Headline: Hazelnut dan elerji
Tajuk: Bagaimana elerji berlaku di sebalik sistem pertahanan tubuh?
Tarikh menulis: 15 November 2018M
Assalamualaikum wbt, rentetan daripada kisah di Bartin, Amasra Turki. Heheh! Malu betul. Boleh pula ter'elerji' teruk (sampai sesak nafas) sewaktu tengah berjauhan dengan keluarga (baca: jauh dengan negara sendiri). Dahla waktu itu baru seminggu di Karabuk Universiti (dengan tanpa insurans, keluar pula dengan kawan-kawan dari pelbagai negara). Sabar jelah!
Teringat masa belajar asasi di UIA Petaling Jaya: Izzati datang ke klinik untuk hantar laporan kesihatan. Setelah tiba giliran Izzati, doktor minta laporan kesihatan dan tengok tulisan, "Hmm, arkitek?" "Eh mana ada, IRK heheh". "Ohh, awak ada elerji kacang Hazel dan kacang Badam." Kacang luar negara ni…bla bla bla~
Imbas semula zaman sekolah Izzati: Setiap kali makan Cadburry dan coklat yang ada Hazelnut, automatically akan rasa gatal. Gatal dia bukan macam kena gigit nyamuk. Tapi gatal yang rasa bisa. Disebabkan itu, Izzati jadi tak suka coklat yang ada kacang Hazel (contoh: Cadburry, Ferrero Rocher, Nutella dll) dan apa yang manis sangat (tapi kalau nak belanja plain moist chocolate cake, saya tak elerji hahah #kidding).
Sebelum mula untuk memahami bagaimana elerji terjadi dalam system imunisasi badan kita yang Allah cipta, Izzati nak kongsi mengenai kacang Hazel:
Maka, ayuhlah kita mengambil tahu serba sedikit mengenai kacang kegemaran kalian iaitu Hazel. Bak kata orang, "Tak kenal, maka takcinta."
Hazelnuts Facts by Health Benefits Times:
Name: Hazelnuts
Scientific Name: Corylus avellane
Origin: Native to Europe and western Asia (from the British Isles south to Iberia, Greece, Turkey and Cyprus, north to central Scandinavia, and east to the central Ural Mountains, the Caucasus, and northwestern Iran).
Colors: Thin, dark brown
Shapes: Spherical to oval, 15 to 20 mm long, 12 to 20 mm broad
Calories: 178 Kcal./cup
Major nutrients: Manganese (155.91%), Copper (50.44%), Total Fat (49.54%), Vitamin E (33.07%), Vitamin B6 (12.77%)
Health benefits: Healthy heart, Diabetes management, Antioxidant source, Brain health, Cancer prevention.
Colors: Thin, dark brown
Shapes: Spherical to oval, 15 to 20 mm long, 12 to 20 mm broad
Calories: 178 Kcal./cup
Major nutrients: Manganese (155.91%), Copper (50.44%), Total Fat (49.54%), Vitamin E (33.07%), Vitamin B6 (12.77%)
Health benefits: Healthy heart, Diabetes management, Antioxidant source, Brain health, Cancer prevention.
History of Hazelnut:
Hazelnuts, also referred to as filberts, happen to be grown in the Black Sea region of northern Turkey for around 2,300 years and have already been exported from the area for more than 600 years. The world’s highest quality hazelnuts range from lush fields along the Black Sea of Turkey, that has the finest climate for growing hazelnuts. Today, 80% of the world’s hazelnuts are made in Turkey and the Turkish family farmers producing hazelnuts are incredibly happy with the hazelnut crop, since it has been part of their family histories for hundreds of years. More than 500,000 producers are involved in the cultivation, harvest, processing as well as sale of hazelnuts for the world to enjoy. Because of the extremely top quality of Turkish Hazelnuts, Turkey remains the top global hazelnut producer and exporter. In reality, Turkey exports roughly 250,000 tons of hazelnut kernels annually to more than 100 nations all over the world (Health Benefits Times, 2017).
