Can allergies be cured

"Allergies can also go away completely"

Why are allergies increasing? Allergologist Jörg Kleine-Tebbe explains why dirt and eating fish have a preventive effect.

NZZ am Sonntag: Can an allergy go away without therapy?

Jörg Kleine-Tebbe: For many of those affected, the symptoms decrease as they get older. They can also disappear entirely. But if and when that will happen cannot be predicted.

What does it mean if you develop an allergy late?

People who develop an allergy early in their life are likely to have a higher genetic susceptibility.

Who has a higher hereditary risk?

High-risk children in whom two first-degree relatives, i.e. both parents, have an allergy. Children at risk are those in whom a first-degree relative has an allergy. The least hereditary burden is found in people who have no first-degree relatives with an increased susceptibility to allergies.

Why is the number of people who develop allergies increasing as adults?

In fact, we have been observing for years that the number of adults - including the elderly - who develop a typical mucosal allergy is increasing. That hardly existed in the past. This trend will continue. This is probably due to epigenetic influences - to put it simply, environmental influences that switch genes on or off, are passed on to children and thus shape the risk of allergies in the offspring.

Did you do something wrong if you still get an allergy at an advanced age?

There is still no clear answer to that. What we know: When small children grow up with a dog in the house, the risk of later allergies decreases. It is assumed that this dog may have a protective function due to its colonization with germs and that allergies are less common as a result.

This fits in with the hygiene hypothesis that children who have grown up on farms enjoy special protection against allergies. Does it help an adult allergy sufferer if he goes to the pigsty?

That is to be doubted. Because the influence of germs from the environment must take place very early - already during pregnancy or during the first year of life. These are the crucial phases in which the immune system is shaped. This can no longer be influenced at a later age. We know, however, that there are other factors in this early age that determine whether the susceptibility to allergies is higher or lower in later life.

Which?

There is an increased risk of allergies when mothers smoke, when children are born by caesarean section and when potentially allergenic foods are completely avoided in the very young.

The likelihood of developing an allergy to substances increases if one is exposed to them, e.g. B. House dust or mold?

That is very likely. In the case of mold, however, there are also often unspecific complaints, e.g. B. on the airways. The removal of larger mold growth is recommended in any case. In the case of house dust mite allergies, small amounts are apparently sufficient to develop a willingness to develop allergies - doctors speak of sensitization.

Or can it even help not to develop an allergy to house dust or mold when one is exposed to these substances?

It is difficult to investigate. In any case, all methods have so far failed to prevent the development of a mite allergy through preventive measures. If the allergy to house dust mites has already developed, measures for house dust prophylaxis are recommended; this includes mattress, pillow and duvet covers, so-called "encasings", which are resistant to mite allergies. The health insurance companies cover the costs.

A study from England suggests that peanut allergy in children can be prevented by feeding babies with peanut ingredients. Does that mean that you can protect children from food allergies by hardening them with the appropriate foods?

Presumably, the immune system developed "tolerance" through regular contact with potential allergens. However, if children already have a threatening peanut allergy, they must still avoid all products containing peanuts. The new study results will likely gradually change our recommendations for preventing food allergies. However, before infants with a high risk of allergies are fed wildly with potential allergens, it should first be proven that what applies to peanuts also applies to other foods.

Can fish allergies be triggered by eating fish?

Absolutely, without fish there is probably no fish allergy. No wonder that it occurs much more frequently in the Scandinavian countries than in ours. However, similar to peanuts, there are indications that the consumption of fish, both by pregnant women and by children in the first year of life, lowers the child's general risk of allergies. This is attributed to the omega-3 fatty acids. That is why it is no longer the case today that fish are banned before the age of two or three. It seems that it is the fish oil, or the fish itself, that protects.

Does this also apply to vegetable oils with a high content of omega-3 fatty acids?

No data are available on this so far; These oils are not recommended for allergy prevention, even if they may otherwise be beneficial to health.

Can vitamin D protect against allergies?

The study results are contradictory - some point to a protective effect of vitamin D, others not.