Autumn in New York might be a great song, but that’s about as far as it goes for allergy sufferers. In a city made from concrete and glass, you’d think it was easy to escape an attack by natural allergens, like pollen and mold. Ragweed is the chief culprit that arouses immune cells to churn out antibodies to its pollen. The subsequent biochemical reactions flood the bloodstream with histamine, the chemical that gives rise to the familiar allergy symptoms. One ragweed plant can produce a billion grains of pollen in a season, and the grains are so light that they can travel hundreds of miles on the gentlest waft of air. That is why a city made of concrete and glass is not immune to a covert pollen attack. To make matters worse, you can’t just move to the mountains. The ragweed will follow you.
What used to be an allergy season running from mid-August to September is now on the calendar from the first of August to the middle of October. Rising temperatures and elevated carbon dioxide levels extend the season. Trees, grasses and molds are not dismissed as causes of seasonal misery. Damp leaves harbor molds that are kicked up when hit by the rake. In school, kids are assaulted by dust mites that have waited all summer for company.
It’s generally accepted that allergies are triggered by a protein. When a cruising lymphocyte identifies a threat it launches a countermeasure against it. In this complicated biochemical process antibodies are made. The particular antibody for allergic reactions is called immunoglobin E, or IgE, which attaches itself to mast cells and basophils, the cells that activate and release histamine. Histamine opens the flood gates of response, and blood vessels dilate, causing blood pressure to drop. The spaces surrounding cells fill with fluid and the symptoms begin—itching, hives, sneezing, wheezing, and more. In severe cases, anaphylactic shock may occur, a reaction that can be fatal if not handled immediately. The Epi-Pen addresses anaphylaxis. It contains epinephrine, a natural hormone that counteracts dangerous physiological changes that appear during allergic response.
Conventional treatments for allergies include steroid nasal sprays, antihistamines, decongestants, eye drops and shots. They’re used before, during and after symptoms occur. Rhinitis, characterized by irritated mucous membranes of the nose, is a common sign of seasonal allergy that responds to alternative measures, notably to butterbur. Butterbur rhizome extracts that are free of pyrrolizidine alkaloid hepatotoxic constituents have been found safe to use for up to four months (Schapowal, 2005), though many people use them longer. Pyrrolizidine alkaloids are produced by plants to protect them against insect herbivores, but are a danger to the liver, occluding small blood vessels and causing the organ to swell. Petasin, the active ingredient in butterbur, is an anti-inflammatory compound with relaxant properties (Ko, 2001), able also to inhibit histamine and leukotrienes, the latter being white blood cell components responsible for allergic and inflammatory reactions (Thomet, 2002).
Cetirizine is Zyrtec, the antihistamine that addresses the symptoms of allergic rhinitis. A quickened heartbeat, weakness or tremors, problems with urination, insomnia and dizziness are among its side effects. Butterbur, on the other hand, is generally well tolerated, although belching may occur, and those who are sensitive to some plant compounds may experience itching and mild rash. The fatigue and drowsiness common to cetirizine are absent. In a randomized study conducted in Switzerland, seasonal rhinitis patients receiving butterbur fared as well as those receiving cetirizine, without any of the sedative effects (Schapowal, 2002).
Nasal irrigation is the practice of using a fluid-filled vessel to flush excess mucus and debris from the nose and sinuses. Advocates insist that it promotes nasal and sinus health. The saline solution that is commonly employed may act as an antibacterial agent, as well. Being inexpensive and simple, the practice has gained considerable acceptance among Canadian and American medical practitioners, who agree that it could reduce reliance on antibiotics (Papsin, 2003) and antihistamines (Garavello, 2003). If it relieves symptoms, it’s a welcome ritual.
There is a plant chemical that acts simultaneously as a bronchodilator and an inhibitor of histamine and other allergic or pro-inflammatory chemicals in the body—quercetin, a compound common to apples, onions, dill, Hungarian peppers, capers and radishes. How’s that for diversity? Quercetin is a flavonoid, one of several substances known years ago as vitamin P, a designation that has fallen from favor. Flavonoids are noted for the coloration of many flowers designed to attract pollinators. In the higher plants, they act as chemical messengers, cell cycle inhibitors and directors of the total physiological machinery. Good for us is that these properties translate to humans, although they are slow to be recognized by the FDA and its European counterparts, primarily because absorption is an issue and clinical studies are few.