The point is I want to highlight that Hazelnut is a nut that originally from Turkey and one of the people who has allergy to Hazelnut in her immune system, is staying in Turkey near to Black Sea from September 2018 to January 2019. Okay, let figure out the hikmah! Mungkin Allah nak ajar Izzati supaya jadi seorang yang teliti, berhati-hati dalam mengambil sesuatu hidangan atau makanan, serta sabar khasnya bila tengok kawan makan menu makanan sedap yang ramuannya dimasukkan kacang Hazel; hmm sabar Izzati🍂
Hazelnut allergy:
Hazelnut allergy is really a type-1 (Ig-E mediated) hypersensitivity response in certain individuals to food substances prepared with utilizing these nuts. Generally, the allergic reaction might be more commonly precipitated on contact with tree pollen.The allergic symptoms, referred to as “oral allergy syndrome,” can include itchiness around lips, tongue as well as throat followed by swelling of lips and throat resulting in breathing problems. Quite often, cross-reactions to particular other nuts, seeds, fruits, and vegetables are typical. People with recognized hazel nut allergy are, therefore, advised to prevent any food preparations which contain hazel nut products. People allergic to mugwort pollen, peanuts, birch pollen, Brazil nut and macadamia nut might be allergic to hazelnut as well (Health Benefits Times, 2017).
Berbalik kepada perkongsian kita,
Dalam masa yang sama, lama dah sebenarnya, nak tahu pasal elerji ni. Tiba-tiba, direzekikan ada satu sahabat daripada sekolah menengah sudi nak terangkan dengan lebih terperinci untuk Izzati, alhamdulillah! Penerangan yang baik dan jelas adalah seperti berikut:
Immune system terbahagi kepada dua: Innate immune response & Adaptive immune response. Innate immune response contohnya adlh lysozymes dlm air mata, gastric juice (HCl 1.5-3.5pH), cilia (ibrat penyapu) pada sluran prnfsn. Diorg bunuh/buang bacteria x kira jenis apa pon. Second, adaptive immune response. Sprti gmbar dibwh:
Hazelnut allergy is really a type-1 (Ig-E mediated) hypersensitivity response in certain individuals to food substances prepared with utilizing these nuts. Generally, the allergic reaction might be more commonly precipitated on contact with tree pollen.The allergic symptoms, referred to as “oral allergy syndrome,” can include itchiness around lips, tongue as well as throat followed by swelling of lips and throat resulting in breathing problems. Quite often, cross-reactions to particular other nuts, seeds, fruits, and vegetables are typical. People with recognized hazel nut allergy are, therefore, advised to prevent any food preparations which contain hazel nut products. People allergic to mugwort pollen, peanuts, birch pollen, Brazil nut and macadamia nut might be allergic to hazelnut as well (Health Benefits Times, 2017).
Berbalik kepada perkongsian kita,
Dalam masa yang sama, lama dah sebenarnya, nak tahu pasal elerji ni. Tiba-tiba, direzekikan ada satu sahabat daripada sekolah menengah sudi nak terangkan dengan lebih terperinci untuk Izzati, alhamdulillah! Penerangan yang baik dan jelas adalah seperti berikut:
Immune system terbahagi kepada dua: Innate immune response & Adaptive immune response. Innate immune response contohnya adlh lysozymes dlm air mata, gastric juice (HCl 1.5-3.5pH), cilia (ibrat penyapu) pada sluran prnfsn. Diorg bunuh/buang bacteria x kira jenis apa pon. Second, adaptive immune response. Sprti gmbar dibwh:
Adaptive mknanya, diorg belajar utk kenal jenis2 bacteria, virus, antigen(foreign molecules). Diorg akn bljr & mncari kelemahn bcteria, virus & antigen. Diorg jugak akn simpan mklumt bctria, vrus & antigen slma brtahun2 (in case kene attck kali ke 2 or bnyk kali) hebat kann…
Allergy disebabkan oleh antigen (foreign molecules) yg masuk dlm badan (cell/tissues/blood stream, ect). Allergen adlh term utk penyebab allergic. Allergen ada bnyk.
