ENGLISH PAPER

ALLERGY
SUPPORTING LECTURER:
YULIA SARI HARAHAP, S.Pd, M.Hum

COMPILED BY:
ABDUL WAHID
AMELIA
ATIKAH NABIL ADAWIYAH
AQILA PUTRI BR SARAGIH
PASYA RAHMASARI HARAHAP

MEDICAL LABORATORY TECHNOLOGY

POLTEKKES KEMENKES MEDAN
TA. 2023/2024
 FOREWORD
Alhamdulillahi rabbil 'alamin, praise and gratitude to Allah SWT for
His mercy and grace, we were able to complete our paper entitled
"Allergies" smoothly.

We have prepared this paper to fulfill basic English assignments. In

writing this paper, we feel that there are still many shortcomings in both
writing techniques and materials, considering the abilities we have. For
this reason, we really hope for criticism and suggestions from all parties to
improve the writing of this paper.

In writing this paper, we would like to express our deepest gratitude to

those who helped in completing this paper, especially to our lecturers who
gave us assignments and instructions, so that we could complete this
assignment.

Medan, 3th October 2023

Writer

i
 TABLE OF CONTENTS

FOREWORD ............................................................................................................. i

TABLE OF CONTENTS........................................................................................... ii

CHAPTER 1 INTRODUCTION................................................................................ 1

I. BACKGROUND OF THE PROBLEM ............................................................ 1

II. FORMULATION OF THE PROBLEM ........................................................... 2

III. PURPOSE OF THE PROBLEM ...................................................................... 2

CHAPTER 2 REVIEW OF LITERATURE ............................................................... 3

CHAPTER 3 DISCUSSION ...................................................................................... 6

A. CLASSIFICATION OF ALLERGY ................................................................. 6

B. PATHOPHYSIOLOGY ................................................................................... 7

C. FACTORS THAT SUPPORT THE OCCURRENCE OR FORMATION OF

ALLERGIES .................................................................................................... 9

D. TREATMENT AND MANAGMENT ............................................................ 10

E. PREVENTION............................................................................................... 10

CHAPTER 4 CONCLUSION .................................................................................. 12

A. CONCLUSION .............................................................................................. 12

B. SUGGESTION............................................................................................... 12

CHAPTER 5 REFERENCE..................................................................................... 13

ii
 CHAPTER 1

INTRODUCTION

I. BACKGROUND OF THE PROBLEM

Several scientific reports both domestically and abroad show that the
incidence of allergies has continued to increase sharply in recent years. It
seems that allergies are a case that dominates patient visits at the
Children's Health Services outpatient clinic. According to household
surveys from several countries, allergic diseases are one of the three most
frequent reasons why patients seek treatment from a family doctor.
Respiratory diseases are found in around 25% of all visits to general
practitioners and around 80% of them show recurrent disorders leading to
allergic disorders. Some time ago, the BBC reported that allergy sufferers
in Europe had a rapidly increasing trend. The incidence of allergies has
increased sharply in the last 20 years. At any time 30% of people develop
allergies. More than 40% of school-aged children have 1 allergy symptom,
20% have asthma, and 6 million people have dermatitis (skin allergies).
Hay Fever sufferers are more than 9 million people (Judarwanto, 2005).

Allergy is an abnormal reaction in the body caused by harmless

substances. Allergies arise when there is contact with certain substances
that normally do not cause a reaction in normal people. Substances that
cause allergies are called allergens. Allergens can come from various types
and enter the body in various ways. It could be through the respiratory
tract, from food, through injection or it could also arise due to contact with
the skin such as; cosmetics, metal jewelry watches, etc. Substances that
most often cause allergies: Plant pollen; certain types of grass; a type of
tree with smooth and thin skin; spore powder; penicillin; seafood; egg;

1
long beans, peanuts, soybeans, and other nuts; milk; corn and corn flour;
insect stings; animal fur; cockroach; dust and fleas. What is also no less
common are food additives, flavorings, colorings, and preservatives.

II. FORMULATION OF THE PROBLEM

1. What is meant by allergy?
2. How are allergies divided?
3. What are the signs and symptoms of allergies?
4. What factors support the occurrence of allergies?
5. Mention the various types of allergies!
6. How can allergies be prevented?

III. PURPOSE OF THE PROBLEM

The purpose of this discussion of allergies is intended to provide
knowledge of pathophysiology, etiology, treatment, etc. so that allergies
can be prevented early.

