Allergic hay fever - causes, symptoms and treatment. How to get rid of hay fever forever? Can hay fever go away with age?

And other related areas.

Causes of hay fever

There are hundreds of thousands of plants that produce pollen. However, after numerous studies, it was found that about 50 of them can cause allergic reactions.

Plant pollen is very small in size, and therefore is easily able to penetrate and penetrate the mucous membranes of the eyes and upper respiratory tract. In addition, in one day one of the small plants is capable of releasing a huge amount of pollen grains.

People are not equally sensitive to pollen from different plants. So, for some, a few tiny pollen particles, for example, from birch, are enough, and they instantly have an allergic reaction. While others are completely insensitive to birch tree pollen.

The disease is based on increased sensitivity to plant pollen. There are special receptors in the mucous membrane of the nose, eyes, pharynx, and larynx. As well as immune cells (macrophages, neutrophils) containing a large amount of biologically active substances (histamine, bradykinin). When pollen comes into contact with mucosal receptors, the latter activate macrophages, and they, in turn, release histamine into the surrounding space. Histamine has the property of increasing the permeability of blood capillaries and dilating them. As a result, a lot of water enters the peripheral tissues from the blood and a large amount of mucus is released. Along with water, other active substances penetrate from the blood, supporting and intensifying allergic reactions. All this creates conditions for swelling of the mucous membranes, nasal congestion, sneezing, watery eyes and other manifestations of an allergic reaction.

The causative factors, as mentioned above, are pollen from various plants, be it trees, shrubs, flowers, and other weeds. There is a pattern between the periods of the seasons and the time of maturation of pollen of different plants. Thus, three peak values ​​are identified according to the frequency of occurrence of hay fever

1. The first peak period occurs between the months of April and May. During this period, the appearance of hay fever from pollen of woody plants predominates: oak, ash, birch, walnut, poplar, maple.

Graph showing increased sensitivity to pollen of various trees, depending on the seasons.

1. The second period of rise in allergic phenomena occurs in the summer. From June to August, cereal plants begin to bloom. These include grasses such as wheatgrass, rye, bluegrass, corn, bromegrass, and many others. In June, the amount of poplar fluff in the air increases, so many people often associate allergic reactions that appear at this time with fluff, and not pollen. Poplar fluff, unlike plant pollen, does not cause a pronounced clinical picture of hay fever.

1. The third period of increasing incidence of hay fever occurs in autumn. During this period, an increased concentration of pollen from various weeds prevails in the air. It is believed that pollen from plants such as ragweed, dandelion, hemp, quinoa and others has the greatest allergenic activity.

Symptoms of hay fever

Associated primarily with damage to the upper respiratory tract, as well as the mucous membrane of the eyes. Clinical symptoms begin to appear in childhood, from about 5-6 years of age, when the child just begins to attend school.

The most typical clinical symptom is rhinoconjunctival syndrome. This syndrome combines signs of allergic reactions, both from the mucous membrane of the eyes and from the mucous membrane of the nose and upper respiratory tract.

The disease begins with damage to the mucous membrane of the eyes. Signs of conjunctivitis appear:

• Itching, burning on the inside of the eyes
• The patient feels as if he has some kind of foreign body in the eye
• After some time, lacrimation and photophobia appear

When examining the eyes, you can easily see pronounced redness of the conjunctiva and swelling of the eyelids. Unlike other inflammatory eye diseases, hay fever usually affects both eyes at the same time.
In parallel with conjunctivitis, the patient develops signs of rhinitis (inflammation of the nasal mucosa). Rhinitis is characterized by:

• Palpable itching in the area of ​​the nose and the junction of the nasal cavity and the pharyngeal cavity (nasopharynx).
• Characteristic is the presence of frequent bouts of sneezing. In some cases, the number of sneezes reaches up to 10-20 times in a row.
• Sneezing is accompanied by copious mucus discharge from the nose (rhinorrhea).
• Pain in the sinuses (maxillary - on the sides, frontal - on top of the nose).

In addition to disruption of the respiratory functions of the nose, patients experience pain in the parotid region and a crackling sound in the ears when chewing food. Ear symptoms are often accompanied by nausea and sometimes vomiting. These symptoms are due to the fact that the nasal cavity is closely connected with the oral and middle ear and therefore the pathological process of one of them will affect other neighboring areas.

As pollen disappears from the surrounding air (during rain, winter), all of the above symptoms weaken or disappear altogether.

Manifestations of the disease depend on the degree of sensitivity of each person individually. For example, in one person, pollen causes ordinary conjunctivitis (inflammation of the mucous membrane of the eyes) with the appearance of symptoms such as lacrimation, photophobia and other characteristic symptoms. In others, hay fever can manifest itself as generalized swelling of the upper respiratory tract (mucous membrane of the nose, larynx, trachea), with the onset of a suffocating state (loss of consciousness, fainting, a sharp drop in blood pressure).

The severity of symptoms and the course of the disease largely depend on the amount of pollen inhaled. The more pollen that gets into the respiratory tract and the mucous membrane of the eyes, the more pronounced the symptoms of the disease will be.

There is an obvious connection between the incidence of hay fever and other diseases of allergic origin. It is noted that among patients with bronchial asthma, in 40% of cases, a concomitant disease is detected - hay fever. Of those who suffer from hay fever, there are people who are allergic to certain foods, house dust, and medications.

Diagnosis of hay fever

Diagnosis of such a disease does not present great difficulties, since the connection between the appearance of allergic symptoms and contact with pollen particles is obvious. The importance is that it is necessary to accurately establish the connection, ask the patient in detail about the history of the disease, what preceded the appearance of the first symptoms, and how they manifested themselves.

Allergological examination of patients is mandatory in the program, upon detection of which one allergen caused this reaction. An allergy examination consists of applying a known allergen in a very small dose to the patient’s skin or under the skin (scratch, injection) and after some time the local manifestations are assessed. If a person has an increased reaction in the form of local redness of the skin, swelling, or itching, it means that he either has hay fever or simply has an increased sensitivity to this substance. It all depends on the size of local allergic changes, as well as in conjunction with symptoms and other laboratory tests.

Laboratory diagnostics

For laboratory diagnostics, blood must be taken from the patient for testing. The presence of an increased number of eosinophils (one of the blood elements) suggests that this organism is predisposed to allergies. The normal range of eosinophils in the blood ranges from 1 to 5 percent of the total number of blood cells.

Immunological diagnostics is nothing more than taking blood tests for the content of specific proteins (class E immunoglobulins), which appear in large quantities during the development of allergic reactions in the body.
So, in order to make a correct diagnosis, the doctor must first study in detail the history of the disease, become familiar with the symptoms of the disease, and laboratory tests.

Treatment of hay fever

If a person has acquired increased sensitivity to pollen allergens, then it is practically impossible to reduce it. Based on this fact, the only reliable way to prevent and treat hay fever is to have as little contact as possible with plant pollen. Treatment of hay fever is the only thing that helps the patient get rid of the endless runny nose, lacrimation and other symptoms. Only treatment, together with preventive measures, will help get rid of annoying symptoms.

Children under 18 years of age are usually under the supervision of two specialists - a general practitioner and a pediatrician.

In case of crises and significant disturbances in the general condition of patients, intensive therapy is prescribed, aimed at relieving swelling of the mucous membranes of the eyes and nasal cavity, reducing mucus secretion, and improving respiratory function.

• Antihistamines are drugs that directly destroy the pathological chain that leads to the appearance of symptoms of the disease. In acute conditions they are administered intravenously and intramuscularly. When general well-being improves, they switch to the enteral route of administration (through the mouth). Antihistamine drugs include suprastin, diazolin, tavegil, loratadine, and many others. The dose and regimen are prescribed by the attending physician.

• Vasoconstrictors, such as naphthyzine, oxymetazoline, galazolin, are also widely used as drugs against hay fever. Topical vasoconstrictors belong to a group of substances that affect adrenergic receptors, which are widely located in the nasal mucosa. Stimulation of adrenergic receptors leads to constriction of peripheral blood vessels, relieves swelling, reduces symptoms of allergies, nasal congestion and facilitates breathing. They are usually used as nasal drops several times a day.

For symptoms of conjunctivitis, a solution of albucid is instilled into the eyes to avoid secondary infection and the development of a purulent process.

During the period of remission, that is, when the main symptoms of the disease subside, a type of treatment such as specific hyposensitization is prescribed. This term refers to the gradual adaptation of the body to small doses of allergens. The patient is prescribed daily administration of small doses of purified pollen allergens, which do not cause a violent pathological reaction in the body. But, at the same time, resistance to certain types of allergenic substances develops, and the patient feels completely healthy. Hyposensitization is carried out in courses from several weeks to several months until a lasting positive effect is achieved.

Prevention of hay fever

Preventive measures are perhaps the only simple and at the same time, reliable way to avoid the occurrence of allergic reactions, as well as their complications. Specific tasks for preventing the occurrence of not only hay fever, but also other allergic diseases are to avoid contact with allergens, to prevent pollen and other small dust particles from entering the nasal and oral cavities.

Preventive measures, in turn, are divided into primary ones, which must be carried out for people susceptible to various allergic diseases, as well as categories of people at risk. These are gardeners, beekeepers, agricultural workers, and people of other professions whose activities are related to plants and flowers.

