Allergies

Symptom causing allergens are introduced to the immune system slowly from low to higher doses to adapt and acclimate the immune system to the offending allergen. This is called immunotherapy. SLIT therapy stands for sublingual immunotherapy.

What Are Some Types Of Allergies?

Pollen allergy

Pollen allergy, also known as “hay fever” is one of the most common triggers of seasonal allergies. Experts usually refer to pollen allergy as “seasonal allergic rhinitis.”

What are Symptoms of Pollen Allergies?

People with pollen allergies only have symptoms when the pollens they are allergic to are in the air. Symptoms include:

  • Runny nose (also known as rhinorrhea – this is typically a clear, thin nasal discharge)
  • Stuffy nose (due to blockage or nasal congestion – one of the most common and troublesome symptoms)
  • Sneezing
  • Itchy nose, eyes, ears, and mouth
  • Red and watery eyes
  • Swelling around the eyes
  • Brain fog
  • Sinus headache

If you have asthma and pollen makes your asthma worse, you may have allergic asthma. It is the most common type of asthma.

What are some Types of Pollen?

Typically produced by species of trees, grass and weeds. The most common allergens are listed below.

Trees

Alder, Ash, Aspen, Beech, Birch, Box elder, Cedar, Cottonwood, Elm, Hickory, Juniper, Maple, Mulberry, Oak, Olive, Pecan, Poplar, Walnut, Willow.​

Grass

Bahia, Bermuda, Fescue, Johnson, Kentucky blue, Timothy.

Weed

Ragweed, Burning bush, Cocklebur, Lamb’s-quarters, Mugwort, Pigweed, Russian thistle, Sagebrush, Tumbleweed​.

Mould

Types of fungi caused by excessive water and humidity. They’re typically found in poorly ventilated areas like bathrooms and basements.

pet dander

Flecks of dead skin shed by pets with fur or feathers like dogs, cats and birds. Dander floats in the air of your home and is the main source of pet allergies.

dust mites

Tiny, microscopic bugs that live in your home. They can collect on humid, dust-prone furnishings like pillows, mattresses, carpets and stuffed toys.

Seasonality of Pollen Allergies

Oral Allergy Syndrome

Pollen Food Allergy Syndrome (PFAS), also known as oral allergy syndrome (OAS), is a condition where individuals experience allergic reactions to certain raw fruits, vegetables, and nuts. The symptoms are usually limited to the mouth and throat and may include itching or swelling of the lips, tongue, and throat. In some cases, it can cause mild systemic reactions. OAS is often triggered by proteins in certain fruits, vegetables, and nuts that are structurally similar to proteins found in pollen.

Pollens and their food cross-reactivity counterparts additions to the document to the right:​

  • Grass pollen: celery, melon
  • Ragweed pollen: melons, sunflower seeds.

Resources: FOOD ALLERGY CANADA

OAS is primarily associated with IgE-mediated allergic reactions rather than IgA or IgG

Panallergens

Panallergens play a significant role in IgE and IgG cross-reactions, particularly between pollens and seemingly unrelated plant-based food allergens. These cross-reactions occur due to shared structural components in various allergens. Notably, panallergens are implicated in reactions involving both immunoglobulin E (IgE) and immunoglobulin G (IgG). Examples of well-known panallergens include seed storage proteins, profilins, lipid transfer proteins (LTPs), and cross-reactive carbohydrate determinants (CCDs). These components are found in diverse plant sources and can lead to allergic responses in individuals sensitized to them.

Cross-reactions extend beyond plant-based allergens and may involve other sources such as latex, mammal milks, or invertebrates. The shared allergenic components in these substances can trigger immune responses in individuals with sensitivities, leading to allergic reactions. Understanding the presence and potential cross-reactivity of panallergens is crucial for accurate diagnosis and effective management of allergies associated with diverse sources.

Seed storage proteins are proteins primarily found in seeds, nuts, and kernels of plants. These proteins serve as a source of nutrition for the developing plant embryo. Unlike some allergens that may be denatured by heat or stomach acid, seed storage proteins are stable under these conditions. This stability makes both raw and cooked foods containing these proteins potential allergens. In some cases, genetic modification of plants may introduce novel proteins that could lead to cross-reactions. For instance, there have been instances where genes from Brazil nuts were found to be similar to those in genetically modified soy, potentially causing allergic reactions in individuals sensitive to Brazil nuts.

Profilins are proteins found in the cytoplasm of plant cells, and they play a role in the sensitization of individuals to pollens. Unlike some allergens, profilins are denatured by heat, meaning that clinically significant reactions typically occur with raw foods. In Canada, there is evidence of clinically relevant cross-reactions with foods listed under birch, ragweed, and timothy pollens. Sensitization to profilins can lead to allergic reactions in individuals exposed to these specific pollens and related foods, particularly when consumed in their raw form. ​

Lipid transfer proteins are allergenic proteins resistant to heat, stomach acid, and proteolytic enzymes, making both raw and cooked foods potential allergens. They are considered major allergens in the rosaceae family of foods, which includes fruits like apples, apricots, and peaches. LTPs are often found in the peel or skin of these fruits. Due to their stability, LTPs can cause allergic reactions even after cooking. Allergic responses to LTPs may manifest as oral allergy syndrome or more severe systemic reactions.

Cross-reactive carbohydrate determinants (CCDs) are carbohydrate structures found on glycoproteins in various plants. These structures are not unique to specific allergens and can be shared among different plant sources. IgE antibodies may recognize these common carbohydrate structures, leading to cross-reactivity between seemingly unrelated allergens. CCDs are not heat-labile, so cooking does not eliminate the potential for cross-reactions. While CCDs themselves may not always cause clinically significant allergic responses, they can interfere with the accurate diagnosis of specific allergies, as tests may detect IgE antibodies targeting CCDs rather than allergen-specific proteins.

Labs we use for testing IGE: Aller Detect or USBiotek or LifeLabs.
Cost: Highly variable.

Sublingual Immunotherapy for Allergies Treatment

Allergy desensitization therapy is best initiated 6-12 weeks BEFORE the allergy season.

January/ February is a good time to get started.