Positive or negative? A new HIV test should provide more certainty. Patients now only have to wait six weeks instead of the previous three months before they can be tested. However, not everyone can take the test. HIV positive or negative is a scary question. Previously, you had to wait three months to be tested. Now it’s much faster. Unprotected sex , a prick with a needle – and the fear of the AIDS pathogen is there. Now there should be certainty faster. Six weeks of fear instead of three months: An HIV test can now provide security much earlier in Germany. Corresponding guidelines now apply, as the Deutsche Aids-Hilfe announced on Friday. “So far, people have been told: you have to wait three months, otherwise it is not safe,” said Holger Wicht, spokesman for the German Aids Aid. The number of viruses and antibodies is only increasing gradually. But now the responsible medical societies have shortened the required deadline. More sensitive process “This is a relief for many people and can motivate them to take the test,” says Armin Schafberger, medical expert at Deutsche Aids-Hilfe. The reason for the shorter time window between a risk situation and a diagnosis is a more sensitive and combined procedure and multiple reviews of this test. This Ag-Ab combination test checks for antigens (Ag) and antibodies (Ab). It detects antibodies in the blood earlier and more reliably than older versions. It can also display an antigen: the p24 protein of the AIDS pathogen. It can only be found temporarily – but after about two to three weeks after infection. People can get tested earlier These tests are not new, however. According to German Aids Aid, they have been on the market since 1997 and almost all laboratories are now using them. What is new, however, is that people who want to be tested for the HI virus can now do so earlier. “The three-month deadline that used to apply was simply a safety factor,” says virologist Jörg Hofmann from the Charité University Hospital in Berlin. “Of course you want to be sure that the test does not reveal anyone who was infected as HIV-negative – just because you tested too early.” Enough research should have shown that the test works for the majority of people after just six weeks. In England you have to wait four weeks With their statement, the German Association for Combating Viral Diseases (DVV) and the Society for Virology (GfV) are following the European guidelines that were changed a year ago. In Great Britain, the diagnosis period for the combined test has even been reduced to four weeks. In Germany, however, something has changed after the DVV and GfV statements. If the combined test works, those affected can get confirmation faster than before. If the first test reveals an infection, it cannot be determined whether it reacted to antibodies or to the antigen that was present before the antibodies were formed. If it is the antigen, the previously specified confirmation procedure – the Western blot test – cannot recognize it. So people had to wait in uncertainty until antibodies could also be detected. Additional genetic evidence should bring certainty However, there is a method that can confirm a result even without antibodies: genetic evidence (via PCR). If the Western blot test remains negative, genetic evidence should now be made according to the new guidelines. This is already common practice: after a reactive addiction test, many doctors have initiated such a test immediately, according to the current AIDS report of the German AIDS Association. “But that has not yet applied to the registration form,” says Schafberger. “But you want to report the infection to the Robert Koch Institute straight away and give the patient a clean result right away.” Just a blood draw Uncertainty is a burden. “That is why it is psychologically good if you know earlier,” says Klaus Überla, head of the Virological Institute at the University Hospital Erlangen. He also points out another relief for patients: a sample should now be taken for both tests, the search test and the confirmation. “Then the person concerned does not have to be written to again, to give blood again.” Exceptions to the test For HIV rapid tests and older test versions, however, there remains a diagnostic window of twelve weeks. The DVV and the GfV also make two exceptions to the shorter period: It does not apply to people who are infected with a rare HIV variant, namely HIV-1 group 0 or HIV-2. And even those who already have immunosuppression or an immunodeficiency with antibody formation disorders cannot rely on the test after six weeks. According to an estimate by the Robert Koch Institute, around 80,000 people in Germany were living with HIV or AIDS in 2013 and around 14,000 had the virus without knowing about it. The first HIV test was patented in the USA in January 1985 and approved in Germany a few months later.