Primary preventive measures include:

• First of all, protect the primary contact of a pregnant woman with pollen allergens, eliminate occupational hazards, and also observe a work and rest schedule and eat healthy food.
• For younger and older children, periodic preventive monitoring is necessary to identify acute respiratory diseases, the chronic course of which often leads to increased sensitivity of the body to allergens.
• Reducing contact with allergenic substances (chemical products, exhaust gases, household allergens).

Secondary preventive measures, by their nature, also contain actions aimed at preventing the occurrence of allergic reactions. But unlike primary prevention, in this case we are talking about patients with hay fever who have been ill for more than one year and practically themselves must know and implement more stringent measures to prevent contact with allergens of plant origin.

Recommendations for people suffering from hay fever and other allergic diseases should be constantly followed, regardless of where the person is, at work, at home, or on vacation. The following conditions must be met:

At home and in the workplace in the office

• Ventilate the premises and wet clean at least once a day.
• Books, bedding, especially feather pillows and duvets are stored and maintained in appropriate conditions where the risk of spreading dust particles is minimal. For example, bed linen is in durable covers, and books are in a lockable cabinet.
• Minimum carpets and furniture clutter. The premises should be spacious, easily ventilated and cleaned.
• The use of synthetic air fresheners, perfumes, and other odorous substances is limited.
• Do not have pets in the house or apartment, as wool has a strong allergenic property.
• In the off-season, the risk of mold fungi appearing on the walls and ceiling increases (they have allergenic properties). From this we can conclude that the fight against mold plays an important role in preventing the occurrence of allergic reactions.

Outdoors and outdoors, it is impossible to protect a person from the harmful effects of the environment, therefore it is necessary to try not to be in crowded places, in the company of people who smoke, if possible, not to be exposed to prolonged exposure to exhaust gases, close the windows in the car when driving on the road.

• People who are hypersensitive to plant pollen should limit their stay in places with large concentrations of various types of plants (gardens, fields).
• Wearing sunglasses reduces the risk of allergies for those categories of people who have increased sensitivity to the sun (photosensitivity).
• Timely treatment of acute diseases of an infectious-allergic nature will prevent the possibility of developing hypersensitivity to various allergens and in particular to plant pollen.

• Pre-season preventive preparation of the body by taking medications that reduce susceptibility to pollen allergens. There are several of the most active drugs from this group. These include intal (cromoglycic acid) and zaditen (ketotifen). The mechanism of action of both is focused on the fact that they stabilize the membranes of cells responsible for the release of biologically active substances. In other words, the body’s resistance to the perception of allergens of any origin increases.

What diet should you follow for hay fever?

Before prescribing the optimal diet for hay fever, it is necessary to establish the type allergies for pollen.

There are the following types of hay fever:

• allergy to tree pollen;
• allergy to grass pollen;
• allergy to weed pollen.

Allergy to tree pollen
This type of hay fever most often occurs in the spring, in late April - early May. Among the tree representatives whose pollen most often causes allergic reactions are birch, oak, maple, poplar and alder.

If you are allergic to tree pollen, the patient is advised to exclude from the diet such foods as:

• Birch juice;
• apricots, peaches;
• plums;
• hazelnut;
• cherries, sweet cherries;
• nuts ( e.g. almonds, hazelnuts);
• carrot;
• apples, pears;
• cucumbers, tomatoes;
• herbs and spices ( e.g. curry, cumin).

Allergy to grass pollen
This type of hay fever is usually observed in late spring - early summer ( from late May to early July). At the same time, pollen from such cereal grasses as wheat, barley, rye, wheatgrass, oats, timothy grass, and feather grass can cause hay fever.

If you are allergic to grass pollen, the patient should refrain from taking:

• cereal products ( e.g. rice balls, oatmeal);
• bakery products;
• pasta;
• kvass;
• alcoholic drinks;
• beans;
• peanuts;
• corn;
• sorrel;
• citrus fruits ( for example, orange, tangerine);
• strawberries, wild strawberries;
• herbal medicines, which include cereal herbs.

Allergy to weed pollen
Typically, this type of hay fever occurs between the end of July and the beginning of September. Representatives of weeds that most often cause allergic reactions are ragweed, quinoa, and wormwood.

If you are allergic to weed pollen, the patient is advised to exclude from the diet such foods as:

• sunflower seeds;
• sunflower oil;
• citrus fruits ( for example, oranges, tangerines, lemons);
• melons ( for example, watermelons, melons);
• greenery ( for example, parsley, dill, celery);
• spices ( e.g. anise, cumin, chicory);
• herbal remedies from dandelion, wormwood, chamomile, calendula, yarrow.

It is also necessary to exclude foods of plant origin from the diet ( for example, honey, halva, sunflower oil). Any of the above products can aggravate the course of this disease.

Most people suffering from hay fever also have a so-called “cross allergy”, the manifestations of which are provoked by certain foods. Based on this, it would be advisable to follow a hypoallergenic diet, in which the patient should refrain from eating foods that most often cause allergies.

Among the foods that most often cause allergic reactions are the following:

• dairy ( for example, whole cow's milk, cheese, chicken eggs);
• nuts;
• mushrooms;
• red berries ( e.g. strawberries, raspberries);
• citrus fruits ( );
• red vegetables ( e.g. tomatoes, beets, carrots);
• chocolate;
• cocoa;
• Exotic fruits ( e.g. pineapple, mango);
• seafood;
• smoked meats;
• canned and pickled foods.

For hay fever, it is recommended to eat foods with low levels of allergens, such as:

• dairy products ( for example, natural yogurt, kefir, cottage cheese);
• stewed or boiled lean meat;
• dried fruits.

Why is hay fever dangerous during pregnancy?

During pregnancy, a physiological decrease in immunity occurs in the female body. This is necessary so that the pregnant woman’s immune system does not reject the foreign organism, that is, the fetus. Any pathological process ( in this case hay fever) in this condition can lead to serious complications. Thus, an ordinary allergy to pollen, which usually manifests itself as a simple seasonal runny nose, during pregnancy can be bacterial in nature. Often, against the background of hay fever, pregnant women experience inflammatory diseases such as otitis media ( ear infection) or sinusitis ( inflammation of the maxillary paranasal sinus).

Also during pregnancy, due to an allergic reaction to pollen, a woman may experience complications such as:

• tracheitis ( inflammation of the trachea);
• swelling of the vocal cords;
• frequent migraines;
• Meniere's syndrome, in which the amount of endolymph increases in the cavity of the inner ear ( special liquid);
• allergic inflammation of the pia mater.

Much less often, hay fever can provoke serious allergic diseases in a pregnant woman. This is due to the fact that when fighting allergens, the body’s immune system sometimes destroys its own cells.

In this regard, a pregnant woman may experience complications such as:

• allergic cystitis ( cystitis);
• allergic colpitis ( inflammation of the vaginal mucosa);
• allergic myocarditis ( inflammation of the muscular lining of the heart);
• allergic vulvitis ( inflammation of the external female genitalia);
• allergic gastritis ( inflammation of the gastric mucosa);
• allergic hepatitis ( liver inflammation).

It should be noted that the manifestation of hay fever during pregnancy can negatively affect the unborn child. Often, after birth, such children experience various allergic pathologies.

To avoid any complications during pregnancy if you have hay fever, you must follow the following recommendations:

• Avoid contact with plants as much as possible.
• Always wear sunglasses on clear days.
• Wear a medical mask in dry, windy weather.
• Shake off street clothes before entering the house.
• When you come home, you should change clothes.
• Wet clean your home daily.
• To increase humidity, you can hang a cloth soaked in water around the rooms.
• Strictly adhere to a hypoallergenic diet. Eliminate foods such as carrots, nuts, and stone fruits from your diet ( e.g. peaches, apricots, apples, cherries), cereal products ( for example, corn, bread, various cereals), melons ( for example, zucchini, melon, eggplant), sunflower seeds and sunflower oil, citrus fruits ( for example, tangerines, oranges), honey, herbal seasonings.
• Avoid herbal medicine.
• Avoid contact with household allergens, such as dust, animal hair, down pillows, cigarette smoke, strong odors of deodorants and perfumes.
• From time to time, rinse the nasal passages with sea water or saline.
• Avoid stressful situations.
• Treat respiratory diseases in a timely manner.
• Treat hay fever strictly under the supervision of a doctor.

If hay fever is present, in order to prescribe appropriate treatment, a woman must first undergo a blood test ( immunoglobulin E is detected) to confirm the diagnosis. It should be noted that performing allergy skin tests during pregnancy is strictly not recommended.

A pregnant woman is usually prescribed third-generation antihistamines, as they are more effective and have less negative effects on the body.

For hay fever during pregnancy, a woman may be prescribed antihistamines in the form of tablets ( for example, Telfast, Claritin), sprays ( for example Cromohexal) or powders ( for example, Nazaval).

How to treat hay fever in children?

Treatment of hay fever in children includes three stages:

• treatment of the acute period;
• anti-relapse therapy;

Treatment of the acute period
First of all, it is necessary to protect the child from contact with the allergen. It is recommended to spend more time indoors where pollen concentrations are significantly reduced. At home, you should close the windows, hang a cloth soaked in water around the rooms, or turn on the air conditioner. To relieve symptoms ( for example, allergic rhinitis, angioedema (Quincke's edema) or urticaria) use antihistamines and vasoconstrictors.

