ALLERGY

Pharm .D , M. phil
Lecturer ( Pharmacognosy)
Deffinition:
Allergy is a specific hypersensitivity reaction of an
individual to a specific substance usually a protein to
which individual has previously been exposed . It is an
inflammatory reaction which is a consequence of
immunological process
Allergen: The foreign substance which induces
hypersensitiveness in allergically sensitized person is
called ‘’Allergen’’
 TYPES OF ALLERGY
Following are the types of allergy;
Environmental allergy: It is caused by changes in climate
Physical allergy: It is caused by heat, coldor at extreme
pressure
Psychasomatic allergy: I t is caused by anger or frustration
Anaphylacted allergy: It involves the humoral immunity
(antigen-antibody reaction). It produces IgE in response to
allergen
Cytotoxic allergy: It involves humoral immunity. It produces
IgG in response to allergen
Immune complex &Arthus reaction: In this type allergen-IgG
complex precipitate in tissues, resulting in inflammation
Delayed Hypersensitivity Reaction: It doesnot involve humoral
immunity. In this T- lymphocytes release which trigger a series
of inflammatory reactions.
Causes Of Allergy:
Factors causing allergy are as follows.
1) Emotional factors
2) Atmospheric factor
3) Chronic types of infections
4) Hereditary tendency to allergic response
5) Disfunction of endo- crine glands
6) Increased excitibility of ANS
7) Psychic influences
 1) Hay fever:
It is a form of allergic rhinitis in which there is inflammation of
mucous membrane of nose and throat precipitated by
exposure to pollens with continuous mucosal flow
2) Asthma
It is a paroxymal attack of difficulty in breathing. It may be of
different types.
e.g. Bronchial Asthma ( breathlessness attacks associated with
bronchial obstruction or spasm).
3) Urticaria
It is an allergic skin eruption characterized by pinkish, itching
wheals developing very suddenly, usually lasting a few days
and having no visible traces
 4) Eczema
It is also regarded as one form of dermatitis
(inflammaton of skin) describing it as tha eczema
reaction to an irritant on an already susceptible skin
Mechanism Of Allergic Reaction
There are two mechanisms for the occurance of allergic
reaction.
1. Antigen-Antibody Reaction
2. Cellular mediated mechanism
1- Antigen- Antibody Reaction:
This mechanism involves the following steps;
 Any foreign particle i.e. Allergen acts an antigen and
as a result of it an antibody is produced in body. Some
of these antibodies circulate in the blood stream
Whereas others become attached to the cells of the
nasal membrane
During Primary Exposure s, no symptoms of allergy are
observed due to absence of antibodies.
During Secondry Exposure, allergens contact the fixed
antibodies, where an antigen- antibody reaction occur
This antigen- antibody reaction causes a liberation of
histamine or other mediators like bradykinin from the
cells of certain tissues or organs called Shock tissues or
Organs.
Histamine is produced in the form of Globules which are
absorbed in the Mast Cells which are present in the
endoplasmic stream causing redness of skin.
2) Cellular Mediated Mechanism
This mechanism involves the following steps.
Antigens having mol. wt less than 500 are called Haptans
or incomplete antigens e.g. plant allergens.
When they enter the skin , they combine with skin
proteins to become complete antigens.
These complete antigens become attached with
Langerhan Cells from there they are transferred to
lymphatic system of body.
On receiving the complete antigens lymphocytes become
activated . They move by lymphatic vessels to the
lymph mode and enter through the effernt vessels
In the lymph node and increase in size and number. Now
they are called as Blast cells or Lymphoblasts.
When they leave through efferent vessels, lymphocytes
are of two types
a) Memory cells: It stores information through
lymphocytes. Re enter the circulation and
lymphocytes(propagation phase)
b) Stimulating cells : These go towards the skin where
Lymphokinens are produced due to which skin
becomes red
 Diagnosing Tests For Allergy
(Skin Test)
Some important diagnosing tests for allergy are as follows.
1. Scratch Test
2. Intra- dermal test
3. Blotting paper method
4. Open Test
5. Patch Test
1) Scratch Test
This test is mainly used for detection of intermediate
hypersensitivity that is mediated by circulating antibodies.
Procedure:
For performing scratch test we formulate allergenic
materials in the form of solution by using an inert solvent
e.g. Petroleum ether, Acetone etc
 The solution is then introduced to skin by making a scratch on
the side of the arm and area is marked and result will be
observed.
If any arrythma or swelling occur then test is +ve
Disadvantage :
Sometime systemic allergens are present which can not
be detected.
2) Intradermic Test:
In this case plants extracts are dissolved in a solvent of
stronger conc and little is injected carefully b/w epidermis
and dermis layer.
If any allergic symptoms appear then test is +ve.
 3) Blotting Paper Method
Staedelar (German) in 1847 used method blotting paper
strips to examine the effect of Anacardium occidental. He
applied sap of this plant to lower part of skin.
A piece of blotting paper previously diped in same material
was applied to same side.
After 15 min patient experienced a burning sensation which
increased rapidly and reached at climax in about half hour.
Skin under blotting paper turned white while surrounding area
had marked redness.
Overnight skin become covered by tiny vesicles, wound heals
after about 2 weeks
 4) Open Test:
This test is used to access the effect of unknown substances
before applying them as patch test and to cosmetics,
medicaments , household substances.
When useful procedure for patch test is of doubtful nature.
Procedure:
In this test, test substance is applied to marked area of skin
and side left uncovered.
In clinics, a circular area is marked on the flexor surface of
patient forearm and material is applied twice a day for two
days or more
The test area is red after two days . The objective sign such as
erythma, papules are stronger reaction in +ve test.
 5) Patch Test:

This test is performed to identify allergen causing contact

dermatitis
Procedure:
The suspected material in appropriate conc. Is applied to skin
under the non-adsorbent adhesive patch and left for 48 hours
If burning or itching develop earlier , patch is removed.
+ve test consist of erythma with some necrosis and ocassionally
vesicles formation.
Patch test is done after patient contact dermatitis
has cleared in order to prevent its excerbation (severe
necrosis)
Advantages:
 Not painful
 No specific skill is required
 No chance of severe reaction
 No chance of infection
Disadvantages:
 Biological test can have false +ve & false -ve test
 It is time consuming about 48 hours
 Treatment Of Allergy
Following methods are used
1. Hypo- sensitivity test method
a) Water extract treatment
b) Alum pyridine method
2. Elimination diet
3. Anti- histamine treatment
1-Hyposensitivity Test Method
a- Water Extract Method
Pollen extract are made by collecting the pollen grains by w/v
of pollen extracts then pass through the following steps
I. Defatation: The extract is defatted by adding some non-
polar solvent which dissolve the fat in it.
II. Standardization: Then it is standardized according to the no
of pollen units.
 Pollen Unit: One pollen unit represent the activity in .001
pollen
I. Dilution: Then it is diluted and at regular interval a
measured dose is injected
II. The dose is gradually increased until these develop
immunity in patient for a particular allergen
b-Alum Pyridine Method
In this method non-defatted pollen is mixed Pyridine
resulting in extraction of lipid material.
Alum is then added, therby precipitate an antigen
complex
Pyridine & alum are removed by washing and the
precipitate is suspected in buffer saline solution
Alum precipitate allergenic extracts are administered
subcutaneously
 2- Elimination Diet
In this type of treatment , first important thing is
to be determined which food is causing allergy in patient
e.g. Cow’s milk, orange juice, cod liver oil etc
So allergy can be treated by removing that portion of food
3- Anti- histamine treatment
The allergist may select antihistaminic drugs orally in
addition to using the allergenic extracts
The anti-histamine cannot prevent the antigen- antibody
reaction. But they prevent the shocked damaged
normally caused by released histamines
Treatment is of very short duration about 2-3 days
 ALLERGENS
Definition:
Allergens are the antigenic substances which are
capable of inducing allergy or specific hypersensitivity in
allergicaly sensitized individuals
Allergens are protein in nature
Almost any substance whether of biological, chemical or
synthetic origin may prove to be allergenic
Examples: Pollen grains, spores of fungi, dust, danders
From horses, cats, dogs and other animals, clothes, nail
polish
 Types Of Allergens

1. Inhalant allergens
2. Ingestant allergens
3. Infectant allergens
4. Contactant allergens
5. Infestant allergens
 1- Inhalent Allergens