Since 2018, a certain “disease X” can be found on a list of the WHO for dangerous and little researched pathogens. The explosive thing about it: the disease does not yet exist and initially only serves as a concept. Various theories are circulating about the origin of the pathogen. The flu could also play a role. The Robert Koch Institute RKI recorded almost 23,900 confirmed cases of flu in the third week of February this year. This was announced by the Influenza Working Group. With almost 60,000 sick people in the current season, the extent of the current flu wave in Germany is enormous. In the 2017/2018 season there were a total of 333,567 sick people. The flu wave hits us again every year. And every year it kills countless people. In the 2017/18 season, 1,674 deaths with influenza infection were reported to the RKI. The flu is repeatedly triggered by new forms of influenza viruses. The vaccines therefore have to be adjusted every time. For most, the flu is harmless. But what if it spreads into an epidemic? “Illness X” only serves as a concept The World Health Organization (WHO) has been publishing a list of potential diseases and pathogens that could trigger a pandemic every year since 2015 . In other words, a disease that spreads across countries and continents. The viruses are classified as very dangerous and there are as yet no or insufficient therapies to combat them. In addition to Ebola, Lassa fever, Zika virus and Crimean-Congo fever, the WHO has listed a “disease X” for the first time since 2018 . This is representative of a pathogen that is still unknown and which, according to speculations, could take a devastating course. The purpose of the list is to stimulate and develop research into suitable drugs and vaccines for the potential pathogens. Previous epidemics caused by influenza viruses Past pandemics such as the plague or Ebola claimed the lives of countless people. The last time an influenza epidemic raged between 1918 and 1920 was caused by the Spanish flu virus. Almost 50 million people died worldwide, a staggering five percent of the world’s population. The peculiarity of these viruses was that healthy young people in particular fell ill with the flu. Researchers believe that the pathogens influenced the immune system in such a way that it worked against its own body. So the stronger the immune system, the more devastating the effects. They published their findings in 2004 in the “Journal of Virology” . Are influenza viruses the trigger for “disease X”? Several theories are circulating about the origin of “disease X”. One of them explains John-Arne Rottingen, he is executive director of the Norwegian Research Council and scientific advisor to the WHO committee. Rottingen told the British “Telegraph” : He assumed that the mysterious disease of pathogens could develop from an already existing disease. For example, as a mutation of aggressive influenza viruses. Most likely, “X” is also a virus that is transmitted from animals to humans. Avian influenza or avian influenza could also be considered as a possible starting point for “disease X”. When infected with avian influenza viruses, this usually leads to the death of the infected bird species. In individual cases, some variants of the pathogen have also been transmitted to humans. As yet unknown viruses as a trigger for disease “X” Another theory sees the threat to mankind in an unprecedented type of virus. According to this, “disease X” is caused by a form of pathogen that is still completely unknown, but is also transmitted from animals to humans. This could be structured in such a way that it can easily be transmitted from person to person, says Jonathan Quick, chairman of the US Global Health Council, the British “Daily Star” . In order to be prepared for such an unpredictable disease as “X” in the event of a problem, the WHO included the mysterious pathogen in its catalog. Since last year, the Global Virome Project has been working on the listing of all potential infectious viruses for humans. We already know about 260 of the estimated 600,000 to 800,000 pathogens.
Many people have saved pneumonia as an old-age disease. The lung tissue of those who were previously completely healthy can also become inflamed. Initially, the symptoms often resemble those of a cold. The consequences are far more serious. No infectious disease is more fatal in Western Europe than pneumonia. According to the Helmholtz Zentrum München, up to 500,000 people develop it every year in Germany alone . This does not even include patients who become infected with the corresponding germs in the hospital. Doctors estimate that around 35,000 die as a result of the infection. Worldwide there are probably around four million deaths every year, exact figures are not available for many countries. In this country the cases of illness increase especially in autumn and winter. It mostly affects the elderly, babies, toddlers and people with a weak immune system. Your body can fight pathogens less well, germs have it easier to establish themselves in the organism than in people whose immune defenses are intact. Smokers and asthma patients are also at increased risk of their lungs becoming inflamed. But pneumonia is by no means an old-age disease or something that only super germs from the clinic can trigger with correspondingly serious previous illnesses. The danger is then much greater, but even healthy people can develop pneumonia – for example if they drag off a cold or are stressed. The Helmholtz Center names the following possible symptoms: a severe feeling of illness sudden fever chills to cough purulent expectoration in infants and toddlers also poor drinking, paleness and an accelerated pulse Pain in the lungs, on the other hand, is not a common symptom. Particularly bad: Many associate pneumonia with a high fever and assume that this is what expresses the infection. Fever is not a compelling symptom of a lung infection. Cases without a fever are also known. Especially in older