[Health Tip] Seasonal Allergy Troubles... "Consider Immunotherapy If Daily Life Is Difficult"

As the seasons change and the daily temperature range widens, the number of patients complaining of allergy symptoms is also increasing. Allergic diseases have various causes and symptoms, so treatment usually focuses on symptom control rather than fundamental cures. However, if symptoms appear throughout the body or are severe enough to make daily life difficult, immunotherapy can be considered even if it takes time. We explored the symptoms and treatments of allergic diseases with Professor An Jin from the Department of Respiratory Allergy at Gangdong Kyung Hee University Hospital.

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According to Gangdong Kyung Hee University Hospital, allergic disease patients are common in Korea and increase during spring and autumn when pollen is abundant and the daily temperature range is large. According to data from the Health Insurance Review and Assessment Service on diseases of public interest, in 2021, a total of 13,041,855 patients visited hospitals for allergic diseases. Among them, the highest numbers were in April, with 2,437,071 patients, and in September, with 2,580,555 patients, which are transitional seasons. Regarding this, Professor An Jin of the Department of Respiratory Allergy at Gangdong Kyung Hee University Hospital explained, "Recently, the number of allergy patients is increasing due to spring and autumn pollen as well as worsening air pollution, so caution is needed."

Substances that cause allergic symptoms include pollen and air pollutants. The reason for the increase in patients during the spring and autumn transitional seasons is also pollen. In spring, pollen from trees such as birch, alder, and oak is the main cause, while in autumn, weed pollen, especially ragweed, mugwort, and Virginia creeper pollen, are major causes. It has been reported that these pollen components combined with air pollutants like fine dust trigger allergic reactions.

The main symptoms of allergic diseases include conjunctivitis with itchy, swollen, and red eyes, as well as rhinitis symptoms such as runny nose, sneezing, and nasal congestion. These symptoms usually worsen in the morning, and in severe cases, systemic symptoms such as feverish sensation, fatigue, and body aches similar to a cold or flu may accompany. Bronchial symptoms can include cough, sputum, chest tightness, and in severe cases, wheezing and difficulty breathing.

For the treatment of allergic diseases, it is important to accurately identify the causative antigen. Methods to find antigens include blood tests and skin prick tests. There are two types of blood tests: MAST, which tests multiple allergies at once, and ImmunoCAP, which tests selected specific suspected antigens. Generally, MAST tests are performed, but ImmunoCAP tests provide more precise measurements due to higher specificity. Skin prick tests involve injecting a small amount of the causative substance into the skin to observe the reaction and are performed to identify antigens for immunotherapy or to evaluate its effectiveness.

Most symptoms of allergic diseases can be controlled with medication. For those seeking fundamental treatment beyond symptom control, finding the causative antigen that triggers allergic symptoms and implementing tailored treatment and antigen avoidance to prevent symptoms can be considered. If active treatment is necessary, immunotherapy can be performed by repeatedly exposing the body to the allergen to induce immune tolerance.

Immunotherapy is a treatment method that gradually increases the dose of the allergen, starting from a small amount, to desensitize the body slowly and improve symptoms. It is similar to the approach used in general vaccines. If symptoms are severe not only in the eyes and nose but also systemic or bronchial symptoms are present, immunotherapy is strongly recommended. It is mainly recommended for young patients with severe symptoms or active social lives and for those who find medication treatment difficult. However, since the immune system does not change immediately, a treatment period of about 3 to 5 years is required.

Immunotherapy is divided into subcutaneous immunotherapy, which involves injections in the arm, and sublingual immunotherapy, which involves administering medication under the tongue. Sublingual immunotherapy is mainly used for perennial allergic patients caused by house dust mites. Seasonal allergies are usually treated with subcutaneous immunotherapy. Subcutaneous immunotherapy is administered once a month at the hospital, while sublingual immunotherapy is self-administered daily at home by dissolving the medication under the tongue.

Professor An advised, "Although immunotherapy requires a relatively long treatment period, considering the quality of life without allergic symptoms after treatment, it is definitely worth considering."

Professor An Jin, Department of Pulmonology, Gangdong Kyung Hee University Hospital.
[Photo by Gangdong Kyung Hee University Hospital]

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