Pharmacological group	Name of the drug	Mechanism of therapeutic action	Directions for use and doses
Antihistamines	Claritin	By suppressing the activity of histamine, they prevent the development of allergies. Relieves spasm of smooth muscles and prevents the development of edema. They also have antipruritic and antiexudative effects.	Children over twelve years of age should take the drug orally, one tablet ( 10 mg) or two teaspoons of syrup once a day. For children aged two to twelve years, the dose of the drug is one teaspoon of syrup ( 5 ml) once a day.
	Zodak		Children over twelve years of age should take the drug orally, two scoops ( the total is 10 ml) syrup once a day. For children from six to twelve years of age, the drug is prescribed one measuring spoon ( 5 ml) syrup twice a day. For children from one year to six years, the dose of the drug is half a measuring spoon ( 2.5 ml) syrup twice a day, morning and evening.
Vasoconstrictors	Nazol	They have a vasoconstrictor effect. Reduce redness of the nasal mucosa. Relieves swelling and facilitates nasal breathing.	For children over twelve years of age, the drug should be sprayed into each nasal passage two to three times, twice a day. For children aged six to twelve years, the dose of the drug is one spray into each nasal passage, twice a day. The interval between applications should be at least twelve hours.
	Naphthyzin		For children over fifteen years of age, the drug is prescribed one to three drops of 0.05 - 0.1% solution in each nasal passage, three to four times a day. For children aged six to fifteen years, the dose of the drug is two drops of a 0.05% solution in each nasal passage, two to three times a day. The course of treatment with vasoconstrictors should not exceed three days.

In case of severe hay fever, hormonal preparations (glucocorticosteroids) are also used topically in the form of drops and nasal spray, which are dispensed strictly as prescribed by the doctor.

In order to alleviate the course of acute hay fever, it is necessary to monitor the child’s nutrition. Since many plant-food products, like plant pollen, have the same antigenic structure, most children suffering from hay fever are allergic to various foods. To avoid the development of allergic reactions to food products, the child is prescribed a certain hypoallergenic diet.

Foods that need to be excluded from the diet	Foods that are recommended to be included in the menu
nuts; milk; Exotic fruits ( for example pineapple); chocolate, cocoa; eggs; mushrooms; fish and fish roe; citrus fruits ( for example, oranges, tangerines); melons ( for example, watermelons, melons); vegetables, fruits and red berries ( e.g. tomatoes, apples, strawberries); bananas; eggplant; smoked products; canned goods; sweets ( for example, halva, sweets); herbs and spices.	boiled beef or chicken; lactic acid products ( for example, cottage cheese, kefir, yogurt); dried fruits; green and white vegetables and fruits ( e.g. green peppers, cucumbers, potatoes, apples, pears); vegetable soups; White bread; fruit compotes; baked apples; sugar.

Anti-relapse therapy
To prevent repeated manifestations of allergic reactions during the flowering period of plants, the child is prescribed a course of anti-relapse treatment, which uses antihistamines and cromones. In each specific case, anti-relapse therapy is prescribed individually.

At this stage of treatment for hay fever, a gradually increasing dose of allergy vaccine is introduced into the child’s body. This is done in order to reduce the body's sensitivity to allergens. To determine the main allergen that caused hay fever, an allergist performs a specific allergological diagnosis, which includes such activities as collecting an allergic history, conducting skin tests with allergens and laboratory tests.

A course of allergen-specific immunotherapy is carried out exclusively in the autumn-winter period. If therapy is carried out during the flowering period of plants, that is, during the period of exacerbation of the disease, then the child may have serious allergic complications.

Today, there are various ways to administer allergen vaccines into a child’s body. In pediatric practice, oral administration is widely used ( through the mouth), in which the risk of developing anaphylactic reactions is minimal.

How to treat hay fever with folk remedies?

There are a large number of different folk remedies used in the treatment of hay fever. Some of them can alleviate the course of the disease, others may not bring the desired result or aggravate the course of hay fever. The positive effect of treatment will always depend on the individual characteristics of the body.

Among the many folk remedies used for hay fever, the following components have proven themselves well:

• horsetail;
• series;
• calendula;
• chamomile;
• celery root;
• nettle;
• mumiyo ( mountain resin).

Folk remedy	Useful and healing properties	Preparation and method of use
Horsetail	It has anti-edematous, anti-inflammatory and restorative effects.	Twenty grams of horsetail should be poured into one glass ( 200 ml) boiling water and leave for twenty to thirty minutes. You should drink the infusion half a glass ( 100 ml) three times a day, after meals.
Series	Increases the body's resistance to allergens. Promotes rapid recovery and renewal of the skin. It has a pronounced anti-inflammatory and antiallergic effect.	It is necessary to pour one tablespoon of dry string into a fireproof container ( eight - ten grams) and pour one glass of grass ( 200 ml) hot boiled water. Then you should cover the prepared solution with a lid and steam for twenty to thirty minutes. After the broth has cooled, it needs to be strained and squeezed out. Then you need to add enough boiled water to the resulting decoction so that the total volume is two hundred milliliters. It is recommended to drink one hundred grams of the decoction after meals, three times a day.
Calendula	It has analgesic, anti-inflammatory and antiseptic effects. Reduces allergic manifestations.	Ten grams of calendula inflorescences must be poured into half a glass ( 100 ml) hot boiled water and let it brew for one to two hours. The infusion should be taken one tablespoon two to three times a day.
Chamomile	It has antispasmodic, anti-inflammatory and carminative effects.	You need to pour ten grams of chamomile flowers into a glass ( 200 ml) hot boiled water and keep the broth in a water bath for half an hour. After this, you should wait until the finished broth cools down. You need to take the product two to four times a day, one tablespoon.
Celery root	Has a beneficial effect on the nervous system. Has a general strengthening effect.	Ten grams of crushed celery roots should be poured into one and a half liters of boiling water and left for four hours. After time, the infusion must be strained. It should be taken one tablespoon, thirty minutes before meals, four times a day.
Nettle	It has a general strengthening, vitamin and decongestant effect.	Ten grams of nettle should be poured into one glass ( 200 ml) boiling water and leave for half an hour. It is recommended to take the infusion warm, half a glass ( 100 ml) four to five times a day.
Mumiyo	Reduces swelling due to allergies, and also has a general strengthening effect.	It is necessary to dissolve one gram of mumiyo in one liter of water. The solution should be taken for at least ten days, half a glass ( 100 ml) once a day.

The use of folk remedies as a treatment for hay fever involves the following actions:

• Before using any folk remedy for the treatment of hay fever, you must inform your doctor.
• It should be remembered that the herbal ingredients used in the recipe for folk remedies can also provoke allergic reactions, thereby aggravating the course of the existing disease. If you feel the slightest deterioration, you should immediately consult a doctor.
• If the main allergen of hay fever is wormwood pollen, then taking those folk remedies that include plants such as calendula, chamomile, coltsfoot, string, and elecampane is strictly contraindicated. If you are allergic to tree pollen, you should not treat with alder cones or birch buds. It is also not recommended to take honey products as honey contains about ten percent pollen.
• When treating hay fever with folk remedies, you should not stop taking medications.

When does hay fever worsen?

Hay fever, as is known, is an allergic disease caused by plant pollen. This disease is also called seasonal allergies, since the manifestation of allergic reactions is observed precisely during the flowering period of plants.

The Central Russian region is characterized by three seasonal periods of plant flowering:

• spring period;
• summer period;
• summer-autumn period.

Spring flowering period of plants
During this period of time ( usually from April to May) dusting of wind-pollinated trees occurs. Representatives of this group of plants are trees such as maple, birch, oak, alder, and poplar. The pollen of all of the above trees has allergenic properties and during the flowering period can cause hay fever in humans.

Summer flowering period of plants
Starting from the end of May and ending in July, cereal grasses begin to dust. The most dangerous plants during this period of time are wheat, hedgehog rye, barley, oats, timothy, and wheatgrass. Contact with grass pollen during the summer flowering period of plants can cause hay fever in humans, as well as provoke an exacerbation of the disease in chronic allergy sufferers.

Summer-autumn period of flowering plants
During this period of time, dusting of weeds occurs. As a rule, the peak of allergy exacerbations occurs in August – October. Allergic reactions during the summer-autumn period of flowering plants can be triggered by pollen from grasses such as ragweed, wormwood, and quinoa.

For all periods of flowering plants, exacerbation of hay fever is typical in windy and dry weather.

With an exacerbation of hay fever, the patient may experience the following symptoms:

• irritability;
• fatigue;
• inflammation of the skin, manifested by redness of the skin, papular rashes and swelling;
• eczema, in which a rash appears on the patient’s body, causing a burning sensation and itching;
• allergic conjunctivitis ( inflammation of the outer membrane of the eye), in which the patient's eyes itch and become red, the eyelids swell, spontaneous lacrimation occurs, and photophobia occurs;
• allergic rhinitis ( runny nose), in which repeated sneezing occurs, mucous discharge from the nose is observed, a feeling of nasal congestion and itching appears;
• a sore throat, frequent dry and unproductive cough with attacks of suffocation;
• fever.

During the period of exacerbation of hay fever, it is recommended to perform the following actions:

• contact with allergens should be avoided, for example, during the flowering period of plants, refrain from traveling to nature;
• take medications strictly as prescribed by the doctor;
• It is necessary to carry out wet cleaning in the house daily;
• It is recommended to shower more often;
• During the daytime, all windows and doors should be closed, and it is recommended to hang a cloth soaked in water around the rooms or turn on the air conditioner ( for air humidification);
• in dry, windy weather it is recommended to spend more time at home;
• Ventilation of premises should be done at night or immediately after rain.

