Pathogenesis (development of disease)
Seasonal allergic rhinitis (pollinosis; hay fever) is an immediate-type allergic reaction (synonyms: Immediate-type allergy, type I allergy, type I allergy, type I immune reaction). The triggers are pollen or spores of extramural (“located in the organ wall”) fungi. The immune system overreacts to inhaled allergens – substances that trigger allergies – in the case of hay fever, it is pollen. The immune system then produces antibodies – known as IgE antibodies – which bind to mast cells and stimulate the release of histamine. Histamine is responsible for the allergic symptoms and complaints.
In addition to genetics and epigenetics, the intestinal microbiome (gut flora) certainly plays a significant role in the development of allergic rhinitis.
Perennial allergic rhinitis, compared with seasonal allergic rhinitis, involves different allergens that are present in the environment throughout the year:
- Chemicals
- House dust mites
- Wood dust
- Intramural fungi (e.g. molds).
- Flour dust
- Food
- Animal hair
Etiology (causes)
Biographical causes
- Genetic burden
- The risk of allergy is doubled if one parent suffers from allergy, and quadrupled if both parents are allergy sufferers
- The risk of allergic rhinitis was lower if parents had urticaria (aHR: 1.32) or suffered from asthma (aHR: 1.29)
- About 8% of allergic rhinitis cases can be explained by 20 risk genes.
- Birth in summer or autumn
- Firstborns are more often affected.
- Gender – male gender (+ 28%).
- Lack of lactation – children who were breastfed develop fewer allergies.
- Contact with pollen in the first months of life – people have twice the risk of developing pollen allergy if they were born just before the start of the pollen season and had intensive contact with pollen in the first months of life
- People who grew up in a rural environment have fewer allergies than people who live in the city
- Exposure to cigarette smoke in the first year of life.
Behavioral causes
- Nutrition
- Micronutrient deficiency (vital substances) – see Prevention with micronutrients.
- Repeated exposure to the triggering allergens (e.g. chlorinated water in swimming pools) Chlorinated water in swimming pools increases the risk of allergic rhinitis (hay fever) and may increase the frequency of attacks of bronchial asthma if predisposed. The reason for this is probably that chlorine compounds damage the barrier of the lung epithelium, making it easier for allergens to penetrate. Since 1980, the water in swimming pools may contain a maximum of 0.3 to 0.6 mg / l free and 0.2 mg / l combined chlorine at a pH between 6.5 and 7.6 according to DIN standards.
Causes due to disease
- Eczema in the first three years of life (aHR: 1.83).
Other causes
