What helps against hay fever? When can this become asthma?

dr Catherine Geissler: In Germany, every fourth to fifth person suffers from a cold caused by an allergy. About 40 percent of these will develop asthma in their lifetime.

dr Catherine Geissler: When new symptoms are added to the typical symptoms of a pollen allergy such as a runny nose and itching in the nose and eyes. These are shortness of breath, shortness of breath, especially during exertion, coughing, tightness in the chest and breathing noises such as whistling or buzzing. Then a doctor should be consulted.

dr Catherine Geissler: Yes, we also see that in the allergy center of our clinic. Due to climate change and air pollution, especially in large cities, the pollen season is increasing. It often begins as early as January or even December. Due to the appearance of new, previously non-native pollen such as ragweed or the olive tree, the pollen season is extended until September. As a result, pollen allergy sufferers can now have symptoms for nine months of the year.

dr Catherine Geissler: It is known that this allergy also occurs more frequently in Germany and should be considered in patients with allergic symptoms in summer. We have also switched our tests to this for a few months, but have not yet had any olive tree allergy sufferers among our patients. The pharmaceutical industry has already adapted so that immunotherapy can be offered for this allergy.

dr Catherine Geissler: In acute cases, a combination of local therapy with antiallergic nose drops, which decongest the mucous membrane of the nose and counteract itching, antiallergic eye drops and asthma sprays, and systemic therapy with an antiallergic tablet that affects the whole body, helps.

If possible, avoid contact with the allergy-triggering plant, for example by adapting your daily activities to the pollen count. In a critical emergency, such as acute shortness of breath, an adrenaline pen must be placed in the outside of the thigh to stabilize circulation and expand the bronchi.

dr Catherine Geissler: Subcutaneous allergen-specific immunotherapy (SCIT) or desensitization, which is given via injections at intervals of a few weeks, has long been used. There is also sublingual allergen-specific immunotherapy (SLIT), in which the allergen is placed under the tongue every day in tablet or drop form. There are significantly more preparations here than there used to be.

These therapies require a very reliable patient with a duration of three to five years. In order to shorten this, there are new therapy concepts in which the allergy-causing substances are given for a shorter period of time. The immune system is stimulated more strongly by additives in order to accelerate the tolerance reaction of the immune system so that the immune system learns more quickly not to react allergically. These therapies are currently being tested in studies and are therefore not yet in routine use.

dr Catherine Geissler: Hyposensitization can alleviate symptoms, reduce medication use and prevent or improve asthma in 90 percent of patients for about ten years. Who will benefit from hyposensitization and how strong the effects are depends on various individual factors and cannot be predicted beforehand.

dr Catherine Geissler: Yes, that’s the way it is. It is even the goal that children and adults with allergic rhinitis are hyposensitized at an early stage so that they do not develop asthma.

dr Catherine Geissler: Biologics are drugs that work against substances in the body that cause allergies and inflammation. In the case of allergic asthma, they come into question for severe cases in which asthma sprays are not sufficiently helpful, even in higher doses. Depending on the preparation, they are given every two to four weeks, also by the patient themselves. They should be used for a lifetime.

These drugs can also be used to treat concomitant diseases such as chronic sinusitis with nasal polyps and skin diseases such as atopic eczema and urticaria, i.e. hives.