Spring allergies

It’s that time again. Yep, spring, which while welcome after a brutal winter still has a fearsome downside for allergy sufferers. That’s because the trees are having sex, which they do once a year, which is kind of sweet and almost chaste of them.

Unfortunately, most trees depend on the wind, unlike most flowering plants which get pollinating insects to do the job of moving grains of male pollen onto female stigmas. Trees being, well, trees, and usually the biggest living things around, they churn out a huge volume of pollen. So much of it, in fact, that cars, windows, house siding, lawn furniture and decks can all turn green and yellow under the onslaught in an hour or two.

That means we all breathe in some of that pollen. It’s inescapable, especially on dry windy days when it gets blown from one county to the next. For allergy sufferers, those days are hellish.

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Of course, it’s nothing personal. They were here first. Trees have been doing it their way for a long, long time, since long before there were mammals, let alone humans with sensitive noses, throats and eyes.  Among the earliest known trees is one called Wattieza, a fossil found in New York State in 2005. It dated back to 385 million years ago, the middle of the Devonian period. In that era, the earliest trees truly changed the world, spreading roots through the soil, and removing so much carbon dioxide from the atmosphere that oxygen levels rose to almost 35% of the atmosphere (today it’s 21%). That allowed for scarily huge insects, dragonflies the size of seagulls, millipedes as big as cats. Billions of tons of carbon turned into tree trunks that were sequestered into the ground as coal. And yes, this was followed by an ice age.

Today’s trees have long histories, too. Conifers got going around 250 million years ago. The hardwoods started up about 150 million years ago. Much as we like to think this planet is ours, it is really the planet of the trees. This is really too bad for people with allergic reactions to pollen.

Actually, as noted allergist Dr. Pradeep Sharma of Poughkeepsie explains, it’s not the pollen per se. “The problem lies with the proteins on the outer layer of the pollen granules,” he says. “When we inhale these granules of pollen, these proteins become dislodged and are absorbed through our mucus membranes [nose, throat, eyes] and enter our bodies. There they initiate an immune reaction, because they’re foreign proteins.”

To get a little more technical, these proteins are “allergens.” In our bodies they’re recognized by Immunoglobin E — an immune system antibody, present in tiny amounts in our bodies, which binds on to the allergen with one end of itself and then hooks up with its other end to a mast cell. That activates the mast cell, which goes into action and releases a flood of histamines — proteins designed to destroy invasive microbes. IgE’s primary function has nothing to do with pollen proteins. IgE is there to protect against invading parasites like those that cause schistomiasis and malaria.

For those of us with sufficiently sensitive immune systems, this activation sets off what Sharma calls, “the itch, the sneeze and the wheeze.”

“The proteins responsible are like a lock-and-key system that enable the pollen grain to grow a root to reach the ovary in the stigma of the female flower and open it to allow pollination” he explains. “It’s a beautiful thing if you aren’t allergic to those proteins.”

This year the allergy season is likely to be intense. The Hudson Valley — a temperate rain forest– receives 44 inches of rain a year on average, enough to ensure forestation and plenty of pollen. The past winter was marked by a very cold February with lots of snow. That was followed by a cold March, ensuring a slow meltoff. The upside has been less flooding in the region. The water table has been refreshed, and the trees will benefit. Spring is likely to be short and front-loaded.

Alas, we know what that means. A prodigious outpouring of pollen is on the cards.

Dr. Sharma notes that there are many over the counter anti-histamine products for most of us who have mild to moderate allergies to tree pollen to use. “They even have steroid nasal sprays now, available over the counter.” (See, Flonase, Rhinocort, Nasacort, etc.)

“Most patients can manage the problem with those,” says Sharma. “But for somebody with more significant allergies, well, they come to us.”

Sharma and other allergists do have some useful weapons in the fight. “There are some prescription medications that can be added,” he says. “And then there’s also the use of allergy immunization therapy. Recently the FDA approved some treatments that are non-shot, that is, they don’t require weekly injections. So for grass and ragweed pollen problems, there are now tablets you take. You begin that course under physician supervision, and then you continue at home.”

This gets around the problem of having to have weekly injections to overcome the allergic response to particular allergens. The process begins with a skin test, and analysis of the patient’s needs, and then proceeds to the course of injections. The need for multiple doctor visits, over months and even years, is the primary reason only about five per cent of people with serious allergies have ever gotten the shots, despite the fact that they can provide real relief.

The advent of a tablet form that can carry the same kind of protein extracts used in the allergy shots may bring a major change for the third or more of people who suffer badly from allergies.

Of course, you still need to know what it is you’re allergic to, and that means going to an allergist. Sharma provides another bit of useful advice for all those who suffer from the annual outpouring of tree pollen. “Once symptoms begin,” he says, “we become sensitized to all kinds of allergens. So, dust or heavy fragrances can set it off.”  In our bodies, that combination of IgE and mast cells, locked and loaded, is ready to spill histamines at the slightest provocation.

Clearly, pre-spring cleaning and less fragrance are important options. Another is to try and avoid the great outdoors on particularly bad days, which are usually dry, sunny and windy. It may not help with the runny nose and itchy eyes, but at least we have the comfort of knowing that this annoyance is just a byproduct of the effort by big trees to make little trees.

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