How to treat hay fever?

If the eyes are damaged due to a pollen allergy, the patient may experience the following symptoms:

• redness, peeling, itching and swelling of the eyelids;
• lacrimation;
• photophobia;
• sensation of a foreign body and a feeling of stinging in the eyes;
• When an infection occurs, purulent discharge will occur.

Before starting treatment, you need to make sure that the cause of the above manifestations is hay fever and not another eye disease. To do this, the doctor collects an anamnesis, during which he asks the patient about the history of the disease ( for example, what preceded the appearance of the first symptoms, and where the patient was at that time). After which the patient's blood is drawn for subsequent laboratory diagnostics. To increase the reliability of laboratory analysis, fingerprint smears are taken from the conjunctiva of the lower eyelid or the cornea of ​​the patient’s eyes. In both cases, hay fever reveals a high content of eosinophils ( an increased level of eosinophils will indicate the presence of an allergic reaction in the body).

After confirming the presence of an allergy to pollen, the patient is individually prescribed medication depending on the symptoms and severity of the disease.

For hay fever of the eyes, a person may be prescribed the following medications:

• Naphthyzin;
• Histimet;
• Dexamethasone;
• Garazon.

Name of the drug	Description	Directions for use and doses
Naphthyzin	Vasoconstrictor. It is used in the form of a 0.05% aqueous solution. Causes pupil dilation, eliminates swelling of the conjunctiva, and reduces symptoms of eye irritation.	Having pulled back the lower eyelid, you need to drop one or two drops of the drug into each eye. The procedure should be repeated one to three times a day.
Histimet	Antihistamine eye drops 0.5 mg/ml. Provides antihistamine ( blocks histamine production) and antiallergic effect ( reduces allergies).	The drug should be instilled one drop into each eye two to three times a day.
Dexamethasone	Glucocorticosteroid for local use. It has antipruritic, anti-inflammatory and antiallergic effects. This drug is usually prescribed for severe hay fever, as well as in cases where the drugs used from other groups have not brought the desired effect.	For adults, the drug should be instilled into the conjunctival sac, one to two drops four times a day for two days, with gradual withdrawal over one to two weeks. For children aged six to twelve years, the drug is prescribed one drop in each eye two to three times a day for seven to ten days. Long-term use of the drug may cause an increase in intraocular pressure.
Garazon	Glucocorticosteroid in combination with an aminoglycoside and an antibiotic. Has anti-allergic and anti-inflammatory effects. This combination drug is especially effective for purulent discharge from the eyes.	The drug should be instilled into the conjunctival sac, one to two drops three to four times a day.

In addition to drug treatment during the flowering period of plants, the patient will need to follow the following recommendations:

• You should not go out into nature or visit parks.
• In dry and windy weather, it is recommended to stay at home with all doors and windows closed. To make breathing easier, you can turn on the air conditioner or hang wet sheets around the rooms.
• It is recommended to take a shower and wet clean your home every day. The room should be ventilated at night or after rain.
• It is necessary to follow a hypoallergenic diet.
• At the slightest deterioration in health, you should immediately consult a doctor.

What drops are prescribed for hay fever?

For hay fever, drops from the following pharmacological groups can be prescribed:

• antihistamines;
• glucocorticosteroids;
• vasoconstrictor drugs.

Antihistamines
It is the main pharmacological group prescribed for hay fever. These drugs block the release of histamine from mast cells and basophils, thereby reducing and eliminating the manifestation of allergic reactions ( for example, reduce itching, rhinorrhea, conjunctivitis).

Currently, there are the following groups of antihistamines:

• First generation antihistamines (e.g. Meclozine, Clemastine). They have a pronounced sedative effect and also have a shorter duration of action.
• Second generation antihistamines (for example, Cetirizine, Antazoline, Azelastine). The occurrence of side effects when taking these drugs is reduced, and they also have a therapeutic effect on the body within twenty-four hours.
• Third generation antihistamines (for example Levocetirizine). They are highly effective and have significantly fewer side effects.

Drops	Name of the drug	Characteristics of the drug	Mode of application
Drops for oral administration	Cetirizine hexal	The active ingredient is cetirizine. Second generation antiallergic drug.	Adults and children over six years of age need to take twenty drops orally daily. For children, this dose can be given at one time or divided into two doses of ten drops in the morning and evening. Children from two to six years old should take ten drops orally at a time or divide the intake into two parts, that is, five drops in the morning and evening.
	Xizal	The active substance is levocetirizine dihydrochloride.	Adults and children over six years of age are recommended to take twenty drops once a day ( drops can be mixed with a small amount of water). Children from two to six years old are recommended to take ten drops, divided into two doses, five drops in the morning and evening.
	Fenistil	The active ingredient is dimethindene maleate.	Adults and children over twelve years of age are recommended to take twenty to forty drops three times daily. Children from three to twelve years old need to take fifteen to twenty drops three times a day. Children from one to three years should take ten to fifteen drops three times a day.
Nasal drops	Sanorin-Analergin	The active ingredients are antazoline mesylate and naphazoline nitrate.	For adults and children over sixteen years of age, the drug is prescribed in the amount of two to three drops in each nasal passage three to four times a day. Children under sixteen years of age should instill one or two drops into each nasal passage three to four times a day.
	Prevalin	Ingredients: bentonite, emulsifiers and oils.	Adults and children over twelve years of age need to make one to two injections into each nasal passage two to three times a day. For children from six to twelve years of age, the drug is also prescribed in the amount of one to two injections up to three times a day. Before use, the bottle must be shaken several times.
Eye drops	Opatanol	The active ingredient is olopatadine hydrochloride.	Place one drop in each eye twice a day. The bottle of drops must be shaken before use.
	Spersallerg	The active ingredients are antazoline hydrochloride and tetrizoline hydrochloride.	It is recommended to instill one drop of the drug two to three times a day.
	Okumetil	Active ingredient: diphenhydramine hydrochloride, zinc sulfate and naphazoline hydrochloride.	One drop should be instilled into each eye two to three times a day.
	Allergodil	The active ingredient is azelastine hydrochloride.	Adults and children after four years of age need to instill one drop in the morning and evening ( the frequency can be increased to four times a day).
	Optikrom	The active ingredient is cromoglycic acid.	One or two drops of the drug should be instilled into each eye three to four times a day.

Glucocorticosteroids
These drugs are hormonal, therefore they are taken only in severe cases of hay fever, and also when other drugs used have not brought the desired results. Glucocorticosteroids have an anti-inflammatory and anti-allergic effect, and also help reduce and eliminate such manifestations of hay fever as nasal congestion, runny nose, itching and others. These drugs can be given orally, by injection, or by topical application ( e.g. drops, sprays and inhalations).

Name of the drug	Mode of application
Budesonide	Adults and children over eighteen years of age are advised to administer two to three drops into each nasal passage twice a day.
Fluticasone	Adults and children over twelve years of age are recommended to take two sprays into each nostril once a day. If necessary, the number of administrations can be increased to twice a day.
Mometasone	In the form of inhalations, adults and children over twelve years of age should take two inhalations into each nostril once a day. After achieving the desired effect, the dose is reduced to one inhalation.
Flunisolide	Adults and children over fourteen years of age are recommended to take two sprays into each nasal passage twice a day. Children from six to fourteen years old should use one spray in each nostril.

Vasoconstrictor drugs
Drugs from this group have a vasoconstrictor effect, reducing redness and swelling of the mucous membranes of the nose and eyes. They are not recommended to be used for more than five days, as a person becomes addicted and the therapeutic effect may be reversed.

Name of the drug	Active substance	Mode of application
Naphthyzin	Naphazoline	Place one to three drops into each nasal passage three to four times a day.
Galazolin	Xylometazoline	For adults and children over six years of age, drops of 0.01% should be administered two to three drops into each nasal passage two to three times a day. Children from two to six years old should administer 0.05% drops one to two drops into each nasal passage once or twice a day.
Nazivin	Oxymetazoline	For adults and children over six years of age, 0.05% drops are recommended to be administered one to two drops into each nasal passage two to three times a day. Children from one to six years of age should take 0.025% drops one to two drops two to three times a day. For children from birth to four weeks, 0.01% drops are recommended to be administered one drop two to three times a day, and for children from five months to a year it is recommended to be administered one to two drops two to three times a day.

Can hay fever cause bronchial asthma?

Allergic bronchial asthma is hereditary, that is, a person can inherit this pathology if one of his parents had or continues to have asthma ( the probability is 20 – 30%). If both parents are sick, the risk of allergic bronchial asthma in the child increases to 75%. Moreover, such children have hypersensitivity to certain allergens, which may also include plant pollen.

The main symptoms of atopic bronchial asthma are:

• paroxysmal dry cough;
• attacks of suffocation, in which the patient takes a forced half-sitting position;
• wheezing – creaking or whistling sounds in the chest during breathing;
• feeling of chest congestion;
• shortness of breath that occurs during physical exertion.

The following treatment methods for allergic bronchial asthma exist:

• environmental control;
• drug treatment;
• allergen-specific immunotherapy.

Environmental control
It is very important for the patient to limit contact with allergens.

