PREVENTION OF ALLERGY Dr Blent Tutluolu President of

PREVENTION OF ALLERGY? Dr. Bülent Tutluoğlu President of Academic Respiratory Society Acıbadem International Hospital Chest Diseases Department tutluoglu@gmail. com

PRIMARY PROTECTION § Breast feeding § Avoidance of passive and active smoking § Allergen avoidance

PRIMARY PROTECTION-BREAST FEEDING • In 8, 183 children with atopic dermatitis have been shown to have protective effects against the development of asthma (meta-analysis) Gdalevich • Breastfeeding should be encouraged. Protective effect against wheezing in infants (BTS and SIGN guidelines)

PREVENTION Of PASSIVE SMOKING • Do not smoke, do not smoke in houses and cars. • Be a supporter and follower of smoking ban in closed areas. • Support your loved ones' smoking cessation efforts.

DIETARY FACTORS TO BE EFFECTIVE IN ASTHMAALLERGY DEVELOPMENT • Consuming high omega 3 containing fish such as salmon, sardines, tuna, anchovies have protective role • Increase in atopy by margarine usage • Nutrition with Mediterranean diet allergy and asthma risk

DIETARY FACTORS TO BE EFFECTIVE IN ASTHMA-ALLERGY DEVELOPMENT • Magnesium, selenium deficiency may be effective in the development of asthma, which can make asthma control difficult. • There is significant relationship between intake of A-C-E vitamins and prevention and control of asthma • There is a relationship between the intake of food additives and the development and aggravation of asthma

SECONDARY PREVENTION

INDOOR ALLERGENS • • House dust mites Mold Cockroach Cigarette smoke Pets Combustion products Consumer products

PROTECTION FROM HOUSE DUST MITES • • • Washing bed linen, linen and linen at a temperature above 60 °C at least twice a week Frequent cleaning at home, preferential cleaning done by someone, using a mask if you are doing it yourself Frequent ventilation of the house, Removal of carpet in the bedroom Leather, artificial leather, wood and plastic are preferred instead of fabric-paved items

MOLD CONTROL • • • Increase ventilation. Use air purifiers Do not dry your clothes in the house. Repair the water leaks. Use dehumidifiers / air conditioners. Clean moldy areas with bleach.

PROTECTION FROM COCKROACH • Insect entry areas must be destroyed • Appliance of insecticides, followed by intensive cleaning • Do not leave garbage unnecessary goods and food in the kitchen , keep kitchen clean

ANIMAL FEATHERS, SKIN WASTES, URINE AND SALIVA • • • Do not allow pets in the bedroom. Remove dusts and clean with a vacuum cleaner. Keep away the animals out of the house. Use air purifiers Advise not to have pets to atopic individuals

CONSUMER PRODUCTS • Cleaning materials, detergents, paints, adhesives, insect killers, room sprayers, perfumes and cosmetics.

RISK REDUCTION IN CONSUMER PRODUCTS • Restrict the contact. • Store and use in well ventilated locations. • Observe the warnings on the label.

OUTDOOR PROTECTION

PROTECTION FROM POLLENS? • Pollen season (April-May-June) avoid being outside, not go to picnics unless necessary. • At home and cars, air filters and air purifiers that hold pollen can be used • Masks and glasses can be worn on the outside when pollen load is heavy • Doors and windows should be kept closed during peak periods of pollen • Closing the windows in the house with a thin braided wire may be beneficial • Antiallergic medicines must be taken against allergy during pollen season

AIR POLLUTION • Both indoor and outdoor air pollution can produce respiratory symptoms in healthy people, and chronic respiratory and allergic diseases can worsen the disease.

PSYCHOLOGICAL PROTECTION • Psychological problems may trigger allergic complaints and asthma attacks and may improve compliance with asthma treatment. • Learn and practice techniques such as relaxing, relaxation breathing techniques, meditation • Always try to think positively. If necessary, be involved in educational activities such as reading books and courses about relaxation techniques • Use medication if necessary

NEW PERSPECTIVES IN PREVENTION OF ALLERGIC SYMPTOMS -NAZAL MUCOSAL PROTECTION • Nasal filters • Nasal barrier products

NASAL FILTERS

COMFORTABLE AND PATIENT COMPLIANCE IS HIGH • Clinical Application of Nasal Filters: An Observational Study on the Usability of Nasal Filters in Managing Seasonal Allergic Rhinitis. J Allergy Clin Immunol Pract. 2016 May-Jun Kenney P, Hilberg O, Sigsgaard T.