2
 CHAPTER 2

REVIEW OF LITERATURE
Description
Allergies are a type of immune response. The immune system
normally responds to microorganisms or foreign particles by producing
specific proteins called antibodies that bind to a specific foreign molecule
called an antigen. The reaction between an antibody and its antigen sets
off a series of chemical reactions designed to protect the body. Allergies
are immune responses triggered by common harmless substances.
Allergens may be inhaled into the lungs (pollen, dust, animal dander, mold,
pollutants), swallowed (food, drugs), injected (drugs, insect venom), or
contacted by the skin (poisonous plants, latex).

There are two main types of allergic reactions. Immediate

hypersensitivity reactions are mediated predominately by immune-system
mast cells and occur within minutes of contact with the allergen. Delayed
hypersensitivity reactions are mediated by T cells and occur hours to days
after exposure to the allergen.

Inhaled or ingested allergens usually cause immediate

hypersensitivity reactions. The allergen binds to a type of antibody called
immunoglobulin E (IgE) on the surfaces of mast cells. Mast cells are filled
with granules containing potent chemicals, including histamine. When IgE
binds its allergen, the contents of the granules spill out onto neighboring
cells. Histamine binds to histamine receptors on the surfaces of these cells,
causing a chain reaction that leads to allergy symptoms. Histamine binding
to receptors on blood vessels increases leakage, leading to fluid
accumulation, swelling, and redness. In the nasal passages, histamine
causes swelling, congestion, and increased mucus production. Histamine

3
also stimulates pain receptors on nerve cells, causing sensitivity and
irritation. These symptoms last from one to several hours following
contact with the allergen.

Allergens on the skin usually cause delayed hypersensitivity reactions,

in which roving T cells contact the allergen, initiating a more prolonged
immune response.

Risk factors
Although specific allergies are not inherited, an inherited propensity
for developing allergies is the single most important risk factor.
 A child has a 10-20% risk of developing allergies if neither
parent has allergies.
 A child with one allergic parent has a 30-50% chance of
allergies.
 The likelihood of a child developing allergies rises to 40-75%
if both parents have allergies.
Repeated exposure to certain allergens or prolonged exposure to strong
allergens are risk factors for specific allergies. Risk factors in children
include the following:
 low birth weight
 being born during a high-pollen season
 not being breastfed
 exposure to tobacco smoke
 exposure to pets
Causes
A genetic predisposition toward hypersensitivity reactions upon
exposure to specific antigens is called atopy. After birth, an interplay of
heredity and environment causes the immune system to become either
non-allergy prone (TH1) or allergy prone (TH2). TH1 cells are T-helper

4
cells that fight bacteria and viruses and protect against allergies. TH2 T-
helper cells fight parasitic infections and promote the production of
excessive IgE, increasing the likelihood of allergies. TH2 immunity is
much more likely to be switched on in children with a family history of
allergies. However, children are not necessarily sensitive to the same
allergens as their parents; they may simply have inherited a tendency to
produce more IgE. They must also be exposed to the specific allergens to
which they are genetically susceptible and, possibly, to a threshold level of
and duration of exposure to the allergen. High IgE levels increase the
likelihood of sensitivity to multiple allergens.

Anaphylaxis is an IgE-mediated hypersensitivity reaction brought

about by mediators released by mast cells in tissues and by basophils in
the blood. These mediators can cause airway constriction, blood pressure
drop, widespread tissue swelling, heart rhythm abnormalities, and
sometimes loss of consciousness. Other symptoms may include dizziness,
weakness, seizures, coughing, flushing, or cramping. Symptoms can begin
Symptoms can begin immediately although they usually reach peak
severity by 5–30 minutes. Anaphylaxis is most often associated with
allergies to foods, medications, and insect venoms.

Atopy increased significantly in the United States between 1970

and 2013, for reasons that are not wellunderstood. Environmental
allergens may have increased, and protective factors may have been
removed from the environment. For example, there is some evidence
suggesting that increased personal cleanliness and the worldwide fight
against infectious disease may be interfering with immune system function.
The so-called hygiene hypothesis theorizes that lack of exposure to germs
and other antigens in early life is increasing childhood allergies. Climate
change— and accompanying changes in vegetation patterns and increased
pollen production may also be factors.

