FACTORS INFLUENCING DEVELOPMENT OF ALLERGIC RHINITIS
Genetic Factors
In order for you to develop allergic rhinitis, you must have inherited the ability to form allergic antibodies, called IgE antibodies, to things like pollen, mites, animals, etc. This ability runs in families, but the exact manner of its transmission from generation to generation has been difficult to define. Recent work suggests that a small fraction of chromosome number six carries this ability.
What is clear about the inheritance of allergic illness is that one’s chances of developing allergic rhinitis are increased when one parent suffers from it and further increased when both parents are afflicted. Only a small percentage of people born into families in which neither parent has allergic rhinitis will ever develop allergic rhinitis.
Exposure
One thing is for certain about allergic rhinitis: you must be exposed to the things to which you have the inherited ability to make IgE antibodies, or you cannot become allergic.
INHERITANCE + EXPOSURE = ALLERGY
Geographic Location
The effects of geographic location are largely those of exposure. If you change geography-local, regional, national, or international – your exposure may be altered for either better or worse.
Pollution
Pollutants in the outdoor or indoor air mainly function as irritants, stimulating nerve endings in already-irritated allergic noses and causing symptom-producing reflexes to occur. To date there is no evidence that natural exposure to outdoor pollutants plays a causative role in the development of allergic rhinitis.
Such is not true for indoor pollutants, however, specifically cigarette smoke and the fumes of natural gas. Maternal cigarette smoking has been shown to increase the likelihood of developing allergic respiratory disease in nonsmoking children. Chronic exposure to maternal cigarette smoking and natural gas fumes have been associated with increased upper and lower respiratory infections in children. (In these studies mothers were the primary caretakers of the children; thus, their smoking affected the children adversely. If the situation was reversed and the father was the primary caretaker at home, his smoking would have an adverse effect on the children.
Age
It is estimated that 80 percent of the people who suffer from allergic rhinitis have their first symptoms prior to twenty years of age, with many at less than ten years of age. Allergic rhinitis tends to begin early in life, gradually worsen over many years, then decline in old age. Its decline during old age is likely due to a decline in the ability of our immune systems to mount allergic responses. Spontaneous remission of symptoms sometimes occurs in early to mid-life, but only in 15 to 25 percent of patients with seasonal allergic rhinitis. Sufferers of perennial allergic rhinitis are much less likely to undergo spontaneous remission.
Nationality
The incidence of various allergic disorders does vary between countries, but the factors responsible for this have not yet been defined.
Sex
During childhood, about twice as many boys as girls suffer from allergic rhinitis. During late childhood and adolescence this sexual difference equalizes. During the midlife years, more men are affected than women, but this difference disappears as people pass into their 50s. The reasons for these sexual differences are not known.
Infection
The ubiquitous nature of upper respiratory infections precludes any definitive statement about their role in the causation of allergic rhinitis. But the fact that the spring and fall pollen seasons coincide with a time of increased viral upper respiratory illnesses and the fact that infections can alter immune responses (increasing certain ones and decreasing others) invites further research into the relationship of infectious illnesses and the development of allergic illnesses.
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