Frequently Asked Questions


What is IgE?

IgE is the antibody associated with allergy.  When a foreign invader or substance is recognized by the immune system, antibodies are produced against specific substances, such as pollen. There are specialized classes of antibodies with different functions in the body. The IgE class is associated with allergic reactions. Pollen, for example, is inhaled and an immune process takes place in allergic individuals causing wheezing, sneezing, coughing, etc., depending on the location of the allergic reaction



What is anti-IgE treatment?

Anti-IgE therapy is taken by injection and is primarily used to treat moderate-to-severe allergic asthma.  Anti-IgE therapy keeps the allergic reaction from taking place and potentially can treat all types of allergic reactions. The production of anti-IgE is high tech and costly to develop.



What is the difference between allergy and asthma?

Asthma is frequently the result of an allergic reaction. Allergy involves the body releasing chemical mediators, like histamine, that cause reactions or symptoms when an individual is exposed to a substance(s) such as pollen, cat, or mold to which he or she is allergic.


Various parts of the body can be affected by allergy (nose, skin, gut, etc.), including the lungs. Asthma involves sensitive airways which react to allergens (allergic reaction), as well as other conditions, such as exercise, infections, or weather changes.


Airways in the lungs NARROW due to muscles tightening around the airways, swelling inside of airways, and producing extra mucus making it difficult to breathe. Allergy is the most common asthma trigger.



Sometimes I have trouble breathing when I run in PE. What should I do?

Exercise can trigger asthma in individuals with asthma or in some individuals who have allergy. It may be the only trigger for asthma.


Talk to your doctor about using a quick-relief inhaler like Proventil®, Ventolin®, or Maxair®, 15 minutes prior to strenuous activities. If this is not enough, adding Singulair® once a day for prevention can help. Also, taking a daily low-drowsy antihistamine like Zyrtec®, Clarinex®, or Allegra® during the seasons your allergies are worse might prevent allergy problems and consequently decrease asthma symptoms.


If you do not have a specific diagnosis, an allergy evaluation or tests can pinpoint your specific problem and provide you with a plan that should enable you to play sports or participate in PE.



My doctor prescribed two inhalers for asthma – one for daily use and one to use when I have symptoms. Why should I use an inhaler when I am not having trouble breathing?

Asthma involves a chronic inflammatory process of the airways in the lungs. Airway inflammation (twitchy, irritated, and swollen airways) is present even when symptoms (cough, wheeze, or shortness of breath) are not present; it takes less of a trigger to cause symptoms when the airways are inflamed.


Consequently, asthma is treated with two kinds of medicines – “controller” medicine used daily and “quick-relief” medicine taken when symptoms occur. Your daily inhaler decreases airway inflammation making it less likely that you will have breakthrough symptoms.
It is important that you treat airway inflammation daily reducing the need for quick-relief medicine. “Controller” medicines are usually taken once or twice daily and should be left at home; however, always carry your quick-relief inhaler in your purse or pocket.



Do you take inhaled corticosteroids?
Rinse mouth immediately after inhaling even when using a spacer. DO NOT swallow rinse water.



Are you allergic to dust mites?
Encase even new mattresses, box springs, and pillows in zipped allergen-proof covers as they quickly become infested with dust mites.



Are you allergic to dust mites and mold?
Moisture increases both of these allergens. Keep indoor humidity between 25 and 50 percent. Do not lay carpet on concrete/cement; moisture from the concrete can keep the carpet damp.



Have you had an acute asthma flare?
Avoid strenuous activity for a day or two following an acute asthma flare or attack.



Do you exercise outdoors?
When breathing fast and through the mouth during exercise, one can inhale more allergens and irritants than usual.



Do you use eye drops?
When using topical eye medicines, do not touch the eyelid or surrounding area with the dropper tip to avoid contamination of tip and solution.



What are some maintenance tipsthat can reduce mold exposure?

Use exhaust fans in bathrooms. Repair leaky plumbing. Empty the drip pan under the refrigerator. Air out dark spaces under sinks. Wash and dry wet clothing and towels promptly or hang to dry until they can be laundered. Spread out the shower curtain across the shower rod in order for it to dry following a shower.



What fall activities may increase mold exposure?
Raking leaves Walks in the woods Fall camping trips Fall planting Spreading pine straw Handling fire wood



How can ear or sinus pressure be reduced during air travel?
Taking a short-acting decongestant by mouth or using an over-the-counter decongestant nasal spray (like Afrin®) 30 minutes prior to flight will help sinus or ear discomfort. On a long flight, use a decongestant 30 minutes prior to descent which is when the pressure problem occurs. If possible, avoid flying during and shortly after acute sinus or ear infections. Chewing gum, swallowing, or sipping water may decrease ear or sinus pressure.



How do allergy shots help?

Allergy shots work by vaccinating a person against the inhaled allergens to which that person is allergic.  Venom therapy for stinging insect allergy works in the same way; the shots expose a person to a small increasing amount of the venom.


By exposing a person to allergen by an injection, we are able to trick the body into responding to these allergens in a different way, since most of these allergens typically enter the body across mucous membranes.  By slowly increasing the amount of allergen we are able to suppress production of the allergy antibody, or IgE, and also increase the production of blocking, or IgG, antibody which helps prevent the allergen from attaching to cells (called mast cells) which explode and release the chemical mediators that cause inflammation and allergy symptoms.



How long should one continue to take them?

Most patients are typically on allergy shots for 3-5 years.  Some patients may require shots longer and potentially for a lifetime.



Who should take allergy shots?

Candidates for allergy shots include patients with allergic causes of nasal rhinitis, chronic sinusitis, extrinsic or allergic asthma, or skin conditions such as hives.  In addition, patients who are allergic to stinging insect venom are also candidates for allergy shots directed against the venoms.



What is the difference between conventional immunotherapy and rapid desensitization?

Conventional allergy shot build-up is the traditional technique or method to achieve therapeutic doses of allergen in allergy shots.  With rapid desensitization or RUSH immunotherapy, we are able to bypass several months of build-up in less than a day. This is accomplished by pre-medicating the patient with prednisone or corticosteroid and two types of antihistamines for a couple of days before the procedure. With these medications on board, most patients can tolerate the rapid build-up without any problem other than minor soreness of the arms.


Both methods are effective at achieving therapeutic benefit from the allergy shots; however, we find that patients who have undergone RUSH immunotherapy are able to benefit earlier and reduce medications sooner than those who have the traditional or conventional build-up.  Overall, either method works.  However, because of the effectiveness, safety, and time saved — for many patients the rapid desensitization is preferred.  This is especially true in patients who have stinging insect allergy and are at high risk for anaphylactic reactions which we can prevent with the allergy shots.



Who can take these methods?

Most patients are candidates for allergy immunotherapy by either method if they do not have problems taking the premedications and their heart and lung status are at acceptable levels.