patients, there is often no increased body temperature. Therefore, to rule out pneumonia would be a fallacy – it can be dangerous. Because if the respiratory tract infection is not treated in time, it can lead to death. Even in Germany, a country with a high medical standard and comprehensive care, every tenth patient treated for pneumonia in hospital dies as a result of the infection. The triggers are usually pneumococci In most cases, bacteria, viruses or fungi are to blame. Legionella and chlamydia can also be triggers. Most infections outside of the hospital are responsible for so-called pneumococci ( Streptococcus pneumoniae ). As with a flu-like infection, the bacteria spread via droplet infection, i.e. through tiny droplets of saliva that pass through the air to others, explains the Helmholz Center – in other words, when speaking, laughing, kissing, sneezing or coughing. Once in the body, the bacteria then settle on the mucous membrane of the nasopharynx and disrupt the gas exchange in the alveoli. The body can no longer channel oxygen into the bloodstream and expel carbon dioxide unhindered. However, those who become infected with the bacteria do not necessarily get sick, according to the doctors. In fact, many people are carriers of the germ, but remain as healthy as possible because their immune system either kills the pathogen or successfully keeps it in check. Pneumococci were found in the mucous membrane of up to 40 percent of all healthy children. They usually only cause damage when the body’s immune system is no longer working properly. “Then the pathogen can spread to other organs and cause an infection there.” Pneumococcal infection is particularly treacherous Pneumococcal pneumonia is particularly tricky, warns the Helmholtz Center. Because severe symptoms such as acute shortness of breath and lack of oxygen occur particularly often without warning. If pneumonia is suspected, those affected should therefore not wait days to see the doctor or artificially postpone it. Doctors then usually make the inflamed tissue visible by means of an X-ray image. In the picture it stands out against the healthy tissue. To contain the inflammation, medical professionals almost always prescribe antibiotics, such as amoxicillin. “Ideally, the infectious agent is known at the beginning of the therapy in order to hit the germ as precisely as possible,” explain the lung specialists at the Helmholtz Center. “Pneumonia, however, is a very serious illness that requires rapid treatment for the patient. In most cases, an antibiotic is selected based on the clinical picture and therapy is started. What helps the sick lungs If the pathogen is only identified in the course of treatment, the treatment can also be changed or supplemented if necessary, they add. “The more precisely the pathogen is determined, the more targeted antibiotics can be used and the risk of resistance build-up in the bacteria is minimized.” In addition to antibiotic therapy, patients should drink enough and take it easy. Medicines that loosen the mucus in the airways also aid healing. To prevent the lungs from becoming dangerously inflamed, the Standing Vaccination Commission of the Robert Koch Institute (Stiko) recommends that people who are at increased risk of pneumococcal infection get vaccinated by a doctor. This applies in particular to: Babies from two months of age Older people over 60 years People with chronic heart, circulatory and lung diseases – including asthma and COPD patients People with diabetes in need of treatment or certain neurological diseases People with a weak immune system (immunodeficiency) or triggered by certain drugs (immunosuppressants) People with a cochlear implant or CSF fistula, as these people are also more prone to pneumococcal meningitis (meningitis) A booster vaccination is not necessary according to current knowledge.
Eat this, forego it. Diet recommendations sound like the Ten Commandments: rigid and demanding. Even small steps bring a lot. The usual recommendations for a healthy diet are demanding and they just seem to follow the principle of “all or nothing”: eat large amounts of vegetables and fruits every day, drink several bottles of water, and always pay attention to the fat. Nutritionists try to pour the rules into crisp slogans (“5 a day” for fruit and vegetables). For many, however, they are not suitable for everyday use. In the current National Consumption Study, for example, just under 88 percent of those questioned did not reach the recommended daily amount of 400 grams of vegetables, and just under 60 percent missed the 250 grams of fruit. Only a minority eat according to the textbook It doesn’t look much better with further recommendations for a healthy life: A study by the Sport University Cologne in 2010 came to the conclusion that only 14 percent of 2500 respondents achieved all five criteria for a healthy lifestyle: they eat varied, exercise enough , do not smoke, drink little alcohol and practice adequate stress relief. For 86 percent there is more or less room for improvement. A little more, a little less Fortunately, even small changes bring a lot. Because the common nutritional advice is useful even if you only partially follow it. As part of the so-called CORA study, scientists from the University Clinic Hamburg-Eppendorf examined diet as a risk factor for heart disease in women. Study leader Eberhard Windler came to the conclusion: “The effect of nutrition is much stronger than all other known risk factors. In our mathematical model, the most unhealthy diet carries 24 times the risk of a heart attack than the healthiest. But: Even every small step towards healthier eating habits reduces this risk. “
