A few days ago, while visiting a friend, we inevitably ended talking about the weather. We were delighted with the warmth of the beautiful summer sunshine pouring over us this year but my friend was sad that her husband did not share her enjoyment. He suffers from hay fever; the same sunny spells that are so delightful for most of us, fill the air with heavy loads of pollen, giving him one of the worst hay fever attacks in years.

I remember one particular thing that my friend said: ‘It is amazing that in the 21st century we still suffer from hay fever! We can replace people’s arms and legs, transplant hearts, and even take out parts of the brain, but we are incapable of curing as easy a disease as hay fever!’ If she tried her best, she couldn’t have illustrated better the paradox of allergy. With a few exceptions, allergies largely express through trivial symptoms – sneezes, sniffles, watery nose and eye, itch, hives that come and go out of the blue – creating the image of a simple and not really serious problems.

Not surprisingly then if, just like my friend, we think that allergy treatment should be within easy reach: just avoid that cat or flower or food or drug and everything will be back to normal. Leonardo da Vinci used to say that ‘Simplicity is the ultimate of sophistication’.

A perfect description for allergy, which, similar to an iceberg, shows only one third of the problem – the symptoms – while the main part is hidden. Although seeming to affect isolated organs, allergy is in fact a whole body illness. It is a disease of the immune system which consists of an army of cells dispersed throughout our body, intercommunicating permanently and ready to commute from one organ to another, fighting whatever threats arise. Sometimes, however, the immune system gets things wrong. In allergy it mistakes harmless substances like pollens, house dust mite or even food, with parasites. So masses of immune cells rush to our nose, skin, lungs or gut, releasing toxic substances aimed to kill the parasite. But as there is no parasite, only allergens, it’s our own organs that get harmed. Our immune system is programmed at birth to react like this; its abnormal behaviour is encoded in our genes. This is why allergy does not go away like a simple cold, but strikes again and again, every time we come across the allergen.

However, in some patients, immunotherapy (allergy shots) brings a hope for curing allergy. Immunotherapy consists of repeated administration of small amounts of allergen which make the immune system tolerant to it. In the past this was done by injections, which carried a risk for severe unwanted effects, were unpleasant and time consuming. Nowadays, though, there are allergen solutions or tablets that can be taken by mouth which are much safer and easier to use.

They must be taken daily but you can do it at home and don’t need to see your doctor more than three-four times a year. Thanks to these newly developed products, immunotherapy is on the rise and is promising to help a great many allergy sufferers to obtain long term relief from their disease.

Dr Diana S Church is allergy specialist and from September 2009 will run an allergy clinic at Fenwick Hospital, Lyndhurst – Diana S. Church – MD

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