Distribution and determinants of house dust mite allergens in Europe: The European Community Respiratory Health Survey II

doi:10.1016/j.jaci.2006.04.060

Journal of Allergy and Clinical Immunology

Volume 118, Issue 3, September 2006, Pages 682-690

https://doi.org/10.1016/j.jaci.2006.04.060 Get rights and content

Background

Several studies in European homes have described allergen levels from the house dust mite species Dermatophagoides pteronyssinus and to a lesser extent Dermatophagoides farinae, but geographic comparisons of exposure levels and risk factors have been hampered by a lack of standardized methods.

Objective

To study the distribution and determinants of the major house dust mite allergens Der p 1 and Der f 1 in 10 European countries using a common protocol.

Methods

During home visits with 3580 participants of the European Community Respiratory Health Survey II from 22 study centers, mattress dust was sampled and analyzed for Der p 1, Der f 1, and Der 2 allergen. Information on housing characteristics was obtained by both observations and interview.

Results

Der 1 and Der 2 allergens were detectable (≥0.1 μg/g) in 68% and 53% of the samples, respectively. Large differences in allergen levels between study centers were observed, and geographic patterns for Der p 1 and Der f 1 were different. Low winter temperatures reduced Der p 1 rather than Der f 1. Important risk factors for high allergen levels included an older mattress, a lower floor level of the bedroom, limited ventilation of the bedroom, and dampness for Der p 1 but not for Der f 1.

Conclusion

There are large qualitative and quantitative differences of house dust mite allergen levels in Europe, which can partly be explained by geographic and housing characteristics.

Clinical implications

Mite allergen exposure may be reduced by replacing the mattress regularly and increasing ventilation of the bedroom, particularly in winter.

Section snippets

Selection of homes

The methodology of the European Community Respiratory Health Survey (ECRHS) II has been described elsewhere.¹¹ Briefly, 29 study centers performed a follow-up investigation on asthma, allergy, and their known or suspected risk factors in a random population sample of men and women who were 20 to 44 years of age at the baseline survey (ECRHS I). Most study centers included an additional symptomatic sample of individuals who had reported current asthma symptoms and/or medication in a screening

Results

A total of 3679 homes were visited: 84% of the initial goal of 22 × 200. According to information obtained for all participants of ECRHS II during the main interview, there were no major differences in basic housing characteristics between those with and without home visits. A total of 3580 dust samples (97% of home visits) were obtained. One hundred sixty-six samples (4.6%; range, 1% to 16% across centers; Table I) had insufficient dust (<50 mg) for extraction and hence allergen analysis. The

Discussion

The ECRHS II provides a unique set of house dust mite allergen measurements taken from 22 cities in 10 European countries, using 1 standardized protocol of which several procedures were comparable with methods used in other epidemiologic surveys. Overall, Der p 1 and Der f 1 were each detectable in mattress dust from half of the homes. Both mite species are widely distributed in Europe, although some regions show almost exclusively 1 of the 2 species. There is a wider distribution of D farinae

In Memoriam

We thank all field workers for collecting the dust samples, and Marcus Burrows, Sharon Hughes, and Kashif Cheema for processing and analyzing the dust samples in the central laboratory in London.

Christina Luczynska contributed to two of the papers published in this issue of the Journal. Sadly, she died before the work was completed.

