The effect of dry heat on mite, cat, and dog allergens

Background Various techniques have been tried in an attempt to reduce allergen levels in homes. This study investigated the effect of dry heat on mite, cat, and dog allergens.
Methods Samples (50 mg) of Dermatophagoides pteronyssinus and D. farinae cultures, and of house dust rich in the major cat and dog allergens Fel d 1 and Can f 1 were heated for 5, 10, 15, 30, and 60 min at 60°, 80°, 100M20°, and 140°C. Control samples remained at room temperature. Extracts were assayed with the appropriate two-site mono- or mono/polyclonal sandwich ELISA, Results For Der p 1, the breakdown was proportional to temperature and heating time; after 30 min at 120°C, allergen levels were reduced to < 1 % of control. Der p 2 was more heat stable, requiring 140°C for 30-60 min to achieve >99% reduction. D. farinae groups 1 and 2 allergens showed results similar to those obtained with D. pteronyssinus. In contrast. Can f 1 and Fel d 1 were considerably more thermostable, with 50% and 70%, respectively, of allergen remaining after 60 min at 140°C.
Conciusions The effect of dry heat on allergens increased with increasing time and temperature, cat and dog allergens demonstrating greater heat resistance than mite allergens. Dry heating methods may represent an alternative technique for removal of mite allergens: however, the greater stability of Fel d 1 and Can f 1 suggests that this procedure may not be appropriate for pet allergens.     

Occurrence of dog, cat, and mite allergens in public transport vehicles

BACKGROUND AND METHODS: Helsinki City Transport buses, trams, and underground trains carry 687,000 passengers on a weekday. Of the passengers, 0.13% travel with a pet. We interviewed passengers and measured allergen levels in vehicles to determine what difficulties allergens cause to passengers with allergy and asthma. RESULTS: Of 2,021 interviewed passengers, 14% complained about inconvenience caused by pets, usually health problems. Of 324 adult passengers with allergy or asthma, 53% had experienced symptoms in public transport; the corresponding figure for 75 children was 32%. The median concentration of the main dog allergen, Can f 1, in dust from seats and floors in public transport vehicles was 2,400 ng per g of dust (range 20-8,500 ng/g). For the main cat allergen, Fel d 1, the median was 870 ng/g (range 3-2,600 ng/g). These levels can be regarded as low or moderate, and they cause symptoms in sensitive persons. Concentrations of mite allergens were undetectable or low. Allergen levels were lower in vehicles where pets were not allowed than in vehicles where pets were allowed, lower in dust from uncovered seats than in dust from seats with a covering, and lower after cleaning vehicle floors and seats than before cleaning. CONCLUSIONS: Dog and cat allergens are present in public transport vehicles in Helsinki at levels that cause symptoms in sensitive persons. Prohibiting pets would probably bring only a modest reduction in levels, as few pets are carried, and much allergen contamination comes from passengers' clothes.     

Relationship between mite, cat, and dog allergens in reservoir dust and ambient air

BACKGROUND: Standardized methods to measure allergen exposure are essential to assess the relationship between exposure, sensitization, and asthma. Most studies have measured allergen levels in reservoir dust, although air samples may be more representative as a measure of inhaled allergen. The aim of this study was to define the relationship between mite, cat, and dog allergen content in the reservoir dust and the levels in the ambient air. METHODS: Dust samples from the living-room floor (LF) and sofa (S) were collected in 127 homes: 62 without and 65 with pets (31 dogs, 34 cats). Air samples were taken in the same room, with a high-volume pump for 1 h (flow 60 l/min). Der p 1, Fel d 1, and Can f 1 were determined by mAb-based ELISA. RESULTS: Airborne Der p 1 was below the detection limit (0.8 ng/m3) in all homes, with reservoir levels (GM and range) being 1.14 microg/g (0.2-66) and 1.15 microg/g (0.2-127) in LF and S, respectively. Airborne Can f 1 was detected in 40/62 homes without pets (range 0.6-12.4 ng/m3) and in all homes with dogs (range 0.5-99 ng/m3). In the multiple linear regression analysis, Can f 1 level in the LF was an independent correlate of the airborne Can f 1 (P=0.01, homes with dogs; P=0.04, homes without dogs). Fel d 1 was detected in the air in 16/62 homes without pets (range 0.16-1.8 ng/m3) and in all homes with cats (range 0.4-22.3 ng/m3). Fel d 1 level in the LF was an independent correlate of the airborne Fel d 1 in homes without cats (P=0.008), but airborne levels in homes with cats did not correlate with reservoir levels. CONCLUSIONS: The aerodynamics of each allergen must be taken into account when assessing exposure: while levels in reservoir dust are the best available index for mite allergens, airborne levels might be more suitable for defining exposure to pets. If air samples are difficult to obtain, levels of Can f 1 and Fel d 1 in the LF samples should be used as a surrogate measure of personal exposure.     

