Question: Dr Bruno Gennaro, you have a long experience in the field of allergy. Could you tell us if the symptoms and syndromes that relate to this field have changed significantly in the last 10 years?
Answer: Certainly, beyond the ordinary classical forms that we continue to see, we are witnessing an increase in symptoms and syndromes linked, presumably, to serious problems of environmental pollution (domestic, landscape, etc.) with the formation of "new allergens molecularly modified by the fusion with benzene derivatives and fine dust, degradation of waste, etc. and to the food adulteration of large food industries, which cause immunological and metabolic reactivities that are often complex and multifaceted. Unfortunately, we must not forget the anxiety disorders associated with specific forms, such as dermatitis and urticaria, which are significantly increasing, or asthma from allergies to inhalants.
Question: In the past, the onset of an allergic symptom was observed since childhood or at most from adolescence. Lately, allergic symptoms seem to arise for the first time even after the age of 50. Can you confirm this? If so, why is this happening?
Answer: Allergies can actually manifest themselves at any age: certainly the fact that the various diagnostic tests have become increasingly sensitive and specific (CRD molecular diagnostics), starting with the classic ones, can be one of the explanations, the other aspect is that today in allergology we speak more and more of a "threshold limit", for which each individual has a time limit of resistance, beyond which, the pathology manifests itself.
Question: Allergic manifestations are usually IgE mediated, but IgG mediated allergies seem to be making their way. Do you have any evidence of this?
Answer: This problem opens up a kaleidoscope of forms and symptoms associated with a probable increased intestinal permeability and chronic inflammation generally of a persistent low degree, in relation to the factors that we listed before regarding individual eating and luxury habits (smoking, alcohol, for example), preservatives, sweeteners, abuse of drugs and medicines, infections; the possibility of a family predisposition and, perhaps, genetics that needs to be investigated cannot be excluded. Obviously, the problem needs to be studied in a multidisciplinary manner. Our Clinical Allergology Service, which is an integral part of the Department of Laboratory Medicine, also offers, in addition to the classic laboratory tests (Prist and Rast), Alex Test which, by analyzing hundreds of allergens, allows us to identify cross-reactions between inhalants and foods with high sensitivity and specificity. Alex test It is the first in vitro allergy test that allows the simultaneous measurement of the presence of immunoglobulins E – antibodies produced by the immune system in response to a stimulus that is perceived by the body as a threat – specific for 282 substances; and an innovative test, Fox Test, also based on microarray technology, capable of investigating food intolerances through a panel of 287 food antigens: It is a test performed using a latest-generation technology that reduces the risk of false positive/negative results and allows for greater reliability of the results. The test can be used to support dietary clarifications and to monitor compliance with the diet, as well as being useful in cases of suspected food intolerance of immunological origin (not allergy). A simple blood sample is enough to start the aforementioned tests.
Question: Are the therapeutic tools that you know to combat allergic pathologies only based on classic antihistamines and cortisone or have new effective scenarios opened up on homotoxicological drugs, with less adverse impact and with equal or superior therapeutic efficacy?
Answer: In my clinical practice, in addition to the use of classical Pharmacopoeia (antihistamines, cortisone, antileukotrienes, desensitizing therapy, etc.) I associate, with the full correspondence of the patients who are fully informed, homotoxicological and Functional Medicine products that give us, in a good component of cases and patients, excellent results, also using them in synergy with chemically synthesised drugs. Draining, detoxifying and desensitizing is the principle that moves us to use these pharmacological aids. A very promising future is emerging with LDM (low dose medicine) and small doses.
Dr. Gennaro Bruno
Medical Director 1st level - Clinical Allergology Service - Fatebenefratelli-Gemelli Isola Hospital - Rome
