Allergy and Inflammation

If you’re among the susceptible, the first whack in the face by a giant pollen ball is enough to set you back.  You get the runny nose, the watery eyes, the headaches and all the accessories.  If they were temporary symptoms, you wouldn’t pay much attention.  A handful of tissues and a couple of antihistamines, and you’re on your way.  Few of us understand, though, that seasonal allergies incite an inflammatory response, which is a protective attempt by the body to remove the enemy and clean up the place where it was.  Inflammation is not infection, but may be caused by it.  It’s considered part of the innate immune system, which activates as a function of your natural biological makeup.

Allergic disorders, which include hay fever, eczema and asthma, afflict almost a quarter of the population in the developed world (Holgate, 1999) (Galli, 2008).  Persistent exposure to allergens, basically innocuous substances in the environment, results in chronic allergic inflammation.  This can cause the affected organ(s) to go through substantial changes in function.  In fact, some people can develop a potentially fatal systemic reaction, called anaphylaxis, within seconds of exposure to an allergen (Simons, 2011).  Certain foods, as well as other non-infectious substances, may be involved.  In allergic responses, allergen-specific immunoglobulin E (IgE) and T helper cells (Th2) are switched on.

An acute response to an allergen that happens after a single exposure is called an early-phase reaction, or a Type-1 immediate hypersensitivity reaction.  Histamine is released here during mast cell degranulation. These molecules hook up with IgE and eventually cause itching, mucus production, swelling of blood vessels (vasodilation), edema and the airway constriction seen in allergic asthma (Hansen, 2004)  (Katelaris, 2003).  Chronic inflammation may be characterized by a continuum of tissue destruction and healing that may lead to loss of function, but this is not often seen with seasonal allergies, called allergic rhinitis. Allergic rhinitis is linked to decreased learning, poor performance at work and school, and of course, reduced quality of life.  The course of action taken by a doctor offers several pharmacologic options (Sadeq, 2004), many of which are shunned by patients in favor of natural alternatives.  Allergen-specific immunotherapy is designed to suppress the mechanism that responds to allergen attack.  This entails the use of chemical agents to regulate body function (Fujita, 2012), and this engenders a jaundiced eye among the holistic crowd.

Within the domain of complementary and alternative medicine is a plant whose use predates medieval times—stinging nettle, scientifically known as Urtica dioica.   For hundreds of years it’s been used to treat gout, painful joints, arthritis, eczema and anemia.  In modern times, nettle has been used to treat urinary problems during the early stages of benign prostate hyperplasia, and to treat urinary infections and hay fever.  It’s also been used in compresses to address joint pains, sprains and strains, tendinitis and insect bites.  Freeze-dried preparations were matched against placebo in a double-blinded randomized allergic rhinitis study performed at the National College of Naturopathic Medicine, and were found to be more effective than placebo at relieving symptoms (Mittman, 1990).  Cytokines are regulatory proteins that are released by cells of the immune system, where they act as mediators in the generation of an immune response, and may be assayed by the measurement of Th1 and Th2 cells, as well as by other markers of immune activation.  Extracts of stinging nettle, registered in Germany for therapy of rheumatic disease, were found to inhibit the inflammatory cascade identified by these artifacts (Klingelhoefer, 1999).

Quercetin is a bioflavonoid derived from red wine, citrus, onions, parsley, apples and tea, demonstrating several noble qualities, anti-inflammation and anti-oxidation among them.  The anti-inflammatory property arises from its inhibition of the production and activity of leukotrienes and pro-inflammatory prostaglandins, and inhibition of histamine release by basophils and mast cells.  Additionally, quercitin represses expression of the COX2 enzyme that is responsible for the manufacture of pro-inflammatory substances, and it stems the interleukins that characterize inflammation (Nieman, 2007).  Studies at Northwestern University agree that quercitin has its place as a primary therapy or as an adjunct in the treatment of allergic rhinitis (Thornhill, 2000).  Ocular symptoms of allergy are uncomfortable and often more bothersome than nasal symptoms.  Japanese scientists found that quercitin, in a double-blind placebo-controlled study, was substantially more effective than placebo at ameliorating the ocular symptoms that can plague sufferers of allergic rhinitis.  Ocular scores that rated tearing, itching and ocular congestion were low, while nasal scores differed little from the control group (Hirano, 2009).

Complementary medicine is not without allies in the allopathic medical community, especially when a supplement has proven efficacy against a traditional modality.  In the conventional medical sector, where raised eyebrows are the norm after the mention of complementary approaches, bromelain, the proteolytic enzyme from pineapple that digests proteins and tenderizes meat, has found favor in the treatment of otolaryngology disorders that include allergic rhinitis.  In a multicenter trial composed of 116 children, bromelain monotherapy (used by itself) effected faster recovery from sinusitis compared with standard therapy (Karkos, 2007).  As adjunctive to traditional therapy, bromelain exhibited supportive strength against acute rhinosinusitis (Guo, 2006).  Although marketed as a digestive aid, bromelain appears to have systemic anti-inflammatory activity (Hale, 2005) (Kumakura, 1988) (Onken, 2008).

In recent announcements, oral vitamin D added to regular intranasal corticosteroid dosing improves symptoms beyond that seen with corticosteroids alone, leading researchers to conclude that vitamin D affords benefit to patients with allergies (Baroody, 2012).  Treating inflammation may be nearer at hand than previously thought, and that just might eliminate, or at least reduce, the misery of seasonal allergy.

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