Type 2 diabetes is widespread, has serious consequences and – mostly preventable. Those who turn the right screws in everyday life protect themselves against diabetes and become fitter and more attractive. + Good sleep reduces the risk of diabetes + Rüdiger Landgraf lists the most important risk factors for type 2 diabetes as being older than 45 years, familial predisposition, obesity, lipid metabolism disorders, coronary heart disease, gestational diabetes . The factors age and genetic predisposition cannot be shaken. “Metabolic disorders generally increase with age, and that also means that the sugar metabolism can derail more easily,” explains the chairman of the German Diabetes Foundation. “The inherited predisposition to diabetes makes a disease more likely, but does not mean that it will inevitably occur.” Change your lifestyle and have fun with it On the other hand, everyone can defuse the other sources of danger of diabetes individually. This rarely works without a change in lifestyle. But if diabetes prevention is associated with a better attitude towards life, the change can even be fun. 1. Protection factor “slim waist” Most people at high risk of diabetes have been carrying too many pounds for years. The path to diabetes often begins with obesity in childhood . The proverbial hip gold is less risky than the fat deposits in the stomach. A high waist is an indicator that fat has also accumulated around internal organs. This threatens not only the sugar metabolism, but also the cardiovascular system. Unfortunately, belly fat melts particularly stubbornly – but if you resolutely declare war on it, you gain a new body feeling and a slim silhouette in addition to more health. 2. Protection factor “keep moving” In addition to being overweight, lack of exercise is the most important self-inflicted diabetes risk. Both usually go hand in hand. “30 minutes a day is the minimum of physical activity, if necessary in ten-minute bites,” recommends diabetologist Rüdiger Landgraf. “You don’t necessarily have to work up a sweat. And you shouldn’t force yourself to do any sport because it is considered particularly effective. The movement has to be fun. “ Endurance sports such as walking, jogging, swimming or cycling are effective. But weight training is also recognized today as a healthy physical activity. The regular exercise has a positive effect on the effectiveness of insulin from. It contributes to the fact that the sugar is consumed directly from the blood in the muscle cells with a low need for insulin. 3. Protection factor “light cuisine” “There is no special diabetes diet,” says Rüdiger Landgraf. “Everything that is part of a sensible, healthy diet today is suitable both for diabetes patients and for prevention .” Anyone who has a problem with blood sugar should only pay particular attention to fruit consumption. “Ripe fruits contain a lot of fructose. For example, eating a pound of cherries at a time in summer is unfavorable. ” Various studies suggest that a diet with an emphasis on plant-based foods helps prevent diabetes. Dietary fiber in particular improves the insulin effect and thus helps the disturbed sugar metabolism on the jumps. In addition, a fiber-rich diet causes the blood sugar level to rise only slowly, so that blood sugar peaks are avoided. Plenty of vegetables and fruit contribute to the daily recommended dietary fiber ration of around 30 grams. Because of the sometimes very high fructose content in many types of fruit, the emphasis should be on vegetables. Pulses and preferably whole grain bread, rice and noodles several times a week also increase the fiber balance. 4. Protection factor “soft drink stop” Cola, lemonades or fruit juice drinks are mountains of liquid sugar and as such have become the focus of diabetes prevention in recent years. In many families, they are used as a thirst quencher and drink to accompany every meal, and they also provide the amount of calories in a meal – a liter of cola, for example, 450 calories. A French study has also only just unmasked the “light” versions with sweeteners as a diabetes risk . Because the artificial sweetness probably also drives up the blood sugar level and can initially lead to insulin resistance and ultimately to diabetes. Sugar-sweet drinks should be an occasional exception, just like enjoying a glass of wine . “The healthiest thirst quencher is still fresh water,” says the diabetes expert. 5. Protection factor “good sleep” Lack of sleep or disturbed sleep are considered independent risk factors for type 2 diabetes . Too little sleep not only increases body weight, but also upsets your metabolism. A lack of sleep has a negative effect on insulin release and blood sugar levels after a short time . The reason for this is that when you don’t sleep enough, the body releases stress hormones that intervene in the sugar metabolism. Short-term sleep deprivation has no lasting effects, but persistently poor sleep does: “People with nocturnal breathing pauses get diabetes more than average, on the other hand diabetes patients often suffer from the so-called sleep apnea syndrome,” says Rüdiger Landgraf. 6. Protection factor “relaxed vessels” There is a link between high blood pressure and diabetes. The causes for both ailments are comparable: overweight, poor diet, lack of exercise. Almost 90 percent of type 2 diabetics also suffer from high blood pressure. The risk of suffering cardiovascular disease is four times higher for them than for people without diabetes. If you lower your blood pressure to a normal level, you primarily reduce your risk of dangerous long-term effects of diabetes. Since diabetes attacks the blood vessels, high blood pressure accelerates the development of damage to the small blood vessels, for example in the retina or the kidneys. 7. Protection factor “nicotine renunciation” Smokers have a 30 to 50 percent higher risk of type 2 diabetes than non-smokers. The question of why has not been clearly clarified. Smokers may have an overall unhealthy lifestyle that encourages diabetes. However, nicotine, carbon monoxide or other substances from tobacco smoke may also have a direct harmful effect on the pancreas and fatty tissue. Subliminal inflammation occurs, combined with reduced insulin activity, which severely affects the metabolism.
