COLUMN IN YOUR GENES Sneezing and sniffles... Y How integrated genetics can help your allergy patients BY DR. PENNY KENDALL-REED, ND allergies and, despite taking antihista-key players. mines, often remain quite symptomatic, Stress Genes: Stress can stimulate especially if they lower the antihistamine and destabilize mast cells, forcing them dose or stop it entirely. to release histamine in the absence of an But does examining the DAO gene allergen. Stress also increases inflamma-tory cytokine production, es-explain the twin statistics pecially IL6, and that further above? Or explain why anti-histamines don’t resolve For patients triggers the allergen response symptoms for all allergy suf-and worsens symptoms. Let’s with DAO ferers? Unfortunately not. issues, the “fix” examine 5 genes that you There are a few important should consider when looking may seem mechanisms that greatly aug-straightforward at the role of the stress re-sponse in allergies: ment the allergenic response COMT and MAOA break by directly stimulating the mast cells. Thus, even in the absence of down and clear out our stress hormones. an actual allergen, the same allergy Slow stress hormone breakdown, as symptoms arise. Antihistamine treat-seen with the variant coding of these ment is only half (if not less) of the ar-genes, means they stick around in the DAO (diamine oxidase gene) tillery needed to fight the battle raging body. The longer these hormones cir-only part of the allergy within the immune system. Thankfully, culate, the more likely they are to have picture genetic analysis can help us identify a profound negative impact. We know that genetics plays a signifi-what other mechanisms are at play, and NR3C2 and FKBP5 variant alleles cant role in allergenic disease. Yet, the strength of their impact. alter the normal feedback loop of the identical twins are likely to have the For patients with DAO gene issues, hypothalamic-pituitary-adrenal (HPA) same allergies only about 70% of the the “fix” seems straightforward; lower axis. NR3C2 codes for the mineralocor-time, and non-identical twins about histamine and avoid allergens. But even ticoid receptor. Those with the variant 40% of the time. What’s going on with in these patients, you may need to look allele have reduced expression and ac-the other 30% or 60%? deeper. What happens if you don’t treat tivation of the receptor, which leads to When faced with seasonal allergies, dysfunction in the stress pathway or a decreased feedback response to corti-most clinicians look to traditional al-sensitivity in the inflammation and im-sol. FKBP5 produces a protein that lergy genes such as DAO. This gene mune system response? The expression blocks cortisol from binding to the codes for diamine oxidase production of genes affecting these factors will keep glucocorticoid receptor. Patients carry-– the enzyme responsible for inactivat-igniting the allergy reaction repeatedly ing the variant allele produce more of ing or degrading histamine. Is looking such that the mast cells are never fully this protein leading to impaired negative at this gene extremely valuable? Abso-turned off. feedback. The result? Patients carrying lutely. Patients with a genetic profile In my opinion, these other genes are the variant alleles of these genes get indicating low DAO production cannot almost more important than the classic trapped in the sympathetic side of the effectively metabolize or excrete hista-“allergenic genes” such as DAO. Let’s nervous system, chronically producing mine, leading to histamine buildup. take a closer look at how the following more stress hormones (even in the ab-These patients may regularly experience genes impact allergies, and which are sence of stress), destabilizing their mast cells. DR. PENNY KENDALL-REED, N.D ., is a naturopathic doctor in Toronto. After graduating from McGill CRHR1 produces receptors for Cor-University in Neurobiology, she earned a degree in Naturopathic Medicine from the Canadian College of ticotropin Releasing Hormone (CRH). Naturopathic Medicine, where she received the Dr. Allen Tyler Award for Most Outstanding Clinician. Dr. When stimulated they activate the Kendall-Reed is the author of five national bestselling books, and recently released her latest, “Fix Your HPA-axis stress response, which again Genes to Fit Your Jeans,” which she co-authored with her husband, Dr. Stephen Reed. In 2013 she was increases the allergenic response. Those voted Naturopath of the Year and in 2018 was the recipient of the top Naturopathic Doctor. with the variant coding for this gene 18 Chiropractic and Naturopathic Doctor March/April 2022 www.Cndoctor.ca our patients likely know that they have seasonal allergies, and may be looking to you for symptomatic relief. But are you prepared to answer these patient questions? • I tried antihistamines – why didn’t they work? • I’ve never had allergies before – why am I getting them now? • I got a cold months ago – why do I still have symptoms? Let’s take a closer look at which ge-netic factors influence the immune re-sponse, and how using integrated genet-ics can help you get to the root of your patients’ allergies.
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