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The pollen season progresses: climate change and the countermeasures to it

The pollen season progresses: climate change and the countermeasures to it

THE POLLEN SEASON PROGRESSES: CLIMATE CHANGE AND THE COUNTERMEASURES TO DEAL WITH IT. Pollen, whose size varies from a minimum of 5 to a maximum of 200 microns are the masculine elements of plants, which has the task to fertilise, i.e. feminine elements of plants of the same species. Pollen are present in the air only during the period of flowering plants and therefore especially during spring. Very light, are transported by the wind at a great distance: rain, instead it promotes the fall to the ground, with concentrations of pollen in the air decreases significantly after several hours of heavy rain. When the pollen are inhaled and reach the mucous membranes of the Airways, bunding is dissolved by water and mucous secretion of enzymes and protein fractions are released with allergen. Pollen, to have a power allergenic, must belong must be pollens which are wind pollinated plants, i.e. plants whose pollen wind-borne pollination can give. Exceptions for sensitizing of pollen of plants entomofile may be in the air because it carried by insects or manipulated during agricultural or industrial operations by operators in the sector. Changes of pollen are closely dependent on climatic conditions for herbaceous and arboreal plants have annual oscillations. The trees have a dormancy period in autumn and winter with awakening of gems in the period of increased temperature. A monosensibilizzazione, i.e. isolated sensitization to pollen of a single family, is frequent only in cases of allergy to ragweed, parietaria and very rarely to pollen of other plants. The pollen of the olive tree needs an increase in temperature slightly higher and does not appear before April and reaches maximum concentration in the first half of may, but have appeared in recent years the pollination advances for rising temperatures relatively colder periods. Often, however, the allergy from olive tree are associated with other sensitizing, for which the annual variations are most recognizable symptoms in monosensibili, while polisensibili symptoms overlap. The alternating cycles of production and growth of the leaves compared to fruits, and vice versa, between 25–35, favors the storage of reserves for the next season. The alternation is also and especially for fruit trees (peach, pear, Apple, birch, Hazel, Cypress, etc.). Dissemination of other plants are relatively new, not type Ambrosia (pollination late August-September) and Betulaceae, occurs in certain geographical areas. Another problem is related to the use of plants for urban furniture with sensitizing the most varied (from horse chestnut, Cypress). Knowing the period of direct contact and, therefore, crucial for pollination is the possibility of a correct approach in the treatment of allergic rhinitis and asthma. Inevitable therapeutic measures of various kinds in order to control the symptoms of rhinitis and preventing complications local and distance learning. Therapeutic measures that relate to the wash nostrils with solutions that help eliminate pollen and mediators of inflammation. Symptomatic drug therapy with preparations to be able to act, such as protein levels, antihistamines, Nasal Decongestants. Pharmacotherapy, anti-allergic and antiinfiammatoria with known as Chromones and corticosteroids. Specific immunotherapy. Antihistamines H1 anti-receptors are the drugs of first choice for the symptomatic treatment of rhinitis by pollens. Introduced orally the action is fast and able to control the symptoms of irritation and hypersecretion, but with little affection on nasal obstruction; side effects are scarce and sedation, now with the choice of the right medication and adapted, is practically nothing or negligible. Since antihistamines, does not improve nasal obstruction, can join the vasoconstrictors (used for short periods in order to not incur in rhinitis medicamentosa), to improve sleep and facilitate the use of corticosteroids. The known as Chromones prove useful in preventing symptoms of hay fever, used before the start of allergy in maintaining the status after the use of nasal corticosteroids and restrict its use. The drugs most active in controlling allergic rhinitis, nasal corticosteroids are in aqueous solution, of which effects are almost nil, since their use is limited to certain periods. The treatment of rhinitis varies depending on the period in which the patient presents medical observation, during pre-season, when rhinitis is asymptomatic can implement prevention with known as Chromones, starting 15 days before the scheduled pollination. Prevention tier local corticosteroid can be made to start one-two days before the peak of pollination. During the period