Pathophysiology and Genetics

Plant-borne asthma and respiratory tract allergies are by definition caused by inhalation of the allergen. However, some allergens such as pollens can cause rhinitis after exposure through the conjunctiva of the eye; severe rhinitis can lead to conjunctivitis. Rhinoconjunctivitis is a common indicator of an allergy that is usually IgE-mediated, involving irritation and inflammation of the mucosa, with increased interleukens identified in nasal discharge. Ragweed (and all hayfever) allergies are activated by Type I hypersensitivity reactions. Asthma symptoms that are due to plant-borne disease are also IgE-mediated and identified by the sine qua non symptoms wheezing and shortness of breath typical of any type of asthma. Both plant-borne asthma and allergic rhinitis are stimulated by organic dusts, pollen, or plant particles (8).

For both allergies and asthma there is a significant hereditary component, with a stronger affect on homozygotic than heterozygotic twins. Genetic variations in two cytokines implicated in respiratory tract hyper-responsiveness (those genes encoding IL-4 and IL-13) have been implicated as one of several polymorphisms that may increase the risk (9,10,11).

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