore they were all thought to be reasoned by an awkward activation of the immune system. Further it was discovered that there are different mechanisms involved (Matricardi 2007, p. 999).

There is a great variety of tests to diagnose allergic terms now; they include checking of skin for answers to the known allergens or blood test for a presence and levels of allergen-specific IgE. Treatment of allergies includes cancellation of allergen, use of steroids, anti-histamines, or other oral treatments. One of the most important ways out is immunotherapy. It is applied to decrease the sensitiveness of response to the allergen.

One of the most spread transporter of allergens is food. Allergic reaction to food is seen in bloating, abdominal pain, tearing, itching skin, diarrhea, and swelling of skin during chicken-poxes. A food allergy causes respiratory (asthmatic) reactions, or rhinitis rarely. The paper Deuthses Arzteblatt International provides a range of such reactions (Figure 1).

Figure 1 (Yurdagül et al. 2009, p. 359)

It has been discovered that propensity for this or that kind of allergy depends on such factors as sex and race, background and age, and hereditary factor is considered to be the most involving (these are host factors).

In Food allergy knowledge, attitudes and beliefs: Focus groups of parents, physicians and the general public, study conducted by Ruchi S Gupta, Jennifer S Kim, Julia A Barnathan, Laura B Amsden, Lakshmi S Tummala, and Jane L Holl (2008, p. 36) food allergy is defined as an hostile immune response to specific products, usually proteins. Children have 8 products that cause 90% of food allergies. Diagnosis is based on clinical history, and can be supported by tests, such as skin prick testing of specific IgE and oral food challenges. IgE-mediated food allergy can cause anaphylaxis and anaphylaxis have been shown to occur in 93% of food allergic children who go through an anaphylactic reaction. It is assumed that 150 Americans die each year because of food allergy, with most of her death among adolescents and young adults. At the moment, management of food allergy is primarily in the strict avoidance of offending food allergens and the beginning of therapy with oral administration (Madsen 2005, p. 414).

A number of organizations such as the Food Allergy and Anaphylaxis Network (FAAN) and the local groups of parent support in favor of enhancing the knowledge and awareness about food allergies at the national and local level (Krugman et al. 2006, p. 558). Nevertheless, previous studies have shown that malnutrition on the prevalence of allergy exists among the general population, and that the knowledge of physicians of food anaphylaxis caused by absent.

Furthermore, it was well established that families of children with food allergies are of poor quality of life. Food allergy has been shown reduce the overall perception of health, curb the activities of the family, and significant emotional and economic consequences for parents. Delayed diagnosis of doctors and the social stigma the public might be factors leading to further difficulties that parents of children with food allergies face in daily fear of life-threatening reaction.

Allergic diseases are rather 'ancestral'. In the national survey of pediatricians, Diagnosis and management of food-induced anaphylaxis, provided by S. D. Krugman, D. R. Chiaramonte, and E. C. Matsui, it is proven by the following statistics: identical twins are by 70% likely to have the same allergy; non-identical twins are likely to have the same allergic diseases occurs by 40%. Moreover, if parents have allergy, children are very likely to be allergic too. And in case when the allergic disease is received from parents, children can have it even in more severe forms than when acquired (Krugman et al. 2006, p. 555). "Some allergies, however, are not consistent along genealogies; parents who are allergic to peanuts may have children who are allergic to ragweed. It seems that the likelihood of developing allergies is inherited and related to an irregularity in the immune system, but the specific allergen is not," M. N. Primeau (2000, p. 1138) claims. It means that there is no gen responsible for this or that abnormality, but parent's disorders influence immune system of a child. This is also analyzed by W. Hu, C. Grbich, and A. Kemp in Parental food allergy information needs: a qualitative study (2007, p. 771-775).

Many researchers pay attention to the fact that small children have much higher allergic sensitivity, young children are generally at risk, that is why it becomes mainly a concern of pediatricians. Among works and surveys conducted on this matter are, for instance, The prevalence of food hypersensitivity in an unselected population of children and adults by M. Osterball, T. K. Hansen, C. G. Mortz, A. Host, and C. Bindslev-Jensen; Pediatric food allergy update by S. A. Bangash amd S. L. Bahna; Anaphylaxis: a 7-year follow-up survey of 46 children by A. Cianferoni, E. Novembre, N. Pucci, E. Lombardi, R. Bernardini, and A. Vierucci; The impact of childhood food allergy on quality of life by S. H. Sicherer, S. A. Noone, and A. Munoz-Furlong; The impact of food allergy on the daily activities of children and their families M. E. Bollinger, L. M. Dahlquist, K. Mudd, C. Sonntag, L. Dillinger, and K. McKenna; Diagnosis and management of childhood food allergy by S. H. Sicherer; Prevalence of IgE-mediated food allergy among children with atopic dermatitis by P. A. Eigenmann, S. H. Sicherer, T. A. Borkowski, B. A. Cohen, and H. A. Sampson; Dietary prevention of allergic diseases in infants and small children by A. Muraro, S. Dreborg, S. Halken, A. Host, B. Niggemann, R. Aalberse, S. H. Arshad, Av. A. Berg, K. H. Carlsen, K. Duschen, P. Eigenmann, D. Hill, C. Jones, M. Mellon, G. Oldeus, A. Oranje, C. Pascual, S. Prescott, H. Sampson, M. Svartengren, Y. Vandenplas, U. Wahn, J. A. Warner, J. O. Warner, M. Wickman, and R. S. Zeiger; Effects of early nutritional interventions on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas by F. R. Greer, S. H. Sicherer, and A. W. Burks; Atopic versus infectious diseases in childhood: a question of balance? by P. G. Holt, P. D. Sly, B. Bjorksten; Atopy in children of families living with an anthroposophic lifestyle by J. Alm, J. Swartz, G. Lilja, A. Scheynius, and G. Pershagen; Prevalence of hay fever and allergic sensitization in farmer's children and their peers living in the same rural community by C. Braun-Fahrlander, M. Gassner, L Grize, U. Neu, F. H. Sennhauser, and H. S. Varonier, et al. in these studies the authors look for reasons and roots of child allergies, determine correlations between parent's diagnoses and child's health, explore impacts of childhood reactions on further living, confront biological, social and environmental factors and try to find solutions and treatments to cure allergies as well as media to prevent their acquirement.