To do this, during the flowering period of plants, the patient must follow the following recommendations:

• stay indoors more often, especially in dry and windy weather;
• close doors and windows during the daytime;
• to increase the air humidity in the room, it is recommended to hang sheets soaked in water around the rooms or use air conditioning;
• Do wet cleaning at home every day;
• You should shower as often as possible;
• put hypoallergenic covers on mattresses and pillows, as dust mites usually live in them;
• contact with pets as little as possible;
• refrain from trips to nature.

Drug treatment

Groups of drugs	Representatives	Description
Beta-agonists	Salbutamol Fenoterol Ventolin	The drugs stop attacks of bronchial asthma, relieving the symptoms of suffocation.
Mast cell membrane stabilizers	Intal Tailed	They have anti-inflammatory and therapeutic effects. The medicinal properties of these drugs are aimed at preventing the development of the late and early stages of the asthmatic reaction.
Antihistamines	Zyrtec	Has antihistamine and antiallergic effects. This drug is usually prescribed for mild allergic bronchial asthma.
Glucocorticosteroids for local use	Pulmicort	The drug reduces the severity of bronchial edema and sputum formation. Has anti-anaphylactic and anti-inflammatory effects.
Leukotriene receptor blocker	Singular	Relaxes bronchospasm. Usually prescribed for the relief of seasonal allergic rhinitis and cough.
Combination drugs	Seretide Symbicort	These drugs contain a long-acting inhaled bronchodilator and an inhaled glucocorticosteroid in one bottle.

The dose of drugs, as well as the duration of treatment, is determined by the doctor depending on the severity of the disease and the individual characteristics of the patient’s body.

There are four degrees of severity of atypical bronchial asthma:

• Mild intermittent severity, in which symptoms of the disease appear less than once a week.
• Mild persistent severity when manifestations of allergic bronchial asthma are observed more than once a week, but less than once a day.
• Moderate severity, in which symptoms appear daily and attacks occur at night more than once a week.
• Severe severity when the symptoms of atypical bronchial asthma become permanent, significantly complicating the patient’s motor activity.

Allergen-specific immunotherapy
A small dose of the allergen is introduced into the patient's body, which is gradually increased until the patient becomes immune to the allergens. This procedure is carried out exclusively during the period of time when the dusting season of plants is over - as a rule, this is autumn or winter.

Hay fever is a classic allergic disease, which is based on an immediate allergic reaction. The disease is characterized by acute allergic inflammation of the mucous membranes of the respiratory tract, eyes, and skin. Less commonly, the digestive, cardiovascular, genitourinary, and nervous systems are involved in the process. The disease has a clear, repeating seasonality from year to year and coincides with the dusting of certain plants. Every year, the clinical symptoms of hay fever recur in the same months, even dates, with the exception of hot or cold weather, when the dusting period of plants begins earlier or is delayed. There is a clear connection with being in a certain area where allergenic plants generate dust. The patient's departure from this region leads to the disappearance of the symptoms of hay fever. The intensity of clinical manifestations of the disease depends on the concentration of pollen in the air. Therefore, patients feel much worse outside the city, in the field, where the pollen concentration is higher. Rainy weather has a beneficial effect on the condition of patients (the amount of pollen decreases). Hot weather leads to abundant pollen production and leads to an increase in clinical manifestations.

In different countries of the world, hay fever affects from 0.2 to 39% of the population. People aged 10 to 40 years are most often affected; in children under 3 years of age, hay fever is rare; boys under 14 years of age are 2 times more likely to get sick, and women aged from 15 to 50 years old. Among city residents, the incidence is 4-6 times higher than among rural residents. The prevalence of pollen allergies depends on natural-climatic, environmental and ethnographic features.

Three main groups of allergenic plants have been identified: woody plants, cereals and forbs, weeds.

The first peak in the incidence of hay fever - in the spring - is caused by tree pollen (from mid-April to the end of May). Among trees, pollen from birch, oak, hazel, alder, maple, ash, plane tree, elm, and poplar has pronounced allergenic activity.

The second spring-summer increase in incidence causes the flowering of cereals from early June to late July. The greatest antigenic activity is exhibited by wild-growing (timothy grass, meadow fescue, cocksfoot, wheatgrass, meadow grass, bromegrass, foxtail, ryegrass) and cultivated cereals (rye, corn).

The third pollen wave (July-September) is associated with rapid dusting of weeds (wormwood, quinoa, ragweed, sunflower).

It has been established that in central Russia, the disease is more often associated with sensitization to pollen of cereal grasses, trees, and weeds. In the south of Russia, the main allergens are ragweed, wormwood, sunflower, and corn. In Siberia, the sensitization spectrum is dominated by tree and grass pollen. In the countries of central Europe, the leading role in the etiology of hay fever belongs to cereal grasses and trees, in northern Europe - cereals and weeds, in southern Europe - trees, shrubs and herbs, in the USA - ragweed.

It is known that there are similarities between the allergens of different pollen species. Antigens are present not only in pollen grains, but also in other parts of plants (seeds, leaves, stems, fruits). This is the reason for the appearance of cross food allergies and intolerance to herbal preparations in patients with hay fever.

Factors contributing to sensitization: heredity for atopic diseases; high level of serum IgE; place of birth (area of ​​high concentration of plant pollen); month of birth (children born during the dust season are more likely to get sick); low birth weight of the baby; artificial feeding; frequent respiratory infections; smoking; poor nutrition; atmospheric air pollution (industrial and chemical allergens, xenobiotics change the chemical composition of pollen grains and contribute to the accumulation of toxic components).

The most common manifestations of hay fever are allergic rhinitis (95-98%), allergic conjunctivitis (91-95%), pollen bronchial asthma (30 - 40% of patients). A number of patients experience skin manifestations of hay fever: urticaria, Quincke's edema, dermatitis. Rare manifestations of hay fever include damage to the urogenital tract (vulvovaginitis, urethritis, cystitis, nephritis) and the gastrointestinal tract (nausea, vomiting, epigastric pain, stool disorders). The peculiarity of these lesions is the seasonality of the development of symptoms, a favorable course, the effect of the use of antihistamines, and the presence of other symptoms of hay fever. Manifestations of hay fever in the form of pollen allergic myocarditis have been described.

When eating products of plant origin or herbal remedies that have common antigenic properties with plant pollen, as well as honey, symptoms of allergic gastroenteritis, urticaria, Quincke's edema, and even anaphylactic shock may occur. Such reactions are also possible outside the pollen season. Food and medicinal plant intolerances are detailed in .

To diagnose hay fever, allergy history data, the results of a specific examination (skin tests, provocative tests) and laboratory research methods are used.

Primary prevention of hay fever is aimed at preventing the development of pollen allergies.

• Limiting the total antigen load.
• Balanced diet.
• Using methods of physical healing and hardening.
• Rational urban landscaping (use of non-allergenic plants).
• For parents with atopic diseases, planning the birth of a child outside the dust season.

Secondary - prevents deterioration of the condition in those individuals who already suffer from hay fever.

• Education of the patient and his family members on the treatment and prevention of pollen allergies.
• Monitoring indoor pollen concentrations (closed windows and doors, air conditioning, humidifiers and air purifiers, water vacuum cleaners).
• Travel to other climatic zones during the flowering period.
• Limiting going outside in sunny, windy weather.
• Exclusion from the diet of foods with cross-allergenic properties.
• Limiting exposure to nonspecific irritants (varnishes, paints, chemicals).
• Refusal of herbal medicine.
• Timely diagnosis, adequate pharmacotherapy and allergen-specific immunotherapy.
• Do not carry out preventive vaccinations or planned surgical interventions during the period of pollination of plants to which the patient is allergic.

The basic principles of treatment of allergic diseases are also used in the treatment of hay fever: elimination of allergens, pre-seasonal allergen-specific immunotherapy and pharmacotherapy during exacerbations.

The most effective method of specific treatment is the complete elimination of allergens.

Patients are advised: not to travel outside the city or into green areas, limit walking; change of clothes after walks; wearing dark glasses outside; shower after being outside; indoor air conditioning; exclusion of products with cross-allergenic properties and herbal medicine.

Currently, for the treatment of patients with severe manifestations of hay fever, allergen-free wards have been designed, equipped with a fine air purification system that allows pollen to be retained.

Allergen-specific immunotherapy (ASIT) or specific allergen vaccination has been successfully used for many years.

During ASIT: tissue sensitivity to allergens decreases; nonspecific hyperreactivity of tissues to various mediators decreases; signs of allergic inflammation decrease.

ASIT inhibits the increase in specific IgE, and after repeated courses its decrease increases. ASIT differs from pharmacotherapy by long-term preservation of the clinical effect after completion of treatment courses. The earlier ASIT is started in the early stages of the disease, the more effective its therapeutic effect. Timely specific treatment prevents the transition of the disease from mild to more severe forms. A lasting clinical effect is achieved upon completion of 3-5 courses of ASIT. For ASIT, allergens are selected that cannot be eliminated. The individual sensitivity of patients to medicinal forms of allergens is determined. There are various schemes for conducting ASIT (classical, accelerated, “lightning fast”, treatment with modified allergens). Non-injection methods of ASIT have been introduced into practice (oral, sublingual, intranasal, endobronchial)

Pharmacotherapy of hay fever consists of the use of pharmacological agents aimed at eliminating the main symptoms of rhinitis, conjunctivitis, and bronchial asthma. Histamine is the main mediator involved in the development of symptoms of rhinitis and conjunctivitis. Antihistamines are the main pathogenetic therapy for hay fever during exacerbation. Their action is associated with blockade of H1-histamine receptors. It is customary to divide antihistamines into: sedative, or first generation (classical), and non-sedating, or second generation ( ).