Contohnya ada pd gmbr dbwh…
Izzati ada allergy pd hazelnuts. Jd hazelnuts mrupkn allergen yg mmbawa antigen. Bila zati mkn hazelnut, hzelnut msuk dlm perut. Hazelnut td ada bawak antigen sekali. So, antigen msuk dlm bdn. Act antigent tu x bhya pon sbb kan drpd hazelnut (harmless). Tp...
Utk org yg ada allergy, mereka ada sebuah genes yg unik. Genes ni mnyebbkan helper T cell jd hypersensitive (over reaction) trhdpt certain antigen (kalo zati antigend hazelnut tu la)
Kisahnya bermula apabila Izzati Nadia makan waffle yg ada hazelnut...antigen drpd hzelnut tu masuk dlm badan. Tgok gmbr dbwh:
Petunjuk:
*wrna merah tu antigen hazelnut
*hijau adalah dendritic cells yang ronda dalam lymph, darah, & tisu (mncari bnda aneh dlm badan)
*biru adlh helper T cell
Antigen hazelnut msuk dlm sistem tisu, darah, dan limfa. Dendritic sel jln2 mase tu cari benda pelik mcm antigen. Tiba2 jumpa satu antigen tu, dia pon phagocytes (cikgu Fazlini ada ajar dulu, dia telan antigen tu). Then, dia pon cepat2 bwk pegi jumpa helper T-cell yg brhmpiran.
Anggap mase ni umur zati 12 tahun (sebelum kene severe allergic reaction first time). Mase ni first time bdn zati jumpa antigen hazelnuts.
Dendritic cell tu bwk antigen jumpa dlm helper t cells dlm sistem lymphatic (sistm prthnn bdn). Kalau perasan dlm gmbr kat ats tu, nama cell biru tu adlh naive T-helper. Naive T-helper adalah T cell yg fresh, dia tak kenal pon antigen tu.
Tp, lepas dendritic cell tu tunjuk antigen tu dekat naive t helper trus dia kaji psl antigen tu & dan bertukar menjadi primer t helper (activated).
SENSITIZATION PHASE: Fasa mula-mula sistem pertahanan badan nak kenal allergen.
Slps naive t helper brtukr mnjadi primer t helper. Dia akn kaji psl antigen tu & hantr mklumat pada B cell. Maklumt tu dkenali sbgai cytokines (pchn bg cytokines ada byk, tp dlm kes allergy ni ada 2 je yg pnting iaitu interleukin 4 & 5).
Kemudian B cell akn ambik IL 4, b cell pon berpecah kepada bnyk (proliferation) & trbhgi kpd 2 group iaitu sel plasma & sel memory.
Sel plasma tugas dia adlh utk hsilkan antibody untuk certain antigen shja (dlm kes ni, dia hsilkn antibody utk antigen hazelnut).
Sel memory pulak akn hfl segala mklumt & antibody trhdp antigen td. So, next attck kita dh immune.
Antibody yg dihasilkan oleh plsma cell utk kes allergy adalh IgE (immunoglobulin E). So, dlm kes ni IgE trsebut hnylh utk antigen hazelnut.
Kemudian IgE td akn bind dgn receptor yg ada pd mast cell (tgok gmbr first). So, next attck bdn kita dh ready.
SUBSEQUENT PHASE: kali kedua terdedah kpd allergen yg sama.
