The Rise of Allergies

Allergies are very common, whether it be from food, pollen, metals, or countless other substances. Known as allergens, they will elicit an immune response, even though there is no threat of disease. The symptoms can range from a mild rash to anaphylactic shock and death. Food allergies in particular have increased by 50% from 1997 to 2011. About 1 in 13 children now have a food allergy (Robertson 2019). However, due to no universal definition on what a food allergy is, it can be difficult to map out the true scale of the problem (Hadley 2006). Medically, an allergy is defined as a specific antibody response to an allergen. However, people can perceive an intolerance or mild food poisoning as a food allergy. Regardless, the medical community believes that food allergies are underreported (Hadley 2006). Multiple studies are still underway to understand the extent of this phenomenon.

Allergies are on the rise in the developed world, seen in direct proportion with increased urbanization (Robertson 2019). It is expected that the future growth in urban population globally will be extremely uneven. In the developing world, the urban population is predicted to double by 2050, while in developed regions, it is a steady growth (Berg 2012). So far, this growth is not slowing down. This growth may yield even more allergies. With the global access to different kinds of food, people are exposed to more potential allergens. While some allergies seem benign, many can lead to anaphylactic shock, which is an extreme allergic reaction that leads to a drop in blood pressure and a narrowing of the airways. This is a significant health concern that appears to only be getting worse in the future.

A theory behind this increase is that there is a delayed introduction of food allergens. A study found that by age five, 17% of children who didn’t eat peanuts developed an allergy while only 3% of children who ate peanuts did (Robertson 2019). The science behind this theory is that the gut’s immune system is quickly trained to tolerate new foods as a baby is weaned off of breast milk or formula. 

Another theory is the “hygiene hypothesis.” Advancements in sanitation practices and medicine have decreased the amount of pathogens people come into account with, especially parasites. With less exposure, the immune system is not well-regulated and will treat allergens as a threat (Robertson 2019). Studies have shown that people living on farms have fewer allergies, likely due to the exposure from the farm animals (AAAAI 2019).

There are other theories as well, including the vitamin D hypothesis. Researchers have shown that a lack of exposure to sunlight can increase the risk of developing an egg or a peanut allergy (Robertson 2019). This also leads to the idea that vitamin D helps regulate the immune system. In additional to general allergies, asthma has also increased. Researchers have linked this increase to antibiotics, Tylenol, and obesity (AAAAI 2019). Antibiotic use can alter the natural bacterial community in the gut, which can lead to a prevalence of asthma and allergies. However, there is no one, clear reason behind the rise in allergies.

There are a few solutions that can help mediate the rise. Guidelines on food labeling can be improved to ensure that any potential allergy is listed, not just the most common ones (Hadley 2006). The societal pressure to ensure the safety of the children can influence food industries to ensure safety and clarity in their ingredients (Hadley 2006). A medical treatment for a severe allergic reaction is the EpiPen, which gives a shot of epinephrine. However, the company that bought the rights to it in 2007, Mylan, had increased the price by more than 400% (about $50 to over $600) just to increase their profits (Mole 2018). This led to many people not being able to afford this life-saving medication. Fortunately, other companies are now creating generic rivals of the EpiPen. FDA has approved a medication from Teva Pharmaceuticals USA, and reported that it should lower drug costs to a more manageable amount, however no price has been given thus far (Mole 2018). While there is no guarantee the cost will lower, it is at least a step in the right direction for severe allergy treatment.

Current treatments include allergen avoidance, medications, or immunotherapy. Immunotherapy involves introduction of pure allergen (via injection or under the tongue) to condition the immune system. However, these do have a risk of a severe reaction. Researchers are also looking at oral immunotherapy, where the allergen is consumed in the digestive tract (AAFA 2018). While the treatments are promising, there is a need of preventative measures. It seems that more exposure to germs may help, however that increases the risk of infectious diseases. This leads to the current trade-off between sanitation and disease. Infectious diseases may have been decreasing with increased sanitation, but allergic diseases are seemingly increasing. Both types of diseases can have high mortality and morbidity. This poses interesting questions about whether or not there can be a balance between the types of disease, and what the future might look like as humans, their immune systems, and diseases continue to advance.

Works Cited

AAAAI (2019). “Increasing Rates of Allergies and Asthma.” American Academy of Allergy, Asthma & Immunology. Retrieved from: https://www.aaaai.org/conditions-and-treatments/library/allergy-library/prevalence-of-allergies-and-asthma

AAFA (2018). “Allergy Treatment.” Asthma and Allergy Foundation of America. Retrieved from: https://www.aafa.org/allergy-treatments/

Berg, Nate (2012). “The Uneven Future of Urbanization.” Citylab. Retrieved from: https://www.citylab.com/equity/2012/04/uneven-future-urbanization/1707/

Hadley, Caroline (2006). Food allergies on the rise? EMBO Rep 7:1080-3. https://doi.org/10.1038/sj.embor.7400846

Mole, Beth (2018). “Years after Mylan’s epic EpiPen price hikes, it finally gets a generic rival.” Ars technica. Retrieved from: https://arstechnica.com/science/2018/08/fda-approves-generic-version-of-mylans-600-epipens-but-the-price-is-tbd/
Robertson, Sally (November 20, 2019). “What’s Driving the Recent Rise in Food Allergies?” News: Medical: Life Sciences. Retrieved from: https://www.news-medical.net/health/Whats-Driving-the-Recent-Rise-in-Food-Allergies.aspx