Something’s In The Air
Most people in Pakistan are prone to different kinds of allergies. Dr M. Anwar Waqar and Dr M. Yahya Noori explain why they occur.
Many times we wake up with itchy eyes and a runny nose — coughing, sneezing and cursing — wondering what happened overnight.
As our nose and eyes water incessantly, we search for a cure and as we do not know the cause, we are unable to find relief. At times our routine activities are disturbed by this inconvenience, rendering us useless. Still, we do not know what caused this. They are everywhere and could be anywhere. Few of us know that a runny nose, itchy eyes, and urticaria are basically signs of an allergy attack. It is a medical condition, which occurs when one comes in contact with different substances containing proteins, lipoproteins or glycoproteins and becomes sensitised to them. The body regards them as foreign and reacts whenever it comes across them. These substances are called allergens. They are capable of throwing us into a sneezing and coughing fit, while one’s eyes and nose start to water. They attach themselves to antibodies, which activate special cells called mast cells and basophils. These cells release powerful molecules such as histamine that are responsible for the symptoms of allergy, as they cause the vessels to dilate and smooth muscles to contract, resulting in the sneezing and watering of eyes and nose. They can also cause anaphylactic shock, which is a life-threatening condition characterised by severe constriction of the airways and a marked drop in the blood pressure. They may result in eczema and itch as well.
Some of us suffer from repetitive attacks of wheezing (a whistling noise coming from the chest during expiration), difficulty in breathing, tightening around the chest and dry cough. These symptoms are the hallmark of a disease called asthma and occur due to a decrease in the diameter of the airways. It is more common in children but adults are also prone to such attacks. It also occurs due to the hyper responsiveness of airways to various allergens, which cause the release of noxious substances in our body. This brings about the symptoms seen in the asthmatic individual. The symptoms may become unremitting, a state called “status asthmaticus”, which is potentially fatal.
There are a wide variety of allergens, which can be broadly classified as outdoor and indoor. The main outdoor allergens are pollens and spores from plants or fungi, which result in seasonal allergies. Indoor allergens cause perennial allergy and may be of several types such as fungal spores, cat and dog dander, fecal material from cockroaches and mites. These allergens are a source of different proteins, glycoproteins and lipoproteins, which sensitise us and create
trouble.
Most people generally don’t know much about allergies and they link allergy with the amount of dust, smoke, gases and various pollutants present in their environment. Pollutants do not cause allergy – they only cause irritation and add fuel to fire because they do not contain proteins, lipoproteins or glycoproteins to sensitise them. They make the mucous membranes of our nose, eyes and respiratory tract more responsive by causing chemical injury so the magnitude of their reaction significantly increases.
Thankfully, asthma and allergies are considered treatable to some extent. Various preventive and near-curative strategies can be employed to overcome these problems. Prevention can be achieved by the identification of proper allergens and then devising strategies to overcome their effect. In case of pollen, western countries have an allergen calendar, which help them warn people for the upcoming pollen season, and helps in forecasting upcoming allergens. This enables people to take preventive measures. Unfortunately, we do not have such a database, which can help us in forecasting and predicting the pollinating seasons of allergenic plants in our country. We don’t even know the proper distribution of these plants along with the role of fungi and other indoor allergens. A great deal of work needs to be done in this field, which would save time and money. Since we do not have any concrete information about allergies in Pakistan, not much is done to prevent them from occurring.
Previously, there was outrage regarding the paper mulberry pollen allergy in the federal capital. According to sources, the Capital Development Authority (CDA) imposed a ban on planting paper mulberry trees in Islamabad and planned to replace it with pine trees. To deal with the problem, thousands of trees have been brutally chopped off and uprooted but there has been no report of a decrease in the incidence of allergy in the federal capital since then. Besides there is no scientific basis for singling out paper mulberry as the only culprit, as there might be other factors involved in the sensitising the people of the federal capital. It might be fungal spores, cockroach faeces, dust mites or the pollen of other trees, weeds or grasses.
Unfortunately, to this day, there is no cure for allergies and asthma, but we can only deal with them by prevention or treating them symptomatically. However, latest scientific research is showing promising results, as scientists are working on the development of vaccines, which would be able to desensitise patients against allergens after the identification of offending agents. Newer strategies are slowly moving from labs to clinics and, hopefully, we will be able to use them in the near future.
In this regard, a database of aerobiological agents present in Pakistan is being development at a research centre in the country. Data is being collected in Karachi and Islamabad by gathering pollen and spore samples. Epidemiological studies are also being carried out to find out the pattern of symptoms in the general population. This database will be used to find out the actual culprits in the causation of asthma and allergies and preparation of local allergy calendar for the masses. The allergy calendar can be used to forecast allergens and warn the sensitised individuals to take precautionary measures and prevent themselves from illness and loss of working and school-hours. However, this is just initiative. More scientific and research centres need to come together and gather data on the subject in order to warn people about both recurring and future allergies.
Dr M. Anwar Waqar is a senior professor and Dr M. Yahya Noori is a PhD scholar.
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