NASAL FILTERS • NAZAL FILTERS DECREASE NASAL AND OCULAR SYMPTOMS • Preventive effect of nasal filters on allergic rhinitis: A randomized, double-blind, placebo-controlled crossover park study. J Allergy Clin Immunol. 2015

NASAL FILTERS • NAZAL FILTERS REDUCE RHINOCONJUCTIVITIS SYMPTOMS • Improvement of quality of life in allergic rhinoconjunctivitis patients using nasal filters, a preliminary study. Eur Ann Allergy Clin Immunol. 2013 Sep

NASAL BARRIER PRODUCTS

NASAL BARRIER PRODUCTS v 15 placebo controlled double blind study v The barrier forming the nasal mucosa cellulite powders benefit in eliminating allergic rhinitis symptoms Barrier-enforcing measures as treatment principle in allergic rhinitis: asystematic review (2014) Andersson M(1), Greiff L, Ojeda P, Wollmer P

NASAL BARRIER PRODUCTS Allergic rhinitis oxymetazoline plus cellulosic powder symptoms, PNIF values were significantly increased compared to placebo. Allergy Asthma Proc. 2015 Valerieva A(1), Popov TA, Staevska M, Kralimarkova T, Petkova E, Valerieva E, Mustakov T, Lazarova T, Dimitrov V, Church MK.

GLYCEROL

RESULT • Glycerol-containing emulsion creates a barrier effect on the nasal mucosa, which results in less symptoms in allergic rhinitis patients with pollen allergy.

NAZAL BARRIER PRODUCTS FUTURE QUESTIONS • CAN THEY INCREASE THE EFFICACY OF OTHER DRUGS? • WE CAN PROTECT AGAINST HARMFUL AGENCIES such as AIR POLLUTION, SMOKE, etc. ? • PROTECTIVE EFFECTS AGAINST INFECTIONS? • DO YOU CONTRIBUTE TO THE TREATMENT OF NASAL POLYPOSIS? • IS THE DEVELOPMENT OF NASAL POLYPOSIS?

PROTECTION FROM INFECTIONS • Adult vaccination: Influenza, pneumococal vaccination , oral vaccination with H. influenza • Cessation of smoking • Vitamin D supplementation • Exercise • Diet: uniform diet, obesity, rapid weight loosing diets • Prophylactic antibiotic usage • Echinacea, Ginger, turmeric, carob • IVIG therapy • OM- 85 BV • Beta Glucan

BETA GLUCAN • It is a completely natural nutritional supplement containing 1, 3 -1, 6 Beta Glucan as the active ingredient • Beta-Glucan "Saccharomyces cerevisiae" is a natural substance that strengthens the immune system in the fiber structure of the polysaccharide extracted from the cell wall • It is a biological response regulator that stimulates the immune system against infectious diseases and cancer

BETA GLUCAN • Beta glucan is a good regulator of the immune system and exhibits potent immunomodulator activity, especially 1, 3 /1, 6 Beta-glucan • Beta glucan has the ability to strengthen the immune system, such as antitumor effect and protection from carcinogenesis, and also acts as a powerful regulator of the immune system

BETA GLUCAN • Increases immune response, allowing body-defense cells to destroy pathogens more effectively • In both healthy and infected individuals, it increases body resistance to infection and makes it easier for the body to fight infection • Side effects of chemotherapy and radiotherapy have positive effects on neutropenia and mucositis • Increases cytokines from spleen and bone marrow • Increases hematopoietic activity • Strengthens the immune system • Reduces allergic rhinitis

BETA GLUCAN The use of Beta Glucan reduces the likelihood of getting a cold and the severity of the symptoms if caught

BETA GLUCAN In children with allergic rhinitis, when 12 -week betaglucan therapy is used with standard therapy, T helper lymphocyte-derived IL-1 and eosinophil levels are reduced

BETA GLUCAN Chemotherapy increases beta glucan, leukocyte, neutrophil and platelet levels while reducing the chance of developing mucositis and diarrhea

BETA GLUCAN Beta glucan improves in stressed women, upper respiratory tract symptoms and general emotional state

BETAThere GLUCAN are numerous studies on beta glucans in the prevention and treatment of respiratory tract infections Jesenak M et al. Nutrients. 2017 Jul 20; 9(7). pii: E 779.