Natural Allergens

Dr. Soumya Deb

What is Allergy?

It is common immune system disorder. Our body shows hypersensitivity against

allergens due to overreactions of immune system.

Hypersensitivity or allergic reactions are responsible for various allergic diseases,

such as hay fever, atopic dermatitis, allergic asthma, and anaphylaxis.

Allergens may be any harmless environmental agents that body cannot recognize
and encounters as a harmful foreign particle.

Type of allergens

1) Inhalant allergens:

Pollen is the most common. It is microspores of flowering plants, grasses

and weeds. Allergic rhinitis is clinical condition.

Dust mites are microscopic bugs that commonly live in house dust. It
produces symptoms similar to pollen and it can produce asthma.

House dust commonly consists mold spores, light cotton fibers, animal
dander (epithelial scale) and hairs, insect excreta and odor. These might develop
hay fever and asthma.

2. Ingestant allergen:

Many foods produce abnormal response in the body's immune system.

Symptoms may be itching of mouth, trouble in breathing, rash, stomach pain,
vomiting, diarrhea etc.

Foods most often cause allergy are milk, eggs, wheat, fish, peanuts, tree nuts,
shellfish etc.

3. Injectant allergen:

a) Antibiotics such as penicillin, cephalosporin etc.

b) Allergens that injected by the sting of bees, hornets and wasps.

Symptoms may be itching of palms and soles of feet, erythema, peeling of skin,
anaphylactic shock and sometimes causing death.

4. Contactant allergen:

These are mostly responsible for contact dermatitis causing itchy, redness and
leaking of the skin.

Urushiols are a group of phenolic compound found in plants like poison ivy, oak
and sumac.

Some sesquiterpene lactones from family compositae, lauraceae and

magnoliaceae cause contact allergy.

Additives used in cosmetics and perfumes.

5. Infectant allergens:

Metabolic wastes of living organisms in human body, such as hook worms, tape
worm, pinworm, thread worms and certain microorganisms like bacteria,
protozoa and molds are responsible for chronic infection.

Types of allergic reaction:

1. Type I (IgE-mediated hypersensitivity):

Reaction is initiated by the antigen reacting with tissue mast cells.

Mast cells are passively sensitized by antibodies (IgE).

Reaction leads to active mediator release from mast cells.

The reaction is referred to as immediate hypersensitivity.

Manifestation of various symptoms like rhinitis, urticaria, vomiting, diarrhoea,

bronchial asthma including general anaphylaxis are observed in this type of
allergic reaction.

2. Type II (Antibody-mediated cytotoxic or cytolysis hypersensitivity):

# Antibody involve in this type is IgG/IgM, but not IgE.

# Antibody is directed against the antigen (allergen), present on an individual’s

own cells (target cells).

# Antibody can be directed against foreign antigen cells (e.g., transfused red
blood cells).

# This may lead to cytotoxic action by killer cells or by complement mediated

cytolysis.

# The examples are mismatched blood transfusion, transplant rejection, etc.

3. Type III (Immune Complex-mediated hypersensitivity):

# It is delayed allergic reaction. In type III reaction, antibodies (IgG and IgM) form
complexes with antigen (allergen) and complement.

# The immune complexes clump together, deposited in the tissue and blood
vessels.

# The complement cascade is activated and polymorphs are attracted to the site
of deposition causing local damage.
# The examples include the Arthus reaction (associated with severe pain, swelling,
hemorrhage and necrosis), serum sickness (symptoms are painful swelling joints)
etc.

Type IV (Cell-mediated hypersensitivity):

Reaction is initiated by the action of antigen sensitized T-lymphocytes, releasing

lymphokines following a secondary contact with the same antigen.

Lymphokines (IL2-IL6) induce inflammatory reaction and activate macrophages

which release mediators.

The reaction takes more than 12 hours to develop. The examples are tuberculin
hypersensitivity, graft rejection, contact dermatitis, etc.

Mechanism of allergic reaction:

Primary exposure: When body is first subjected to allergen. No allergic symptoms

occur, because no antibody formed previously. Formation of antibody occurs after
primary exposure.

Secondary exposure: Subsequent exposure to allergen produces symptoms,

because antibody generated already. Antigen antibody reaction occurs, results
liberation of powerful inflammatory chemicals like histamine, cytokines,
prostaglandin, leukotriene or bradykinin.

● Allergens when enters into the body, TH2 cells (one type of helper T cell or
CD4+Tcell) get activated.

● When activated, TH2 cells liberates interleukin-4 or IL-4 (a type of cytokine with
short peptide chain).
● Now B-cell lymphocytes get activated by IL-4 and releases IgE (immunoglobulin
E).

● IgE binds to the receptor present in Mast cell or Basophil.

● Further Allergen when attached with IgE, cross linking occurs.

● It causes degranulation of mast cell and releases histamine, prostaglandin,

leukotriene etc.
Test for allergy

Immunoglobulin-E (IgE):

Rise of IgE level in blood is associated with allergic reactions, which is normally
found in very small amounts in the blood.

The allergen-specific IgE antibody test is used to screen for an allergy to a specific
allergen. The specific IgE tests can be for one particular allergen or a group of very
specific allergens.

Skin test:

Skin is exposed to suspected allergens and is then observed for signs of an allergic
reaction.

There are two methods of skin test:

Scratch test or prick test: First cleansing forearm or back with alcohol, followed
by marking and labeling areas of skin with a pen.
 Then placing a drop of potential allergen on each of those spots and scratching
the outer layer of skin to let the allergen in.

Intradermal test: Injecting a small amount of allergen just under skin after
cleaning, marking and labeling.

Information from skin test helps to develop an allergy treatment plan that
includes allergen avoidance, medications or allergy shots (immunotherapy).

Allergy skin tests are widely used to help diagnose allergic conditions, including
hay fever (allergic rhinitis), allergic asthma, dermatitis (eczema), food allergies,
penicillin allergy, bee venom allergy etc.

Patch test:

Patch testing does not involve scratches or pricks to the skin, allergens are on a
patch, only to stick that on arm or back.

Patch tests take more time. It needs to wear a patch for about 48 hours to
observe any delayed reaction to the allergen. It does not identify allergies to food,
oral medications or inhaled substances.

Treatment of Allergy:

Allergen avoidance: Identify and avoid your allergy triggers. This is the most
important step in preventing allergic reactions and reducing symptoms.

Low or moderate allergic reaction: Medication depends upon type of symptoms

and can help to reduce immune system reaction. Antihistamines, corticosteroids,
leukotriene receptor antagonists, decongestants are used in the form of pills or
liquid, nasal sprays, or eye drops.

Severe allergic reaction: Doctor might recommend allergen immunotherapy. It

involves a series of injections of purified allergen extracts, usually given over a
period of a few years.
Emergency: Epinephrine is the most important medicine to give during a life-
threatening anaphylaxis (severe allergic reaction). It treats life-threatening allergic
reactions to food, stinging insects, latex and medicines/drugs.

Natural remedies:

Honey: It consists pollens allergen. Repeated exposure to small amounts of

allergens can counteract allergic reactions by stimulating the immune system.

Butterbur: Extract or dietary supplement of this herb used for preventive action
of histamine and others.

Quercetin: This natural antioxidant blocks the synthesis of histamine.

Grape seed extract and ascorbic acid: This combination is meant to prevent an
allergic reaction before triggers are encountered.

Omega-3-fatty acid: It also lowers the inflammatory chemicals that produced by

the allergic reaction.