A review on aero‐allergen induced allergy in India

Abstract

Allergic diseases such as bronchial asthma, rhinitis and eczema are an important public health issue globally in 21st century. Their prevalence and impact in India is high, in terms of total numbers of people affected. Due to diverse climate and lifestyle, the Indian population is exposed to a rich and varied range of aerobiological particles. In the last two decades in India, 83 pollens, 34 fungi, six dust mite and 19 insect species were reported as allergenic, often contributing to heavy allergenic exposure in indoor and outdoor environments. There are currently few practitioners who offer allergy diagnosis and treatment in India, but there is active basic and molecular research aiming to improve the health of allergic patients. This review explores the field of aero-allergy in India during the last two decades, with special emphasis on prevalence across various centres and relevant scientific advances such as genetic associations and new therapeutics. This review will be helpful for clinicians to select aero-allergens for sensitisation testing in patients suffering from symptoms in different regions of India, and to support patients undertaking prophylaxis of allergic symptoms in India according to local environmental conditions. This study also helps to define patient selection for allergy testing and the role of test results in guiding allergic disease management in the Indian context. Finally, we summarize genetic findings relevant to aero-allergy in India and discuss the development of novel therapeutics for investigation and management of aero-allergy in India.

Allergy testing in lower middle income countries

“…Over‐emphasis on in‐vitro and/or in‐vivo allergy tests, without clinical correlation, often leads to overdiagnosis in LMICs. Allergen diversity, due to wide geographical and climatic disparities, different methods of food processing and consumption, type and timing of complementary food introduction, and widely varying regional practices such as those relating to infant skincare, are just a few issues to be addressed in LMICs 4,6 . Rapid urbanization has brought multifaceted problems, including an increase in pollen counts (wide and intense pollination season due to greenhouse effect), increased allergenicity (various epigenetic and oxidative changes on allergenic proteins), direct mucosal damage due to the irritant effect of pollutants, reduced natural environment exposure in early childhood due to restriction of outdoor activities and improved indoor hygiene practices, reduction in natural modes of birth, and enhanced exposure to indoor allergens (mites, cockroaches, fungi, and pets), thus potentially influencing the development of allergic immune reponses 7,8 .…”

Allergy in India

“…Laha et al dissect the very complex nature of indoor and outdoor allergens (83 pollens, 34 fungi, six dust mite) that are of relevance to the Indian population 1 . Given the large cross‐sectional geographical area of the country with some contrasting climatic conditions between north–south and east–west, they identified commonalities and differences in aeroallergens and highlight cross‐reactivity between pollens, dust mite and fungi 1 .…”

“…Laha et al dissect the very complex nature of indoor and outdoor allergens (83 pollens, 34 fungi, six dust mite) that are of relevance to the Indian population 1 . Given the large cross‐sectional geographical area of the country with some contrasting climatic conditions between north–south and east–west, they identified commonalities and differences in aeroallergens and highlight cross‐reactivity between pollens, dust mite and fungi 1 . However, as allergy practice in India is still in its infancy, there are major challenges in standardising allergen panels for testing and establishment of allergens in immunotherapy extracts for the treatment of allergic airways disease.…”

Effectiveness of Tea Tree (Melaleuca alternifolia) Essential Oil and Jojoba Carrier Oil through Topical Application on the Relief of Allergies Caused by Aeroallergens

“…The common problem also faced by the students trying to manage their allergies through these pharmacologic treatments is that it causes drowsiness or daytime sleepiness which could greatly affect their academic performance (Rodrigues et al, 2002;Shah, 2023). Allergic diseases caused by aero-allergens are becoming a rising global public health problem in the current century which compels various practitioners to explore new scientific advances, therapeutics, and innovations to manage allergic symptoms, including alternative remedies like the use of herbs, organic products, essential oils among others (Laha et al, 2023). Nowadays, several studies explore nonpharmacologic treatments such as alternative medicine and the use of natural products in managing diseases.…”