5
 CHAPTER 3

DISCUSSION

A. CLASSIFICATION OF ALLERGY
Allergies are divided into 4 types, types I to IV related to humoral
antibodies, while type IV includes delayed allergic reactions by cellular
antibodies.
1. Type I (early anaphylactic reaction)
After the first contact with an antigen/allergen, IgE-type antibodies
will be formed in the body (sensibilization process). On subsequent
contact, an antigen-antibody complex will form. In this process mediator
substances (histamine, serotonin, bradykinin, SRS = slow-reacting
substances of anaphylaxis) will be released into the body's circulation. The
tissue that mainly reacts to these substances is smooth muscles which will
contract (contract). There is also an increase in permeability (translucency)
of the endothelial capillaries so that blood plasma fluid will seep out of the
vessels into the tissue. This results in blood coagulation with the clinical
effect of severe hypovolemia. Symptoms or signs of early anaphylactic
reactions are: - anaphylactic shock - urticaria, Quincke's edema -
recurrence/exacerbation of asthma bronchiale - rhinitis vasomotorica.

2. Type II (cytotoxic immune reaction)

This reaction occurs between antibodies from the IgG and IgM
classes and parts of the cell membrane that are antigenic, resulting in the
formation of complementary compounds. Examples: reactions after blood
transfusions, neonatal hemolytic disease, hemolytic anemia, leukopenia,
thrombopenia, and autoimmune diseases.

6
 3. Type III (overreaction by immune complexes)
This reaction is an inflammatory reaction or local inflammation
(Type Arthus) after the second intracutaneous or subcutaneous injection of
an allergen. This process takes place in the walls of blood vessels. In this
reaction, intravasal complements are formed which results in tissue death
or necrosis. Examples: Arthus phenomenon, serum sickness, lupus
erythematodes, periarteritis nodosa, and rheumatoid arthritis.

4. Type IV (Tuberculin type slow reaction)

This reaction only starts a few hours or up to several days after
contact and is a reaction from t-lymphocytes that have been sensitized.
The process is an inflammatory process or cellular inflammation with
tissue necrosis and fibrinoid changes in the vessels concerned. Examples:
tuberculin reactions (tuberculosis skin test), contact eczema, contact
dermatitis, autoimmune diseases (polyarthritis, colitis ulcerosa), etc.).

Etiology
In general, all objects in the environment (clothing, food, plants,
jewelry, cleaning tools, etc.) can cause allergies, but other factors include
(a) differences in the physical condition of each material, (b) frequency of
exposure, (c) body resistance a person, (d) the existence of a cross-reaction
between ingredients will influence the emergence of allergies.

B. PATHOPHYSIOLOGY
A complex allergic reaction can be described as follows: the reaction
begins with exposure to an allergen which is captured by Antigen
Presenting Cells (APC), broken down into small peptides, bound to HLA
molecules (MHC II), moved to the cell surface and presented to Th-cells.
2 . Th-2 cells are activated and produce cytokines including IL-4 and IL-
13 which stimulate the switching of IgG production to IgE by B cells,

7
sensitization of mast cells and basophils occurs, while IL-5 activates
eosinophils which are the main inflammatory cells in the reaction. allergy.
IgE antibodies (sensitized antibodies) attach to mast cells and basophils. If
an allergen enters the body, a complex bond between the allergen and IgE
will be formed. This bond causes the entry of Ca++ ions into mast cells
and changes occur in the membranes of mast cells and basophils. As a
result, mast cell degranulation occurs which then causes the release of
histamine and other inflammatory mediators. Apart from that, resident
cells also release mediators and cytokines which also cause allergic
symptoms.

These mediators cause peripheral vasodilation and swelling of the

intestinal space so that capillary permeability increases and seepage of
fluid and plasma proteins into the tissue which ultimately causes edema
and hypovolemia.

In the respiratory system, histamine causes bronchoconstriction which

causes dyspnoea. In the digestive tract, the release of histamine in the
fundus of the stomach activates parietal cells which increase stomach acid
production and cause nausea, vomiting, and diarrhea. Histamine receptors
are also found in sensory nerve endings which can cause pain and itching,
while in the eyes they cause itching and redness.

Severe allergic reactions can cause a decrease in blood pressure, this

condition is usually called anaphylactic shock which is characterized by
itching, abdominal cramps, reddish skin, gastrointestinal disorders, and
difficulty breathing.