Several studies (including Confirmation of the association between high levels of immunoglobulin E food sensitization and eczema in infancy: an international study by D. J. Hill, C. S. Hosking, F. M. de Benedictis, A. P. Oranje, T. L. Diepgen, and V. Bauchau; Validity of specific IgE antibodies in children with egg allergy T. Boyano Martinez, C. Garcia-Ara, J. M. Diaz-Pen, F. M. Munoz, G. Garcia Sanchez, and M. M. Esteban) have demonstrated that levels of IgE are highest in childhood and drop fast between 10 - 30 years. Hay fever is spread at highest level in children and young adults. The rate of asthma is at highest level in the age under 10 (Strannegard 2008, p. 250). What is more, gender makes sense too: it is claimed that higher risk of allergy occurrence is among boys than girls (Matricardi 2004, p. 69). Still it would be wrong to take that fact as absolute truth, as much belongs on the type of allergy. For instance, asthma attacks more young females than males.

As for ethnicity, it is also a wide spread subject being studied as a factor. It may play a significant role in some allergies; still, racial factors are not easy to be separated from impacts of environment and migration influence. A group of scientists, S. O. Shaheen, P. Aaby, A. J. Hall, D. J. P. Barker, C. B. Heyes, A. W. Shiell studied measles and atopy in Guinea-Bissau (2006, p. 1792-1796); H. Yemaneberhan, Z. Bekele, A. Venn, S. Lewis, E. Parry, and J. Britton concentrated on wheeze and asthma and relation to atopy in urban and rural areas of Ethiopia (2007, p. 85-90). It has been discovered that various genetic loci are connected with asthma, particularly and strong by far, in patients of European, Asian, Hispanic, and African origin.

In the article by W. Burks and B. K. Ballmer-Webe, Food allergy much attention is paid to the origin of disease, and it is shown that genetic factor can't be decisive. The environmental factors to be taken to account are changes in exposure to infectious diseases during babyhood, ecological contamination, levels of allergens, and dietary alterations (Burks and Ballmer-Webe 2006, p. 595).

Further on, Yurdagül Zopf, Eckhart G. Hahn, Martin Raithel, Hanns-Wolf Baenkler, and Andrea Silbermann ling the terms food allergy and food intolerance (2009, p. 359-370). Intolerance of food by functional origin is often caused only by separate functional disorders (like the shortage of lactase in the small intestine) and is unaccompanied by other anatomical and morphological gastrointestinal tract changes. It is said that food intolerance structural etiology, however, has its origin in an anatomically and morphologically visible disease involving structural changes in the gastrointestinal tract. This leads to the second in the food-related symptoms. Small intestinal diverticula, for instance, lead to bacterial excessive growth of the small intestine, which in turn causes postprandial bloating and diarrhea (Teitelbaum 2008, p. 499).

Toxic reactions work in connection with the actions of toxins, which may be bacterial, plant or fungal origin, such as those associated with food contamination, as well as other toxins, such as glycoalkaloids. Intolerance long-term food is used to describe a variety of symptoms of food of different etiologies. Non-toxic reactions fall into two basic mechanisms further: immunological and not immunologically mediated reaction. Non-immunologically mediated reactions make up a great part of all reactions to food (15-20%). The immune system is not directly involved in these cases, and therefore non-immunologically mediated types of food intolerance are not allergies. This range covers pseudoallergic and pharmacological effects caused by: salicylic acid, biogenic amines (e. g., histamine, tyramine, serotonin, etc.); sulphites (at present in wine and medicines); MSG (flavor enhancer); dyes and preservatives (such as tartrazine, benzoates, sorbates, etc.); sweeteners (aspartame), or in connection with enzymopathy (Sampson 1999, p. 719).