Born to Polish parents in London, she worked on both sides of the Atlantic during her short life. After completing her doctoral studies with Maurice Lessof on human

References (29)

H.S. Nelson
The importance of allergens in the development of asthma and the persistence of symptoms
J Allergy Clin Immunol
(2000)
L.G. Arlian et al.
Biology, ecology, and prevalence of dust mites
Immunol Allergy Clin North Am
(2003)
S.J. Arbes et al.
House dust mite allergen in US beds: results from the First National Survey of Lead and Allergens in Housing
J Allergy Clin Immunol
(2003)
T.J. Lintner et al.
The effects of season, climate, and air-conditioning on the prevalence of Dermatophagoides mite allergens in household dust
J Allergy Clin Immunol
(1993)
J.P. Zock et al.
Housing characteristics, reported mold exposure, and asthma in the European Community Respiratory Health Survey
J Allergy Clin Immunol
(2002)
G.T. O'Connor
Allergen avoidance in asthma: what do we do now?
J Allergy Clin Immunol
(2005)
R.T. Van Strien et al.
Mattress encasings and mite allergen levels in the Prevention and Incidence of Asthma and Mite Allergy study
Clin Exp Allergy
(2003)
J. Macan et al.
Differences in mite fauna between the continental and Mediterranean climates of Croatia: microscopy and Dustscreen test findings
Allergy
(2003)
K.E. Sidenius et al.
House dust mites and their allergens in Danish mattresses: results from a population based study
Ann Agric Environ Med
(2002)
G. Moscato et al.
Levels of house-dust-mite allergen in homes of nonallergic people in Pavia, Italy
Allergy
(2000)

I. Gross et al.

Indoor determinants of Der p 1 and Der f 1 concentrations in house dust are different

Clin Exp Allergy

(2000)

K. Wickens et al.

The determinants of dust mite allergen and its relationship to the prevalence of symptoms of asthma in the Asia-Pacific region

Pediatr Allergy Immunol

(2004)

The European Community Respiratory Health Survey II Steering Committee

The European Community Respiratory Health Survey II

Eur Respir J

(2002)

P.G.J. Burney et al.

The European Community Respiratory Health Survey

Eur Respir J

(1994)

