Spring is approaching and with it its share of pollen which will cause rhinitis, cough and fatigue in part of the population. Behind these events that can be considered harmless, there are much more important health issues. That’s what hammers at 20 minutes Marc Sapene, pulmonologist and allergist from Bordeaux. The one who is also vice-president of Asthma and allergies association is, he says, in the process of creating a sleep apnea prevention unit, “a first in France”.
How to explain that people with allergies are more and more numerous?
The number that everyone repeats is that by about 2050, half the population will be allergic. Allergies are developing in the population and especially those that are respiratory. It’s linked to lifestyles, because we live much more indoors, and to air pollution, which is also a factor booster allergies. In New Aquitaine for example, a hot and humid region, grass pollens are present over long periods and many mites proliferate in indoor environments.
We also know that living conditions since childhood play a role: children are less in contact with a whole variety of allergens (hygienism), which means that their immune system is a little deviated, benefiting allergies. We transmit a facility to be allergic. It is then the way of life and other factors that we do not know that cause some allergies to go to dust mites, others to pollen, cat hair or food.
Shouldn’t we distinguish the allergic person who has some symptoms of rhinitis from the one who develops more serious forms, with asthma for example?
In this respect, small is not necessarily small. Of course, there is the visible and the encounter that can be violent with pollens when you are asthmatic or allergic. But there is also the “it’s not that bad, they have a bit of a cold”. One of my battles for several years, and which I am going to intensify, is to raise awareness that rhinitis due to dust mites (present in dust and mattresses) which cause stuffy noses in children should not be minimized.
What should get parents’ attention?
Children should sleep with their mouths tightly closed and not snore, except for the three days when they have a cold. It is very important to breathe well through the nose, especially at night. What is not widely known is that the circulation of air in the airways between 0 and 12-13 years will shape the facial massif in the same way as the wind shapes the Pyla dune.
The harmonious development of the facial bones (all the bones not surrounding the brain), with a very wide palate, takes place thanks to good air circulation. The tongue must tap on the palate to enlarge it. However, a child of three or four years old who has a clogged nose due to mites in his mattress will not develop enough certain muscles, in particular of the tongue.
What complications can occur in the medium and long term?
I am in the process of creating a sleep apnea prevention unit, a first in France. We realize that many of our patients are children who had allergies when they were younger. In them it is misleading because it can manifest as attention deficit disorder with or without hyperactivity (ADHD) while in adults it is more fatigue. Untreated, this can lead to cardiovascular and metabolic diseases much later.
What should be done when symptoms occur?
There are very visible manifestations. If when the pollens arrive I cough or I have a little asthma, it is necessary to treat and if possible anticipate. If left untreated, it gets worse because inflammation leads to inflammation. There are very specific screenings to determine the grasses that trigger allergies, with tests on the skin. And even while being treated, it is necessary to reduce its exposure to pollens. Put on glasses and a mask, for cycling for example. Washing your hair after a walk in nature is also useful. Symptoms will depend on how much exposure you have.
Air circulation in the airways between 0 and 12-13 years will shape the facial massif in the same way as the wind shapes the Pyla dune. »
What is the inflammatory process at work in allergy?
When you have an allergy, you have inflammation: the mucosa is in poor condition at that time and the allergens pass through. Upon encountering the substances you are allergic to, the cells then begin to explode and release chemicals which further aggravate the inflammation. This is called an inflammatory cascade. As soon as it is inflammatory, the porosity is reinforced. When you smoke, the mucous membrane is inflammatory and promotes this system.
Can we speak of a social factor in terms of allergies?
Of course. What is terrible is that our health evolves with risk factors (genetic, environmental) which lead to others. Ultra-processed food causes inflammation, which promotes allergy. It is one of the two major factors, along with air pollution. This observation leads me to take an interest in the major determinants of health (diet, physical activity and sleep) notably through the creation of the Maison Bleue in Bordeaux. In a framework of liberal medicine, research and prevention are carried out there.