Allergy in children is not just a runny nose - it's a pathway to asthma that can and should be stopped

Impact of inhalant allergies on the child and his family

Inhalant allergies are chronic diseases that affect both children and their families, affecting daily functioning and quality of life. Symptoms such as persistent cough, runny nose, conjunctivitis or sleep problems lead to chronic fatigue and difficulty concentrating. This in turn affects not only the child's daily well-being, but also his or her functioning at school and academic progress. Frequent infections and exacerbations of symptoms result in numerous absences from educational institutions.

- Children suffering from allergies attend institutions with great irregularity: one week they go to the nursery, kindergarten or school, and then they are sick for weeks. This leads to backlogs in learning and isolation from peers," says Malgorzata Sosnowska, mother of twins whose tests showed a very severe allergy to house dust mites.

Although children are the ones who most often struggle with allergy symptoms, its effects are felt by the whole family. Daily life requires a great deal of commitment and increased attention from parents. In addition, there are costs: visits to specialists, diagnostic tests, medications and the purchase of specialized equipment. For many families, this is a major financial challenge that becomes increasingly difficult to bear over time.

- Expenses for medicines put a great strain on our household budget. And we only have one child! It's hard for me to imagine how we would cope with a larger family," says Ewelina Swionder, mother of a boy allergic to pollen, Alternaria fungi, who additionally suffers from cross allergies.

However, inhalant allergy is not only an organizational and financial challenge, but also a huge emotional burden for children and their parents. Chronic illness, recurrent infections and severe exacerbations of symptoms become a source of daily stress and anxiety about the child's health.

- Last year the situation was really serious. My son had such a severe allergic reaction that there were ulcers on the corneas. Doctors downplayed the problem for a long time - they said it was simple conjunctivitis. If we hadn't gone privately to an ophthalmologist at the time and gotten an immediate referral to the hospital, our son could have lost his sight. The ulcers were literally millimeters from the visual zone. If they had moved a little higher, the changes would have been irreversible. Since then, every conjunctival symptom, even the smallest, has caused me great stress. He was already one step away from losing his eyesight once. The second time I can't risk it," adds Ewelina Swionder.

Pharmacotherapy - treating the symptoms, but not the cause

The most common treatment for inhalant allergies is pharmacotherapy - primarily antihistamines and glucocorticosteroids, which help control symptoms. Although they are effective, their long-term use - especially in children - can be associated with serious side effects, such as weight gain, hyperactivity, skin problems, increased susceptibility to infection or even stunted growth. Moreover, despite symptomatic treatment, the disease itself progresses - new symptoms appear and the body begins to react to more allergens. Over time, if left untreated causally, inhalant allergy can lead to the development of asthma.

Allergen immunotherapy - the only effective method of causal treatment

Currently available symptomatic therapies often effectively alleviate the effects of the disease, but do not eliminate the cause. The only causal treatment is allergen immunotherapy, or desensitization. It involves the controlled administration of an allergen, which leads to a gradual "habituation" of the immune system and a reduction in the body's hypersensitivity. As a result, allergy symptoms can be significantly alleviated or completely disappear, improving the quality of life for children and their families.

In general, desensitization treatment is used for a period of 3 to 5 years. In the case of seasonal allergies, specific immunotherapy is carried out for several seasons in successive years, but the first positive effects can be seen after just a few weeks of use. Clinical studies confirm its effectiveness.

- The effectiveness of allergen immunotherapy is very high. In the case of allergies to tree or grass pollen, it reaches up to 80-86%, and house dust mites - 73-76%. In addition, many years of rigorous scientific research indicate its long-term effects, even after withdrawal of post-treatment interventions," emphasizes Dr. Witold Bartosiewicz, a specialist in allergology who has been conducting allergen immunotherapy for many years, thus helping many patients with severe allergy symptoms.

Allergen immunotherapy can be administered in two forms: subcutaneous, or injections, and sublingual. Due to the risk of anaphylactic shock, administration of injections requires visits to a doctor's office under the supervision of a specialist each time, while sublingual therapy can be administered independently at home, making it more convenient for patients. The high safety profile, efficacy and sustained treatment effects have resulted in immunotherapy being recognized by the European Medicines Agency (EMA) and the Polish Society of Allergology as the standard of allergy treatment.

Allergen immunotherapy as prevention of asthma

Allergen immunotherapy is not only an effective allergy treatment, but also a key strategy for preventing allergic asthma. Studies show that children undergoing immunotherapy have a significantly lower risk of developing bronchial asthma compared to those treated symptomatically alone.¹ Therefore, allergy and pulmonology experts emphasize that immunotherapy should be viewed not just as a treatment for symptoms, but as a long-term investment in the health of the youngest patients. The earlier it is implemented, the greater the chance of stopping the allergic march before it develops into asthma.

- During my childhood, no one diagnosed my allergy or took treatment, which led to serious health consequences. Untreated or improperly treated allergies can lead to asthma - a disease I wish for no one. Therefore, for my children I look for specialists with modern knowledge, who do not underestimate their symptoms," declares Malgorzata Sosnowska.

Unfortunately, reimbursement currently covers only a portion of patients with inhalant allergies. Children between the ages of 5 and 12 can only benefit from injectable preparations free of charge, while effective and convenient sublingual therapy remains fully chargeable.

Experts recommend extending reimbursement to sublingual therapy for children aged 5 and older. The possibility of home treatment not only reduces stress in the youngest patients, but also relieves the burden on their parents, while ensuring the effectiveness and safety of the therapy.

- Subcutaneous therapy is reimbursed, but even if we could find a doctor who would undertake it not far from where we live, there remains the issue of frequent visits to the doctor, which would of course involve not only my son's absence from educational institutions, but also my leave from work. In addition, injections are a major stress for my son - after previous difficult medical experiences, every prick causes him severe anxiety. The specialists I consult remotely recommend sublingual immunotherapy - more convenient, less invasive, possible to administer at home. Unfortunately, it is not reimbursed. The cost would be a heavy burden on our household budget," Ewelina Swionder makes no secret of her concerns.

Two forms of sublingual immunotherapy are currently available on the market: tablets and a solution in drops. For the youngest, solution therapy is particularly recommended because of its customizable dosage, convenience of use and high level of safety.

- The solution form is applied by carefully dosing a specific number of applications under the tongue. Some patients, especially smaller children or those with particularly sensitive oral mucosa, tolerate this solution better than sublingual tablets and application in this form is more comfortable for them. For me as a practitioner, it is also important that this form makes it possible to gradually increase the dose, which gives more control over the body's adaptation to the therapy, says Dr. Witold Bartosiewicz, MD.

Expanding reimbursement for immunotherapy would not only enable more effective treatment of inhalant allergies in children, but more importantly reduce the number of new cases of asthma in the future, benefiting both patients and the health care system. Immunotherapy is an investment in a child's health and future. The earlier it is started, the greater the chance that it will stop the progression of the disease before it takes a more dangerous form.

Source: press mat.