Aeroallergen Explained

An aeroallergen (pronounced aer·o·al·ler·gen) is any airborne substance, such as pollen or spores, which triggers an allergic reaction.

Pollens

See main article: Rhinitis.

See also: Hay fever.

Spores

See main article: Spore. In fungi, both asexual and sexual spores or sporangiospores of many fungal species are actively dispersed by forcible ejection from their reproductive structures, which travel through the air over long distances. Many fungi thereby possess specialized mechanical and physiological mechanisms as well as spore-surface structures, such as hydrophobins, for spore ejection. These mechanisms include, for example, forcible discharge of ascospores enabled by the structure of the ascus and accumulation of osmolytes in the fluids of the ascus that lead to explosive discharge of the ascospores into the air.[1] The forcible discharge of single spores termed ballistospores involves formation of a small drop of water (Buller's drop), which upon contact with the spore leads to its projectile release with an initial acceleration of more than 10,000 g.[2] Other fungi rely on alternative mechanisms for spore release, such as external mechanical forces, exemplified by puffballs.

Foodstuffs

It is commonly thought that peanuts and other allergic foodstuffs may become airborne, thus triggering allergic reactions in susceptible individuals, especially children.[3] [4] [5]

However, one report notes:

Eosinophilic gastroenteritis

See main article: Eosinophilic gastroenteritis. Eosinophilic gastroenteritis (EG) is a rare and heterogeneous condition characterized by patchy or diffuse eosinophilic infiltration of gastrointestinal (GI) tissue, first described by Kaijser in 1937.[6] [7] Aeroallergens can cause EG.

The stomach is the organ most commonly affected, followed by the small intestine and the colon.[8] [9]

As a part of host defense mechanism, eosinophil is normally present in gastrointestinal mucosa, though finding in deeper tissue is almost always pathologic.[10] What triggers such dense infiltration in EG is not clear. It is possible that different pathogenetic mechanisms of disease is involved in several subgroups of patients. Food allergy and variable IgE response to food substances has been observed in some patients which implies role of hypersensitive response in pathogenesis. Many patients indeed have history of other atopic conditions like eczema, asthma etc.

Eosinophil recruitment into inflammatory tissue is a complex process, regulated by a number of inflammatory cytokines. In EG cytokines IL-3, IL-5 and granulocyte macrophage colony stimulating factor (GM-CSF) may be behind the recruitment and activation. They have been observed immunohistochemically in diseased intestinal wall.[11] In addition eotaxin has been shown to have an integral role in regulating the homing of eosinophils into the lamina propria of stomach and small intestine.[12] In the allergic subtype of disease, it is thought that food allergens cross the intestinal mucosa and trigger an inflammatory response that includes mast cell degranulation and recruitment of eosinophils.[13]

EG is "managed" (treated) with corticosteroids, with a 90% response rate in some studies. Various steroid sparing agents e.g. sodium cromoglycate (a stabilizer of mast cell membranes), ketotifen (an antihistamine), and montelukast (a selective, competitive leukotriene receptor antagonist) have been proposed, centering on an allergic hypothesis, with mixed results.[14] An elimination diet may be successful if a limited number of food allergies are identified.[15]

See also

Notes and References

  1. Trail F.. 2007. Fungal cannons: explosive spore discharge in the Ascomycota. FEMS Microbiology Letters. 276. 12–8. 17784861. 10.1111/j.1574-6968.2007.00900.x. 1. free.
  2. Pringle A, Patek SN, Fischer M, Stolze J, Money NP. 2005. The captured launch of a ballistospore. Mycologia. 97. 866–71. 16457355. 10.3852/mycologia.97.4.866. 4.
  3. The Michael C. Young, M.D., "Common Beliefs About Peanut Allergy: Fact or Fiction?" (reprinted with permission of the Food Allergy & Anaphylaxis Network, in Anaphylaxis Canada, September newsletter) found at allergysafecommunities.ca . (.pdf) Accessed March 19, 2009.
  4. "Passengers with the condition, which can be deadly, can try to ensure a peanut-free flight. But even the best plans sometimes don't work." See "Out of the Blue: Peanut allergies are a little-known danger." Elliott Hester, St. Petersburg Times, December 30, 2001, St. Petersburg Times. Accessed March 19, 2009.
  5. Constance Hays, "Ideas & Trends: Airborne Allergies; A New Fear of Flying: Peanuts", The New York Times, Sunday, May 10, 1998, found at NY Times archives. Accessed March 19, 2009.
  6. Kaijser R. Zur Kenntnis der allergischen Affektionen des Verdauugskanals vom Standpunkt des Chirurgen aus. Arch Klin Chir 1937; 188:36–64.
  7. Whitaker I, Gulati A, McDaid J, Bugajska-Carr U, Arends M . Eosinophilic gastroenteritis presenting as obstructive jaundice . European Journal of Gastroenterology & Hepatology . 16 . 4 . 407–9 . 2004 . 15028974 . 10.1097/00042737-200404000-00007.
  8. Naylor A . Eosinophilic gastroenteritis . Scottish Medical Journal . 35 . 6 . 163–5 . 1990 . 2077646. 10.1177/003693309003500601 . 43539786 .
  9. Jimenez-Saenz M, Villar-Rodriguez J, Torres Y, Carmona I, Salas-Herrero E, Gonzalez-Vilches J, Herrerias-Gutierrez J . Biliary tract disease: a rare manifestation of eosinophilic gastroenteritis . Dig. Dis. Sci. . 48 . 3 . 624–7 . 2003 . 12757181 . 10.1023/A:1022521707420. 23627059 .
  10. Blackshaw A, Levison D . Eosinophilic infiltrates of the gastrointestinal tract . J. Clin. Pathol. . 39 . 1 . 1–7 . 1986 . 2869055 . 10.1136/jcp.39.1.1 . 499605.
  11. Desreumaux P, Bloget F, Seguy D, Capron M, Cortot A, Colombel J, Janin A . Interleukin 3, granulocyte-macrophage colony-stimulating factor, and interleukin 5 in eosinophilic gastroenteritis . Gastroenterology . 110 . 3 . 768–74 . 1996 . 8608886 . 10.1053/gast.1996.v110.pm8608886. free .
  12. Mishra A, Hogan S, Brandt E, Rothenberg M . An etiological role for aeroallergens and eosinophils in experimental esophagitis . J. Clin. Invest. . 107 . 1 . 83–90 . 2001 . 11134183 . 10.1172/JCI10224 . 198543.
  13. Pérez-Millán A, Martín-Lorente J, López-Morante A, Yuguero L, Sáez-Royuela F . Subserosal eosinophilic gastroenteritis treated efficaciously with sodium cromoglycate . Dig. Dis. Sci. . 42 . 2 . 342–4 . 1997 . 9052516 . 10.1023/A:1018818003002. 19266537 .
  14. Barbie D, Mangi A, Lauwers G . Eosinophilic gastroenteritis associated with systemic lupus erythematosus . J. Clin. Gastroenterol. . 38 . 10 . 883–6 . 2004 . 15492606 . 10.1097/00004836-200411000-00010.
  15. Katz A, Twarog F, Zeiger R, Falchuk Z . Milk-sensitive and eosinophilic gastroenteropathy: similar clinical features with contrasting mechanisms and clinical course . J. Allergy Clin. Immunol. . 74 . 1 . 72–8 . 1984 . 6547462 . 10.1016/0091-6749(84)90090-3. free .