Allergy in children is not just a runny nose – it is a path to asthma that can and must be stopped

• Inhalant allergies are a disease that affects an increasing number of children, affecting their daily functioning and the lives of their families.
• The most common allergens include pollen, animal dander, molds, and house dust mites. Contact with these factors can cause a number of troublesome symptoms, and as a result of the so-called allergic march, can lead to the development of allergic asthma.
• However, this process can be stopped – thanks to effective causal treatment, it is possible not only to improve the quality of life of the youngest patients, but also to stop the development of asthma.

Inhalant allergies are chronic diseases that affect both children and their families, affecting daily functioning and quality of life. Symptoms such as persistent cough, runny nose, conjunctivitis or sleep problems lead to chronic fatigue and difficulty concentrating. This in turn affects not only the child's daily well-being, but also their functioning at school and progress in learning. Frequent infections and exacerbations of symptoms result in numerous absences from educational institutions.

– Children suffering from allergies attend institutions with great irregularity: they go to nursery, kindergarten or school for a week, and then they are sick for weeks. This leads to falling behind in school and isolation from peers – says Małgorzata Sosnowska, mother of twins whose tests revealed a very strong allergy to house dust mites.

Although children are the most likely to struggle with allergy symptoms, the effects are felt by the entire family. Everyday life requires a great deal of commitment and increased attention from parents. In addition, there are costs: visits to specialists, diagnostic tests, medications and the purchase of specialist equipment. For many families, this is a serious financial challenge, which becomes increasingly difficult to bear over time.

– Spending on medicines is a huge burden on our household budget. And we only have one child! It's hard for me to imagine how we would cope with a larger family – says Ewelina Świonder , mother of a boy allergic to pollen, Alternaria fungi, who also suffers from cross allergies.

Inhalant allergy is not only an organizational and financial challenge, but also a huge emotional burden for children and their parents. Chronic disease, recurrent infections and severe exacerbations of symptoms become a source of daily stress and anxiety about the child's health.

– Last year, the situation was really serious. My son had such a strong allergic reaction that it caused ulcers on his corneas. Doctors downplayed the problem for a long time – they said it was just conjunctivitis. If we hadn’t gone to an ophthalmologist privately and gotten an immediate referral to the hospital, my son could have lost his sight. The ulcers were literally millimetres from the vision zone. If they had moved a little higher, the changes would have been irreversible. Since then, every, even the smallest, conjunctival symptom has caused me enormous stress. He was already one step away from losing his sight once. I can’t risk it a second time – adds Ewelina Świonder.

Drug therapy – treating symptoms but not the cause

Inhalant allergies are most often treated with pharmacotherapy – primarily antihistamines and glucocorticosteroids, which help control symptoms. Although they are effective, their long-term use – especially in children – can be associated with serious side effects, such as weight gain, hyperactivity, skin problems, increased susceptibility to infections or even growth retardation. What's more, despite symptomatic treatment, the disease itself progresses – new symptoms appear, and the body begins to react to other allergens. Over time, untreated causal inhalant allergies can lead to the development of asthma.

Currently available symptomatic therapies often effectively alleviate the effects of the disease, but do not eliminate its cause. The only causal treatment method is allergen immunotherapy , or desensitization. It involves the controlled administration of an allergen, which leads to the gradual "habituation" of the immune system and a reduction in the body's hypersensitivity. Thanks to this, allergy symptoms can be significantly alleviated or completely eliminated, improving the quality of life of children and their families.

Generally, desensitization treatment is used for 3 to 5 years. In the case of seasonal allergies, specific immunotherapy is carried out for several seasons in successive years, but the first positive effects can be seen after a few weeks of use. Clinical studies confirm its effectiveness.

- The effectiveness of allergen immunotherapy is very high. In the case of allergies to tree or grass pollen, it reaches up to 80-86%, and to house dust mites - 73-76%. Additionally, many years of in-depth scientific research indicate its long-term effects, also after discontinuing the intervention after the end of treatment - emphasizes Dr. Witold Bartosiewicz, a specialist in allergology, who has been conducting allergen immunotherapy for many years, thus helping many patients with severe allergy symptoms.

Allergen immunotherapy can be performed in two forms: subcutaneous, i.e. injections, and sublingual. Due to the risk of anaphylactic shock, administering injections requires visits to a doctor's office under the supervision of a specialist, while sublingual therapy can be used independently at home, which makes it more convenient for patients. The high safety profile, effectiveness, and lasting effects of the treatment have resulted in immunotherapy being recognized by the European Medicines Agency (EMA) and the Polish Society of Allergology as a standard of allergy treatment.

Allergen immunotherapy as asthma prevention

Allergen immunotherapy is not only an effective method of treating allergies, but also a key strategy for preventing allergic asthma. Studies show that in children undergoing immunotherapy, the risk of developing bronchial asthma is much lower compared to children treated only symptomatically. Therefore, experts in allergology and pulmonology emphasize that immunotherapy should be viewed not only as a treatment for symptoms, but as a long-term investment in the health of the youngest patients. The sooner it is implemented, the greater the chance of stopping the allergic march before it turns into asthma.

- As a child, no one diagnosed my allergy or started treatment, which led to serious health consequences. Untreated or improperly treated allergy can lead to asthma - a disease I wouldn't wish on anyone. That's why I'm looking for specialists for my children with modern knowledge who don't trivialize their symptoms - declares Małgorzata Sosnowska.

Unfortunately, the refund currently covers only a part of patients with inhalant allergies. Children aged 5-12 can only use injectable preparations free of charge, while effective and convenient sublingual therapy remains fully paid.

Experts recommend expanding the scope of reimbursement for sublingual therapy for children from the age of 5. The possibility of treatment at home not only reduces stress in the youngest patients, but also relieves their parents, while ensuring the effectiveness and safety of the therapy.

– Subcutaneous therapy is reimbursed, but even if we could find a doctor who would do it not far from our place of residence, there is still the issue of frequent visits to the doctor, which of course would involve not only my son's absence from educational institutions, but also my absence from work. Additionally, injections are very stressful for my son - after previous difficult medical experiences, each prick arouses strong anxiety in him. The specialists I consult with remotely recommend sublingual immunotherapy - more convenient, less invasive, and possible to administer at home. Unfortunately, it is not reimbursed. The cost would be a big burden on our household budget - Ewelina Świonder does not hide her concerns.

There are currently two forms of sublingual immunotherapy available on the market: tablets and solution drops. For the youngest, solution therapy is particularly recommended due to the possibility of adjusting the dose, convenience of use and a high level of safety.

– The solution form is used by precisely dosing a specific number of applications under the tongue. Some patients, especially smaller children or people with particularly sensitive oral mucosa, tolerate this solution better than sublingual tablets and application in this form is more comfortable for them. For me as a practitioner, it is also important that this form allows for a gradual increase in the dose, which gives greater control over the body's adaptation to the therapy – says Dr. Witold Bartosiewicz, MD.

Extending the reimbursement of immunotherapy would not only enable more effective treatment of inhalant allergies in children, but above all reduce the number of new cases of asthma in the future, bringing benefits to both patients and the healthcare system. Immunotherapy is an investment in a child's health and future. The earlier it is started, the greater the chance that it will stop the development of the disease before it takes on a more dangerous form.

Copyrighted material - reprint rules are specified in the regulations .