- The Washington Times - Monday, August 23, 2004

Paul Schneider sneezes and wheezes and itches on a regular basis. He has a hypersensitive immune system, leaving him with multiple allergies.

To control his allergic reactions, Mr. Schneider, 43, of Falls Church receives allergy shots every three to four weeks.

Since starting the therapy in the 1980s, his body has built a tolerance for mold. Although his reaction to other allergens, such as certain trees, grasses and pollen, has improved, he still needs the shots for those substances.

“Before I came [to the doctor] for allergy shots, I was a real case,” Mr. Schneider says. “I’d wake up in the morning and my mouth would be itchy, and my nose would run, and my eyes would water. … I would get hives occasionally on my body everywhere.”

Allergy shots, or immunotherapy, are an effective tool in improving the quality of life for many allergy sufferers by building immunity to specific substances.

Although shots for food allergies are controversial and uncommon, immunotherapy for airborne substances is widespread and effective for most persons.

The immune system of a person with allergies acts as though a particular substance or allergen is harmful, and the body creates antibodies to attack the invading material, says Dr. Stephen J. Wall, otorhinolaryngologist at Washington D.C. Ear, Nose, Throat & Allergy Center in Northwest.

When the immune system is alerted to the allergen, chemicals also are released from other blood cells. This reaction can cause the symptoms of allergies, such as sneezing, congestion, itchy eyes and ears, wheezing, coughing, rash, shortness of breath, sinus problems or a sore palate.

“Some people think their immune system is not working if they have allergies, but it’s overaggressive,” Dr. Wall says. “Allergies create flulike symptoms … but the flu is over in a week. … Symptoms from allergies can be with you for an extended period of time.”

It is hoped the purified form of the allergens in allergy shots will prevent the allergen from eliciting symptoms when the person is exposed, Dr. Wall says.

Shots usually are taken on a weekly basis for three to six months. Then, the patient receives maintenance doses as needed, about every two to four weeks. The severity of the symptoms determines how often and how long the patient takes the shots. Patients generally take the shots for two to five years.

Although a person can be allergic to almost any substance, the most common allergens include molds, pollen from trees and grasses, dust mites, pet dander from cats and dogs, stings from wasps and bees, industrial and household chemicals, and medicines. Some people also are allergic to foods such as milk, eggs, peanuts and shellfish.

Marie Bonkowski, 42, of Northwest is allergic to pollen and dust. She also has “hidden” food allergies — which produce delayed symptoms — to wheat, soy and corn. She has been receiving allergy shots since 1992 and is now a patient of Dr. Wall’s.

Although the easiest way to avoid symptoms related to food allergies is to avoid the food, Mrs. Bonkowski takes shots for her food allergies because the substances are harder to avoid than a single item, such as shrimp.

The food shots and food drops she takes were developed by Dr. Wall’s former colleague, Dr. Robert Pumphrey. She is thankful the food shots have proved effective for her because the therapy doesn’t work for everyone, and doctors don’t know why.

“I had to have repeat sinus surgery,” she says. “Since I had allergy shots, it helped a great deal and minimized the frequent infections. … For me, spring pollen season is the worst. Summer is not so bad.”

Sometimes when people move to a different location, they become allergic to new substances, says Dr. Y. Howard Pung, director of the division of allergy and immunology in the department of pediatrics at Georgetown University Hospital in Northwest.

“People with allergies are born with an allergy tendency, but you are not born with symptoms,” he says. “Only after exposure to the antigen do you develop the symptom.”

Therefore, if a person hasn’t been exposed to the substance, an allergy test won’t test positive, Dr. Pung says. With any allergy test, there is always the chance that the test will present a false positive. Two basic ways of testing allergies are a skin-prick test and a blood test.

A skin-prick test shows quicker results than a blood test. It also gives patients a visual reference for what happens when antigens affect their systems.

Blood tests are used to locate allergies if the patient is at risk to go into anaphylactic shock during a skin-prick test. Sometimes the soreness and irritation of eczema causes skin-prick testing to be ineffective.

Further, when a patient’s symptoms are too extreme to stop antihistamine medicine for a skin-prick test, blood tests may be a good idea.

“Never rely on the test itself,” Dr. Pung says. “For airborne allergies, it’s usually specific, but for the food tests, there are reasons that they might be unreliable. You need to go by the patient’s history.”

Norbert Barrion, 32, of Arlington has had allergies since he was a child. As a patient of Dr. Pung’s, he has received allergy shots for the past four years.

He received the shots when he was younger and stopped them, but his allergies began to bother him again. Even with the immunotherapy, he is unable to have a pet.

“My wife wants a dog so bad,” he says, “but it’s just one of those things. It’s either I’m going to stay outside, or the dog will stay outside. It brings new meaning to the doghouse.”

Even though some people might want to avoid needles, Shelley Dreifuss, 54, of Burtonsville, says she feels more uncomfortable without the allergy shots.

She is allergic to items such as plant pollens, mold, cat dander and dust and has been receiving immunotherapy on and off for about 20 years. She is a patient of Dr. Pung’s.

“Shots are nothing to me,” she says. “I don’t even notice them. I get three injections every time I go. When you’ve taken them for a long as I have, it’s like a feather brushing against your skin.”

Although some people wouldn’t want to travel to Dr. Pung’s office every week for the shots, Leon Levenson, 70, of Rockville, says it’s not that much of an inconvenience. Dr. Pung also has an office in Rockville.

“I live near where the shots are given,” Mr. Levenson says, “but I would go farther to get them because they work.”

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