If the child suffers from type 1 diabetes, everything changes for families. Now it’s time to measure sugar levels and attend training courses. Nevertheless, normality should return soon, experts advise. The first signs seem banal: the child drinks a lot and often has to go to the toilet at night. It looks increasingly exhausted and tired and loses weight. All of this could speak for type 1 diabetes. Martin Holder knows that drinking too much is not so noticeable, especially in summer. He heads the training and treatment facility for children and adolescents with type 1 diabetes at the Stuttgart Clinic. “Often the parents are still happy about it.” The symptoms are often recognized too late, as Prof. Andreas Neu explains. This leads to a metabolic derailment. The blood sugar rises considerably, acids are produced that over-acidify the body. “Cells and organs are paralyzed or incapable of functioning,” explains the Vice President of the German Diabetes Society. Children’s clinic as the first station The diagnosis is usually made very quickly, a blood or urine test brings clarity. Families, however, are hit hard by the chronic illness. “Life changes suddenly,” says Holder. As a rule, the children dealt with it better, explains Bernhard Kulzer, a specialist psychologist for diabetes. After the diagnosis, it is important to be admitted to a children’s clinic quickly to stop the insulin supply. The first days are to normalize the metabolism. Only then does the training of parents and child begin. How do I measure my blood sugar? What do I have to pay attention to when eating and how do I do sports in the future? All of these questions are answered in the process. This usually means a 14-day inpatient stay, says Holder. “The aim is that the children and their families can continue to live as normally as possible.” Don’t fall into the debt trap The initial phase is crucial for dealing with the disease, explains Kulzer. How do the parents overcome this shock together, and how do they integrate the disease into the family system? “Most of the time, research is carried out to see whether there are similar cases in the family and whether it is hereditary.” Despite intensive research, it is not yet certain how this type of diabetes develops. Certain structures of the immune system are definitely hereditary, reports Kulzer, but there are many people who do not develop diabetes. That is precisely why parents need to be informed and supported in order not to even ask the question of guilt. “At some point, however, everyone begins to struggle with the disease,” says Holder. For this reason, ongoing psychosocial support is often part of the program in the clinics. Type 1 diabetes is usually treated with insulin injections or an insulin pump. If the child is supplied with a pump, he or she has to change the catheter every two to three days, depending on age or with the help of the parents. “At the beginning the extra effort is of course still great and is often perceived as a burden,” explains Neu. However, measuring sugar, estimating carbohydrates and injections quickly become routine. Normality is crucial in everyday life Kulzer’s most important tip is therefore: normality. “The fact that the child becomes chronically ill means that more attention is paid to him.” His team therefore always advises taking it slow. “The technology is now very good, especially at the beginning, little can happen,” says Kulzer. He recommends parents to deal openly with the disease and to let the child deal with it openly. “This is the best chance that everything will normalize.” New pleads for a good balance between control, surveillance and restriction on the one hand and strengthening personal responsibility and freedom on the other. “Parents should trust that the child can achieve something themselves.” The experts know that siblings are often neglected. “The biggest mistake would be to wrap the sick child in cotton or to pay too much attention to the disease,” warns Kulzer. Holder recommends consciously involving siblings, maybe even handing over responsibility to them depending on their age or doing something exclusively with them. Support group for sharing According to the experts, it is important to extend the training to include the family. For example, the supervisors in the daycare center, kindergarten or teacher are informed in order to avoid misunderstandings. “Children think that it is contagious and then no longer want to sit next to the sick child or play with him,” says Neu. Teachers should be prepared especially for school trips. New at the University Clinic for Pediatric and Adolescent Medicine in Tübingen offers to train good friends of the child beforehand. “We instruct them about the signs of a possible metabolic derailment so that they know when to get help,” explains the professor. The experts advise parents to find a self-help group to exchange ideas and give tips. This is also important for the children to meet like-minded people and to realize that they are not alone. In addition, role models such as competitive athletes with diabetes 1 can help to better accept the disease.
If you get type 2 diabetes, you often have to change your eating habits and take blood sugar-lowering medication or even inject insulin. A diabetologist now points out that the disease is not a one-way street: a sharp weight reduction increases the chance of getting well again. Once diabetes, always diabetes: this was exactly a principle within medicine for a long time, writes Professor Stephan Martin, chief physician for diabetology and director of the West German Diabetes and Health Center (WDGZ) in Düsseldorf , in an article he published in the medical newspaper . It is no secret that, in addition to other factors such as genetics and lack of exercise, obesity also plays a role in the development of type 2 diabetes. However, the fact that those affected can actually defeat the disease through targeted weight reduction was, according to Martin, up until a few years ago in medical circles at best dismissed as an isolated case. Strong weight reduction leads to a decrease in symptoms A rethink only arose as a result of the results of bariatric surgery – i.e. surgical interventions to reduce body weight, which resulted in high remission rates in type 2 diabetes. A study from England from 2019 then also showed that non-surgical interventions such as sustained weight loss led to remission of type 2 diabetes. A new study from Quatar , which was published in the journal “Lancet” in June, also showed how targeted weight reduction resulted in lasting remission in the sick. For this purpose, 147 people who suffered from type 2 diabetes under two years of age , had a body mass index of 35 kg / m² and some were already taking medication, were divided into two different test groups: One was treated according to the regular guidelines. The others on a strict diet consisting of liquid meals. While the group lost an average of four kilograms with the regular measures, the kilograms fell by an average of twelve kilograms in the second group. A remission with normal long-term blood sugar values for at least three months was achieved in the first test group by only twelve percent; in the second, with the high weight reduction, an impressive 61 percent. “Unfortunately, these interventions are not accepted in Germany” According to Martin, it can be concluded from this study that a weight loss of ten kilograms gives those affected a 50 percent chance that the symptoms of diabetes will subside. “Unfortunately, these interventions are not accepted in Germany,” criticizes the diabetologist. That is why they are not implemented systematically. The doctor points out, however, that doctors have a duty to inform patients about such measures. “At least every person with newly diagnosed type 2 diabetes should be told that if you manage to lose more than ten kilograms, you have a 50 percent chance of defeating diabetes,” he urges.