of seasonal rhinitis treatment is symptomatic and may add to the antistamico and the nasal decongestant. If it comes to asthma by pollini is necessary to prevent the crises of bronchospasm, and treat them when the disease is already established. The therapy is based primarily on the Elimination of the causes or reduction of the causes. Bronchodilator medications are beta 2 release stimulants that make smooth muscle, improve mucociliary clearance and reduce vascular permeability, acting on the substrate pathologically asthmatic crisis. Bronchodilators in short duration of action are the drugs of first use, and preferably in inhalation or dust inhalation solution by educating the patient to use them appropriately. Side effects are known and are tremor, tachycardia are linked in a manner proportional to the amount of medication. The asthma by pollini as Chromones are shown in mild asthma prevention and prevention of seasonal increase of bronchial reactivity. Corticosteroids are the drugs of choice in the treatment of asthma, having Antiinflammatory, can be administered via aerosol, Parenteral and orally. Are used to reduce and prevent, inhibit the inflammatory component of asthma. serious and rarely needed in asthma by pollens. The IDU is rarely used in asthma by pollens and only in cases of serious acute exacerbation. The use of the existing corticosteroid is effective and safe, limited effects at therapeutic dosages and you do not detect current systemic effects. Side effects are only local, oropharyngeal candidiasis, dysphonia and rarely cough. Antileucotrieni also useful, especially in asthma stress, exercise and additive effect with corticosteroid therapy, in forme poorly controlled. One of the mainstays of treatment of Allergy immunotherapy is specifies that consists in the provision of a specific allergenic pollen extract where the patient is sensitive to progressively escalating doses in order to obtain a reduction in the patient's sensitivity towards those certain pollens. It can be assumed that children can be initiated the ITS since the age of 3-4 years. In adults, of course, ITS can be started at any age, if the doctor considers it appropriate, after careful assessment of the conditions of the patient. Since it is a personalized therapy it is necessary that the doctor requires the fitting of a suitable therapy for each patient. The treatments are divided into short-term treatments and treatments in the long term. Short-term treatment with doses of allergen extract scalar progressively up to maximum tolerated dose, to be repeated every year with the pre-season to begin several months before flowering plants whose pollen is sensitive and the patient to be completed until the beginning of the first pollination. Continuous treatment consists of initial doses of the allergen extract scalar until reaching the maximum tolerated dose and continued for some years, with administration of the same maximum tolerated dose, spaced at intervals and a reduction of doses in most pollination period. ITS traditional, subcutaneously, it must be carried out exclusively by the doctor, even better by specialist allergist, which may vary, depending on the clinical judgment and depending on the degree of sensitivity of the patient, the standard regimen and adapting the annex to the individual subject. ITS effectiveness is well documented by clinical observations strictly controlled, especially as regards the major allergens. The effectiveness of ITS due to profound bioactive effect on the immune system, with the involvement of cellular network and variations in the levels of cytokines and immunoglobulins. Inoculation of ITS may cause unwanted reactions, those local ono quite common, but moderate clinical significance. More rare systemic reactions, especially serious ones, requiring use of adrenaline. The majority of systemic reactions occurs almost immediately after administration of the allergen and tends to be so serious as early onset. There are currently prepared for specific immunotherapy decreasing insecticidal efficacy for different routes from the classic one. They are represented primarily by extracts for sublingual. This method seems effective and can be recommended at least in two cases: o when the patient has already made ITS therapy with good results and want to continue or in patients polisensibili when you want to associate an injective therapy therapy with other allergen sublingual. You can, in fact, observe the clinical picture, improvements in more than 80 percent of cases, assessed objectively, using controls with various score in comparison to the symptomatic or symptomatic medications. Judgment of the practitioner, experience suggests that ITS should be prolonged for at least 3-5 years. If ITS does not produce a clinical improvement within two years, you will need to review fully the diagnosis.