HEALTH

Published: 09 April 2020

doi: 10.3389/frym.2020.00043

ALLERGY: CONCEPTS AND TREATMENTS

Sarah de Oliveira Libório 1 , Gabriela Gama Freire Alberca 2 , Maria Notomi Sato 1 and Ricardo
Wesley Alberca 1*
1
Laboratory of Dermatology and Immunodeficiencies, LIM-56, Department of Dermatology, School of Medicine, Institute of
Tropical Medicine of São Paulo, University of São Paulo, São Paulo, Brazil
2
Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil

Allergy is a syndrome characterized by an undesirable bodily reaction

YOUNG REVIEWERS:
against a harmless substance. Allergies are very common, and the
ALESSIA prevalence of allergic diseases has continued to grow over the last
AGE: 13 50 years. It is not completely clear why some people develop allergic
reactions and others do not. In this article, we explore how an
ANTONIO
allergic reaction occurs, as well as discuss the causes of allergy and
AGE: 12
its treatments.

IMPORTANCE TO CHILDREN AND TEENS

IMMUNOTHERAPY
Is a type of treatment Allergy is a worldwide problem, and there is a high prevalence of
that aims to modify allergic syndromes like allergic asthma and food allergies among
how your immune
system reacts to
children. It is important to understand what triggers and how to
something, in the case prevent/treat an allergic reaction. Not only that but highlight the usage
of allergy of immunotherapy for allergic disorders and how they can improve
immunotherapy it aims the quality of life of non-drugs responders.
to modify the reaction
to the allergen.

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 Libório et al. Allergy Concepts

WHAT IS AN ALLERGY?
We all have a recognition and defense system in our bodies, which is
called the immune system. The immune system is made up of cells,
substances called antibodies, and many other components. When we
are vaccinated or when we get infected by a microorganism that
can cause disease, our immune system aims to develop cells and
antibodies that will protect us against that specific microorganism.
Antibodies are molecules produced by cells called B cells, and
antibodies have the ability to bind to the invading microorganism, to
prevent or combat an infection. However, in an allergy, the immune
system reacts in a different way.

An allergy occurs when, for some reason, the immune system creates
a response against a harmless substance, like pollen or a certain kind of
food. Allergies are very common, and it is estimated that around one in
three people has some type of allergy. Allergy can generate a reaction
in any part of the body. For example, a food allergy can cause problems
in the intestines, with symptoms, such as abdominal pain and diarrhea.
Allergy can show up in the lungs in the form of allergic asthma, causing
ALLERGEN
difficulty breathing and overproduction of mucus.
Is normally a harmless
substance, which in the
case of an allergic
person can trigger a HOW DOES AN ALLERGIC RESPONSE HAPPEN?
response for the
immune system and When the body of an allergic person encounters an allergen (the
results in an substance that causes the allergic reaction), the immune system
allergic reaction.
produces cells and antibodies against that harmless substance.
ANTIBODY
Common allergens are shown in Figure 1. Some of the cells produced
in an allergic response are called type 2 T helper cells (Th2), and
A Y-shaped protein
produced B cells.
these Th2 cells help other cells, called B cells, to produce a certain
Antibodies bind to type of antibody called immunoglobulin E (IgE). The IgE then binds
microorganisms that to other immune cells, making those cells very sensitive to the
infect the body, to allergen. When the person comes into contact with that same allergen
neutralize them, and
also to allergens, which
again, the immune cells coated with IgE release chemicals that cause
creates an inflammation and swelling, and those chemicals are the cause of the
allergic response. itching and sneezing symptoms that often occur in the body’s attempt
IgE to remove the allergen. The Th2 cells can also go to the site where the
A type of antibody allergen entered the body and promote inflammation in that site. For
produced by an allergic example, the eyes of an allergic person can become swollen, red, and
person. IgE binds to itchy in response to an allergen in the air, like pollen.
certain cells of the
immune system and
causes an immediate
allergic reaction if the WHY DO ONLY SOME PEOPLE HAVE ALLERGIES?
person comes in
contact with the Although we know a lot about how allergic reactions occur, the exact
allergen again.
reason why some people develop allergies while others do not is still a
mystery. We know that there is a genetic predisposition, meaning that
if your mother or father have allergies, you are more likely to also have

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 Libório et al. Allergy Concepts

Figure 1
Examples of common
allergens. Mites present
in house dust, fur from
domestic animals,
compounds in drugs,
venom and other
substances presents in
insect stings, nuts,
eggs, milk, and pollen
from flowers.