Pharmacological effects of antihistamine drugs (AGLS) of the first generation: antihistamine effect (blockade of H1-histamine receptors and elimination of the effects of histamine); anticholinergic effect (decreased exocrine secretion, increased viscosity of secretions); central anticholinergic activity (sedative, hypnotic effect); increased effect of CNS depressants; potentiation of the effects of catecholamines (blood pressure fluctuations); local anesthetic effect.

First generation H1 receptor antagonists have the following disadvantages: incomplete binding to H1 receptors (relatively high doses are required); short-term effect; blocking M-cholinergic receptors, α-adrenergic receptors, cocaine-like and quinidine-like effects; due to the development of tachyphylaxis, it is necessary to alternate AGLS of different groups every 2-3 weeks.

II generation AGLS (acrivastine, astemizole, cetirizine, ebastine, loratadine, fexofenadine, desloratadine) have been widely used in the treatment of hay fever. They are effective in relieving itching, sneezing and rhinorrhea, but have no effect on nasal congestion. When taken orally, antihistamines also have a pronounced effect on conjunctivitis and rashes. With the exception of acrivastine, all second-generation AGLS are used once a day.

Acrivastine, astemizole, loratadine and terfenadine are transformed into active metabolites by the cytochrome P450 system in the liver. Cetirizine and fexofenadine are not metabolized in the liver and are excreted unchanged in urine and feces. Desloratadine (Erius) is the active metabolite of loratadine and is not bound to P450. The cytochrome P450 system is responsible for the metabolism of other drugs that have a competitive effect. The simultaneous administration of terfenadine and astemizole with antifungal drugs (ketoconazole), macrolide antibiotics (erythromycin), and grapefruit juice leads to a cardiotoxic effect, and therefore these drugs are excluded from sale in Russia. The remaining second generation drugs do not have clinical data to link the development of complications with taking these drugs. The second generation of antihistamines causes significantly fewer unwanted cardiotoxic and cholinergic effects than their first generation predecessors.

Loratadine— the antiallergic effect develops within the first hour after ingestion and lasts 24 hours. The drug does not penetrate the blood-brain barrier, therefore, does not affect the central nervous system and does not have a sedative effect; lacks anticholinergic activity. Eating does not affect the absorption of loratadine. Age, liver and kidney dysfunction do not affect pharmacokinetics. Loratadine is characterized by a high safety profile; complaints of fatigue, headache, dry mouth, nausea, and palpitations are rare. It is possible to increase the concentration of loratadine in plasma when combined with erythromycin, ketoconazole, cimetidine without changes in the ECG and clinical manifestations.

Cetirizine- a metabolite of hydroxyzine, in therapeutic doses does not cause anticholinergic and antiserotonin effects, does not enhance the effect of alcohol. Basically, cetirizine is excreted unchanged by the kidneys, a small amount is metabolized in the liver. In patients with impaired renal function, the total clearance of cetirizine is reduced, and therefore a 2-fold dose reduction is necessary. When using cetirizine in therapeutic doses, no clinical impairments in the ability to concentrate attention and the speed of psychomotor reactions were detected; dry mouth, dyspeptic disorders, transient drowsiness, headache, and fatigue were rarely encountered. The drug does not enhance the effects of alcohol. The drug is approved for use in children from 2 years of age. Interactions with other drugs have not been established.

Akrivastine— the therapeutic effect occurs 20-30 minutes after administration, so acrivastine can be recommended as an emergency treatment for acute urticaria and Quincke's edema. In addition, a flexible dosage regimen and “as needed” administration are possible. When using acrivastine, there is no need to adjust the dose in elderly people, patients with liver diseases, or cardiovascular diseases. The drug is excreted mainly by the kidneys, and therefore is contraindicated in renal failure. When administered simultaneously with drugs that depress the central nervous system, alcohol reduces attention and speed of reactions.

Ebastine— the onset of action of the drug within the first hour after administration. Ebastine is almost completely metabolized in the liver, so the drug is contraindicated in severe liver failure. In renal failure, the half-life of the drug increases. In therapeutic doses, ebastine, registered in Russia in dosages of 10 and 20 mg, does not affect the speed of the reaction. When using the drug, headache, dry mouth, and drowsiness rarely occur. The drug should not be prescribed simultaneously with ketoconazole and erythromycin.

Fexofenadine- the first metabolite of second generation antihistamines used in the clinic. Fexofenadine is an active metabolite of terfenadine, characterized by high selectivity for H1-histamine receptors and the absence of anticholinergic and antiadrenergic properties. Fexofenadine does not penetrate the blood-brain barrier and is clinically effective in unchanged form, without previous metabolism. Fexofenadine does not block slow potassium channels and therefore does not cause changes in the QT interval. The drug is rapidly absorbed when taken orally, the maximum concentration in plasma is reached after 1-3 hours, and the duration of action is 24 hours. Co-administration with antifungal drugs and macrolides without dose adjustment is possible. Eating does not reduce the absorption of the drug; with prolonged use there is no cumulation effect.

Desloratadine- active metabolite of loratadine. The drug has similar pharmacological properties, but is superior in activity to loratadine. Desloratadine inhibits many cytokines, chemokines, and adhesion molecules. The drug is prescribed once a day and is safe in cases of liver dysfunction. Does not cause drowsiness and prolongation of the Q-T interval on the ECG. Eating does not affect drug absorption. The antihistamine, anti-asthmatic and anti-inflammatory effects of the drug are being studied.

Topical AGLS: azelastine and levocobastine. The drugs are used in the form of eye drops and nasal spray. Basic therapy with levocobastine and azelastine is recommended for mild forms of allergic rhinitis and conjunctivitis. It is possible to prescribe “as needed” in combination with other drugs. The obvious advantage of AGLS is the elimination of side effects that may occur when using systemic drugs, the easy achievement of sufficiently high local concentrations of the drug and the rapid onset of the therapeutic effect (15 minutes after use). Levocobastine is absorbed slowly and plasma concentrations are low. 70% is excreted unchanged in the urine, which requires careful use in cases of impaired renal function. Bitterness in the mouth may occur when treated with azelastine in the form of eye drops. Dryness and irritation of the mucous membranes are rarely observed. The use of contact lenses is not recommended when using ophthalmic forms of local AGLS. For local AGLS, no interactions with other drugs were noted.

Topical glucocorticosteroids-GCS(beclomethasone, budesonide, flunisolide, fluticasone, mometasone, triamcinolone) are the most effective drugs for controlling local symptoms in hay fever, especially with severe rhinorrhea and pollen bronchial asthma. Regular preventive use of topical corticosteroids in adults and children effectively reduces nasal congestion, rhinorrhea, sneezing and itching and prevents the development of asthma attacks. Topical corticosteroids reduce nasal and bronchial hyperreactivity, actively reduce mucosal inflammation; the effect appears after 6-12 hours and reaches its maximum after a few days. In addition, the use of topical glucocorticosteroids can reduce the course cost of treatment.

System GCS are used when other drugs are ineffective and severe manifestations of hay fever. As a rule, short courses are prescribed (< 3 нед) до полного купирования симптомов.

Cromony, used for the treatment of hay fever, are represented by cromoglycic acid disodium salt (cromolyn, DSKK) and nedocromil sodium. Cromones are thought to block calcium channels in mast cell membranes, inhibit phosphodiesterase, or inhibit oxidative phosphorylation. The effectiveness of cromones for pollen rhinitis remains controversial, especially when compared with topical corticosteroids and antihistamines. Consequently, cromones cannot be considered drugs of choice, although they play a certain role in the preventive treatment of conjunctivitis, as well as in the initial stages and mild forms of rhinitis and bronchial asthma.

Decongestants(vasoconstrictor drugs) regulate the tone of the sympathetic innervation of blood vessels by activating adrenergic receptors and causing vasoconstriction. Includes α 1 -adrenergic agonists (for example, phenylephedrine), α 2 -adrenergic agonists (for example, oxymetazoline, xylometazoline, naphazoline), substances that promote the release of norepinephrine (for example, ephedrine, pseudoephedrine). Topical decongestants are very effective in treating nasal congestion. Long-term (> 10 days) use of drugs can lead to tachyphylaxis, rebound swelling of the nasal mucosa and the development of drug-induced rhinitis, so the duration of use should be limited to 10 days. Not recommended for use in children under 1 year of age, adults over 60 years of age, or pregnant women; with hypertension and cardiopathy, with hyperthyroidism, prostate hypertrophy, glaucoma, mental illness, when taking α-blockers or monoamine oxidase inhibitors.

Anticholinergic drugs are also used for pollen rhinitis. Ipratropium bromide is effective in the treatment of diseases associated with rhinorrhea, but it has no effect on sneezing and nasal congestion. The effect of the drug occurs within 15-30 minutes. A dose-dependent anticholinergic side effect is characteristic. These drugs can be used in combination with other drugs.

Treatment of bronchial asthma should be carried out in accordance with the recommendations of GINA 2002. β 2 -agonists are used to relieve asthma attacks; Cromones and topical corticosteroids are used for basic therapy.

