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Pet allergen control measures for allergic asthma in children and adults

Some people with asthma who own pets can be allergic to the dander that accumulates in and around the home. Certain guidelines recommend the removal of pets as the most effective way of reducing exposure to the allergens emanating from their hair and skin. Other measures have been proposed as an alternative to pet removal, such as pet washing, sprays and air filtration units. The aim of these interventions is to lower the amount of allergen in the air and on the floor of the home, and so limit the risk of asthma symptoms worsening. Very little research of a high quality has been published on this topic, and the current evidence is not sufficiently reliable to draw firm conclusions. Further research should consider the effectiveness of pet washing, sprays and possibly pet removal from the home.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Allergen immunotherapy for the treatment of chronic asthma

Injecting allergens under the skin (allergen specific immunotherapy) can reduce asthma and use of medication and improve the sensitivity of the lungs, but with a risk of severe reactions. Asthma attacks can be caused by allergies, pollens, cigarette smoke or air pollution and can be fatal. An allergen is a substance that causes an allergic reaction in a person sensitive to it. Allergen specific immunotherapy involves having injections of increasing amounts of the allergen under the skin. It is also called hyposensitisation or desensitisation, and there is a risk of severe allergic reactions. The review of trials found that immunotherapy can reduce asthma symptoms, the need for medications and the risk of severe asthma attacks after future exposure to the allergen. It is possibly as effective as inhaled steroids. However, there is an increased risk of a lump at the injection site, rash, wheezing, breathlessness and very rarely a fatal allergic reaction.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Immunotherapy by allergen injections for seasonal allergic rhinitis ('hay fever')

Seasonal allergic rhinitis ('hay fever') is a global health problem and its prevalence has increased considerably in the last two decades. Treatment includes allergen avoidance, drugs such as antihistamine tablets and nasal sprays, and immunotherapy (vaccination). For those patients whose symptoms remain uncontrolled despite drug treatment, specific allergen immunotherapy (SIT) is advised.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Mono and multifaceted allergen reducing interventions for the primary prevention of asthma in children at high risk of developing asthma

It is possible that early exposure to allergens (substances which cause allergy) may lead to development of asthma in high risk children. This review asks whether the risk of developing asthma, which is a disease caused by many factors, can be decreased by reducing single allergen levels in children with genetic susceptibility, or whether the reduction of more than one type of allergen exposure simultaneously will lead to a better outcome. As a direct comparison could not be made using current research we made indirect comparisons using trials that had compared single or multiple interventions with a control. In children who are at risk of developing childhood asthma 'multifaceted' interventions, which involve both dietary allergen reduction and environmental change to reduce exposure to inhaled allergens, reduce the odds of a doctor diagnosing asthma later in childhood by half. However, the effect of these multifaceted interventions on wheeze reported by parents was inconsistent and there was no beneficial effect on night‐time coughing or breathlessness. Single ('monofaceted') interventions were not significantly more effective than controls in the reduction of all outcomes, but there remains uncertainty as to whether multiple interventions are more effective than single component interventions.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Hay fever and dust mite allergies: Allergen-specific immunotherapy (desensitization)

People who have hay fever or a dust mite allergy sneeze a lot, and have a runny or stuffy nose. Many of those who have very severe and bothersome symptoms try out allergen-specific immunotherapy (desensitization). This treatment aims to make the immune system “get used to” the substances triggering the allergy, so that it no longer reacts as strongly to them.The goal of allergen-specific immunotherapy is to reduce allergy symptoms in the medium to long term. It has to be repeated regularly and takes quite a long time to start working. This treatment is also known as desensitization. It aims to do exactly that: make the immune system less sensitive. In people who are allergic to something, their body is oversensitive or hypersensitive to an allergen (the substance that causes their allergic reaction). Their body produces antibodies to fight the allergen, even though the allergen is harmless. These antibodies are part of a chain reaction that leads to allergy symptoms. In allergen-specific immunotherapy, people are given allergen extracts to try to train their body to react differently: It’s a bit like being “vaccinated” against your own allergy.Allergen-specific immunotherapy (SIT) can't be used for every allergy. It is called "specific" because the allergen extract has to be tailored to the individual person's allergic response. There are still no suitable SIT extracts for some substances that cause allergies. But there are extracts for many of the common allergens found in the air, for mold, for animal allergens, and for some toxic substances (like the poison in bee stings).