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Accurate determination of house dust mite sensitization in asthma and allergic rhinitis through cytometric detection of Der p 1 and Der p 2 binding on basophils (CytoBas)
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House dust mite (HDM) is the most common allergen trigger globally for allergic rhinitis and atopic asthma.
To expedite accurate confirmation of allergen sensitization, we designed fluorescent allergen tetramers to directly stain specific IgE on basophils to detect specific allergen sensitization using the flow cytometric CytoBas assay.
Recombinant proteins of major HDM allergens (component), Der f 1, Der p 1, and Der p 2 were biotinylated and conjugated with fluorochrome streptavidins as tetramers. Blood samples from 64 patients who are HDM-allergic and 26 controls that are non–HDM-sensitized were incubated with allergen tetramers for evaluation of basophil binding (CytoBas) and activation (BAT) with flow cytometry.
The tetramers effectively bound and activated basophils from patients who are allergic but not from controls who are nonsensitized. CytoBas with Der p 1 as a single allergen had comparable sensitivity and specificity (92% and 100%) to BAT (91% and 100%) in detecting allergen sensitization, as did CytoBas with Der p 2 (95% and 96%) to BAT (95% and 87%). A positive staining for Der p 1 and/or Der p 2 in CytoBas was 100% sensitive and 96% specific for HDM allergy.
CytoBas has diagnostic accuracy for group 1 and group 2 HDM allergens that is comparable to BAT, but with additional advantages of multiple allergen components in a single tube and no requirement for in vitro basophil activation. These findings endorse a single, multiplex CytoBas assay for accurate and component-resolved diagnosis of aeroallergen sensitization in patients with allergic asthma and/or rhinitis.
Volatile organic compounds (VOC) in homes associated with asthma and lung function among adults in Northern Europe
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Associations between measured specific VOC reported to be associated with dampness and microbial growth in dwellings and asthma, lung function were investigated in 159 adults (one adult/home) from three North European cities (Reykjavik, Uppsala and Tartu). Spirometry was performed and forced vital capacity (FVC), forced expiratory volume in 1 s (FEV₁) and FEV₁/FVC were measured. Among 159 participants, 58% were females, 24.5% atopics, 25.8% current smokers and 41% reported dampness or mold at home. Dimethyl disulphide (p = 0.004), ethyl isobutyrate (p = 0.021) and ethyl 2-methylbutyrate (p = 0.035) were associated with asthma. Isobutanol (p = 0.043), 3-methyl-1-butanol (p = 0.020), 2-hexanone (p = 0.033), 1-octen-3-ol (p = 0.027), 2-methyl-1-butanol (p = 0.022) and 2-ethyl-1-hexanol (p = 0.045) were associated with lower FEV₁. Isobutanol (p = 0.004), 3-methyl-1-butanol (p = 0.001), 2-heptanone (p = 0.047) and 2-methyl-1-butanol (p = 0.002) were associated with lower FEV₁/FVC. The association between dimethyl disulphide and asthma was more pronounced in females (p for interaction 0.099). The association between 1-butanol and lower FEV₁ was more pronounced in males (p for interaction 0.046). The associations between 3-octanone (p for interaction 0.064), 2-ethyl-1-hexanol (p for interaction 0.049) and lower FEV₁, and between 2-heptanone (p for interaction 0.021), 3-octanone (p for interaction 0.008) and lower FEV₁/FVC were stronger in homes with dampness/mold. Factor analysis identified one VOC factor related to asthma and two VOC factors related to lower lung function. Increased air concentrations of 2-heptanone, ethyl 2-methylbutyrate and ethyl isobutyrate were related to prescence of certain mold species (Aspergillus sp., Cladosporum sp. and Penicillium sp.) or building dampness. Some VOC were associated with type of dwelling, building age and pet keeping. In conclusion, some VOC reported to be associated with dampness and microbial growth can be associated with asthma and lower lung function in adults. Associations between these VOC and respiratory illness can be stronger in homes with dampness/mold. There can be gender differences in respiratory health effects when exposed to indoor VOC.
In vitro assessment of house dust mite sensitization: No need for multiple Dermatophagoides tests
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House dust mites (HDM) are one of the major causes of allergic asthma and rhinitis in France. Under temperate climate, the two main species involved are Dermatophagoides pteronyssinus (Dp) and D. farinae (Df). Determination of immunoglobulin (Ig) E to whole Df and Dp extracts is widely used for perennial respiratory allergy diagnosis Few studies have addressed the compared analytical and clinical performance of the two extracts, and the advantage of testing both extracts rather than a single one. Our purpose is to identify whether only one IgE sensitization is enough.
We collected and analysed 3809 results of specific IgE to Dp and Df, from 4 distinct laboratories. Results were obtained from 2011 to 2021 using ImmunoCAP platform (Thermo Fisher Scientific, Uppsala, Sweden).
The overall sex-ratio M/F was 0.85. IgE to Dp and Df were concordant in 95.7% of cases, with 39.4% and 56.3% with negative and positive agreement, respectively. Sensitization to Dp (but not Df) were observed in 108 cases (2.8%) whereas sensitization to Df (but not Dp) were in 56 cases (1.5%). IgE to Dp and Df were positivity class agreement in 67.2%, and there was one IgE class-level difference in 30.2% (in those, IgE to Dp were higher than Df in 70.8%). Specific IgE to Df and Dp were highly correlated (r = 0.98; p = < 10⁻⁴).
Assessing specific IgE to both Dp and Df in routine in vitro diagnosis procedures does not bring advantage over assessing a single extract. Data presented here suggest that measuring IgE to Dp alone is sufficient as a first step for in vitro investigation of HDM sensitization.
