The respiratory tract is a very frequent site of manifestation of allergies due to its large surface area. The lungs are ventilated with about 10,000 liters of air per day, so that allergens contained in the air penetrate the respiratory tract in large numbers.

Pollen grains with a size of up to 100 µm are most likely to be trapped in the upper respiratory tract. Mite and cat allergens with a size of about 5 µm penetrate deeper into the lower respiratory tract.

For hay fever and asthma, the inhalation allergens play the most decisive role. These are tree and grass pollens, mites, molds and animal allergens.

The basis of diagnostics is always a targeted anamnesis. The timing of the symptoms and the correlation to the respective environmental conditions are of decisive importance. The subsequent physical and instrumental examination can determine which organs are involved in the disease and to what extent.

Sensitization to a specific allergen can then be verified in a skin test. For this purpose, a small amount of the allergen is introduced into the uppermost layer of the skin (prick test). Especially in unclear cases, the reaction of the immune system can also be tested in the blood (in vitro).

If necessary for the subsequent therapy, the reaction of the affected mucosa to the previously identified allergen can be tested in a final step (provocation test).

If the allergy contact cannot be avoided, a drug therapy is necessary in case of physical symptoms. Drug therapy can be carried out, for example, with antihistamines, steroids, leukotriene antagonists or biologics.

Allergy immunotherapy offers the possibility of reconditioning the immune system so that tolerance and thus healing of the allergy can be achieved in the case of pre-existing allergy. The allergen in question is injected under the skin (SCIT – subcutaneous immunotherapy) or applied to the oral mucosa under the tongue (SLIT – sublingual immunotherapy). This therapy is usually carried out over three years.