"Large patches of redness, swelling and itching appear all over the body and even on the face anytime and anywhere. I feel that I have lived a very careful life, cleaning every day and washing and changing clothes frequently. I don't know why I still have allergies, and they are getting more and more serious." Every spring , Ms. Zhang, who lives in Ma'anshan City, is miserable.

　　“Before going out, you should check the pollen forecast to decide what mask to wear.” “There are four mite removal devices at home, and a fresh air system is also installed.” “Every time I go on a business trip, oral anti-allergic drugs and nasal sprays have become standard luggage.”… …When it comes to allergies, many people have endless complaints about allergies, and there are not a few people who have been ill for a long time.

　　During interviews, many experts said that there are many more patients with allergic problems now than in the past. One of the characteristics is that there are more and more young people. Their living environment is relatively clean, but they are affected by allergic rhinitis, allergic rash, Allergic cough and other problems have been bothering me repeatedly. Is it that the cleaner you are, the more likely you are to be allergic? With questions, the reporter conducted an interview.

Being too clean may be a mistake

　　Nowadays, many people are accustomed to using alcohol and other disinfectants to clean clothes and floors. Any place that can be touched by hands will be disinfected first. The germs have been eliminated, but allergies cannot escape, and the incidence is increasing. Is there any connection between this?

　　"Allergy is an immune reaction, an abnormal reaction of the human body to a specific substance, also known as an allergic reaction." Ma Tingting, chief physician of the Allergy Department of Beijing Century Monument Hospital affiliated to Capital Medical University, said that type I allergy is an immediate allergic reaction. , is the most common clinical manifestation, often manifesting as urticaria, allergic rhinitis, abdominal pain and diarrhea, etc.

　　"Type I allergy is mainly mediated by IgE and involves the activation of mast cells and basophils. During the sensitization stage, allergens enter the body and stimulate B lymphocytes to produce IgE antibodies. These antibodies interact with mast cells and basophils. The Fc segment on the surface of neutrophils binds, putting the body in a sensitized state. When the body is exposed to the same allergen again, the IgE antibody specifically binds to it, causing mast cells to degranulate and release a variety of biologically active mediators, such as histamine, Kinins, 5-hydroxytryptamine, etc., these mediators cause symptoms such as blood vessel dilation, smooth muscle contraction, increased gland secretion, etc., thus leading to allergic reactions." Ma Tingting explained.

　　"Excessive cleaning will cause the loss of beneficial bacteria, lead to immune imbalance, and may easily lead to allergies." Ma Yanliang, chief physician of the Department of Respiratory and Critical Care Medicine at Peking University People's Hospital, explained to reporters, "Most of the microorganisms in the daily environment are beneficial, and beneficial bacteria Living in the mouth, intestines, and respiratory tract for a long time forms the body's immune barrier, which can resist harmful pathogens and maintain immune balance."

　　"Moderate exposure to microorganisms may reduce people's risk of allergic diseases." This is the main point of the "hygiene hypothesis" that was once popular in the medical community. This hypothesis holds that there is a balance between infectious diseases and allergic diseases. If the former is lacking, the latter is likely to occur more frequently. Allergic reactions include immediate reactions and delayed reactions.

　　"In the early stages of allergy, mast cells release mediators such as histamine, tryptase, leukotrienes, prostaglandins, and cytokines. The immediate reaction occurs within minutes of exposure to the allergen and lasts for 40 to 60 minutes." Ma Yanliang said that for example, sneezing and runny nose immediately after contact with allergens are caused by the edema of the nasal mucosa caused by these particles and the extravasation of fluid in the blood vessels.

　　"Delayed-type reactions can be understood as the immune system producing antibodies against allergens, which activate chronic inflammatory responses after binding to allergens." Ma Yanliang said that delayed-type reactions usually occur hours to days after exposure to allergens. Symptoms include skin redness, swelling, itching, difficulty breathing, and gastrointestinal discomfort.

Immune cells hide “allergy memory”

　　"Preschool is an important period for the formation of human immunity." Ma Yanliang said that when exposed to allergens in the environment, some memory cells in the lymphatic system will form immune memory, and they may not have allergic reactions to them when they grow up.

　　"Our team's investigation also confirmed this result." Ma Tingting said that the team had conducted an epidemiological survey on the prevalence and risk factors of allergic rhinitis and asthma in Inner Mongolia. The data showed that pollen-induced allergies in urban areas The prevalence of rhinitis is higher than in rural areas (23.1% in urban areas and 14.1% in rural areas).

　　"Rural areas mostly rely on coal or wood for heating, and residents are exposed to more microorganisms and their products, such as bacterial endotoxins and environmental mycobacteria-ria7, which may have the potential to prevent atopic diseases." Ma Tingting explained, "With appropriate exposure to an environment with more microorganisms, endotoxins will trigger normal T cell immune responses, promote immune balance in the human body, strengthen immune regulation, and prevent the development of allergic constitution."

　　"Actually, the human body has two types of immune cells, TH1 and TH2. TH1 is mainly responsible for dealing with foreign bacteria and viruses, while TH2 mainly deals with parasites and allergens. A healthy state should be a balance between the two. On the contrary, if one is weakened The other side will become stronger." Ma Tingting said that being too particular about hygiene will reduce the chance of human infection. In this way, TH1, which can deal with bacteria and viruses, cannot be used, and TH2 will take advantage and develop various allergic diseases.

