The nose is perpetually stuffy, rapid sneezing, coughing and even watery eyes. A picture that immediately makes you think of the flu given the record season, but also pay attention to allergies. “When we talk about seasonal or, as in this period, 'pre-seasonal' allergies, we are referring more frequently to respiratory pathologies, i.e. rhinitis, rhinoconjunctivitis, asthma or 'asthmatic equivalents' with cough associated with wheezing, possible breathlessness and 'air hunger'. These are pathologies that undoubtedly have a strong impact on the population considering that, according to updated and accredited sources, in Italy approximately half of the population suffers from respiratory allergies with a constantly increasing trend. Precisely the unstoppable growth of these pathologies leads to correlate their exponential increase to the intervention of some environmental factors which are added to the allergenic ones”. Thus at Adnkronos Salute the immunologist Mauro Minelli, responsible for the South of the Italian Foundation for Personalized Medicine.
Among the allergenic factors, he lists, “the dust mites stand out, more abundantly available in confined environments between September and February, fungal spores, animal epithelia (dogs, cats) and pollens. The most important allergenic pollens come from herbaceous plants ( Gramineae, Compositae, Urticacee) and from trees (birch, hazel, olive, cypress). However, there is a progressive increase in allergies towards 'emerging' pollens – underlines Minelli – once considered of little relevance from an allergological point of view. This phenomenon , in addition to the introduction of new 'exotic' species for ornamental use in parks and gardens, seems to be linked above all to a rapid expansion of new weed species including, for example, ragweed”.
But hasn't the time of allergies always been spring? How come those flowering periods have now become so messed up that we can no longer understand whether we have our usual allergy or simply a cold? “Let's go back to ambrosia for a moment – replies the immunologist – This is a plant native to the United States, but also rapidly spreading in the northern regions of Europe where, due to global warming which leads to a significant lengthening of of flowering, the pollen of this plant is believed to soon constitute a large percentage of the overall pollen production and, therefore, of potential allergic disorders. Even the pollination of the cypress, originally considered pre-seasonal as it was substantially concentrated in the months of January and February , has been recording a marked increase in recent years which seems to extend well into spring, with a consequent increase in the number of patients who are becoming sensitized to the pollen of these arboreal plants”.
“A further element capable of exerting an important strengthening action on allergic phenomenology – continues Minelli – is certainly represented by atmospheric pollution which, together with climate changes, can strengthen the allergenic and inflammatory action of pollen grains. It so happens that , for example, birch pollen usually present in the atmosphere between March and June, exposed to high levels of pollutants in industrialized areas, is much more aggressive than the same pollen originating in rural areas, being able to more easily induce urticarial and respiratory phenomenology. on the other hand, the association between exposure to environmental pollutants and increased incidence of bronchial asthma is well known”.
So, considering these anomalies that create confusion, if in these months I catch a cold, will I have to treat myself with an antihistamine and a little cortisone, or can I more simply take a Tachipirina? For the immunologist “the question is more than pertinent and deserves a precise answer which I will provide through a list of the most characteristic symptoms of the two different pathological conditions”.
The nasal symptoms in colds, explains Minelli, are “stuffed nose often associated with sore throat; production of green or yellowish mucus which can be eliminated through the mouth or nose; powerful sneezing, but generally not in close sequence”. The nasal symptoms in allergies are instead “nasal itching which generally also involves the eyes; secretion of a liquid so clear as to be classically defined as 'rock water'; sneezing in bursts, irritable and rapidly consecutive; tingling in the throat; 'greeting allergic' frequent in children who, to numb the annoying itching, touch their nose by rubbing it with their hand from bottom to top”.
Fever. “In the case of colds – highlights the immunologist – it can be high due to the viral infection that underlies this pathological condition, and can be associated with muscle pain with a sensation of broken bones. In allergy, where classically episodic manifestations are excluded spring of the so-called 'hay fever', with slight temperature increases mostly linked to massive exposure to grass pollen, the fever does not manifest itself, nor are there any involvement of the musculoskeletal district”.
Cough. “In colds – clarifies Minelli – it can be associated with the expectoration of dense and generally yellowish sputum. While in allergies it is generally dry and can be associated with breathlessness, wheezing, laryngospasm and up to the bronchospasm typical of asthma; in allergic cases the cough can also occur when the patient runs or takes the stairs or laughs”.
Duration. “In the case of a cold – the specialist points out – the symptoms progressively attenuate over a period of a few days, generally disappearing completely after a week. In the case of allergies, the symptomatic picture persists as long as the exposure to the antigens lasts sensitizers dispersed in the environment. In the case of allergy to cypress, present these days, the cold and conjunctivitis could last until the end of February, the period in which the flowering of trees belonging to the Cupressaceae genus is expected to end.” But what about therapy? “Never independently or with advice on social media”, warns Minelli. “When faced with a suspicion, you should consult a doctor or perhaps an allergist who will be able to suggest the most appropriate, safe and effective diagnostic and therapeutic path.”
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