The range of differential diagnoses without immunologically mediated forms of food intolerance also include chronic infections (e. g., giardiasis), neuroendocrine tumors (e. g. carcinoid), and psychosomatic symptoms that are causing or are likely to mimic the symptoms of intolerance Especially immunologically mediated forms of food intolerance attributed to food allergy time, and, given the growing prevalence of food intolerance, pose problems of differential diagnosis for patients and physicians alike. No cases of food allergy subjectively overestimated. In one study, one fourth of the population claim that they suffer from food allergies.

In accordance with the hygiene hypothesis, proposed by David P. Strachan (1989, p. 1259-1260), allergic diseases caused by inappropriate immunological responses to harmless antigens are driven by Th2-mediated immune response. N. Sudo, S. Sawamura, K. Tanaka, C. Kubo, and Y. Koga in their article The requirement of intestinal bacterial flora for the development of an IgE production system fully susceptible to oral tolerance induction went further on to study that many bacteria and viruses cause Th1-immune response, which regulates down TH2 responses. The first proposed mechanism of action of hygiene hypothesis stated that the lack of stimulation of the hand Th1 immune system lead to an overactive Th2 arm. An overactive Th2 arm then results in allergic disease. It means that people living in too sterile environment are not opened to pathogens enough for keeping the immune system working (Sudo et al. 2007, p. 1742). While our bodies have evolved to meet a certain level of these pathogens, they are not exposed to this level of the immune system to attack the harmless antigens, and therefore normally benign microbial targets, such as pollen cause the immune response.

The article The association of family size with atopy and atopic disease by D. Jarvis, S. Chinn, C. Luczynska, and P. Burney is devoted to one more aspect of hygiene in accordance with allergy (Jarvis et al 2007, p. 241). The hygiene hypothesis was worked out to find the roots of the idea that such allergic diseases as hay fever and eczema were less common in children growing in big families, probably exposed to more infectious agents through their brothers and sisters than children from families with singular child. The hygiene hypothesis has been actively examined by epidemiologists and immunologists and has become a significant theoretical basis for the study of allergic disorders. It is applied to explain the rise of allergic diseases noticed in the period of intensive industrial growth, as well as the high popularity of allergic diseases in more developed states. If we take a look at the study of C. Braun-Fahrlander, M. Gassner, L. Grize, U. Neu, F. H. Sennhauser, and H. S. Varonier Prevalence of hay fever and allergic sensitization in farmer's children and their peers living in the same rural community we will find out that the hygiene hypothesis now grew to include the effects of symbiotic bacteria and parasites, as significant modulators of development of the immune system, together with infectious agents (2009, p. 33).

Epidemiological data also prove the hypothesis of hygiene (Matricardi 1997, p. 879-882). Investigations have shown that different immunological and autoimmune diseases are to a great extent less spread in developing countries than in the industrialized states, and that immigrants from the developing states to the industrialized world experience increasing development of immunological disorders, depending on the period from arrival in the industrialized countries. Long studies in the countries of the Third World show growth in immunological disorders, as a country becomes richer and, apparently, cleaner. In the article The hygiene hypothesis revised: is the rising frequency of allergy due to changes in the intestinal flora? A. E. Wold revises the problem under consideration. The application of antibiotics during the first year of life was associated with asthma and other allergic diseases. Antibacterial detergents were also linked to higher incidence of asthma, as well as vaginal birth preferred to Caesarean section (Wold 2008, p. 23).

Finally, we come with treatment of food allergies. It goes without saying that much research is naturally devoted to this aspect. One of them is Food allergy: recent advances in pathophysiology and treatment by Julie Wang and Hugh A Sampson (2009, p. 19-29). They determine a range of treatments applied today to cure food allergies. These are allergen immunotherapy, Modified recombinant vaccines, Peptide immunotherapy, Immunostimulatory sequence-conjugated protein immunotherapy, Plasmid DNA immunotherapy (Swoboda 2007, p. 6395).

Immunotherapy is considered to be a promising variant for the treatment of food allergy, especially as safer ways of administration are being researched. Extra randomized, placebo-controlled trials are needed to define the true efficiency and safety of this strategy and to standardize protocols, extracts, and durations of treatment (Niederberger 2007, p. 1015). More than that, research is necessary to clarify if these clinical commodities are connected to true induction of oral tolerance or the process of desensitization and to take insight into the mechanisms of these methods.

Allergen non-specific therapies are Anti-IgE, Chinese herbal medicine, Cytokine/Anti-cytokine, Toll-like receptors. Besides, the authors pay attention to some extra methods which are at the moment being investigated to cure other allergic disorders: "The Fc-Fel d 1 fusion protein inhibited Fel d 1-mediated degranulation in purified human basophils from cat allergic patients and blocked the allergic responses in a mouse model. Since many food allergens are already well-characterized, a similar approach can be taken for food allergy," they say (Wang and Sampson 2009, p. 28).

In this way, reviewing more than … currently available scientific sources, we have examined how food allergies are diagnosed, analyzed and treated, by immunotherapy in particular. Future prospects may refer further insight into the immune mechanisms that cause the lack of oral tolerance and result in food allergies, into various factors influencing it, and potential treatments that can be developed which will hopefully help to discover ways to cure food allergies.