　　A paper in the recent issue of the allergic disease journal "Allergy" conducted a related experiment - using two household laundry detergents to dilute the back skin of mice multiple times. After 4 hours of detergent treatment, electrical impedance spectroscopy ( EIS) and transepidermal water loss (TEWL) measurements were performed to assess barrier function, and human skin biopsy samples were subjected to RNA sequencing and targeted multiplex proteomic analysis to study the effects of laundry detergents and detergents on human skin in vitro. Experiments have found that laundry detergent damages the epidermal barrier of human skin.

　　"Many studies have found that damage to the skin barrier function is related to skin allergic diseases." Yang Bilian, chief physician of the Department of Dermatology at Beijing University of Chinese Medicine Oriental Hospital, said that the skin barrier refers to the sebum film + stratum corneum. When you zoom in to look at the sebum membrane and stratum corneum, you can see that the neatly arranged keratinocytes and the lipids in the intercellular spaces form a protective layer like a city wall, so the skin barrier is also compared to a "brick wall structure."

　　"A complete wall consists of wallpaper, bricks and cement. The wallpaper represents the sebum membrane (mainly oil secreted by the skin), the bricks represent keratinocytes, and the cement represents physiological lipids." Yang Bilian made an analogy: excessive cleaning will cause washing. If the wallpaper is removed, the cement will be lost, and the bricks will become unstable. The permeability of the wall will increase, and water will be lost more easily, making the skin dry and flaky; external irritants can easily enter, thus inducing inflammation, manifested as Redness, heat, tingling, etc.

　　"Detergent may still remain in washed clothes, which can cause irritation when in contact with the skin. People with allergies will develop symptoms such as erythema, papules, and itching." Yang Bilian said.

Cleanliness requires a balance between cleanliness and health

　　It is important to pay attention to hygiene, but pay attention to cleanliness.

　　"Sometimes children are exposed to a small amount of bacteria so that the immune system can withstand it without getting sick." Ma Tingting reminded that if the home is cleaned too much, disinfectant water should be sprayed everywhere for sterilization, so that the children can be in an almost sterile environment. environment, the child may lose the opportunity to enhance immunity, which may increase the probability of allergies.

　　"In the outpatient clinic, it was found that some children had symptoms of repeated blinking and clearing their throats during the pollen season. Parents mistakenly thought that they had tics. Finally, combined with clinical symptoms and allergen tests, they found that it was actually caused by pollen allergy." Ma Tingting told reporters that allergic The disease is a systemic disease that accumulates in various organs throughout the body. Clinical symptoms such as diarrhea, abdominal pain, migraines, oral ulcers, heart palpitations, and hyperactivity are sometimes related to allergies.

Is there a pattern to the progression of allergic diseases?

　　"There is a term 'allergic process' in medicine, which means that allergic diseases usually start with atopic dermatitis, and then gradually progress to IgE-mediated food allergy, asthma and allergic rhinitis. Of course, as we age, some Patients' allergic symptoms tend to be relieved and may heal on their own," Ma Yanliang said.

　　Experts particularly remind that from the perspective of allergy prevention, more contact with the natural environment is very beneficial. "Research shows that people who are exposed to the natural environment have a lower incidence of allergies." Yang Bilian said.

　　During interviews, experts generally stated that humans, as part of nature, coexist harmoniously with bacteria, pollen, dust and other microorganisms. It is impossible for humans to live in a completely sterile state, and our immune systems also need to accept the harmful effects of nature. Various complex substances stimulate it to make it stronger.

　　"Everyone must understand that not all microorganisms are harmful. Certain bacteria and microorganisms are critical to human health. They help our immune system learn to recognize real threats." Ma Tingting emphasized again.

　　"When cleaning and disinfecting, it is recommended to use mild, harmless detergents instead of strong disinfectants." Ma Yanliang explained that excessive use of antibacterial products can lead to the development of drug-resistant strains and may also interfere with the body's own microbiome. "Choose cleaning products labeled 'biodegradable,' which are environmentally friendly and have less of an impact on the human microbiome."

　　In terms of preventing and treating allergies, in addition to using antihistamine drugs, many patients also choose traditional Chinese medicine treatment.

　　"Syndrome differentiation and treatment are the essence of TCM treatment. Only when principles, methods, prescriptions and medicines are consistent can good therapeutic effects be achieved." Yang Bilian introduced that although it is the same disease, different TCM syndromes require different treatments and medicines, such as wind For skin heat syndrome, it is necessary to dispel wind and clear away heat, and often choose Yinqiao Powder. For blood heat syndrome, it is necessary to clear away heat and cool the blood, and choose Xijiao Dihuang Decoction. "If the disease lasts for too long and the patient has insufficient righteousness, he must exorcise evil spirits and strengthen the righteousness at the same time. For example, Yupingfeng Powder contains three medicinal herbs: astragalus, fangfeng and atractylodes. It has a very good effect on rectifying righteousness and enhancing immunity. , which has a better effect on promoting recovery and preventing recurrence of some allergic skin diseases that are difficult to heal, but it must be analyzed clinically and added or subtracted appropriately. "

　　"Distinguishing the color and shape of skin lesions is an effective treatment method for atopic dermatitis." Yang Bilian introduced, "If the color is bright red, consider wind heat or blood heat; if there is swelling and severe exudation, consider dampness evil in the skin; if If the itching is incessant and has no fixed location, consider wind evil as the cause."

　　"Allergies are easy to attack when immunity is low, so you should try to avoid staying up late frequently, unhealthy weight loss, excessive fatigue, etc." Yang Bilian recommended that people with allergies strengthen exercise, strengthen their physical fitness, develop good living habits, and prevent allergies from developing into chronic diseases. causing greater damage to the body.

　　(Our reporter Cui Xingyi and our correspondent Gao Wanrong)

　　"Guangming Daily" (Page 05, April 6, 2024)