Guanine, mite, and cockroach allergens in Costa Rican homes

Previous studies of schoolchildren in Costa Rica have shown an asthma prevalence of 23% and a high level of sensitization, particularly to mite allergens. As a continuation of these studies, some 400 dust samples were collected from various places in Costa Rica, and parts of these were analyzed for specific mite and cockroach allergens, as well as for the number of mites and amount of guanine. Guanine was quantified by a diazo, as well as an HPLC method, which were found to be highly correlated. The concentrations of guanine by the diazo method, Der p 1, Der f 1, and the number of mites were higher in bed dust than in bedroom floor dust, and it was possible to quantify mite allergens and guanine in almost all bed-dust samples. The mean levels were 2–3 times higher than the proposed risk level for elicitation of symptoms in mite-sensitive asthmatics. Bed and bedroom floor dust contained more guanine and mite allergen in humid (>2000 mm rain) than in drier places (P&0.05), but the number of mites in bed and bedroom floor dust was higher in less humid places (P=0.01). The guanine content in bedroom floor dust was higher in areas with a temperate climate than in areas with a warmer climate (P<0.001, Bartlett's chi square [BCS]), as was the number of mites (P<0.01, Kruskal-Wallis [KW], 0.04, BCS) and the Der p 1 concentration (P<0.01, BCS; P=0.02, KW). The Der f 1 concentration in bedroom floor dust was higher in a warmer than in a temperate climate (P<0.001, BCS). More guanine and mites were found in urban than in rural bed dust (P<0.03, KW). Dust samples from the metropolitan area (temperate climate) of Costa Rica contained higher levels of guanine (P<0.01) and Der p 1 (P<0.07) than the coastal areas, but very little Der f 1. In these samples, guanine and Der p 1 allergen were closely related, and 2 μg of the allergen was equivalent to 0.49 mg of guanine. Two-thirds of bed and floor samples collected on cotton filters contained Bla g 2 allergen at mean levels of 1.6 and 2.1 units/g dust, respectively. Cockroach allergen was, however, absent in all bed samples from the metropolitan area, but did occur in very high concentrations in the coastal bed dust samples collected with tighter polyester filters. In conclusion, the concentration of guanine and Der p 1 was very high in the bed dust of Costa Rican homes. Some factors, such as humidity, small houses for large families, and type of bedding, probably favored the heavy mite infestation, which is probably related to the widespread occurrence of bronchial asthma in this country.     

Current mite,cat, and dog allergen exposure,pet ownership,and sensitization to inhalant allergens in adults