8
 Pic. mechanism of hypersensitivity reactions

C. FACTORS THAT SUPPORT THE OCCURRENCE OR

FORMATION OF ALLERGIES
1. The willingness or tendency of an organism to overreact to foreign
substances due to the organism's ability to produce antibodies
excessively. Also, the instability of the vessel structure supports
this.
2. A normal organism (meaning that it does not have these
characteristics can also react excessively if it comes into contact
with very high amounts of antigen (extreme exposure)
3. Recently, a theory has been put forward, that the tendency to
maintain excessive cleanliness can also support the formation of
allergic diseases because it is possible that the body is no longer

9
 used to contact with antigens as a result of the elimination of these
antigens (which are usually contained in everyday "poop"). days)
“absolutely”.

D. TREATMENT AND MANAGMENT

Allergy treatment is carried out with pharmacotherapy which takes into
account safety, effectiveness, ease of administration; immunotherapy, and
patient education. One of the pharmacotherapies recommended in the
treatment of allergies is the latest generation of anti-histamine drugs such
as cetirizine. In contrast to classic/first-generation antihistamines (e.g.
chlorpheniramine, cyproheptadine, dexchlorpheniramine, etc.),
second/latest generation antihistamines generally have a low sedative
effect (low drowsy effect), are effective and some have mild anti-
inflammatory properties. Currently, one of the anti-histamine drugs,
namely cetirizine, has been included in the category of mandatory
pharmacy drugs from the POM Agency so that it can be purchased at
pharmacies in certain quantities using a doctor's prescription.

E. PREVENTION
Several things you can do to prevent allergies:
1. Keep the environment clean, both inside and outside the house.
This includes not piling up a lot of items in the house or bedroom
which can become a nest for dust to accumulate as a stimulus for
allergic reactions. Try not to keep animals in the house or place pet
cages around your house.
2. Personal hygiene must also be paid attention to, to avoid
accumulation of dirt which can also be a source of stimulation for
allergic reactions. To bathe, you must use warm water throughout
your life, and try to bathe in the afternoon before 17.00'. The soap

10
 and shampoo used should be soap and shampoo for babies. Using
hair dye is prohibited.
3. Don't use air freshener perfume or anti-mosquito medicines. If
there are lots of mosquitoes at home, use an anti-mosquito racket.
4. Use a mattress or pillow made of foam, not cotton.
5. Use cotton bed linen and wash it at least once a week with warm
water to be effective.
6. Avoid wearing clothes made from wool, use clothes made from
cotton.
7. Air conditioning (AC) can be used, but it must not be too cold and
must not exceed at 0.00 PM
8. Monitor any food drink or medication that causes allergic reactions.
Avoid these foods, drinks, and drugs. Must comply with allergy
diet rules.
9. Consult a specialist. Allergies that arise require different treatment
for each allergy sufferer. Ask your doctor to do immunotherapy to
reduce your sensitivity to ingredients that trigger allergic reactions,
for example: by giving injections using house dust extract or by
immunizing against Bacillus Calmette Guirine (BCG) at least 3
times (1 time a month) in a row, and repeat once every 6 months.

11
 CHAPTER 4

CONCLUSION

A. CONCLUSION
1. It is known that approximately 80% of respiratory patient visits
to doctors are recurrent disorders that report allergic disorders.
2. It was found that the substances that most often cause allergies
are plant pollen; certain types of grass; a type of tree with
smooth and thin skin; spore powder; penicillin; seafood; egg;
long beans, peanuts, peanuts, and other nuts; milk; corn and
corn flour; insect stings; animal fur; cockroach; dust and fleas

B. SUGGESTION
1. It is hoped that health workers can continue to improve health education in
the form of outreach to the public with the aim of increasing knowledge,
especially regarding allergies.
2. People, especially allergy sufferers, can routinely and diligently participate
in medical therapy carried out by health workers in the hope that they can
immediately overcome the allergies that occur.

12
 CHAPTER 5

REFERENCE

Bibliography
Hall, J. E., & Hall, M. E. (2021). Guyton and Hall Textbook of Medical
Physiology (14th Edition ed.). Park Ave, New York, United States of
America: Elsevier, Inc.
Lounge, J. L. (Penyunt.). (2015). The Gale Encyclopedia of Medicine (5th
Edition ed., Vol. 1). Farmington Hills, Michigan, USA: Gale, Cengage
Learning.
Tortora, G. J., & Derrickson, B. (2017). Principles of Anatomy and
Physiology (15th Edition ed.). Hoboken, New Jersey, United States of
America: John Wiley and Sons.

13