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: March 23, 2017

Allergen-specific immunotherapy in asthma

In a lot of people, asthma is closely linked to an allergy. Their asthma attacks are mainly triggered by allergy-causing substances such as pollen, dust mites or animal fur. Allergen-specific immunotherapy might be considered as a treatment for this kind of asthma.The aim of this treatment is to prevent asthma attacks by making the body less sensitive to the allergy-causing substances. It is also known as desensitization or hyposensitization.In allergen-specific immunotherapy (SIT), people are repeatedly given small amounts of the substances that they are allergic to. This is meant to gradually make them less oversensitive to the substances. Allergen-specific immunotherapy is only possible if extracts of the allergen (the substance that triggers the allergy) are available for the treatment. This is currently the case for things like animal hair, dust mites, pollen, mold and the poison in insect stings.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: February 26, 2014

What kinds of allergy tests are there?

Various tests can be used to find out what kind of substance is causing an allergic reaction: skin tests, blood tests and challenge tests. Your doctor will usually decide which test to use based on your description of the symptoms and your medical history.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: April 20, 2016

Sublingual immunotherapy for allergic rhinitis (including hay fever)

Allergic rhinitis is characterised by red, itchy eyes, a blocked and runny nose, and sneezing. The most common causes of allergic rhinitis are different pollens (grass and tree), house dust mites, mould and animal dander. Allergic rhinitis can be intermittent (such as hay fever) or persistent (all year round). The treatment of allergic rhinitis depends on its severity and duration, and is usually based on the use of antihistamines and nasal corticosteroids. If these drugs cannot control symptoms immunotherapy is recommended. Immunotherapy involves the administration of gradually increasing doses of the allergen over a period of time to desensitise the patient. It is the only known treatment that modifies the immune response and treats the cause rather than the symptoms.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Maternal dietary antigen avoidance during pregnancy or lactation, or both, for preventing or treating atopic disease in the child

Evidence is inadequate to advise women to avoid specific foods during pregnancy or breastfeeding to protect their children from allergic diseases like eczema and asthma.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Specific allergy immunotherapy for the treatment of atopic eczema

At least one in seven children and one in 50 adults suffer from atopic eczema, a skin condition characterised by an itchy red rash. People with atopic eczema are allergic to things in the environment, such as house dust mites, and exposure to what they are allergic to may make their eczema worse. Specific allergen immunotherapy is a treatment that involves a course of injections or drops under the tongue containing the substance to which a person is allergic. The treatment can reduce the severity of a person's allergy and may therefore be able to reduce symptoms of atopic eczema. We evaluated whether specific allergen immunotherapy was better or worse than a standard treatment or placebo at improving disease severity and symptoms as assessed by participants, parents, or investigators.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Does controlling exposure to house dust mites improve asthma?

Asthma is a chronic inflammatory disease of the airways. The prevalence of asthma has increased and it is now the commonest chronic disease among children. Asthma is triggered by allergens (substances that cause an allergic reaction) and house dust presents a problem in some people with asthma. The major allergen in house dust comes from mites and it is hypothesised that controlling exposure to house dust mites will reduce asthma symptoms in people who are sensitive to house dust mites.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Sublingual immunotherapy (tablets, spray or drops under the tongue) to treat inflammation of the conjunctiva due to allergy

Conjunctivitis means inflammation of the conjunctiva. The conjunctiva is the thin 'skin' that covers the white part of the eyes and the inside of the eyelids. Allergic conjunctivitis is the inflammation of the conjunctiva due to allergy. The most common cause is an allergy to pollen during the hay fever season. Symptoms include red eyes, itching, increased tearing and swelling of the conjunctiva and eyelids. If allergic conjunctivitis is combined with nasal allergy, the condition is termed allergic rhinoconjunctivitis. When medications do not provide enough relief another option is immunotherapy, which builds immunity to the allergen causing the reaction. Immunotherapy can be given under the tongue, nasally or by injection. This review included 42 trials with a total of 3958 participants with allergic conjunctivitis; 2011 who had sublingual immunotherapy and 1947 who had placebo. This review found that sublingual immunotherapy (that is, administered under the tongue) can reduce symptoms of allergic conjunctivitis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Immunotherapy for preventing allergic reactions to insect stings