Ingat tak IgE (sp utk hazelnut) yg dh attach pd mast cell td iaitu situasi dia contohnya mase drjah 6 tu mkn hazelnut. So, bila antigen hazelnut tu masuk, automatic bdn akn response (very fast within minutes) sbb zati dh ada antibody IgE utk lwn antigen hazelnut td. So, IgE yg ada pd mast cell td akn bind dgn antigen trsebut. Degranulation akn brlaku pd mast cell tu (ibrt cell tu muntah). Mast cell akn keluarkan inflammation mediator (ada bnyk tp yg pling pnting utk allergy adlh Histamine).
HISTAMINE: penyebb brlkunya allergy reaction pd bdn.
Histamine prlu attach pd sel dlm bdn kita. Dia akn attach pd receptor2 histamine (total ada 4 receptor H1, H2, H3 & H4) kalau utk allergy reaction kita fokus pd H1 & H2 receptor.
Receptor histamine 1 (H1) terletak di saluran darah (artery/vein/capillary), otot licin (ada pd bnyk tmpt antranya ada pada bronchioles), otak & hujung saraf periferi (ada pd kulit). Receptor histamine 2 (H2) terdapt pada gester. Kalau histmine tu attch pd receptor h2 maka perut akn hsilkn bnyak hydrochloric acid (hcl).
Kalau histamine attach pd receptor h1 yg ada pada salur darah...slur drh akn vasodilation (kembang), dan ketelapan akan meningkat (increase permeability). Jd fluid dlm salur darah akn keluar dan pergi ke kwsn interstitial (kwsn diantara cell) mnyebbkan edema (bengkak).
Kalau hstmine attch pd H1 kt smooth muscle yg ada pada bronchial... akn berlaku bronchoconstriction (salur darh sempit), increase secretion (mcm kahak). Hal ini akn mnybbkn kita sukar utk brnafas. Kalau h1 pada otak, otak akn yg wakefulness, Kalau h1 pada ending saraf epithelial, kulit kita akn gatal/sakit.
ANAPHYLATIC SHOCK REACTIONS:
Hypotension (tknn Pulse naik, & dysrhythmias (tidak sekata sekejap laju pastu laju lagi pastu slow sikit) mse ni orgn kita dh kurg oxygen (kn x leh nafas) so jntung cuba sdya upaya utk bg drh pd organ2 pnting mcm kidneys, brain.
Dyspnea (prnfsn mningkat) sbb pru2 cuba utk ambik oxygen bnyk nk bg pd drh. Larygospasm/bronchospasm (laryn dgn bronchial kejang, sbb otot licin contract. Pulmonary edema (pru berair) late stage. Capillary pada alveoli increase permeability mnyebbkn fluid drpd slurn darah kelur pergi ke kwsn paru2.
Jadi, bila izzati mkn wafel Hazelnut. Bdn dh kenal antigen hazelnut (time tu dh bnyk IgE spcidic utk antigen hazelnut dh ada dlm bdn. Sbb tu trus jadi anaphylactic shock & more worsen than before.
Basically, allergy dsbbkn oleh seseorg itu ada satu genes yg mganggap harmless antigen (mcm nuts) sbgai bnda yg mngncam kslmtn bdn. So, bdn kita cuba yg terbaik utk slmtkan kita.
Histamine baik sbnrnya bila dia increase kan permeability slur drh, mnybbkn kita punya white blood cells yg lain senang nk migrates ke kwsn yg trdedah kpd bahaya. Dia jugak akn mnrik prhtian sel2 prthnn bdn yg lain mcm killer t sel, neutral killer t cell.
Begitulah ceritanya, terima kasih kerana menambah ilmu awak dengan membaca perkongsian Izzati. Semoga maklumat ini memberi manfaat kepada awak, saya, dan dia eh? #gurau sahaja. Doakan yang terbaik untuk Izzati Nadia, keluarga, rakan-rakan, dan guru-guru. Assalamualaikum wbt!
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Bismillah, jadilah seorang pengkritik yang berhemah, jujur dan tidak mendengki agar orang yang dikomen mendapat manfaat daripada komen kita #HNquotez