Figure 1

allergies. Factors in the environment also play a role in the likelihood

of developing allergies [1–3], such as:

- Where you live (if it is rural or urban);

- Lifestyle factors (whether you exercise, for example);
- Dietary habits (the food you eat); and
- Medicines (antibiotics for example).

HOW ARE ALLERGIES DIAGNOSED?

To be sure that a person is allergic to something, a medical doctor
can perform some simple tests. The most popular ones are called the
skin-prick test and the IgE test.

In the skin-prick test, the doctor or nurse puts tiny amounts of different
allergens just under your skin. If you are allergic, you will develop a red
bump where the allergen was placed. The doctor can tell how allergic
you are by the size of the red bump. In the IgE test, the doctor will
do some blood tests to see whether you have a high amount of IgE in
your bloodstream, or IgE specific to some common allergens.

HOW ARE ALLERGIES TREATED?

If you have a positive allergy test, and you know which allergen(s)
you are allergic to, the best treatment is to avoid contact with
those allergens. However, it is easier to avoid contact with some
allergens, like peanuts or milk, than it is to avoid airborne allergens,
like dust or pollen. Can you imagine not being exposed to any
pollen during spring? Since it is very hard to avoid some allergens

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Figure 2
The allergy
immunotherapy
“superhero.”
Immunotherapy for
allergy works mainly
through the creation of
T regulatory cells,
which inhibit
allergy-causing Th2
cells and stimulate the
production of blocking
antibodies that prevent
the allergen from
coming in contact with
the “allergy
antibody,” IgE.

Figure 2

completely, particularly the airborne ones, medicines have been

developed to reduce inflammation and stop the allergic reaction
from occurring.

If an allergic person is exposed to a very large amount of allergen, or if

the person has a very severe allergy, that person may develop a serious,
body-wide reaction that can be life-threatening. This reaction is called
ANAPHYLACTIC anaphylactic shock. Anaphylactic shock can occur very quickly after
SHOCK exposure to the allergen. The person’s blood pressure drops, he or
It is a severe, potentially she can have extreme difficulty breathing, and death can even result.
life-threatening, Therefore, if you see someone having an anaphylactic shock, quickly
allergic reaction. Some
common symptoms
call for help, because this is a true medical emergency.
include swelling of
throat or tongue,
difficulty breathing, IS THERE A CURE FOR ALLERGY?
vomiting, dizziness, and
drop blood pressure.
The medicines developed to treat allergies are safe and helpful for
relieving allergy symptoms, but they do not cure allergies [4]. For
more than 100 years, scientists have been working on developing a
cure for allergic disorders [5]. This is especially important because
a part of the allergic population does not respond well to regular
allergy medicines.

Currently, the only treatment with the potential for cure is called
immunotherapy. Immunotherapy is a treatment that regulates a
person’s immune system so that the person responds differently to
an allergen. Immunotherapy is used for other diseases in addition to
allergy, including as a treatment for certain types of cancer.

Immunotherapy for allergies involves giving increasing doses of the

allergen to the allergic person, over time. There are two different

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 Libório et al. Allergy Concepts

allergy immunotherapies: subcutaneous, when the allergen is put

under the skin of the patient (also called allergy shots) and sublingual,
when the allergen is put under the tongue of the patient (also called
allergy tablets). Both types of immunotherapy have strong and weak
points, but they are both effective, to some extent, in reducing
allergic reactions.

In general, allergy immunotherapy aims to teach the immune system

to act differently, producing another kind of T cells, called T
regulatory cells (Treg), and other types of antibodies, the blocking
IgG immunoglobulin G (IgG) (Figure 2). Treg cells encounter the Th2 cells
A type of antibody that and prevent their activation. IgG antibodies encounter the allergen
can be produced after before the allergen meets the IgE antibodies on immune cells, and this
allergy immunotherapy.
IgG can prevent the
can help prevent the allergic reaction.
immediate allergic
reaction by binding to
the allergen and SUMMARY
blocking it, before the
allergen binds to
the IgE.
In conclusion, allergies are a serious health problem. Although there
are medicines that relieve allergy symptoms, the only cure for allergy
is the use of immunotherapy, which changes the patient’s response
to the allergen. Immunotherapy is usually prescribed for patients that
do not respond to the usual medicines. Scientists all over the world
are still working on understanding allergies so that they can develop
better treatments and possibly even a cure for allergies.

