Allergies prevailing in India and its diagnosis measures adopted

A recent experimental study was conducted for a time period of 2003-2007 among 3389 patients suffering from different allergies in India. Results from the study indicate that, among the several allergies asthma, rhinitis and contact dermatitis were found to be more prevalent among the Indian population (Shaikh & Shaikh 2008). Similarly other allergies which have found prevalence include nickel sulphate and parthenium hysterophorus, penicillins, sulphonamides and non-steroidal anti-inflammatory drug allergies, house dust mite and D farinae allergies.

On the other hand, among the four types of allergies discussed in the previous article food allergies are the least prevalent in India. In addition, a recent report by World Allergy Organization (WAO) concludes that 20 to 30 percent of Indian population is affected by one of the other form of allergic disease (Pawankar et al. 2012). As per the report, 50% of children and 40% of adults are affected by one or many allergies (Pawankar 2014). Rise in prevalence of complex allergies is due to:

  • rise in pollution and temperature,
  • altered biodiversity and lifestyle changes.

Further, being too tidy and hygienic are other aspects deteriorating the indoor environment quality (Jindal 2010).

Diagnostic measures adopted in India

In India, both in-vivo and in-vitro diagnostic technologies are practiced for diagnosis (Holgate et al. 2013). Among in-vivo methods:

  • skin-prick test,
  • prick to prick test,
  • intradermal test,
  • bronchial challenge test and
  • nasal challenge test are followed.

While in terms of in-vitro:

  • radioallergosorbent test (RAST),
  • enzyme linked immunosorbent assay (ELISA),
  • microarray and immunocap are applied (Singh et al. 2007).

While the in-vitro techniques are more reliable and sensitive than in-vivo one, the latter ones however give the results instantaneously.

In case of in-vivo tests, the fundamental of skin test is the formation of swollen spot on skin where the allergen is applied. This also signifies antigen-antibody interaction on mast cells. Nasal Challenge test or Rhinomanometry are confirmation tests. These are used when skin or blood tests are not able to provide specific results about asthmatic allergy. Similarly, Bronchial Challenge tests are performed specifically to diagnose asthma (Singh et al. 2007).

Different techniques available to test allergies in India

Various diagnostic techniques of allergy

Radioallergosorbent test (RAST) is an in-vitro test for diagnosing IgE in serum for environmental allergens. Whereas, ELISA gives the amount of IgE circulating in the blood during sensitization by an allergen. In India, ELISA is more favored than RAST. This is because unlike RAST, ELISA does not require radio-labeling to get the results. Similarly Microarray and Immunocap are automated diagnostic tools that provide consistent results with different allergens (Weiss et al. 2010).

Though in-vitro tests are more sensitive than in-vivo tests. However due to their high cost, they are generally not used most of the times for diagnosis (Singh et al. 2007). Among the different techniques, Radioallergosorbent test (RAST) costs twice as much as skin tests. On the other hand, microarray and unicap are labeled as gold-standard in in-vitro techniques. This is because of the fact that they consume less time, require small amount of sample and are not labor-intensive. Yet, it is suggested that India needs newer diagnostic techniques, which are both sensitive and cost effective (Prasad 2013).

Treatment measures adopted to treat allergies in India

India faces huge competition with respect to allergic drugs formulators and manufacturers. Introduction of newer under-development treatment technologies like DNA vaccines, modifications of epitopes and advanced immunotherapy will further burden the medicine market (Elshemy et al. 2013).

The commonly prescribed anti-allergic drugs in India are:

Generic Drug Function Type of allergy Symptoms Relieved Trade Names
Astemizole  Antihistamine Food and environmental allergy Chronic idiopathic urticaria and allergic rhinitis. Acemiz; Alestol; Astizole; Histeese (50 ml).
Chlorpheniramine Antihistamine Environmental and insect allergy. Watery eyes; itchiness by insect bites or bee stings; hay fever; sneezing; common cold. Cadistin; Cesiran; Chloram; Chlorpheniramine; Chlorpheniramine Maleate.
Desloratadine Antihistamine Food, environment, drug and insect allergy Allergic reactions in young children Alerdain; Allerdain; Allerde; Allerede; Desloriv.
Dexamethasone Ophthalmic- Otic Ophthalmic corticosteroid Environmental and chemical allergy Irritation, itching, redness and swelling of the eyes. Dexamethasone Ophthalmic- Otic
Epinephrine Hormone Food, drug, environmental, chemical and insect allergy Cardiac arrest (to restart the heart beat); anaphylactic shock;  increasing the flow of blood to heart; increase of diastolic blood pressure; dilation of .blood vessels, and controls superficial bleeding. Alergin; Asmapax Depot; Asthimo; Asthmino; Asthocap; Binikof; Binilon -650; BiodrylCofcodyl
Epinephrine/ Chlorpheniramine Antidote Environmental, food and insect allergy Asthma; dangerous responses to foods, insect stings and drugs. Epinephrine/ Chlorpheniramine
Flunisolide Corticosteroid Environmental allergy Anti-inflammatory; asthma and allergic rhinitis. Syntaris
Hydrocortisone Corticosteroid Chemical and environmental allergy Severe allergies, multiple sclerosis and skin conditions, asthma and arthritis. Cort – H; Cortola M; EfcorlinInj; Hisone Tab; Hycoson; Succicort; Unicort ; Wycort
Phenylephrin Selective alpha agonist Environmental allergy Nasal decongestant dilating the pupil and constrict superficial blood vessels in eye allergy. Agrus; Alex Paed; Allegone P; Belrin -D Syrup; C -Floxn; Cadicoff -DCeticold.
Triamcinolone Corticosteroid Chemical and environmental allergy Severe allergies; asthma; disorders of skin, kidney, blood, thyroid, eye, arthritis and intestine. Amcort (40 mg); Cinalife (40 mg); Comcort (10 mg)Ledercort (4 mg); Mycort (40 mg).

References

  • Elshemy, A., Elshemy, A. & Abobakr, M., 2013. Journal of scientific & innovative research. , 2(1), Available at: http://www.jsirjournal.com/Vol2Issue1013.pdf.
  • Holgate, Stephen T. Canonica, Giorgio Walter Baena-Cagnani, Carlos E. Casale, Thomas B. Zitt, Myron Nelson, Harold Vichyanond, Pakit Key, 2013. Asthma, Available at: http://www.worldallergy.org/UserFiles/file/WhiteBook2-2013-v8.pdf.
  • Jindal, S.K., 2010. Indian Study on Epidemiology of Asthma , Respiratory Symptoms and Chronic Bronchitis ( INSEARCH ) A Multi ‐ Centre Study ( 2006 ‐ 2009 ) Department of Pulmonary Medicine. , (September), p.335. Available at: http://icmr.nic.in/final/INSEARCH_Full _Report.pdf.
  • Pawankar, R., 2014. Allergic diseases and asthma: a global public health concern and a call to action. World Allergy Organization Journal, 7(1), p.12. Available at: http://www.waojournal.org/content/7/1/12.
  • Pawankar, R. Canonica, G. Holgate, S. Lockey, R., 2012. WAO, white book on allergy, Available at: http://www.worldallergy.org/UserFiles/file/WAO-White-Book-on-Allergy_web.pdf
  • Prasad, R.K., 2013. Allergy Situation in India : What is Being Done ? Indian J Chest Dis Allied Sci, (55), pp.7–8.
  • Shaikh, W.A. & Shaikh, S.W., 2008. Allergies in India: An analysis of 3389 patients attending an allergy clinic in Mumbai, India. Journal of the Indian Medical Association, 106(4), pp.220–226.
  • Singh, Abinav Kumar Arora, Naveen Prasad, Gbks Singh, B P, 2007. Revisiting in-vivo and in-vitro diagnostic approaches for respiratory allergy. , 21(2), pp.95–102.
  • Weiss, Michael E Bernstein, David I Blessing-moore, Joann Cox, Linda Lang, David M Nicklas, Richard A Oppenheimer, John Portnoy, Jay M Randolph, Christopher Schuller, Diane E
  • Spector, Sheldon L Tilles, Stephen Wallace, Dana Macy, Eric M Diego, San Cumberland, Kathleen R May., 2010. Drug allergy: An updated practice parameter. Annals of Allergy, Asthma and Immunology, 105(4), pp.259–273.e78. Available at: http://dx.doi.org/10.1016/j.anai.2010.08.002.
Priyanka Agarwal

Priyanka Agarwal

Research analyst at Project Guru
Priyanka is a post graduate in Biotechnology and has been associated with diverse researches, advancement in fermentation in alcohol industry and water recycling in waste water treatments. According to her “The pursuit of will leads the enthusiastic writer”. She is creative and has lead many successful events on Science Labs for juniors. Her association with India Book of Records has further enhanced the editorial proficiency. Her passion for theatre and arts and zeal for dance makes her an extraordinary performer in her field of work.
Priyanka Agarwal

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