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JazzyWarrior t1_iuv0w4e wrote

this isn't a complete answer but some of it will be mode of delivery. Injected > ingested > inhaled(sometimes depends on how your cytokine storm goes) > skin.

I had severe anaphylaxis after injected immunotherapy gone wrong, and that was for a grass allergy. I had critical asthma but not anaphylaxis like that to grass. The difference was mode of delivery.

Comparatively most pollen/hayfever will be inhaled, with the coating of the sinuses catching most of the allergens, compared to ingested with there not being the sinus mucus protection, but there still being some limited esophageal mucus, and stomach pH as protection, and that compared to injected(IE bee stimgs) having very little primary protection at all since it is into skin and/or muscle/blood by capillary, being the most direct action.

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The_Chaos_Pope t1_iux20ra wrote

This.

I have a severe reaction to tree and grass pollens and I've had anaphylaxic reactions to both immunotherapy and from eating an apple. Allergy season also causes asthma for me

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yourcatchphrase t1_iuxm1ne wrote

So I'm mildly allergic to grass, but I only ever have a reaction when it's been mowed recently and has stiff enough blades to stay sharp and give me little cuts and scratches.

I've had decades to observe that this is true, but I never really thought about the why. Thanks for explaining!

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SlightlyCorrosive t1_iv035ab wrote

It really depends on the individual’s immune system. Any allergen can cause anaphylaxis, technically. It just depends on how sensitive the individual is to it. I’ve seen anaphylaxis from pollen and mild, localized reactions to bee stings. It just depends on what your genetic makeup has in the cards for you, generally speaking.

It is also worth noting that each subsequent time a person is exposed to an allergen it has the potential to be much worse. The immune system “remembers” the allergen and packs a bigger punch next time. There’s hardly any predicting what exposure is eventually going to be the anaphylactic one though: for some people it happens after the second exposure, and for some it takes either much longer or never does occur.

Most people find out about severe allergies early on in life, but every once in a while chronic exposure to a substance triggers a severe reaction out of the blue in an older adult. I don’t believe it’s very well understood why this is.

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