Where funding was available, outside the realm of pharmaceutical giants, quercetin and its comrades were found to demonstrate several pharmacological effects, including anti-viral, anti-microbial, anti-inflammatory and anti-allergic potential. These properties demonstrate a capability to down-regulate and to suppress certain of the many inflammatory pathways, including those involved in allergic inflammation and basophil enlistment (Chirumbolo, 2010). Of the flavonoids, quercetin is the most abundant, but has received the most attention because its effects on basophils are seen at billionth of mole concentrations, where studies in Italy learned that quercetin was able to sequester histamine release in activated cells (Chirumbolo, Marzotto, et al, 2010). Using mast cells sensitized with IgE, Japanese scientists learned that flavonoid varieties akin to quercetin display similar activity by inhibition of the calcium influx that signals the release of histamine and pro-inflammatory mediators (Kimata, 2000) (Kawai, 2007).
A regimen consisting of herbal interventions and dietary flavonoids (there are many to pick from) presents a complementary / alternative approach to the management of allergic misery with considerable effectiveness. Maybe it’s worth a try and you’ll save money on tissues.
Balabolkin II, Gordeeva GF, Fuseva ED, Dzhunelov AB, Kalugina OL, Khamidova MM. Use of vitamins in allergic illnesses in children. Vopr Med Khim. 1992 Sep-Oct;38(5):36-40.
Chirumbolo S. The role of quercetin, flavonols and flavones in modulating inflammatory cell function. Inflamm Allergy Drug Targets. 2010 Sep;9(4):263-85.
Chirumbolo S, Marzotto M, Conforti A, Vella A, Ortolani R, Bellavite P. Bimodal action of the flavonoid quercetin on basophil function: an investigation of the putative biochemical targets. Clin Mol Allergy. 2010 Sep 17;8:13.
Garavello W, Romagnoli M, Sordo L, Gaini RM, Di Berardino C, Angrisano A. Hypersaline nasal irrigation in children with symptomatic seasonal allergic rhinitis: a randomized study. Pediatr Allergy Immunol. 2003 Apr;14(2):140-3.
Hirano T, Kawai M, Arimitsu J, Ogawa M, Kuwahara Y, Hagihara K, Shima Y, Narazaki M, et al Preventative effect of a flavonoid, enzymatically modified isoquercitrin on ocular symptoms of Japanese cedar pollinosis. Allergol Int. 2009 Sep;58(3):373-82.
Kawai M, Hirano T, Higa S, Arimitsu J, Maruta M, Kuwahara Y, Ohkawara T, Hagihara K, Yamadori T, Shima Y, Ogata A, Kawase I, Tanaka T. Flavonoids and related compounds as anti-allergic substances. Allergol Int. 2007 Jun;56(2):113-23.
Kimata M, Shichijo M, Miura T, Serizawa I, Inagaki N, Nagai H. Effects of luteolin, quercetin and baicalein on immunoglobulin E-mediated mediator release from human cultured mast cells. Clin Exp Allergy. 2000 Apr;30(4):501-8.
Ko WC, Lei CB, Lin YL, Chen CF. Mechanisms of relaxant action of S-petasin and S-isopetasin, sesquiterpenes of Petasites formosanus, in isolated guinea pig trachea. Planta Med. 2001 Apr;67(3):224-9.
Mainardi T, Kapoor S, Bielory L. Complementary and alternative medicine: herbs, phytochemicals and vitamins and their immunologic effects. J Allergy Clin Immunol. 2009 Feb;123(2):283-94; quiz 295-6.
Middleton E Jr, Drzewiecki G. Flavonoid inhibition of human basophil histamine release stimulated by various agents. Biochem Pharmacol. 1984 Nov 1;33(21):3333-8.
Papsin B, McTavish A. Saline nasal irrigation: Its role as an adjunct treatment. Can Fam Physician. 2003 Feb;49:168-73.
Schapowal A; Petasites Study Group. Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis. BMJ. 2002 Jan 19;324(7330):144-6.
Schapowal A; Study Group. Treating intermittent allergic rhinitis: a prospective, randomized, placebo and antihistamine-controlled study of Butterbur extract Ze 339. Phytother Res. 2005 Jun;19(6):530-7.
Thomet OA, Schapowal A, Heinisch IV, Wiesmann UN, Simon HU. Anti-inflammatory activity of an extract of Petasites hybridus in allergic rhinitis. Int Immunopharmacol. 2002 Jun;2(7):997-1006.
*These statements have not been evaluated by the FDA. These products are not intended to treat, diagnose, cure, or prevent any disease.
September 02, 2014