Allergy sufferers need to be careful what they eat, what they touch and where they are. This psychological stress puts additional strain on the immune system. Relaxation exercises help relieve itching and shortness of breath. The life stories of allergy sufferers often tell of unfulfilled dreams, marginalization and fear. Rashes, itching, and shortness of breath are just the obvious symptoms. The physical effects of allergies are also very psychologically stressful: Many allergy sufferers sleep poorly, cannot concentrate properly or feel unsightly because of their rashes. “25 to 40 percent of allergy sufferers develop psychological problems, especially fears,” says Uwe Gieler from the Clinic for Psychosomatics and Psychotherapy at the University Hospital in Giessen and Marburg. In a kind of feedback effect, psychological stress can aggravate an allergy, possibly even trigger it. This was the result of numerous molecular biological research projects on the subject. Stress increases allergy symptoms “75 percent of allergy sufferers react to stress with an allergy surge,” says the biopsychologist Angelika Buske-Kirschbaum from the Technical University of Dresden. They put allergic test subjects who suffered from eczemasuffered from a stress test. The test persons had to solve arithmetic problems in a mock application situation and present themselves to a critical committee. Interestingly, after this stress test, allergy sufferers had significantly less of the stress-regulating hormone cortisol in their saliva than a non-allergic control group. The neurodermatitis sufferers had a significantly worsened skin appearance the next day: reddened areas were now significantly larger and more inflamed. “One of the tasks of cortisol is to regulate the immune system, particularly inflammatory reactions, in a stressful situation and to prevent an excessive immune response,” explains Buske-Kirschbaum the result. This control brake is obviously missing in allergy sufferers. Your immune system remains on the highest alert, and inflammation is free. Tenderness alleviates allergy stress At the University of Gießen and Marburg, Eva Peters, who heads the psychoneuroimmunology laboratory, researches the direct effects of psychological stress on the immune system and the skin. In 2008 Peters and her team discovered that a messenger substance called “Substance P” mediates stress in the skin. It acts like an interpreter between the nervous and immune systems. “If we exposed mice to terrifying noise for a long time, a certain type of nerve cell would multiply in them,” explains Peters. “These neurons communicate via substance P directly with those immune cells that aggravate allergic inflammation.” Entrenching is not a solution Complete isolation from the stressful environment is no solution. “It is not recommended to just lock yourself in at home and avoid any excitement,” says neuroimmunologist Peters. Repeated stress in small doses with plenty of breaks in between is even good. “The body becomes more tolerant of stress and produces more cells that suppress inflammation.” Caresses and massages provide an additional immune kick. The more often couples exchanged tenderness, the lower the concentration of stress hormones in their saliva, according to a study by the University of Zurich. Relaxation exercises such as mindfulness training and meditation also help. In a study by the University of Basel, the symptoms of pollen allergy sufferers improved when they put themselves mentally in an allergen-free environment, such as on a ski slope.
The nose runny, the eyes itch: almost a third of all adults in Germany suffer from an allergy – hay fever is the most common. The allergic runny nose is triggered by the pollen from trees, bushes, grasses, cereals and herbs. Flying pollen makes life difficult for many people. What allergy sufferers can do now: Ten valuable tips for allergy sufferers 1. You don’t want to do without regular ventilation, but more pollen comes in every time? Close-meshed pollen protection grids on the windows hold back most of it, but the less exchange of air means that ventilation must be longer. 2. Your clothes collect the pollen from outside and this is how it gets inside. It is better not to undress in the bedroom, because this is where they stay for a long time at night. With the short wash program they are washed out quickly. Then let it dry inside, because if the laundry is outside, the pollen will also hang on it. 3. Vacuum carpets and upholstered furniture regularly, ideally with a vacuum cleaner with a Hepa filter ( ideally class 14). This way, the pollen doesn’t get back into the room. Wipe smooth floors regularly with a damp cloth, otherwise the pollen will be blown up again and again with the dust. 4. Avoid too much exercise outdoors. During exercise, the increased need for oxygen is met by breathing through the mouth, which irritates the airways and leads to stronger reactions. Things are often better after the rain, because the pollen was “washed” out of the air. But be careful: it is worse after thunderstorms, because the pollen is pressed close to the ground and allergenic particles are also knocked out of the pollen 5. Sunglasses that close tightly around the eyes protect the eyes from light and pollen. 6. Refrain from smoking or smoking . The constant irritation of the airways make the mucous membranes even more vulnerable. 7. Wash your hair before you go to bed to prevent pollen from getting on your pillow. 8. Breathe through your nose if possible. The fine cilia filter out some of the pollen. You can flush the pollen out of your nose with a nasal douche. If possible, do not use nasal ointments, gels or powders. They stick together the hairs of the nose and impair the filter function. 9. traveling you do not occur in your main pollen season in a region in which your pollen. 10. Do you spend a lot of time in the car? Then you should equip your car with a pollen filter . Since they gradually become clogged, these filters have to be replaced once a year, preferably after the pollen season in autumn or winter. Pollen allergy: treatment on four levels Allergen avoidance : Allergen avoidance, i.e. avoiding pollen, is the safest method for treating hay fever. However, it is difficult to achieve because the pollen can fly for miles through the air. Desensitization: Specific immunotherapy is the only treatment method that addresses the cause. In the classic variant, the allergy sufferer is given the respective pollen allergen in gradually increasing doses in order to make them insensitive to the allergy trigger. In the meantime, however, drop or tablet therapy preparations can also be used – for use at home. For therapy, preparations should be used for which efficacy has been proven in studies. A hyposensitization should always be carried out by a doctor experienced in allergology. Medicines: The medicinal treatment is used to relieve and avoid the symptoms of hay fever and to treat the inflammatory swelling of the mucous membranes. Mainly anti-allergic antihistamines are used and more severe allergic reactions also anti-inflammatory cortisone preparations or sometimes leukotriene receptor antagonists to supplement therapy. Complementary procedures: A useful measure accompanying therapy is rinsing the nose with isotonic salt solution. This natural method has been shown to reduce the need for antiallergic medication.
