My Favorite Allergen

I spent most of my life breathing easy and smelling the roses, then I moved to the state of Georgia. I acquired a feline roommate for the first time and spent lots of time outside inhaling the Georgia pollen. I then spent most of my days with swollen sinuses, congestion, skin rashes, itchy eyes and joking that I was allergic to the state of Georgia. It wasn’t until I suffered, definitely not in silence, for two years that my doctor decided I needed to get allergy tested. But what could I be allergic to? The cat, the pollen, the plants, the entire state of Georgia? Let me take you on a journey of figuring out what makes me sneeze.

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Image: My favorite allergen, Lexi. Photo Credit: Ben Farnham.

Let’s start with the big question, what are allergies? Allergies occur when your immune system reacts to a benign substance, termed an allergen. This allergen could be pollen, food, bee venom or many other things that your immune system identifies as a harmful substance. When your body perceives something as a threat it produces antibodies. These antibodies act like an alarm system. Whenever your body encounters the allergen, antibodies sound an alarm that kicks the immune system in to action. The immune response causes symptoms such as inflammation of the skin, sinuses, airways or digestive system. However, my body does not need to go in to battle mode when I encounter something like cat hair (even if I believe my cat might be plotting to kill me at times). Which is what an allergy is, an overreaction to a non-harmful substance.

To find out what was causing the constant sneezing and lack of easy breathing, I headed to a local allergist for an allergy test. An allergy test measures your body’s reaction to specific allergens by exposing your body to that allergen. There are two types of allergy tests, a scratch test and an injection test. I was one of the lucky individuals that got to endure both tests! To start, a scratch test was done that involved pricking the surface of my skin with a suspected allergen. The scratch test involved around 30-40 different allergens, ranging from pets and trees to weeds and dust mites, being pricked all over my arm simultaneously. After waiting 15 minutes, a few of the allergens appeared to have produced some redness and swelling, but not a drastic response. This lead to the decision to do an injection test.

An injection test is exactly what it sounds like, a small amount of the suspected allergen is injected into the skin of the arm instead of just being pricked. By injecting the allergen under the skin the body is more likely to react to the allergen when compared to a scratch test. The 10 allergens that showed some reaction on the scratch test were used for the injection test to confirm the reaction. As an individual who hates needles I was ready to run out the door at the thought of ten needles, but after a pep talk from the nurse I survived. The results were in: cats, dogs, trees, weeds, grass, and dust mites were all strong contenders for things that are making me sneeze. Now that the culprits were identified the question was how to treat my allergies.

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Image: a) and b) are the layout for a scratch test and c) is the layout of my injection test. Image Credit: Caitlin Reeves.

Since the cat was originally my husband’s, and I’m not going  to get rid of her (or him), I could not simply avoid all the allergens around me. I needed to control my allergies so a regiment of immunotherapy and medication was suggested. The medication was straight forward, over the counter allergy medication like Zyrtec or Claritin and nasal spray to help reduce sinus inflammation every day. But what would immunotherapy entail?

There are two types of immunotherapy: allergy shots and allergy tablets.  Both  involve introducing a small amount of the allergen to the body at increasing doses over a period of time. The idea is that you train your immune system to stop responding to the allergen as a threat. Allergy tablets, treat certain allergies orally and without the use of shots. However, the use of tablets has only been approved by the Food and Drug Administration for ragweed, grass pollen and dust mites. Allergy shots, change the immune system and make it possible to prevent the development of new allergies while treating current ones. They work similar to a vaccine, as you introduce your body to the allergen your body becomes “immune” to it. Allergy shots consist of two phases, the build-up phase and maintenance phase. During the build-up phase the allergen amount is increased at varying intervals. When you reach the maintenance phase you continue to receive the same amount of allergen and continue shots for three to five years. For many the decision between tablets and shots comes down to your specific allergies and the severity of the allergies, time available for treatment, and cost.

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Image: Vials containing the solution for my allergy shots.  Image Credit: Caitlin Reeves.

Much to my horror my doctor suggested that I take shots over tablets. Just what I wanted, more needles. For multiple weeks, I received 3 shots twice a week, then once a week, and now I go every other week for my maintenance dose. I dread walking in to the allergist, receiving those 3 not-so-enjoyable shots, but now I feel the relief of no longer having day to day symptoms.  As many as 30% of adults and 40% of children in America suffer from allergies. But Immunotherapy can lead to a 70% reduction in allergy symptoms, reduced need for medication, reduced risk for new allergy development, improved quality of life and long lasting symptom improvement in 85% of patients even after treatment is stopped. Despite my hatred of needles, I’d say a few shots are worth the treatment of my allergies. Immunotherapy has helped me and millions of other people who deal with allergies throughout their lives. Now I can spend my days snuggling with my cat, on the rare occasion she lets me snuggle, without sneezing or breaking out in to a rash.

About the Author

10659344_10200100310786746_7394532827731756991_nA native Virginian (GO HOKIES!), Caitlin Reeves is a PhD candidate in the Microbiology department studying attachment of the human respiratory pathogen Mycoplasma pneumoniae to its human host. Outside of the lab she can be found planning events for UGA’s Women in Science (WiSci) organization, snuggling with her labradoodle Sherlock, or playing video games despite being a 26 year old “adult”.