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«Patients must be referred to Allergology so that we can cure them with the vaccine»EP

ASK: Extremadura will be the region with the highest pollen concentration this year, is this usual?

ANSWER: Yes. Here we normally mark the maximum grass pollen counts in Spain, both in the springs that are more intense and those that are less intense. The normal thing is to have moderate or intense springs, due to the conditions specific to Extremadura.

P: Given these forecasts, what are the recommendations for allergy sufferers?

R: The first would be for patients with suspected allergies to be studied by specialists in Allergology. And this is important because in the allergic patient, especially in the patient who has a pollen allergy with rhinoconjunctivitis and who sometimes has asthma, it is very important to identify exactly what they are allergic to because we do not only have to focus on the treatment of the symptoms. (itchy nose, itchy eyes, runny nose, sneezing, cough, shortness of breath,…) but we have a treatment tool, which is allergy vaccines, immunotherapy, with which we are able to reverse the disease , to cure her.

P:What are those vaccines like?

R: They are specific, personalized treatments. It is precision medicine and to do this we have to know exactly what the patient is allergic to; We cannot give allergy shots in an abstract context. We vaccinate the patient based on the allergy they have, therefore it is very important that we diagnose them. We cannot say allergy to pollens, there are no vaccines for pollens, but there are vaccines for an exact profile of patients. And these patients, if they are not studied by allergists, cannot benefit from those treatments that, as I say, will not only control the disease, but will reverse it. It is not about treating the symptoms but about being able to ensure that next spring you do not have them.

P: Does anyone with symptoms have to be studied?

R: Yes, any patient who has recurrent allergy symptoms or more or less intermittent asthma and, of course, if it is persistent asthma, must be studied by the Allergology service. And it must be so because Primary Care cannot prescribe immunotherapy. If we don’t do that, we lose the most innovative treatment.

P: How should we act with the allergic child population?

R: Equal. Children are another very important population group, with them the disease can be reversed more efficiently than when a patient has had asthma for 30 years. In children the results of immunotherapy are even more spectacular. I am aware that not all the patients who should be referred are referred, but sometimes this occurs because there is a certain collapse in the referrals. Still, they must be derived, children and adults. I wouldn’t tell you to do it in the first spring that they have symptoms, but for a patient who has had persistent symptoms for three or four years, antihistamine treatment, daily corticosteroids,… because that is not going to change, next spring it will be the same

P: How do these vaccines work?

R: What immunotherapy produces, based on administrations either subcutaneously or sublingually, is a desensitization of the patient; That is, when you are exposed again to the concentration of pollens that causes symptoms, do not do so. Let’s say that the threshold at which it triggers symptoms is increased; in such a way that, as the pollen concentration will normally be below the threshold achieved with the vaccine, the patient has no symptoms or has many fewer. Symptoms can be reduced by between 50 and 70%, asthma reversal, etc. Not everyone responds equally well, but, in general terms, immunotherapy is the key to curing these patients.

P: Can anyone get vaccinated?

R: It is not about vaccinating all allergic patients because obviously vaccines have their cost and it has to be a cost-effective treatment. People who have persistent, uncontrolled symptoms or those who are developing asthma should be vaccinated.

P: How many times do you get the vaccine?

R: There are different strategies, but to focus on the most common, the usual thing is that the patient receives a dose subcutaneously every month for an estimated time, which can be between three and five years. And the same applies sublingually, treatments are usually given with regimens of five or six months and also between three and five years. This is in the case of pollens.

P: Does the vaccine change the lives of allergy sufferers?

R: Completely. Prevention measures are classic measures from an allergy point of view, such as masks, sunglasses or the recommendation not to go out on days of maximum pollen concentration; It is difficult to predict because when we look at the pollen counters what we see is what concentration of pollen there was days ago, it is retrospective, but I cannot predict what concentration of pollen there will be tomorrow. In today’s concept of life, telling a patient allergic to pollen “hey, you’re stuck in your house,” just when people want to go out after winter, reduces the quality of social life. In this regard, vaccines really do provide quality of life.

P: How do allergies behave?

R: The allergic disease has an important family and genetic conditioning. It is not a direct inheritance, but let’s say that patients are born, from a genetic point of view, with a predisposition to become allergic. And they are going to be allergic depending on the exposure they are exposed to. Our patients in Extremadura, the majority are allergic to grasses and olive trees because those are the most common pollens; If the pollens were other, they would be allergic to other pollens. That is, they are born with a genetic predisposition and become allergic to what they are exposed to on a recurring basis. In fact, there is a certain allergy pattern: patients usually become allergic to grasses, then olive, and then it can be cypress, plantain,…

2024-03-31 05:02:10
#Patients #referred #Allergology #cure #vaccine