Hay fever is increasing, especially in the cities. Although the allergy can develop into asthma within a few years, those affected and even doctors do not take hay fever seriously and do not treat it adequately. There are effective therapies available to prevent the body’s allergic reaction. Hay fever seems to be one of the widespread diseases with the highest growth rates. In recent years there has been a twenty-fold increase. Around 15 percent of adults and almost ten of children now have a pollen allergy. “Several factors are responsible for this increase,” says Knut Brockow, senior physician in the allergy department at the Clinic for Dermatology and Allergology at Biederstein, Klinikum rechts der Isar, TU Munich. Why pollen allergies are increasing so significantly On the one hand, there is the modern lifestyle with excessive hygiene. “If we have less contact with bacteria and parasites, the immune system can turn against harmless substances, which we then call allergens, and which trigger symptoms,” says the allergist, naming an important risk factor. It is known that allergies are increasing particularly rapidly in cities because the bacterial diversity there is much lower than in rural areas. Children who grow up with many siblings, who have daily contact with animals and who stay in the cowshed have a much lower risk of allergies. Bacterial diversity protects against allergies, so to speak. Heavy traffic means a high risk of hay fever The other reasons for the increase in pollen allergies: Due to the climate catastrophe, the flowering times have been extended by many weeks. New allergens, such as ragweed, are an additional burden for allergy sufferers. The undemanding herb was brought in from the USA by airplanes, first reproduced at military bases and now along the highways. Its pollen is much more aggressive than that of our native plants and can trigger an allergy particularly quickly. “Air pollution also plays a role,” warns the expert. Although the air in Germany is less polluted with large particles than it used to be, fine dust and soot particles, for example from cars with internal combustion engines, have increased in some cases. They have been shown to increase the allergenic effect of pollen. It is therefore obvious that city dwellers are probably particularly at risk for pollen allergies. “Anyone who lives on a busy street has a higher risk than in a neighborhood with little traffic,” explains the professor. Hay fever – first sensitized, then allergic The mucous membranes of the eyes, nose, throat and bronchi play an important role in the development of a pollen allergy. If pollen gets on the mucous membranes, the immune system reacts more intensely in some people. Right from the first contact, white blood cells (lymphocytes) cause antibodies (E-immunoglobulins, IgE) to be formed against the pollen proteins – as if these actually harmless proteins were pathogens. After this sensitization, the immune system reacts with every further contact with the corresponding pollen: IgE antibodies are formed, settle on mast cells, these react and release the inflammatory messenger substance histamine, among other things. This triggers the cascade of allergic symptoms, in hay fever these are: Itchy eyes, tears in the eyes Runny nose Stuffy nose Sneeze Hay fever is usually not treated properly or not at all Most of those affected often suffer for decades and fail to get proper treatment, experiment with over-the-counter products that are often not taken properly, for example too short. For example, many stop self-treatment because the antihistamines hardly help. This is the case when the pollen allergy is quite severe. “Hay fever is simply not taken seriously enough,” remarks Knut Brockow. Many patients often see no need for action because the complaints “only” occur temporarily. When it rains or the flowering time of the allergenic plant is over, the hay fever symptoms will also disappear again. But this trivialization would not only apply to the patient, but also to the doctor, such as the family doctor, who is the first point of contact for most people with hay fever. They underestimate the problem of a pollen allergy and do not refer the patient to an allergist. The consequences of hay fever – allergic to more and more pollen and asthma Not treated or not treated adequately, hay fever can get worse and worse. The expert warns that this risk exists especially in the years after the first occurrence of the pollen allergy. This is how the allergy can spread. Initially, it is resistant to grass pollen, for example, then birch and alder are added, possibly also house dust mites. In addition, the allergic symptoms can become so severe that the person affected is really sick and cannot work. “It was not for nothing that people used to speak of ‘hay fever’ because it can paralyze you,” explains the scientist. The head is closed like a flu. However, there is a particularly high risk of bronchial asthma resulting from hay fever. Asthma is known to be chronic, incurable and can occur all year round. This level change from pollen allergy to asthma is possible because the mucous membrane of the nose and lungs form a unit and can react together. “Children up to six years of age diagnosed with hay fever have been shown to have three times the risk of asthma than others,” reports Knut Brockow. Therapy: Antihistamines are usually not a permanent solution Hay fever should therefore best be clarified by an allergist, who can use allergy tests to determine which pollen the body reacts to and to what extent. Then the