The substances that are distributed in atmosphere and

causes the nasal or bronchial mucosal irritation during
respiration are called Inhalent allergens
Example: Spores, pollen, grains, dust, danders and
feathers etc
Symptoms of Allergy:
 Sneezing
 Itching
 Lacrimation
 Swelling of nose and eyes
a-Sinusitis (Hay fever): (Pollinosis)
It appears during certain months of the year and is
usually associated with the release of pollen grains. It is also
called as Pollinosis.
This type of pollen grains responsible for allergy so
their identification is necessary.
Identification of Pollen Grains:
Because of heterogenous nature , pollen grains can
be identified without difficulty. Pollen grains may be;
 Round
 Angular
 Oval
 Square
Structure:
The outer wall of pollen grain is known as Exine
The inner wall of pollen grain is Intine
Wind Pollinated Pollen Grains:
These pollen grains are usually Anemophilous
(Wind pollinated) because they are light in wt, spiny,
coloured & fragnant.
b- Non-Seasonal Hay Fever:
It may be caused by inhalents other than pollen
grains. It can appears during any month of year, that is
why it is known as Perennial Rhinitis
Examples:
Cotton pillow
Dust
Danders of animals
Feathers
Odours & perfumes are major causes
 2- Ingestant Allergens
(Food Allergens)
These are food allergens which occur in food stuff and
are swallowed. The allergy caused by them is called
Food Allergy
In food allergy the activity of the allergens is not
localized in one organ but it is transferred to other organs
Symptoms:
Skin rashes, Paffed lips, Tongue, Rhinits,
Bronchial asthma, GIT symptoms
In Children: Allergy is caused by cow’s milk, orange juice,
cod liver oil, coffee
Milk Allergy:
Milk allergy is due to a protein Lact albumen and
due to this protein antigen antibody reaction take place.
Heating or boiling of milk alters the protein that is why
evaporated . Milk is best source as compare to cow’milk
Milk allergy cause severe dermatitis, bronchitis and
asthma
 3-Injectant Allergens
These are the substances present in parentaral preparations
OR
They are present in a solution to be injected
Examples:
 Penicillin: It is the most commonly known allergen of
this type. About 1-5 persons per 10,000 are allergic
to penicillin
e.g. 6- amino penicillinic acid (6-A.P.A)
6- amino cephalosporanic acid (6-A.C.S.A)
6- cephalosporin
 Other examples are liver extract, antihistamines and
glandular products.
 Insects: It is also caused by insects bite or stings, so
insects like bees, hornets( large insect of wasp family),
wasps, spiders, lice or scorpions etc are considered as a
source of injectant allergens
Symptoms:
 Itching of palms of hands and soles of feet
 Paling of skin
 Anaphylactic shock
 4- Contactant Allergens
These are the allergens which cause allergy on coming
in contact with skin. They cause redness of skin which
is known as Erythema. They pass through the skin
and reach b/w epidermis and dermis.
Examples:
o Urashiol: All the species of genus Toxicodendron

contain some non- volatile phenolic principle

Urashiol, which can cause allergy in hypersensitive
individuals.
o Aero- Allergens: These are the pollen grains which
contain oils & hairs from different kinds of leaves and
flowers. They cause occassional contact dermatitis
o Cosmetics: They also cause allergy
The cosmetics from which certain allergens are
removed are called as Hypo- allergenic cosmetics
 Voilet Talcum Powders: Oris root an ingredient in
voilet talcum powder is one of the chief contact
allergen
 Lipsticks: Dibromo- fluorescence which is commonly
used in lipsticks can cause allergy.
o Perfumes: They are also found to be allergens
Other examples: Soap, soap powders, detergens,
nail polishe removers, hair dyes, hair sprays are the cause
of contact dermatitis
Symptoms: In this type of allergy, water blisters are formed
on the skin. When blisters burst, the watery fluid forms new
blisters spreading rapidly
5- Infectant Allergens
These are the metabolic wastes and growth products of
pathogenic micro-organisms
 A large no of living micro- organisms like;
bacteria, protozoa & molds cause allergy through
their metabolic waste products in the human body.
The patients are not aware of these organisms & their
products producing allergy. When an individual shows the
symptoms of allergy and skin test is positive then it is
considered that the individual has infectant allergy.
Chronic bronchial infection of bronchioles known as
Bronchiactasis ( The person may exhibit allergic
symptoms but will not respond positively to skin tests
for inhalant allergens . In this case bacterial metabolic
wastes are cosidered as infectant allergens
6- Infestant Allergens
These are the metabolic wastes and growth
products of parasitic organisms in or on the body
Infestant allergens to some extent are similar to
the infectant allergens but the organisms are parasites
Examples:
Attack of hookworms, tapeworms, pinworms,
thread worms and other forms have caused allergic
response in susceptible individuals
Growth products and metabolic wastes of
paracites are constantly present in the body and are
referred as infestant allergens.