The safety of topical corticosteroids has been convincingly proven for pollen rhinitis and asthma. In large doses they can have side effects. With the simultaneous use of nasal and inhaled corticosteroids, additive side effects are possible.

The volume of treatment for hay fever depends on the severity of the process. In patients with an intermittent and mild persistent course, topical antihypertensive drugs or sodium cromoglycate preparations are used; if local therapy is ineffective, second generation antihypertensive drugs are used. For moderate cases, topical corticosteroids in combination with second-generation antihypertensive drugs. As an additional therapy, it is possible to use sodium cromoglycate eye drops, corticosteroids, and decongestants. In case of severe hay fever, systemic corticosteroids may be prescribed to this therapy if absolutely necessary. For the treatment of pollen allergies, the possibility of using antileukotriene drugs is being considered.

Thus, the main principles of treatment for hay fever are allergen elimination, ASIT, and pharmacotherapy. ASIT is prescribed and carried out only by an allergist, and therefore all patients with pollen allergies must be registered at the allergology office.

L. A. Goryachkina, professor, doctor of medical sciences
E. V. Peredkova, Associate Professor, Candidate of Medical Sciences.
E. R. Bzhedugova RMAPO, City Clinical Hospital No. 52, Moscow

Due to the deteriorating environmental situation, the number of patients with allergies is growing every day. The most common disease is hay fever, which can cause painful allergy symptoms in both adults and young children.

In different countries, it affects up to 30% of the population. To deal with the problem, you need to know what hay fever is and how to eliminate its manifestations or reduce the manifestations of the inflammatory reaction. Let's look at this in more detail.

Hay fever(the second name is seasonal allergic rhinitis or rhinoconjunctivitis) is a group of allergic diseases that occur seasonally and are characterized by acute allergic inflammation of the mucous membrane of the nose and eyes, and less often of the skin. Sometimes the pathological process can affect other organs and systems (allergic gastritis, cystitis, etc.).

Some sources call this disease hay fever. This name is a tribute to the historical past. When this disease was first described, doctors believed that its development was associated with the influence of hay. It has now been established that hay plays virtually no role in the development of the disease, and fever practically does not occur with this pathology.

Reasons for the development of the disease

Hay fever is caused by various plants. There are several groups of allergenic plants: cereals, weeds and trees.

The incidence and exacerbation of the disease occurs during the flowering period of these plants:

• first wave (April-May). During this period, active flowering of trees is observed. The most common causes of an allergic reaction are: poplar, hazel, birch and alder pollen;
• second wave (beginning of summer). Cereal plants begin to bloom. One of the most active allergens is rye and wheat. This type of disease occurs mainly in rural residents;
• third wave (late summer-early autumn). Weeds (quinoa, timothy, wormwood, etc.) actively produce pollen.

Sensitization to a particular type of pollen depends largely on geographic location. So in the USA, allergies to ragweed are more common, and in the south of Russia to sunflower and corn.

In addition, the following factors are important in the development of the disease:

• family history of allergies;
• birth trauma and infectious diseases in young children;
• unhealthy diet and bad habits;
• frequent viral infections;
• geographic climate and month of birth (children born in regions with abundant pollen activity during the spring and summer months are more likely to develop hay fever);
• harmful industrial and domestic conditions.

Pollen allergies can present with a variety of symptoms. The most common signs of pathology are:

Allergic rhinitis. This form of the disease is accompanied by:

• runny nose;
• nasal congestion and swelling;
• clear mucous discharge;
• decreased or loss of sense of smell;
• constant sneezing;
• stuffy ears.

Allergic conjunctivitis. The patient is concerned about the following symptoms:

• lacrimation;
• photophobia;
• inflammation of the conjunctiva;
• discomfort and pain in the eyes.

A combination of the two previous forms - rhinoconjunctivitis
Bronchial asthma. Occurs in 20-30% of patients. Its common symptoms:

• cough;
• attacks of suffocation;
• shortness of breath at rest and during exercise;
• wheezing in the lungs, rapid breathing and tachycardia.

Skin manifestations of the disease:

• such as various rashes;
• itchy skin;
• hives;
• swelling of the subcutaneous tissue and mucous membranes.

Rare manifestations of hay fever also include:

disorders of the digestive tract and damage to the genitourinary system (nephritis, cystitis, etc.).

All these manifestations of the disease are characterized by one common feature - they develop exclusively in the same season, have a favorable course and respond well to treatment with antihistamines.

Important! Often, an allergy to pollen of certain plants is combined with a food allergy to certain foods. So, if a patient is allergic to wormwood, then he often develops an allergy to potatoes, sunflower oil and seeds. Such patients need to use allergenic foods like honey with caution and it is better not to be treated with herbal medicine.

Hay fever and pregnancy

In pregnant women, hay fever often develops against the background of hormonal changes in the body, especially when the first trimester of pregnancy occurs during the flowering season of plants.

The disease manifests itself in various forms, but usually pregnant women are bothered by a runny nose and eye problems. Severe attacks of bronchial asthma develop less frequently.

Pregnant patients are prescribed to adhere to the regimen and, if necessary, medications are selected. Cases have been recorded in which, after childbirth, hay fever was cured on its own and in the future did not remind of itself with a single symptom. Most likely, this is due to the normalization of hormonal levels.

Hay fever can occur in a child of any age, but the disease most often occurs in children 4-8 years old. Early onset of the disease is observed in children who had diathesis or atopic dermatitis in early childhood. Hay fever is more common in bottle-fed children than in breastfed children. In addition, diseases during pregnancy and infection during childbirth are important. Males get sick more often than females.
Source: website In children, the disease manifests itself as conjunctivitis or a combination of both. A runny nose is accompanied by sneezing, nasal congestion and mucous clear discharge. Conjunctivitis begins with discomfort and itching in the area of ​​the eyeballs, then lacrimation, pain and pain in the eyes. When these two syndromes are combined, the baby may experience increased fatigue and drowsiness. The child begins to sleep poorly and loses weight.

Bronchial asthma as a manifestation of hay fever in children is quite rare. This form usually occurs together with other variants of the disease and is accompanied by chest discomfort, asthma attacks and a dry cough.

Skin manifestations of hay fever develop more often in children than in adults. This may be urticaria with various elements of a rash, skin itching or Quincke-type edema. Allergic contact dermatitis is rare.

In children, the pathology is accompanied by pronounced changes in the nervous system, since children are more emotional and unstable. They become capricious, whiny, irritated for no reason, their sleep and appetite are disturbed. Against this background, an increase in temperature to subfebrile levels may occasionally be recorded. Sometimes there are problems with the functioning of the digestive and cardiovascular systems.

How to identify hay fever? Diagnostics

Diagnosis of hay fever occurs in several stages:

The history of a small patient is studied. To do this, the child himself and his parents are interviewed. They focus on the connection of the disease with the time of year and the flowering season of dust plants. The child is examined by various specialists: ENT, ophthalmologist and others.

The probability of hay fever is high with the following anamnestic data:

• allergies in parents and close relatives;
• the disease and its symptoms occur once a year during the flowering period of plants;
• at other times there are no signs of the disease.

Based on the data received suggest a diagnosis of hay fever.

Establishing a connection between the disease and the causative allergen. For this purpose, various methods are used:

• skin tests. Do not carry out during the period of exacerbation of the disease and in children under 3 years of age. Before the study, the patient should not take hormonal or antihistamine medications.
• determination of specific immunoglobulin E in blood serum;
• immunoblotting. The air panel includes the most common pollen allergens, such as birch, alder, poplar, ragweed, wormwood, etc.
• provocative tests. They are used only in hospital settings for patients with complex diagnoses. Practically not used in childhood.

At the last stage, the doctor assesses the severity of the disease (mild, moderate or severe) and develops an individual treatment regimen for the patient separately for the period of exacerbation and remission.

Hay fever: treatment

Approaches to treating the disease depend on the severity and manifestations of hay fever. Various tablets and medications are used to eliminate symptoms.

How to get rid of a runny nose

To eliminate the symptoms of rhinitis and nasal congestion, various drops and sprays are used:

hormonal (Avamys, etc.). Use a week before flowering so that the effect of the hormone can accumulate and manifest itself in full. Use for a month. Can be used in children after the age of three. They do not have a systemic effect on the body;

decongestants (vasoconstrictors). Used in emergency situations when it is completely impossible to breathe. Use no more than a week. Many sprays and drops with different active ingredients and dosages have been developed for children and adults (Sanorin, Nazol-baby, etc.);

antihistamine drops (Vibrocil, Allergodil). The composition includes a local antihistamine, which effectively eliminates the manifestations of allergic rhinitis. Use for about 2 weeks;

sprays and washes based on sea water. They remove part of the allergen from the nasal mucosa, partially relieve swelling and wash out mucus from the nose. Used in children of any age, pregnant and lactating women.

You can relieve eye symptoms using drops and ointments:

• rinsing with decoctions of antiseptic herbs: chamomile baths, rinsing with calendula decoction, etc.);
• hormonal ointments (prednisolone, etc.) relieve inflammation and relieve itching;
• eye allergy drops (Lecrolin, etc.);
• when an infection occurs, use eye drops with an antibiotic (Sofradex).

How to relieve skin manifestations

For severe itching and rash use:

• antihistamine ointments (Fenistil);
• hormonal ointments (hydrocortisone, etc.);
• baths and lotions with decoctions of antipruritic herbs (oak bark, chamomile).

