"This year the impact of environmental allergies is being explosive. And it can still go further"

Now 30% of the world population suffers from some type of allergy, in 25 years it will be 50%. Why have allergy cases skyrocketed in recent years? Paula Ribó, an allergist at the Hospital Clínic in Barcelona, explains that “there is not a single cause. It is a combination of many factors, each with a specific weight”.

The theory of hygiene, a diet far from natural products and epigenetics are the pillars behind this brutal increase in those affected in recent years.

To these factors we must add that the passage of man on the planet is altering the seasonality of pollens, which results in “explosive springs like the one we are experiencing now. And what remains”, warns the allergist. This is due to the fact that this year the pollination of the Cupressaceae (cypresses and arizónicas, for example) have been late and in the month of March “they have overlapped with those of the shade plantain. We are now seeing high levels of grasses in May.”.

What are the most common allergy symptoms?

For those who suffer from rhinitis, asthma and conjunctivitis derived from exposure to pollens, grasses…. there is only one solution: avoid them. But in big cities it is almost impossible for a person with a high degree of sensitization to the pollen of the plane tree to avoid the effects of its pollination..

“Now that we are in the elections, it would be good if the decision was made to avoid planting these types of trees in the cities. I think that with the help of biologists and experts in the field, other cheap and fast-growing species could be chosen that would not have as much impact on the population.”.

In our country, most patients are polysensitive.. “In many people the allergy to various pollens, grasses, cupresaceae, mites…. And that's why they can have episodes throughout the year”. With this, Ribó puts on the table one of the legends of allergies: there is only in spring. “This is a mistake”. And he points out that “respiratory allergies are seasonal, but you have mites all year round, dog hair too, food allergies…”.

Eight out of 10 children have allergic asthma

She is also the author of Allergy, the new epidemic (Alienta Editorial), a practical manual that sees the light today, warning about the trivialization of allergies. Asthma in Spain affects around 5% of adults and 10% of children, being a fairly common disease.

In general, it is shown from childhood and does not pose a serious risk to health. “Eight out of ten children have an allergic origin in asthma and we are not aware of what this means in quality of life, even more so if it is not controlled”.

In the pages of the book, patients can find a practical guide to each of the manifestations that our immune system performs every time it responds in an exaggerated way to one of the stimuli: pollens, mites, food….

“I have tried to collect recommendations so that patients, whatever type of allergy they have, can live with it in the best possible way,” insists Ribó. Because, “there are many myths surrounding allergies: it cannot be cured, but it can be controlled and 'kept' at bay with vaccines”.

How is allergy controlled with vaccines?

Ribó explains that, with a good diagnostic study, “in the manner of Sherlock Holmes” it is possible to design a vaccination regimen that manages to control responses to allergies for at least 10 or 15 years.. “Clinical tests must be carried out and, in addition to them, ask, inquire into the life that the patient leads to find out what his daily exposure to the allergen is like”.

The current ones based on immunotherapy are administered for three or five years. “The normal thing is that it does not reach four”. The results are seen “almost immediately in those who are allergic to dust mites” and “we will have to wait until the first spring for the rest”.

For this reason, Ribó insists on the detective work that allergists must do, since “it is key to know the patient's allergy well in order to design well what the vaccine has to work against”. And he gives an example: “In Catalonia there are no olive trees and one tests positive for the olive tree. You do not deserve to be vaccinated if there is not going to be an exposure to the allergen”.

Depending on each person, the effects of the response of our defenses to allergies can range from years to a lifetime.. “It could be revaccinated after a while, recalibrating the patient's situation. We do not always suffer from allergies in the same way. Sometimes, over time, the response of our immune system changes.”.

What can be taken against allergies?

Another of the myths that Ribó seeks to demolish is how we deal with allergies. “The solution is not to take antihistamines. You have to see all the options”. He advocates finding a therapeutic solution that does not always come hand in hand with these drugs. Thus, in the chapter of the book, he breaks down how to avoid and deal with allergic rhinitis and conjunctivitis.

In this field, she is very critical of the approach that is taken on some occasions, “we cannot use drugs that make you sleepy, because it is an unwanted side effect that today can be avoided. Many allergists are comfortable prescribing old molecules, but today there are very advanced ones that have a good impact”.

Individualization. The author of Allergy, the new epidemic gives other medical areas as examples in which not all patients are treated with the same. “In Oncology, you don't give the same 'chemo' to everyone. Against pain, not everyone has the same effect with ibuprofen. You have to study the patient well and give him what he really needs”.

Prescribe useful information and applications

The Ribó manual is a compendium in which a patient can find training to live with allergies, whatever the type, and a reference manual for the population. “It will always be better than going to Dr. Google and finding unsubstantiated barbarism,” he stresses.

“We must also prescribe applications where patients can consult without fear.” And here, he launches one for ‘spring’ allergy sufferers, “in addition to the fact that there are already ‘parts’ of the pollen situation, ‘Pollen control’ is very good. It serves to see the concentration in the environment and to record the symptoms experienced by the person. All together it gives us allergists information about the patient.”