Tips for Allergy Relief : Part 3

by Food and Drug Administration (FDA)

(Page 3 of 3)

Galant usually decides to stop shots if the patient has had no symptoms or the degree of symptoms has significantly decreased for about a year. "Generally that's between the second or third year, so when we finish three years, I would seriously consider stopping the shots."

When Yunginger takes his patients off shots, "I have them go through the four seasons to see if the symptoms come back. If the symptoms do come back and can't be completely controlled with medication, then probably the injections should be restarted."

According to Young and colleagues, after stopping shots, one-third of patients will no longer have allergic reactions, one-third will have a partial relapse of symptoms, and one-third will relapse completely.

Lifestyle Changes

"Shots are just one part of this therapy," says Galant. "Good avoidance measures are very important."

Usually outdoor allergens can't be completely avoided. Most people can't stay inside all the time, and, in any case, pollen comes inside through open doors and windows and on people's clothes, hair and shoes. Here are some ways to keep pollen out of the house:

• Keep all windows closed.
• Put a permanent air filter specially designed to keep out pollens and other airborne contaminants in the heating and cooling systems; wash the filter every month.
• Change clothes after coming in from outside, and wash the clothes before wearing them again.
• Keep dirty clothes out of the allergic person's bedroom.
• Wash the allergic person's hair every night to avoid transferring pollen from hair to pillow.

Some indoor allergens are also difficult to avoid, but they can be reduced. House dust mites, although they are so tiny you can't see them with the naked eye, can cause big allergic reactions in susceptible people. (The North American house dust mite pictured at right is, of course, greatly magnified.)

When it comes to dust mites, "it's hard to get rid of them," says Galant. Mites like to live in box springs, mattresses, pillows, and carpets. To keep the mite population down, the allergic person's mattress, box spring, and pillows should be encased in special covers available from companies that make allergy-proof products. Washable curtains should be the only window coverings. To kill dust mites in bed linens and curtains, wash water must be at least 130 degrees Fahrenheit (54 degrees Celsius). (But during all other times, keep water temperature at 120 F [49 C] to protect children from accidental scalding.) Carpets should be removed or treated with an anti-allergen spray. (Ask your allergist, or contact organizations listed in accompanying box for sources of these products.)

For those with allergies to pets, the simple answer, giving up a beloved cat or dog, is often unacceptable. To increase the success of shots, animals should be kept out of the bedroom. Giving pets a weekly bath may help reduce the amount of dander they release into the air.

Whether it means keeping a cat or playing outside in the spring, "my game plan for all patients is to have them live a normal life," says Galant.

That's what I hope will be in store for Paul — time spent outdoors enjoying the sun and spring breezes. For me, it will mean I can finally say, "Yes, it really is a beautiful spring day."

Standardizing Extracts

Biologists and chemists in FDA's Center for Biologics Evaluation and Research are working in their labs to standardize allergenic extracts.

"Without standardization, there is no defined potency for these extracts," says Paul Turkeltaub, M.D., acting director of the center's division of allergenic products and parasitology. "This can reduce the effectiveness of both diagnosis and treatment."

Stanley P. Galant, M.D., an allergist in Orange County, Calif., and a clinical professor and director of pediatric allergy at the University of California, Irvine, explains that different lots of nonstandardized extracts may not be the same strength, and allergists have no way to know if there is any variation. He says that to avoid the risk of a bad reaction with these extracts, a patient starting a new vial of treatment solution must get a lower dose than what the patient is on and build up again.

"Standards for extracts improve medical management of allergies and lessen the risk of an adverse reaction," says Turkeltaub. "Standards should reduce the need for retesting of patients who switch physicians, since the physicians will have access to the same extracts."

Currently, FDA scientists have developed standards for cat allergens, dust mites, short ragweed, and several bee venoms. The venoms were among the first to be standardized because life-threatening reactions to them are more common.

FDA has determined, in consultation with industry and medical professionals, the priority for other extracts to be standardized. In most cases, higher priority went to allergens affecting the greatest number of people.

FDA scientists are nearing completion on standards for latex and cockroach extracts, and work is continuing on standardization of a peanut extract and many pollens.

"Peanut is the most severe form of food allergy," says Marshall Plaut, M.D., chief of the allergic mechanisms section, in NIH's National Institute of Allergies and Infectious Diseases. "A high proportion of deaths from food allergies are from peanuts, and, unlike most food allergies, which disappear after childhood, peanut allergies tend to last a lifetime."

The agency plans to standardize other food allergens, pollens and insect venoms in the future.

About the Author

www.fda.gov
FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.