At least 1 in 200 people have suffered a severe allergic reaction to a sting from a bee, wasp, or ant, and insect stings are the second most common cause of fatal allergic reactions in some countries. Treatment with insect venom, usually given by a course of injections (called venom immunotherapy), is thought to reduce the risk of allergic reactions to an insect sting. In this review, we evaluated the effectiveness of venom immunotherapy for preventing allergic reactions to insect stings.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Pregnancy and birth: Asthma in pregnancy

Many pregnant women who have asthma worry that their medication might harm their child. But most asthma medications are considered to be safe in pregnancy too. Untreated asthma, on the other hand, can have serious consequences.It is estimated that about 1 out of 5 pregnant women with asthma need treatment for asthma attacks. But good asthma control, particularly with the regular use of inhaled corticosteroids, can prevent these attacks. And there are a number of things you can do to avoid possible triggers of asthma attacks.In many women who have asthma, being pregnant does not affect their symptoms. Their symptoms sometimes even get better at first. But the physical changes that happen during pregnancy make asthma worse in 1 out of 3 women. Towards the end of pregnancy it often becomes increasingly difficult to stay physically active. Carrying the extra weight around can even make women who do not have asthma feel out of breath. Many cannot sleep properly, and feel tired and exhausted.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: February 26, 2014

Oral immunotherapy for the treatment of peanut allergy

Allergy to peanut can result in potentially life‐threatening reactions and, on occasions, death. Unlike many other forms of food allergy, allergy to peanut is typically life‐long. There is currently no cure for peanut allergy and people with this allergy must constantly be careful to avoid accidentally eating peanut or peanut‐containing foods.  If a person with a peanut allergy accidentally ingests peanut, he or she may develop serious allergic reactions necessitating emergency treatment with epinephrine (adrenaline).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Hay fever and dust mite allergies: Overview

If you have hay fever or a dust mite allergy, you’re not alone: These conditions affect about one in four people. Various medications and allergen-specific immunotherapy often provide effective relief from the symptoms of hay fever or dust mite allergies. But there are also other ways to prevent or relieve these allergies.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: March 23, 2017

Hay fever and dust mite allergies: Allergic rhinitis: Non-drug interventions

Various medications and allergen-specific immunotherapy often provide effective relief from the symptoms of hay fever or dust mite allergies. But there are also other ways to prevent or relieve the symptoms.The most effective way to prevent the symptoms is by avoiding exposure to allergens (allergy triggers) in the first place. Whereas some allergens can be avoided, others are very difficult or impossible to avoid. Trying to prevent contact with allergens, such as dust mites in your home, is not always worth the amount of effort involved.If the allergy symptoms are mild, saline (salt water) solutions might also help relieve symptoms in your nose.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: March 23, 2017

Shopping tips for people with lactose intolerance

People who are sensitive to lactose need to read the labels on food packaging very carefully.Here you can find out what to watch for when you shop and how much lactose different foods have in them.All packaged foods have a label on them with information such as:Best before dateAll ingredientsIngredients that commonly trigger allergies or food intolerancesNutritional content and calories

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: June 17, 2015

Eczema: Overview

Eczema is an inflammatory skin condition that often occurs in children. The main symptom is a very itchy rash. Acute flare-ups can greatly affect quality of life, but eczema often gets better over time or even clears up completely.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: February 23, 2017

Asthma: Symptoms and diagnosis

In people with asthma, the airways are overly sensitive. This chronic disease typically comes in episodes or attacks of wheezing, coughing and shortness of breath. But other diseases can have similar symptoms. So before starting with treatment, it is important to find out what exactly is causing the breathing problems.The mucous membranes lining the airways of people with chronic asthma are constantly on stand-by, ready to trigger an inflammatory response. This means that certain substances can set off a very rapid and very intense reaction. Compared to people who have healthy lungs, their mucous membranes are red and swollen, and more blood flows through them. The cells in the membranes start producing thicker mucus. If an asthma trigger is also present, the muscles surrounding the walls of the airways tighten as well. Together, all of these factors cause the bronchi (lung airway passages) to narrow and prevent air from flowing freely in and out of the lungs. This leads to shortness of breath.A severe asthma attack feels somewhat like trying to breathe only through a straw for a few minutes. Even if you blow air into it and suck air out of it as hard as you can, you are unable to get enough air into and out of your lungs.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: February 26, 2014

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