BACKGROUND: Simultaneous exposure to more than one allergen might modify the effect of individual allergens. OBJECTIVE: The purpose of this study was to investigate the effect of current exposures to mite, cat, and dog allergen and pet ownership on sensitization in adults. METHODS: Questionnaires, skin tests, and home visits (Der p 1, Fel d 1, and Can f 1, ELISA; mattresses, living room floors) were performed in 2502 adults. Allergen exposure was treated as a continuous variable and divided into quartiles. To investigate the interaction between allergens, quartiles for 3 allergens were added, creating arbitrary combined exposure categories. RESULTS: In the univariate analysis, mite sensitization was associated with Der p 1 in mattresses (odds ratio [OR], 1.10; 95% CI, 1.01 to 1.19; P =.03) and with Can f 1 in living room floors (OR, 1.08; 95% CI, 1.00 to 1.17; P =.05). In a multivariate regression analysis, Der p 1 in mattresses remained an independent associate of mite sensitization (OR, 1.12; 95% CI, 1.02 to 1.23; P =.03) and pollen sensitization (OR, 1.23; 95% CI, 1.11 to 1.36; P =.0001). The proportion of subjects sensitized to mite increased significantly with the increasing combined exposure categories (P <.0001). The highest prevalence of sensitization to cat and dog was in the medium combined exposure categories. Cat ownership was associated with a reduced prevalence of sensitization to cats (P =.002) and a reduced prevalence of sensitization to dog (P =.003) but had no effect on sensitization to mite and pollen. CONCLUSIONS: Sensitization to dust mites increased with the increasing combined exposure. Cat ownership was associated with a lower prevalence of sensitization to cat and dog but not to mite and grass pollen.     

A rapid test for detection of mite allergens in homes

BACKGROUND: International guidelines recommend allergen avoidance for asthma management, but do not include making assessments of allergen exposure. Mite allergen exposure cannot be assumed, especially in geographical regions where climatic conditions vary. OBJECTIVE: To develop a rapid test that would enable consumers to detect mite allergen in the home. METHODS: A lateral flow test using gold labelled antibody for mite group 2 allergen was developed as part of a detection kit incorporating the MITEST dust sampling device. Dust samples were assayed by ELISA for group 1 and group 2 allergens and by using the rapid test. The tests were compared as indices of mite allergen exposure. RESULTS: There was a good correlation between group 1 and group 2 levels by ELISA (n = 349, r = 0.60, P < 0.001). In a multi-centre study of 65 homes (263 dust samples) in five countries, there was a strong correlation between ELISA and the rapid test. Most samples with high scores in the test (43/48, 90%) contained > 1 microg/m2 group 2 allergen, whereas most low samples contained < 1 microg/m2 (50/64, 78%). Differences between mean group 2 levels of samples that scored low (0.28 microg/m2), medium (1.68 microg/m2) or high (3.18 microg/m2) on the test were highly significant (P 0.007 to < 0.001). CONCLUSIONS: A simple rapid test has been developed that detects mite allergen in the home within 10 min. The mite screening test should educate consumers about allergen exposure and encourage compliance with allergen-avoidance procedures. This technology has applications for the detection of other common environmental allergens.     

Optimal conditions for the removal of house dust mite, dog dander, and pollen allergens using mechanical laundry

BACKGROUND: Mechanical laundry is an effective tool for the environmental control of allergens, but the optimal conditions for removing allergens are not yet clear. OBJECTIVE: To evaluate the optimal conditions of mechanical laundry for the removal of house dust mite (HDM), dog dander, and pollen allergens. METHODS: The 4 washing modes of 30 degrees C (86 degrees F), 40 degrees C (104 degrees F), 60 degrees C (140 degrees F), and steam water (SW) with detergent were evaluated. Allergen removal performance was assayed using a 2-site enzyme-linked immunosorbent assay (ELISA) or an ELISA inhibition test. RESULTS: Using the 30 degrees C and 40 degrees C washing modes, only 6.5% and 9.6% of Dermatophagoides farinae, respectively, were killed. However, using the 60 degrees C and SW washing modes, all HDMs were killed. The amounts of Der f 1 remaining after the 30 degrees C, 40 degrees C, 60 degrees C, and SW washing modes were 26.8%, 2.4%, 1.3%, and 0.6%, respectively, with unmanipulated contaminated sheets. The effects of rinse on Der f 1 levels after the 30 degrees C washing were greater compared with those after the 40 degrees C, 60 degrees C, and SW modes. The amounts of Can f 1 in the extractions after washing were 0.3% to 1.3% for all modes, and all extracts, even without a rinse, did not inhibit specific IgE binding to dog allergens according to ELISA. The remaining pollen allergen levels after washing were lower in the 60 degrees C and SW modes than in the lower temperature modes. However, the levels did not differ among the various washing modes after rinsing once. CONCLUSION: Water temperature and number of rinses are critical factors for the removal of HDM, dog dander, and pollen allergens.     