Les acariens domestiques sont l’une des principales causes de rhinite ou d’asthme allergique en France, avec les deux principales espèces retrouvées: Dermatophagoides pteronyssinus (Dp) et D. farinae (Df). Devant une suspicion d’allergie respiratoire perannuelle, la recherche d’Immunoglobulines (Ig) E spécifiques sériques contre des extraits de Dp et Df est couramment réalisée. Cependant, peu d’études ont comparé les performances analytiques et cliniques des 2 extraits pour la recherche d’IgE spécifiques. L’objectif de notre étude est de déterminer si un seul des extraits est suffisant pour le diagnostic.
Nous avons réalisé une analyse rétrospective de 3809 résultats d’IgE spécifiques vis-à-vis de Dp et Df, provenant de 4 laboratoires distincts. Les dosages avaient été réalisés entre 2011 et 2021 par la méthode ImmunoCAP (Thermo Fisher Scientific, Uppsala, Suède).
Le sex-ratio global F/H est de 0,85. Les IgE spécifiques de Dp et Df sont concordants dans 95,7 % des cas, avec 39,4 % de résultats doubles négatifs (soit 1499 échantillons) et 56,3 % de résultats doubles positifs (soit 2146). La sensibilisation à Dp (mais pas à Df) a été observée dans 108 cas (2,8 %) alors que la sensibilisation à Df (mais pas à Dp) a été observée dans 56 cas (1,5 %). On retrouve une concordance de la classe d’IgE dans 67,2 % des cas et un écart d’une classe dans 30,2 % des cas (dont 70,8 % de cas avec un niveau d’IgE Dp supérieur à Df). Les niveaux d’IgE vis-à-vis de Dp et de Df sont fortement corrélés (r = 0,98; p = < 10⁻⁴).
La recherche d’IgE spécifiques vis-à-vis de Dp et Df ne présente pas d’avantage en pratique clinique par rapport à l’évaluation d’un seul extrait. Notre étude tend à montrer que l’utilisation d’un extrait de Dp semble suffisant pour la recherche d’une sensibilisation aux acariens domestiques.
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Effect of combination treatment with Lactobacillus rhamnosus and corticosteroid in reducing airway inflammation in a mouse asthma model
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We used Der p 2-sensitized asthma model in female BALB/c mice. The animals were treated with 75 μl or 50 μl oral prednisolone or combination treatment of these two doses of oral prednisolone with LGG. Airway hyperresponsiveness, serum specific IgE/IgG1/IgG2a, infiltrating inflammatory cells in lung and cytokines were assessed.
Compared to 75 μl prednisolone, a lower dose of prednisolone with 50 μl was less satisfactory in suppressing airway hyperresponsives, serum IgE and IgG1, Th2 cytokines and inflammatory cytokines such as IL-6, IL-8 and IL-17 as well as infiltrating inflammatory cells. However, combination of 50 μl prednisolone and LGG decreased airway resistance and serum IgE and IgG1, inhibited the production of IL-4, IL-5, IL-6, IL-8, IL-13 and IL-17, upregulated serum IgG2a and enhanced Th1 immune response.
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The coordination of ECRHS II was supported by the European Commission as part of their Quality of Life program. The following bodies funded the local studies in ECRHS II included in this article: Albacete: Fondo de Investigaciones Santarias (grant code: 97/0035-01, 99/0034-01, and 99/0034-02), Hospital Universitario de Albacete, Consejería de Sanidad; Antwerp: Fund for Scientific Research-Flanders Belgium (grant code: G.0402.00), University of Antwerp, Flemish Health Ministry; Barcelona: Spanish Respiratory Society (SEPAR), Public Health Service (grant code: R01 HL62633-01), Fondo de Investigaciones Santarias (grant code: 97/0035-01, 99/0034-01, and 99/0034-02), Interdepartmental Council of Technological Research and Innovation (CIRIT) (grant code: 1999SGR 00241), Red Respira Carlos III Health Institute; Basel: Swiss National Science Foundation, Swiss Federal Office for Education and Science, Swiss National Accident Insurance Fund, USC National Institute of Environmental Health Sciences Center grant 5P30 ES07048; Erfurt: GSF–National Research Center for Environment and Health, Deutsche Forschungsgemeinschaft (grant code FR 1526/1-1); Galdakao: Basque Health Department; Göteborg: Swedish Heart Lung Foundation, Swedish Foundation for Health Care Sciences and Allergy Research, Swedish Asthma and Allergy Foundation, Swedish Cancer and Allergy Foundation; Grenoble: Programme Hospitalier de Recherche Clinique-DRC de Grenoble 2000 #2610, Ministry of Health, Direction de la Recherche Clinique, Ministere de l'Emploi et de la Solidarite, Direction Generale de la Sante, CHU de Grenoble, Comite des Maladies Respiratoires de l'Isere; Hamburg: GSF–National Reasearch Center for Environment and Health, Deutsche Forschungsgemeinschaft (grant code MA 711/4-1); Ipswich and Norwich: Asthma UK (formerly known as National Asthma Campaign); Huelva: Fondo de Investigaciones Santarias (grant code: 97/0035-01, 99/0034-01 and 99/0034-02); Oviedo: Fondo de Investigaciones Santarias (grant code: 97/0035-01, 99/0034-01, and 99/0034-02); Paris: Ministère de l'Emploi et de la Solidarité, Direction Generale de la Sante, UCB-Pharma (France), Aventis (France), Glaxo France, Programme Hospitalier de Recherche Clinique–DRC de Grenoble 2000 #2610, Ministry of Health, Direction de la Recherche Clinique, CHU de Grenoble; Pavia: Glaxo-SmithKline Italy, Italian Ministry of University and Scientific and Technological Research, Local University Funding for research 1998 and 1999 (Pavia, Italy); Reykjavik: Icelandic Research Council, Icelandic University Hospital Fund; Tartu: Estonian Science Foundation; Turin: ASL 4 Regione Piemonte (Italy), AO CTO/ICORMA Regione Piemonte (Italy), Italian Ministry of University and Scientific and Technological Research; GlaxoSmithKline Italy; Umeå: Swedish Heart Lung Foundation, Swedish Foundation for Health Care Sciences and Allergy Research, Swedish Asthma and Allergy Foundation, Swedish Cancer and Allergy Foundation; Uppsala: Swedish Heart Lung Foundation, Swedish Foundation for Health Care Sciences and Allergy Research, Swedish Asthma and Allergy Foundation, Swedish Cancer and Allergy Foundation; Verona: University of Verona; Italian Ministry of University and Scientific and Technological Research; GlaxoSmithKline Italy.

