11. April 2018
Focus on Hay Fever – What Are the Latest Research Findings?

In the coming days and weeks, more and more birch pollen will be released into the air, and many people with hay fever will feel it. Around 12 million people in Germany suffer from hay fever, including more than one million children and adolescents. Only one in ten people with allergies receive adequate treatment (1).

The non-profit ECARF Foundation warns that allergic diseases should be taken seriously. Professor Torsten Zuberbier, spokesman for Allergie-Centrum-Charité in Berlin and director of the ECARF Foundation, explains why is it important to seek medical treatment and describes some of the new therapies that are becoming available.

Hay fever can have a serious impact. It can affect sleep, the ability to concentrate, and productivity at work. “Studies have shown that schoolchildren with untreated pollen allergies do not perform at full capacity and have a 40% increased risk of getting lower grades (2)”, says Zuberbier. “Adults with pollen allergies not receiving treatment also experience a decrease in productivity and miss more workdays.” Even so, their condition is often not taken seriously, and sufferers try to get by on their own with the disease.

The seriousness of hay fever is also downplayed in health policy. An increasing number of hay fever medications are being made available without a prescription. For example, several major cortisone nasal sprays were reclassified as over-the-counter medications one and a half years ago. Not only does this mean that patients must pay for these drugs out of their own pockets, but they also have less reason to visit the doctor. “For optimal medical treatment, the ongoing supervision of therapy by a doctor is indispensable. We know from studies that patients with allergic rhinitis often self-administer medications in combinations that are not evidence based, and therefore not proven to be effective”, says Zuberbier. Furthermore, only a doctor can determine whether the patient is at risk of an ‘allergic march’, i.e. when allergic rhinitis progresses to allergic asthma. In many cases, this can be prevented through specific immunotherapy (hyposensitisation). But the doctor must be familiar with the progression of the disease in order to recommend this therapy.

The continual development of modern treatment options is another reason to take charge instead of trying to muddle through a diagnosis confirmed years ago. Short-term immunotherapy, in which the allergen dosage is increased at a faster rate during the initial phase, has been available for some time. This means that the maintenance dose, which is administered once a month, is reached sooner. “At the moment, research is being conducted on a number of new substances that may increase the tolerability of immunotherapy and shorten its course”, explains Zuberbier. Allergens with an altered three-dimensional structure (allergoids) are already in use. The maintenance dose of some allergoids can be reached during the first day of treatment. In addition, studies are being conducted on allergens that have been altered by the addition of a special agent (adjuvant), which boosts their effect so that fewer total injections are required. Research on recombinant allergens also looks very promising. Unlike conventional allergens, they are not made from natural (pollen-based) extracts, but are instead genetically produced as individual proteins. The composition of the preparation is always consistent and contains only ingredients that are relevant to the immunotherapy.
All in all, allergy research shows much promise. Rather than giving up, people with hay fever should seek medical treatment.

The mission of the non-profit European Centre for Allergy Research Foundation (ECARF) is to provide information about allergies and promote medical research. Its goal is to sustainably improve the quality of life of people with allergies. The foundation is politically committed at the federal and state level to raising awareness about allergies and protecting the interests of those affected.

Sources

1 Economic burden of inadequate management of allergic diseases in the European Union: a GA(2) LEN review, Zuberbier T, Lötvall J, Simoens S, Subramanian SV, Church MK, Allergy. 2014 Oct;69(10):1275-9. doi: 10.1111/all.12470. Epub 2014 Aug 1
2 Walker s et al: Seasonal allergic rhinitis is associated with a detrimental effect on examination performance in United Kingdom teenagers: Case-control study. JACI 120 (2007) 381-38
3 Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen Allergy. 2008 Apr;63 Suppl 86:8-160. doi: 10.1111/j.1398-9995.2007.01620.x.