High mite-allergen exposure increases the risk of sensitization in atopic children and young adults

doi:10.1016/0091-6749(89)90300-X

Journal of Allergy and Clinical Immunology

Volume 84, Issue 5, Part 1, November 1989, Pages 718-725

https://doi.org/10.1016/0091-6749(89)90300-X Get rights and content

Abstract

Concentrations of major allergens of Dermatophagoides pteronyssinus (Dpt) and D. farinae (Df), Der p I and Der f I, were determined in 183 dust samples of mattresses of 133 atopic and 50 nonatopic children by a sandwich-type ELISA. Atopic children and young adults living in houses with high levels of Der p I and Der f I (≥2000 ng/gm of dust) were found to have significantly higher serum IgE levels to Dpt and Df (p < 0.0001) compared to patients with low mite-allergen exposure. Washed leukocytes of 55 atopic children and 14 control subjects were investigated for in vitro histamine release to serial dilutions of Der p I; 86% of highly exposed (≥10,000 ng/gm) children demonstrated positive histamine release in response to Der p I compared to 17% in the group with very low exposure (<400 ng/gm). There was a positive correlation between basophil sensitivity (r_s = 0.6; p < 0.0001) and reactivity (r_s = 0.54; p < 0.0001) to Der p I and mite-allergen exposure. The relative risk for sensitization in the highly exposed group versus the group with very low exposure was sevenfold to 32-fold increased. We conclude that high concentrations of mite allergen (≥2000 ng/gm) increase the risk of specific sensitization in atopic children and young adults and thus may facilitate allergic airway disease.

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Citation Excerpt :
At present, this threshold is not well defined in the literature and is likely to be compounded by the presence of other allergens and some predisposing factors, such as viral infections, exposure to chemicals (eg, formaldehyde), individual susceptibility, and use of medication.22,23 Studies seeking to quantify a level of exposure that can be considered “safe” suggest that levels of less than 2 μg/g of HDM allergens are the maximum level for the primary prevention of sensitization in atopic children and young adults.24,25 A study of HDM sensitization during the first 3 years of life found that sensitization was low during infancy (0.5%), with an increase during the second (1.4%) and third (1.9%) years of life, and concluded that interventions aimed at primary prevention of sensitization should be introduced as early as possible, preferably during infancy.15
The house dust mite (HDM) is a major perennial allergen source and a significant cause of allergic rhinitis and allergic asthma. However, awareness of the condition remains generally low. This review assesses the links between exposure to HDM, development of the allergic response, and pathologic consequences in patients with respiratory allergic diseases. We investigate the epidemiology of HDM allergy to explore the interaction between mites and human subjects at the population, individual, and molecular levels. Core and recent publications were identified by using “house dust mite” as a key search term to evaluate the current knowledge of HDM epidemiology and pathophysiology. Prevalence data for HDM allergen sensitization vary from 65 to 130 million persons in the general population worldwide to as many as 50% among asthmatic patients. Heterogeneity of populations, terminology, and end points in the literature confound estimates, indicating the need for greater standardization in epidemiologic research. Exposure to allergens depends on multiple ecological strata, including climate and mite microhabitats within the domestic environment, with the latter providing opportunity for intervention measures to reduce allergen load. Inhaled mite aeroallergens are unusually virulent: they are able to activate both the adaptive and innate immune responses, potentially offering new avenues for intervention. The role of HDM allergens is crucial in the development of allergic rhinitis and asthma, but the translation of silent sensitization into symptomatic disease is still incompletely understood. Improved understanding of HDMs, their allergens, and their microhabitats will enable development of more effective outcomes for patients with HDM allergy.
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^☆: Supported by the DFG (German Research Foundation Grant Wa 409/5-1).

^∗: From the University Children's Hospital, Berlin, West Germany.

^∗∗: From The Protein Laboratory, Copenhagen, Denmark.

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Original articleHigh mite-allergen exposure increases the risk of sensitization in atopic children and young adults☆

Abstract

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy

J Allergy

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

Anal Biochem

J Allergy Clin Immunol

J Allergy Clin Immunol

Lancet

Development of IgE and IgG antibodies to food and inhalent allergens in children at risk of allergic disease

Arch Dis Child

The distribution of dust mite allergen in the houses of patients with asthma

Am Rev Respir Dis

Mite asthma and residency: a case-control study on the impact of exposure to house dust mites in dwellings

Am Rev Respir Dis

Mite fauna and fungal flora in house dust from homes of asthmatic children

Allergy

House dust mites

J Med Entomol

Level of indoor allergens in dust from homes of allergic and non-allergic individuals

Int Arch Allergy Appl Immunol

Original article
High mite-allergen exposure increases the risk of sensitization in atopic children and young adults☆