A CHRONIC CONDITION…
THAT CAN WORSEN
Respiratory allergy is a long-term condition, which can worsen and lead to allergic asthma if inadequately treated.
Why do I have a respiratory allergy?
Allergies are hereditary: a person whose parents have allergies is likely to inherit this allergic tendency (or “atopic” tendency). The environment also plays a part, though it is still little understood. The hygiene theory1 states that excessive cleanliness in early childhood promotes the development of allergic conditions, as the immune system is altered and starts to fight against apparently harmless substances, such as pollen and house dust mites. This theory has been questioned by other researchers who consider that a high level of exposure to allergens such as house dust mites 2-3 and pollution4 during childhood could foster allergies and allergic asthma.
Natural history of the condition: the “allergy march”
The onset of an allergy usually occurs in childhood and can persist throughout a sufferer’s lifetime, with symptoms of varying levels of discomfort. Initially, the sufferer becomes sensitised to food. These food allergies, which are very common in infants, then tend to subside or even disappear. Sensitivity to inhaled allergens develops in their place, causing respiratory allergies such as rhinitis followed by asthma. Subsequently, the person may become sensitised to other allergens: this is known as poly-sensitisation.
It gets more complicated!
In Europe, 1 person in 5 affected by respiratory allergy suffers from a severe form of the condition, so-called “moderate to severe”5 . The allergy can cause “ENT” (Ear, Nose and Throat) and lower respiratory tract (bronchial tube) complications:
- Inflammation and infections: otitis, sinusitis, tonsillitis, especially in children.6
- Sleep apnoea – and its consequences: sleep disturbance, tiredness, etc.7
- Asthma in 40% of cases. 80% of asthmatics have previously suffered from an allergy8 !
A condition that is too often ignored
8 out of 10 allergy sufferers learn to live – with difficulty – with their respiratory allergy9 , and more than 4 in 10 are not even diagnosed10 … On average, they consult an allergist after 7 years of being referred from one doctor after another!11
 David Strachan, Hay fever, hygiene, and household size, Brit Med J 299:1259-1260, 1989
 Huss K et al. House dust mite and cockroach exposure are strong risk factors for positive allergy skin test responses in the Childhood Asthma Management Program. J Allergy Clin Immunol. 2001 Jan;107(1):48-54.
 Lau S, Illi S, Sommerfeld C et al. Early exposure to house-dust mite and cat allergens and development of childhood asthma : a cohort study. Multicentre Allergy Study Group. Lancet 2000 ; 356 : 1392-7.
 Morgenstern V et al. Atopic diseases, allergic sensitization, and exposure to traffic related air pollution. Am J Respir Crit Care Med 2008; 177: 1331-7.
 White P. et al. Symptom control in patients with hay fever in UK general practice: how well are we doing and is there a need for allergen immunotherapy? Clinical and Experimental Allergy. 1998: 28: 266-270
Sih T, Mion O. Allergic rhinitis in the child and associated comorbidities. Pediatr Allergy Immunol 2010: 21: 107–113. Koinis-Mitchell D, Craig T, Esteban CA, Klein RB..Sleep and allergic disease: a summary of the literature and future directions for research. J Allergy Clin Immunol. 2012 Dec;130(6):1275-81
 Blaiss MS. Rhinitis-asthma connection: epidemiologic and pathophysiologic basis. Allergy Asthma Proc 2005; 26: 35–40
 Valovirta E. Patients Perceptions and Experience of House Dust Mite Allergy in European Survey. European Respiratory Disease. 2012
 Bauchau V, Durham SR. Prevalence and rate of diagnosis of allergic rhinitis in Europe. Eur Respir J. 2004 Nov;24(5):758-64.
 Leynadier F. Bases du traitement en allergie respiratoire. Revue française des laboratoires. 281 (1996) 41-45