Not every allergy is a runny nose. Prof. Marcin Moniuszko: "Symptoms that recur regularly should raise your alertness"

Prof. Marcin Moniuszko: Our immune system has certainly been faced with slightly, and sometimes completely different challenges in modern times than it was a thousand, two hundred or a hundred years ago. Fortunately, it has to deal much less with very dangerous bacteria causing serious, often fatal diseases. It also has to fight parasitic infestations to a much lesser extent, which could very often significantly lower the level of health and sometimes lead to the loss of life.

To some extent, this “free space” of immune activity has been filled with elements of the world we live in – the world of plants and animals, with which we have coexisted for thousands of years. Unfortunately, what was neutral for our immune system in the past has become the object of its excessive interest today and has led to the development of allergic diseases. On the other hand, the lack or reduced stimulation from old, serious health threats has caused the immune system to increasingly trigger complex activity not only towards the environment, but also towards its own cells and tissues, which results in an increase in the number of autoimmune diseases.

MM: The increase in the number of allergic diseases, asthma, but also autoimmune diseases is largely due to changes in our lifestyle, but also changes in our environment, in our civilization area. However, let's not demonize the achievements of civilization, let's remember that these same changes have caused - fortunately - a significant increase in life expectancy, in many places in the world the problem of hunger has disappeared, and we have also been able to cope in an excellent way with many very dangerous diseases caused by bacteria or viruses, which for hundreds or thousands of years were fatal.

On the other hand, an important factor that has also influenced the increase in the number of allergic diseases and asthma is air pollution. Many components of smog have a direct damaging effect on the structure of our respiratory tract. This in turn facilitates the penetration of allergens into the upper and lower respiratory tract and additionally causes inflammation, which intensifies allergic or asthmatic reactions in our respiratory tract.

What's more, a very large number of processed ingredients have appeared in our environment, which among other things concerns our diet. This has changed the structure of the intestinal microbiota, which plays a very important role in directing and stabilizing the functions of the immune system. This is also of great importance in maintaining immune balance - and its disorders are one example of the development of allergic diseases.

MM: Specific immunotherapy is very effective especially in two situations: in inhalant allergies and in the case of allergy to hymenoptera venom – i.e. to bees and wasps. These are the two clinical situations in which the effectiveness of this form of treatment is very high. The uniqueness of immunotherapy is that it does not mask the symptoms of allergic diseases, but reaches their source – it leads to the fact that the disjointed paths of the immune reaction, which are characteristic of allergies, are "straightened out". Immune balance is restored, which means that we stop overreacting to components of the environment, such as pollen or pet dander.

Simply put, it is about getting the immune response back on track, on a healthy track, instead of the overstimulated, allergic ones.

As for limitations, the situation is much more difficult in the case of food allergies. Immunotherapy in this area still encounters many problems: it is more risky, less safe, and the effectiveness is more difficult to predict. This is one of the challenges facing global allergology - to develop safer forms of immunotherapy for food allergies.

In contrast, there are very few limitations in inhalant allergies or bee and wasp venom. They usually apply to patients with active cancer or active autoimmune diseases. For most patients, whose symptoms are at least moderate or moderately severe, it is definitely worth considering this form of treatment – ​​and not just focusing on symptomatic treatment, which, although fortunately also very effective, has a short-term effect. Immunotherapy, on the other hand, reaches the source of the problem, repairs the deranged immune response and restores the immune pathways to the right track for many years.

MM : Indeed – these mistakes on the part of patients are particularly important in the case of inhalant allergies, especially those to tree pollen, i.e. plants that produce pollen from January, through February, March, April and into May. So also in the period that many people associate as the “cold season”.

Some people, despite having symptoms of allergic disease at this time, such as runny nose, sneezing, coughing, shortness of breath - do not always associate them with allergies or asthma. Instead, they try to treat the infection on their own, which not only turns out to be ineffective, but often leads to frustration and recurrence of the problem.

It is worth being aware that tree pollen seasons also occur in winter and early spring – long before the green spring arrives. So allergy and asthma symptoms can appear in winter or early spring – not just in summer, as many people wrongly assume.

Vigilance should be raised by symptoms that recur regularly – for example, year after year – in the same periods. Some patients even say: “I always get sick two or three times at this time of year”. They are often surprised when, after starting anti-allergic or anti-asthmatic treatment, the symptoms disappear – because it turns out that they were not the result of infection, but of allergy. So, after implementing treatment, the symptoms do not return, because the problem was properly recognized and addressed.