Domestic allergens in public places II: dog (Can f 1) and cockroach (Bla g 2) allergens in dust and mite, cat, dog and cockroach allergens in the air in public buildings

Background Sensitization and exposure to indoor allergens are the major risk factors for asthma. It is possible that significant exposure to domestic allergens occurs outside the home. Objectives To investigate the levels of Can f 1 and Bla g 2 in the dust from carpeted floors and upholstered seats in public buildings and public transport and the airborne concentrations of Der p 1, Fel d 1, Can f 1 and Bla g 2 in schools and offices. Methods Can f 1 and Bla g 2 were measured in the dust collected by vacuuming a I m² area of carpet, as well as upholstered seats in five schools, six hotels, four cinemas, six pubs, three buses and two trains. Dust was also collected from the bedroom carpet, living room carpet, mattress and sofa in 20 homes with and 20 homes without a dog in the same area. Personal airborne sampling (2 L/min) was conducted for 8 h in offices (n= 16) and classrooms (n= 9). In addition, airborne samples in schools were collected using a high volume pump (60 L/min) for 1 h in three classrooms immediately after the children vacated the school. Can f 1, Bla g 2, Der p 1 and Fel d 1 were assayed using a two–site monoclonal antibody–based ELISA. Results Can f 1 was detected in all dust samples from public places, ranging from 0.2 to 52.5 μg/g, Significantly higher levels were found in upholstered scats (geometric mean – GM 9.4 μg/g) than in carpets (GM 1.5 μg/g; P < 0.001), and levels of Can f 1 > 10 μg/g were found in 40% of upholstered seats in public places. Can f 1 was significantly higher in upholstered seats in public places than in sofas in homes without a dog (GM 1.8 μg/g; P < 0.001). Detectable levels of Bla g 2 were found in all of the schools (GM 2.4 U/g, range 0.8–4.4 U/g). Bla g 2 concentration greater than 2U/g (provisional threshold level representing risk of sensitization) was measured in 65% of the classrooms sampled. Der p 1 and Bla g 2 were below the detection limit in all airborne samples. However, airborne Fel d 1 and Can f 1 were detected in schools and offices, albeit in low concentrations. Conclusions Upholstered seats from public places constitute a reservoir for the accumulation of dog allergen, and a source of exposure to Can f 1 inside public buildings or on public transport. Exposure to cockroach allergens in schools may be important for cockroach sensitized asthmatic children.     

Measurement of Dermatophagoides mite allergens on bedding and human skin surfaces

BACKGROUND: The level of the Dermatophagoides mite group 1 (Der 1) allergens in reservoir dust has been used as an index of exposure in most studies. However, the mite allergen level in reservoir dust cannot directly reflect the personal exposure level. OBJECTIVE: We sought to develop a new method for quantifying the Der 1 allergens on bedding and human skin surfaces as an index of exposure to mite allergens. METHODS: Samples were obtained with a small adhesive tape from the forearm skin of 30 healthy volunteers and from their regularly used mattresses. The level of Der 1 allergens collected onto the adhesive tape was measured by a newly developed sensitive fluorometric ELISA for Der p 1 and Der f 1. RESULTS: The Der 1 allergens could be detected in all the samples from bedding surfaces and in 28 of the 30 samples from skin surfaces. The Der 1 levels by adhesive tape sampling from the mattresses correlated with those by reservoir dust sampling. The sampling of the skin and bedding surface with adhesive tape correlated, but skin sampling did not correlate with reservoir sampling. CONCLUSION: The Der 1 allergens on bedding surfaces and on human skin surfaces could be quantified with a very simple sampling technique. The system developed in this study will provide a new tool for the assessment of mite allergen exposure in daily life.     