REFERENCES
1. Alberca-Custódio, R. W., Greiffo, F. R., MacKenzie, B., Oliveira-Junior, M. C.,
Andrade-Sousa, A. S., Graudenz, G. S., et al. 2016. Aerobic exercise reduces
asthma phenotype by modulation of the leukotriene pathway. Front. Immunol.
7:237. doi: 10.3389/fimmu.2016.00237
2. Schröder, P. C., Li, J., Wong, G. W., and Schaub, B. 2015. The rural-urban enigma
of allergy: what can we learn from studies around the world? Pediatr. Allergy
Immunol. 26:95–102. doi: 10.1111/pai.12341
3. Yilmaz, B., Carvalho, J. C., and Marialva, M. 2019. The intestinal universe—full of
gut heroes who need sidekicks. Front. Young Minds 7:111.
doi: 10.3389/frym.2019.00111
4. Larsen, J. N., Broge, L., and Jacobi, H. 2016. Allergy immunotherapy: the future
of allergy treatment. Drug Discov. Today 21:26–37.
doi: 10.1016/j.drudis.2015.07.010
5. Ring, J., and Gutermuth, J. 2011. 100 years of hyposensitization: history of
allergen-specific immunotherapy (ASIT). Allergy 66:713–24.
doi: 10.1111/j.1398-9995.2010.02541.x

SUBMITTED: 06 October 2019; ACCEPTED: 19 March 2020;

PUBLISHED ONLINE: 09 April 2020.

EDITED BY: Valeria Costantino, University of Naples Federico II, Italy

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Libório et al. Allergy Concepts

CITATION: Libório SdO, Freire Alberca GG, Sato MN and Alberca RW (2020) Allergy:
Concepts and Treatments. Front. Young Minds 8:43. doi: 10.3389/frym.2020.00043

CONFLICT OF INTEREST: The authors declare that the research was conducted in
the absence of any commercial or financial relationships that could be construed
as a potential conflict of interest.

COPYRIGHT © 2020 Libório, Freire Alberca, Sato and Alberca. This is an open-access
article distributed under the terms of the Creative Commons Attribution License (CC
BY). The use, distribution or reproduction in other forums is permitted, provided
the original author(s) and the copyright owner(s) are credited and that the original
publication in this journal is cited, in accordance with accepted academic practice.
No use, distribution or reproduction is permitted which does not comply with these
terms.

YOUNG REVIEWERS
ALESSIA, AGE: 13
Hi, my name is Alessia and I live in Naples, Italy. I am in the eighth grade. I love
playing guitar and piano and I like singing. In my free time I always hangout with my
friend or read books. My favorite school subject is English. I would like to become a
psychologist or a detective, because human mind and solving difficult cases always
fascinated me.

ANTONIO, AGE: 12
Hi, I am Antonio and I live in Naples, Italy. I am in the eighth grade. My passion is
playing tennis, basketball, and football. My favorite school subject is history and I hate
maths. I also like reading adventure books, such as Sandokan and Greek mythology.
My favorite food is pizza and I do not like broccoli.

AUTHORS
SARAH DE OLIVEIRA LIBÓRIO
I am an undergraduate student of Biomedicine in Brazil. My research focuses on
finding ways to improve the health of children via maternal interventions during
pregnancy. When I am not at work or at college, I enjoy relaxing and eating Açaí,
a Brazilian desert.

GABRIELA GAMA FREIRE ALBERCA

I am a Ph.D. student at the Institute of Biomedical Science at the University of
São Paulo. My research focuses on understanding the influence of gastrointestinal
bacteria on the development of diseases. In my free time, I enjoy cooking.

MARIA NOTOMI SATO

I am a professor at the University of São Paulo. My research focuses on maternal-fetal
interactions, allergy, and viral infection. I enjoy coffee and coconut desserts.

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Libório et al. Allergy Concepts

RICARDO WESLEY ALBERCA

I am a post-doctoral researcher at the University of São Paulo. My research focuses
on the development of treatments for respiratory diseases. I enjoy books and movies
*[email protected]

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