Disclosure of potential conflict of interest: A. Soon has received grant support from the Estonian Science Foundation. The rest of the authors have declared that they have no conflict of interest.

^†: Deceased.

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Environmental and occupational respiratory disordersDistribution and determinants of house dust mite allergens in Europe: The European Community Respiratory Health Survey II

Background

Objective

Methods

Results

Conclusion

Clinical implications

Section snippets

Selection of homes

Results

Discussion

In Memoriam

J Allergy Clin Immunol

Immunol Allergy Clin North Am

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

J Allergy Clin Immunol

Mattress encasings and mite allergen levels in the Prevention and Incidence of Asthma and Mite Allergy study

Clin Exp Allergy

Differences in mite fauna between the continental and Mediterranean climates of Croatia: microscopy and Dustscreen test findings

Allergy

House dust mites and their allergens in Danish mattresses: results from a population based study

Ann Agric Environ Med

Levels of house-dust-mite allergen in homes of nonallergic people in Pavia, Italy

Allergy

Indoor determinants of Der p 1 and Der f 1 concentrations in house dust are different

Clin Exp Allergy

The determinants of dust mite allergen and its relationship to the prevalence of symptoms of asthma in the Asia-Pacific region

Pediatr Allergy Immunol

The European Community Respiratory Health Survey II

Eur Respir J

The European Community Respiratory Health Survey

Eur Respir J

Environmental and occupational respiratory disorders
Distribution and determinants of house dust mite allergens in Europe: The European Community Respiratory Health Survey II