Nothing to Sneeze At

Jim Atkinson cures what ails us.

When I first wrote for this magazine about Texas’s unofficial state disease—allergies—nearly a decade ago (“ Blowin’ in the Wind ,” April 1997), I was shocked by how little medical science had to offer our estimated 5.5 million sufferers. Even in Austin, which routinely ranks among the top five most allergic cities in the nation, allergy specialists like William Howland couldn’t recommend much more than “Take a Claritin.” Recent studies suggest that the number of afflicted Texans has only increased in the past eight years, so in February I called Howland for an update: Is there any new hope for the red-eyed and itchy-nosed these days? As a matter of fact, yes. Howland reports that though we now know for certain that allergies are a result of our genes (at least 25 percent of us are predisposed to all the dripping and wheezing), today you may be able to not only prevent allergies but also permanently manage them.

Get down and dirty.  Researchers now believe that allergies may be encouraged by a lack of exposure to germs during childhood. While it may be too late for you, take note for your kids, says Howland: Studies have shown that children who are exposed to pets and their allergenic dander, for example, are less likely to experience allergies later in life, presumably because their developing immune systems are able to build a tolerance.

Bull-rush your therapy. It used to be that if you wanted to do something more permanent about your allergies beyond treating the symptoms with an antihistamine, you had to undergo immunotherapy, an expensive, vaguely medieval regimen of shots of allergenic extracts designed to progressively challenge your immune system and desensitize it. You still have to take the shots, but the process of reforming your immune system can now be accomplished much more quickly and cheaply. Ask your doctor about rush immunotherapy, in which 85 percent of a patient’s “maintenance dose” (the dose at which his immune system is desensitized) is administered in three hours—a process that used to take four or five months. Such heavy dosing with allergens can be more dangerous than the slower protocol, but a study by David Khan, an associate professor of internal medicine at the University of Texas Southwestern Medical Center, revealed that most systemic reactions to the ramped-up approach were mild, and even among those who had such reactions, the success rate and patient satisfaction were high.

Ask for the asthma antidote. It’s called Xolair, and fittingly, a Houston biotech company, Tanox, helped develop it. The source of allergic reactions in humans is the antibody immunoglobulin E (IgE), which triggers the body’s defense system when allergens invade. Xolair works by knocking IgE out of commission: Researchers found a cell in a Chinese hamster that, when cultured, “humanized,” and injected into patients with severe allergic asthma, quickly binds with IgE and disables it. Take enough Xolair, and the number of active IgE antibodies in the bloodstream is reduced, so that when you breathe in that mountain cedar, there’s nothing in your system to set off the allergic cascade. So far Xolair, which Tanox is now producing in conjunction with drug giants Novartis and Genentech, is approved for only moderate to severe asthma in patients age twelve and over. But its effectiveness has been so impressive—up to 75 percent of patients in a clinical trial showed marked improvement when using Xolair together with steroidal therapy—that allergists like Howland are optimistic.  

You Give Me Fever:
The war against the worst of Texas’s allergies.

Mountain cedar, that homegrown nemesis responsible for that most virulent of Texas allergies, cedar fever, may soon meet its match. Scientists have yet to perfect the antidote, but experiments suggest that certain elements of the DNA of cedar pollen can be used to brew up a vaccine against the allergy—much in the way a crippled influenza virus is used to create the flu vaccine. In the meantime, Howland says that of all the alternative cures for allergies, the only tried-and-true one is snorting—salt water, that is. Flush your nose regularly with a saline wash for the best spring cleaning around; it’ll rinse out allergens and irritants and keep your sinuses clear. “And get the solution the right strength and temperature,” Howland says. “This helps allergies, colds, and sinusitis.” Your best bets are over-the-counter solutions Ocean, Ayr, and Salinex.

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