The condition known as atopy is a broad term used to describe a familial or personal predisposition to developing allergic hypersensitivity reactions. Atopy itself means “strange disease”, which gives an indication as to the confusion it caused doctors. It was first defined in 1923 by a couple of researchers called Coca and Cooke who had recognized that there were certain hypersensitive individuals who were all showing similar reactions to the same stimuli.
How Do I Know I Have Atopy?
Only a doctor can make a diagnosis of atopy but there are strong indicators of the condition. Typically, a patient will present with one or more of these conditions:
- Hay fever (allergic rhinitis)
- Allergic asthma
- Some will have all three
A significant number of people who present with these three conditions also have:
- Allergic food reactions
- Hyperallergic conditions like eosinophilic esophagitis and gluten sensitivity
Any and all of the above conditions can be dangerous in the short or long-term, so talking to your doctor about diagnosis and how to treat them best is sensible and can potentially avoid a lot of suffering.
Causes of Atopy
The exact causes of atopy are unknown. It is only in the last 20 years that the understanding of the immune system has enabled the causes of many conditions to be elucidated. So far, it is thought that atopy is a generalized oversensitivity to certain immune system stimuli.
This means that the reaction cascades that occur in healthy bodies when they encounter foreign invaders or objects like pollen are misaligned or dysfunctional. This could be the result of a bacterial or viral infection. As is hypothesized for many autoimmune conditions like Type I diabetes. Our immune systems are very complex and its role in these conditions will be better understood soon.
In allergic reactions, the body has mistakenly labelled a normally inoffensive protein or chemical as extremely dangerous, so even a small amount can trigger a massively over-inflated reaction that can cause serious harm or death to the patient.
- IgE Proteins: In atopy, it is thought that the immunoglobulin E (IgE) allergen-specific protein is working abnormally. In healthy individuals, IgE is the least abundant antibody in the body. It is involved in the immune response, triggering histamine release and vasodilation, both of which can be fatal if they are unchecked. It appears to be involved in cellular and humoral responses too. Normally, this exquisitely sensitive system serves humans well and keeps pathogens and particularly parasites out of our bodies. Tiny amounts of it are needed to produce body-wide responses, hence when it goes wrong the consequences are severe.
- Maternal Stress and Perinatal Programming: The development of the immune system happens relatively early in foetal development and the conditions in the womb can directly affect this development. From the 13th week of development the embryo is receiving antibodies from the mother and after birth, the baby gets a lot of its antibodies from breast milk.
Unusual levels of stress or trauma during pregnancy can affect the way a foetus grows. There are little switches on DNA called epigenetic switches; when the foetus is growing the conditions in the womb affect how these epigenetic switches are configured. This is very new to science but they seem to be responsible for differences in the way babies grow. When the immune system is growing, stress makes it oversensitive in some cases.
- Even after birth the baby is affected by the mother’s stress state. When someone is stressed, their immune systems are usually suppressed and working inefficiently. The baby is relying on the breast milk to provide it with vital cues for its own development, it looks like the early months of a baby’s life inform how the immune system works for the rest of their lives.
How to Prevent Atopy
- Corticosteroids: The main form of treatment for atopy is corticosteroids for the symptoms like atopic eczema. Asthma sufferers will likely be familiar with the use of steroids. The side effects of steroids are plentiful and can be severe. Long-term use is dangerous. Antihistamines have similar safety profiles and some find them intolerable.
- Diet and the Immune System: The complex web of interactions that is the immune system is not well understood, but the relationship between the immune system and diet is slowly being uncovered. Achieving a more balanced immune system is possible, even though it might not always help with the hypersensitivity. Solutions are unfortunately rare but eating a diet that is low on high-glycaemic foods, rich in micronutrients, high in fibre, and probiotic should help you avoid some of the symptoms.
- Smoking: Smoking is bad for every part of your body but it has surprising effects on the immune system. Smokers have a lower chance of developing some immune disorders and neurodegenerative diseases, possibly due to the effect on the immune system. It might suppress the immune system but it will not do so in a way that is beneficial for people with atopy: there is a chronic level of stress smoking causes that adversely affect how the body responds to stimuli.
- Exercise: Keeping fit and healthy is important, especially for people with immune disorders. Regular exercise helps the body to regulate its immune system and keeps a better balance. Stress is a big factor in atopy and exercising can help ameliorate this effect.
- Avoid Stress During Pregnancy: It is a bit late for you if you already have the condition, but you can help your offspring avoid atopy or other autoimmune conditions by having as stress-free pregnancy as possible.
So far, nobody has worked out how to alter the immune system in a way that would cure the hypersensitivity, so people with atopy can only deal with the symptoms and avoid the common triggers of their symptoms. Talk to your doctor about possible treatments for atopy. They will help you manage your condition in the safest and most effective ways possible.