Allergies are a common health problem that affects many people around the world.
According to the Global Platform for Allergy Patients, 30 to 40 percent of people on our planet today have one or more allergies, and the number of those struggling with this health problem has been steadily increasing over the past 20 years.
In Bosnia and Herzegovina, allergies are spreading epidemically from year to year, says prim. Ph.D. Teufik Hadžiosmanović, specialist in lung diseases and TB, emphasizing that young people are most often affected.
And what exactly is an allergy?
According to our interlocutor, it is an inadequate response of the human immune system to stimuli from the external environment.
Genetically determined
In most cases, it is genetically determined, but the triggers for allergies are increasingly found in the modern way of life, changes in diet, climate, lifestyle, excessive hygiene, use of various preparations, detergents.
– In the genetic code, people carry a genetic error to react to the stimuli of natural factors that are not invasive to the organism, but it recognizes them as hostile. This happens at the level of the immune system where the allergy sufferer has too many antibodies – immunoglobulins – which are used to diagnose allergic diseases – explains Hadžiosmanović.
And allergic diseases are most often manifested as vasomotor rhinitis or allergic asthma as the most severe form of respiratory allergy.
– Symptoms that point to vasomotor rhinitis are: runny nose of a clear liquid that you cannot stop, sneezing in volleys, itching of the eyes, but no temperature. Allergy can also cause general weakness of the body, malaise. In the case of asthma, attacks of difficulty breathing and coughing occur most often at night, when the so-called “whistling” in the chest and a feeling of lack of air – points out Hadžiosmanović.
There are also allergies to pet hair and mites, house dust. There are also urticaria, allergies that appear on the skin, and according to our interlocutor, they are usually caused by inhalant allergens, although they can also be nutritional allergens (food, drugs).
– Allergy can occur as a result of physical factors, but also neurogenic factors (stress, physical exertion, sun, temperature change, increased air humidity) – adds our interlocutor.
Anaphylactic shock
In Bosnia and Herzegovina, the majority of inhalant allergies occur seasonally or throughout the year.
Seasonal includes pollen allergies caused by plants that start blooming in Bosnia as early as February (hazel). Tree pollination ends in June.
In addition to plants, already from the end of March, and throughout the summer, grasses bloom, and the season of the so-called of seasonal allergies ends with the flowering of the most potent allergen – ragweed (from the beginning of September to the end of October).
– Summer is also the time of allergic reactions that occur after insect bites. Bee stings are very common and cause very severe reactions. Recently in Herzegovina, we had a case of the owner of a large company who unfortunately died after being stung by a bee. Most often, it is an anaphylactic shock, which, if at that moment you do not have an injection, an adrenaline auto-injector (the most famous examples are EpiPen or Anapen), which you can give yourself, the consequences can be very serious – Hadžiosmanović points out.
He says that the only protection from the sun is to avoid exposure to it and to use preparations with high UV protection.
– A very current allergy, especially during the summer months, is chlorine from swimming pools. It does not cause allergic reactions, but as a mineral it acts in a way that causes conjunctivitis – says Hadžiosmanović.
When an allergy is suspected, the patient is referred for testing to determine the exact allergen, i.e. the exact cause of the allergic reaction.
– The blood test requires a small amount of blood from which the presence of IgE antibodies to specific allergens is tested. In my practice, it is practiced that the patient first performs total immunoglobulin IgE, which is actually a preliminary test. When I worked at the Novo Sarajevo Health Center, there was a Phadiatop test that contained the largest number of the most common allergens. Unfortunately, this has not been done there for years, that branch is rather neglected here, but in the Clinical Center of the University of Sarajevo (KCUS) it is possible to make specific immunoglobulins when individual allergens are determined immediately – the doctor says.
It is impossible to do immunosensitization in Sarajevo
He adds that since 1996 it has not been possible to perform immunosensitization in Sarajevo.
– When it is determined that a person is allergic, they are given small doses of the allergen, which actually treats and prevents the onset of the disease, whether it is vasomotor rhinitis or asthma. Unfortunately, there is no one in Sarajevo who would make the reagents used to do this – he says.
There is no cure for allergies, but there are therapies that make life easier for the patient.
Hadžiosmanović notes that the correct method of treatment depends on the patient’s medical history, the symptoms he is complaining about, and the results of the tests that have been performed.
– Treatment is different for vasomotor rhinitis and asthma. In vasomotor rhinitis, antihistamines are most often given, either in the form of tablets or sprays. Recently, there are sprays on the market that are a combination of corticosteroids and antihistamines, which work quite well. The good thing about this therapy is that it is included only when symptoms appear, which is different from asthma therapy, which must be continuous. According to the recommendations of the World Health Organization guide, corticosteroids and inhalers are the number one drugs. In addition to them, today’s sprays also contain Beta2 agonists, long-term bronchodilators, and in addition there are also good antileukotriene drugs that are given for prevention and test therapy to see if they will cause improvement in patients – he says.
At the end of the conversation, he referred to what he says is an unjustified fear of corticosteroids among parents whose children have allergies.
– Corticosteroids in inhaled drugs do not have the systemic effects they have when taken orally and parenterally, and that is why this fear is not justified. What I want to emphasize is that the therapy must be continuous, and the length of therapy is decided by the doctor based on the clinical picture – concludes Hadžiosmanović, states Factor.
