Well, now we know there are things that can cause allergies, but how does it happen? About 40 years ago or so, a substance called immunoglobulin E (IgE) was discovered. It had been suspected to exist for a number of years, but it was finally proven by a husband-and-wife team of researchers, Drs. Ishizaki. IgE is the bad guy. When you have too much of it, it reacts with your allergic foe (cat, dog, ragweed pollen.) When an allergic reaction occurs, you can get sick. How does this happen? Cells called mast cells are all over the body. The mast cells contain little packets of trouble that are the cause of allergic symptoms. When a special kind of IgE, now called ragweed antibody, meets its corresponding ragweed, the IgE-ragweed interaction sets off a chain of events that leads to the mast cell releasing its contents. The content of the mast cells contains substances that cause symptoms. Some of these substances are histamine, leukotrienes, prostaglandins, and other substances that in the end, make your nose run, your eyes itch, your lungs wheeze, and even skin crawl. What to do? First, we recommend avoidance, even though that does not change the IgE bad-guy pattern, it just gets rid of triggers. Medications are used like band-aids to mend the effects of the mast cell disruption and the liberation of the itch- and allergy-producing substances. When we want something to really make the allergies go and stay away, we are talking about allergy shots.
So we have avoidance, then we add medications, and when we want to use our own bodies to protect ourselves against allergies, we have allergy shots. Sometimes this has been called allergen immunotherapy; other times desensitization, but most people know it simply as allergy shots. By that we mean giving small amounts of the material that had been positive in the skin tests. So it is really important to first find out what you are allergic to. That is where the allergist enters the picture. Simple, not painful, and completed usually in two visits, skin tests define your allergies. Based on the skin tests, an allergy extract is prepared, not as in the opening witch's brew, but using standardized, purified, safe reagents that are controlled and approved by the FDA. (Food and Drug Administration.) We are most fortunate as we begin the new century that we have strong controls and measures of efficacy so that we know the material you receive in an injection is effective as well as safe. Allergy shots begin with small doses and gradually increase in strength until a maximum or a maintenance dose is reached. Patients start to feel better as the maintenance dose is reached. It varies from patient to patient and, therefore, your allergy specialist cannot tell you exactly what is the dose when symptom relief occurs. The most commonly used schedule is injections given once or twice a week. Sometimes injection rates are accelerated, or evenly dramatically accelerated, and immunotherapy can be accomplished in a matter of days. This is called rush immunotherapy and is something you may want to discuss with the allergy specialist. It is not for everyone.