appropriate treatment is initiated. Self-treatment with antihistamines is usually no solution to the hay fever problem. Because they do not target the cause of the hay fever, the misdirected immune reaction, but only slow down the symptoms. “These drugs only reduce the effects of histamine on the organs, but they cannot adequately influence the development of the allergy,” explains the expert. That is why antihistamines are only recommended for mild, sporadic allergic symptoms, but not for complaints that last for several days. Cortisone nasal spray for hay fever Then corticosteroid-containing nasal sprays should be used as a stronger therapy. “The prescription of corticosteroids as a nasal spray is far too seldom used for hay fever,” criticizes the allergist. Many doctors do not know how useful the active ingredient is for pollen allergies because it has a positive effect on inflammation. The cortisone nasal sprays are also available in combination with antihistamines. They treat the symptoms much better than oral antihistamines and are suitable for patients whose symptoms do not increase and who do not have any initial asthma symptoms (slight shortness of breath, slight cough) such as coughing. Specific immunotherapy addresses the cause of the allergy However, both drugs – corticosteroids and antihistamines – only treat symptoms. If the hay fever is severe or worsen, it is best to treat the cause of the disease and not just treat the symptoms. This is where specific immunotherapies (SIT) come in. The desensitization or colloquially also known as “vaccination” against hay fever means: The immune system is slowly, with initially minimal doses, used to the triggering allergen until the body reacts normally to the actually harmless substance. “These therapies are very effective, especially when the allergy has only one trigger, such as grass pollen, but are also used far too seldom – because the patient does not even know that this is possible, as does the first-aid doctor,” explains the expert, Desensitization means: the immune system learns tolerance to pollen How these therapies work: The prerequisite is the identification of the triggering pollen through the appropriate allergy tests. By far the most common triggers are grasses, birch, alder and hazel. Those affected can already be hyposensitized to them. Two forms of SIT are currently available: subcutaneous immunotherapy (SCIT, regular injections of the allergens under medical supervision for about three years) sublingual immunotherapy (SLIT, drops or tablets with the corresponding allergens, which the patient takes independently as instructed by the doctor, also over a period of three years) SCIT has established itself particularly well, “The advantage here is that the doctor carries out the treatment and thus the cooperation of the patient is guaranteed,” emphasizes Knud Brockow. In recent years, however, SLIT has also proven itself more and more and is almost as successful as subcutaneous immunotherapy. The sublingual variant is particularly suitable for patients who have less time and want to carry out the treatment at home. New therapies: more targeted and fewer side effects In the future, the desensitization should have an even more specific effect, but trigger fewer side effects. These include itching and swelling in the area of application, i.e. in the mouth or the injection site. Systemic allergic reactions are also rarely possible. “That is why one tries to change the allergens administered in such a way that they respond less to the mast cells and thus trigger fewer allergy symptoms, but to better address the T lymphocytes, which are supposed to generate allergen tolerance,” the allergist explains the new research approach. Researchers try, for example, to only use the individual molecular proteins in the pollen that trigger the allergy. In the case of birch pollen, for example, this is Bet v 1. However, further research has to be done on this. In addition, new forms of administration for desensitization are being tested, for example as plasters. This epicutaneous desensitization (pollen patch) could simplify SIT compared to sublingual and subcutaneous application. Another research approach could provide a particularly elegant solution, an antibody against the immunoglobulin IgE, the allergic reagin. This would block all IgE molecules in the body. They can no longer dock on the cell surfaces and thus trigger the allergy. The antiallergic effect would start earlier than that of the antihistamines at one point. Anti-IgE antibodies will not only work against pollen allergies, but also against other allergies that take place via this mechanism. “Corresponding drugs are currently not yet approved for this and are still too expensive, but if they are further developed they would be a sensible therapy option,” says the expert. These drugs (omalizumab) have already been approved for the treatment of severe, uncontrollable allergic asthma and urticaria. Conclusion : If the symptoms of hay fever persist for more than a week, are very pronounced and / or if there is a cough, an allergist should definitely clarify the symptoms. Because if left untreated or not adequately treated, the allergy can spread and the person affected reacts allergically to more and more stimuli. There is also a risk of changing floors and asthma in addition to hay fever. But almost everyone who suffers from a pollen allergy today can be helped. Modern therapies such as desensitization slowly and carefully get the immune system used again to react normally to the actually harmless pollen.