Local remedies are used only for mild cases of the disease, or as part of complex therapy. Antihistamines are used as a systemic treatment for allergies. These drugs block the release of histamine and prevent the allergic inflammatory reaction from starting.

To treat hay fever, antihistamines of various generations are used:

• I-th ( Tavegil and others.). The main side effects are sedation and severe drowsiness. They work for 6 hours. A side effect in the form of dry mucous membranes can have a positive effect in the treatment of a runny nose with copious discharge;
• II ( Loratadine and others.). The main group of drugs for the treatment of hay fever. They act quickly and for a long time. These tablets have a negative effect on the heart, which must be taken into account in patients with problems in this area. Do not cause a hypnotic effect;
• III-e ( Tsetrin and others.). Deprived of most of the side effects of the two previous groups. They act for a long time and gently.

Systemic hormones in the treatment of the disease can be used to relieve attacks of bronchial asthma (intravenously or inhaled). In addition, hormones are indicated for severe hay fever, accompanied by the development of life-threatening conditions, for example, Quincke's edema.

Specific immunotherapy can have a good effect in the treatment of hay fever when the causative allergen is accurately identified. It is carried out in courses outside of exacerbation (late autumn, winter or early spring).

Primary prevention is aimed at preventing people at risk from developing hay fever. For this we recommend:

• balanced diet;
• normal sleep and rest patterns;
• living in ecologically clean areas;
• planning pregnancy at a certain time of the year (outside the flowering season);
• choosing a place to live taking into account plants and trees (avoid allergenic plants in the immediate vicinity of housing).

If the patient is already sick with hay fever, then secondary prevention comes into force, aimed at preventing the deterioration of his condition and alleviating the symptoms of the disease. Recommendations for patients with this type of allergy:

1. Limiting or eliminating contact with the allergen, up to moving to another region during the flowering season;
2. Control of dust and pollen content in living quarters. The use of vacuum cleaners with hepa filters, humidifiers and other air purifying devices.
3. Limiting outdoor visits during the period when allergenic plants are active.
4. Regular showering and rinsing your nose after coming from outside.
5. Hypoallergenic diet. It has been proven that with hay fever, cross-allergy to certain foods occurs. For example, with an allergy to birch pollen, a cross-reaction to apples and nuts often develops.
6. The patient and his relatives need to be taught the treatment regimen during exacerbation and prevention during remission.
7. Do not plan operations and trips during the flowering period of plants and do not travel outside the city or into nature at this time.

A unique technology - autolymphocytotherapy (ALT) - will help you cure hay fever in children and adults and achieve remission of the disease 6 months after the course of treatment.

Hay fever or “hay fever” is an allergic disease, the symptoms of which are similar to a cold: a painful runny nose, itching and redness of the eyes (up to conjunctivitis), profuse lacrimation, attacks of dry cough, sore throat, sneezing, difficulty breathing and even choking, sometimes skin rashes, swelling of the face. THOSE. the patient begins to literally suffer when he goes outside, and it’s not much easier for him indoors.

Allergic hay fever has a clearly defined seasonality of exacerbation:

In spring (April-May) worsens with allergies to pollen from trees: birch, hazel, alder, wild rosemary, poplar, linden;

Summer (June-July) with an allergy to pollen of meadow (cereal) grasses : timothy, fescue, bluegrass, wheatgrass, bromegrass, hedgehog grass, foxtail grass, etc.

Late summer-autumn (August-September) for allergies to weed pollen: ragweed, wormwood, quinoa, sunflower, corn, plantain, etc.

Due to the worsening environmental situation, the so-called " autumn hay fever"for allergies to mold spores, although calling it that is not entirely correct.

If you experience regular runny nose, itchy nose and eyes, sneezing attacks and coughing in the spring-summer or autumn period of the year, this is a reason for an urgent consultation with an allergist. In the absence of timely treatment for hay fever, the range of allergens usually expands, and there is a threat of developing bronchial asthma.

With early spring, the flowering season of trees in the Moscow region begins at the end of March with the dusting of alder and hazel. Then, at the end of April and beginning of May, birch trees begin to bloom, the pollen of which remains in the air until June. Allergens in birch pollen usually cause severe hay fever, because... the concentration of pollen grains can reach several thousand units per cubic meter of Moscow air (according to pollen monitoring data). In May, spruce and pine also produce abundant dust, and at the end of the month, the flowering of cereal grasses - timothy grass, etc. - begins. The peak of dusting of cereals occurs in June and early July. From mid-June until September, weeds gather dust - dandelion, plantain, quinoa, and closer to autumn - wormwood. Thus, in Moscow, the allergy season for a patient with hay fever with simultaneous sensitivity to tree and grass pollen affects almost the entire warm season.

Often with hay fever, cross food allergies occur - intolerance to fresh vegetables, fruits, and herbs. With this form of allergy, it is necessary to change your diet and follow a hypoallergenic diet during the flowering period of plants. The menu during hay fever is often a cause for frustration, because... The list of permitted products is significantly reduced.

Among residents of megacities, seasonal allergies affect not only adults, but also children. Hay fever in children requires proper non-symptomatic treatment, because easily turns into an atopic march, then year-round allergic rhinitis is added to the clinical picture, and then everything develops into bronchial asthma. This turns the life of an allergy sufferer into a real nightmare.

If you wish a healthy future for yourself or your child, then forget about:

• antihistamines;
• drops and hormonal sprays (Allergodil, Avamis, Nazaval, etc.);
• antiallergic pills from TV advertisements (Suprastin, Kestin, Zirtek, Telfast, Loratadine, Erius, etc.);
• folk remedies for treatment at home;
• homeopathy;
• healers, healer grandmothers, etc.

All this is not prevention and either gives a symptomatic temporary effect without eliminating the very cause of allergic hay fever, or does not help at all.

The only real ways to cure hay fever in 2019 are ASIT (immunotherapy) and autolymphocytotherapy (ALT), which will be discussed below.

Problems of a patient with hay fever:

Take the ALT course and get rid of flower allergies in 2019!

The medical technology “autolymphocytotherapy” (abbreviated as ALT) has been widely used in the treatment of patients with various forms of allergic diseases for more than 20 years; the method was first patented in 1992.

Successful treatment of hay fever with ALT is carried out in adults and children. For children, allergy treatment using the Autolymphocytotherapy method is performed after reaching 5 years of age.

The "Autolymphocytotherapy" method, in addition to the treatment of hay fever, is widely used for: atopic dermatitis, urticaria, Quincke's edema, bronchial asthma, allergic rhinitis, food allergies, allergies to household allergens, to pets, allergies to cold and ultraviolet rays (photodermatitis) .

THE ALT METHOD ELIMINATES INCREASED SENSITIVITY OF THE BODY TO SEVERAL ALLERGENS AT ONCE, DIFFERENTLY DIFFERENT FROM ASIT.

Outside the flowering season (autumn-winter), treatment is carried out using subcutaneous autolymphocytotherapy.

In severe cases of exacerbation, during the flowering season of plants (spring-summer), the method of endonasal autolymphocytotherapy is used.

The essence of the ALT method is to use one’s own immune cells - lymphocytes - to restore normal immune function and reduce the body’s sensitivity to various allergens.

Video about the treatment of hay fever with ALT in the TV program “About the Most Important Thing”

SUBCUTANEOUS AUTOLYMPHOCYTOTHERAPY:

Autolymphocytotherapy is carried out on an outpatient basis, in an allergology office as prescribed and under the supervision of an allergist-immunologist. Lymphocytes are isolated from a small amount of the patient's venous blood under sterile laboratory conditions.

The isolated lymphocytes are injected subcutaneously into the lateral surface of the shoulder. Before each procedure, the patient is examined in order to individually prescribe the dose of the administered autovaccine. Apart from its own lymphocytes and physiological solution, the autovaccine does not contain any drugs. Treatment regimens and the number and frequency of immune cells administered depend on the severity of the disease. Autolymphocytes are administered in gradually increasing doses with an interval between injections of 2 to 6 days. Course of treatment: 6-8 procedures.

ENDONASAL AUTOLYMPHOCYTOTHERAPY:

It differs from the subcutaneous method of treatment in that autolymphocytes are isolated from 15 ml. venous blood of the patient. The autovaccine is administered directly into the paranasal sinuses using a special soft catheter by an otolaryngologist. The course of treatment is 4-5 procedures with an interval of 2 times a week.

Normalization of the functions of the immune system and a decrease in the body's sensitivity to allergens occurs gradually. The withdrawal of supportive symptomatic therapy is also carried out gradually under the supervision of an allergist. The patient is given the opportunity to have 3 free follow-up consultations within 6 months of observation after completing the course of treatment using the Autolymphocytotherapy method.

The effectiveness of treatment is determined by the individual characteristics of the immune system. This process to a certain extent depends on the patient’s compliance with the recommendations of the allergist during the period of treatment and rehabilitation.

You can familiarize yourself with possible contraindications

Ask a question to a specialist

The effectiveness of autolymphocytotherapy in the treatment of hay fever

When assessing the long-term results of treatment of hay fever using autolymphocytotherapy, the following periods of remission were achieved:

• Remission for over 5 years - in 79% of cases
• Remission for a period of 1 to 5 years - in 16% of cases
• Remission for a period of 6 months to 1 year in 5% of patients

Allergist-immunologist Nadezhda Yuryevna Logina will see you in Moscow on a weekday

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