On April 3, Dr. Mehmet Oz hosted a segment on his TV show called “How to Survive the Allergy Epidemic”. In keeping with many news reports released this spring, Dr. Oz declared: “This year, you’re going to feel even more miserable than ever before.”
New York allergist and Allergic Living contributor Dr. Clifford Bassett was invited to help explain to viewers why this may be. He said that climate change factors, such as warm seasons starting earlier and ending later, are to blame. He also noted that tree pollen and grass pollen seasons can overlap resulting in a “pollen bomb” that can cause misery for allergy sufferers.
Dr. Oz did an excellent job explaining how certain weather patterns can cause what allergy specialists and botanists now call ‘the priming effect’ – where pollen levels rise, fall and rise again in late winter and early spring. When it’s unseasonably warm, plants begin producing pollen early. When the temperature drops again, they stop, and then begin again once the warmer weather returns. In pollen-sensitive individuals, this can cause worsened allergy symptoms that are tougher to control because their immune system has been ‘primed’ for pollen allergens.
The topic of conversation then moved to treatment. Most medications for spring allergies work by blocking histamine receptors, so the histamine in one’s body has nowhere to bind to and cause symptoms. These treatments are effective for most people, but they treat the symptoms but not the underlying allergic disease. Upon each re-exposure, the symptoms will have to be blocked again.
This is why doctors often recommend immunotherapy, or allergy shots, in which a small amount of the allergen (i.e. pollen) is injected into a sensitized individual on multiple occasions over a long period of time. The goal is to allow the patient to build tolerance to the allergen and eventually no longer be sensitized to it.
The trouble with this traditional type of immunotherapy, which Dr. Bassett noted has been available for almost 100 years, is just that – the trouble: injections are required several times before each allergy season for several years, resulting in many, many hours in the allergist’s office.
Fortunately, Dr. Bassett informed Dr. Oz’s audience that sublingual immunotherapy (SLIT), which is a type of immunotherapy that uses under-the-tongue tablets or drops instead of needles, is gaining ground. It is far less invasive: once an allergist determines the proper dosage, a patient can actually conduct this immunotherapy by themselves, at home.
While not yet approved by the FDA, several clinical trials have demonstrated that this type of treatment can be effective, and it has been available in Europe for years. One brand, Oralair, was recently approved for prescription use in Canada.