Correlations between levels of mite and cat allergens in settled and airborne dust

Thirty homes in Rochester, Minn., 20 of which housed cats, were studied to compare cat and mite allergen concentrations in airborne and settled dust. With Air Sentinels in the bedroom and living room for airborne collections, and a Sample Vac for collections from living room carpet and bedroom mattress, immunochemical quantifications of each were made with various radiometric assays with polyclonal and monoclonal antibodies. The most significant correlations were found between airborne mite in the bedroom and living room (p less than 0.001) and airborne mite in the bedroom and dust from the bedroom mattress (p less than 0.001). Most houses had specific epitopes of both Dermatophagoides pteronyssinus and D. farinae, but D. farinae was present in greater amounts. In seven houses we found greater than 10 micrograms of group I mite allergen per gram of settled dust, indicating that some houses in Minnesota have concentrations of mite allergens high enough to cause allergic disease, even in the winter. Clinical interpretation of these data on air levels is hampered by uncertainty as to whether symptoms are more closely related to average steady-state exposure, which we measured, or to brief heavy concentrations. Further epidemiologic studies are needed to define the concentration of mite and cat allergens in the air that are risk factors for allergic disease. The concentration of cat allergen correlated with mite allergen in the air, but not in settled dust, presumably reflecting the fact that both are influenced by ventilation rate.     

Allergens of mammalian origin : IV. Evidence for common allergens in cat and dog serum

IgE antibodies present in serum from 3 patients clinically sensitive to cat and dog were shown to combine with whole cat and dog sera linked to cellulose particles. Employing a modified radioallergosorbent technique (RAST), it was shown that cat and dog sera inhibited the binding of IgE antibodies to insolubilized cat serum and to insolubilized dog serum. These findings suggest that cat and dog sera have common allergens. Other mammalian sera were also tested and found to have little inhibitory activity. Cat and dog sera did not inhibit the binding of IgE antiragweed antibodies to an insolubilized ragweed fraction. Following separation of cat serum by gel filtration on Sephadex G-200 or electrophoresis in acrylamide gel, several fractions were found to inhibit the binding of IgE antibodies to insolubilized cat and dog sera. Whether the heterogeneity observed reflects the presence of single allergens with diverse size and charge properties or multiple allergens remains to be determined.     

Effect of an air cleaner with electrostatic filter on the removal of airborne house dust mite allergens

Purpose

The effects of air cleaners on the removal of airborne indoor allergens, especially house dust mites (HDM), are still controversial. The objective of this study is to evaluate the effect of an air cleaner with an electrostatic filter on the removal of airborne mite allergens.

Materials and Methods

A dried HDM culture medium that contained mite body particles and excretions was dispersed in a chamber equipped with an electrostatic air cleaner. The number of airborne particles was recorded continuously by a dust spectrometer for 60 minutes. Airborne particles in the chamber were collected on a sampling filter at a flow rate of 10 L/min and the Der f 1 concentration in the filter extracts was measured by two-site ELISA.

Results

The air cleaner efficiently removed airborne HDM particles. The air cleaner removed airborne HDM particles (size 2-12.5 µm) 11.4 ± 2.9 fold (cleaner operating for 15 minutes), 5.4 ± 0.7 fold (cleaner operating for 30 minutes), and 2.4 ± 0.2 fold (cleaner operating for 60 minutes) more than the removal of HDM particles by natural settle down. Removal kinetics differed according to the particle size of the airborne particles. The air cleaner decreased the concentration of Der f 1 in the extraction of airborne particles collected on the air sampling filter by 60.3%.

Conclusion

The electrostatic air cleaner can remove airborne HDM allergens and may be useful as a supplementary environmental control tool for HDM sensitized respiratory allergic patients.     

Measurement of allergens associated with dust mite allergy. II. Concentrations of airborne mite allergens (Der I and Der II) in the house

Assays of mite allergens (Der p I, Der f I and Der II) in the air of houses became feasible with the use of a low-noise air sampler and a sensitive radioimmunoassay described previously. The levels of the airborne allergens Der I (Der p I + Der f I) and Der II in the living room of 10 houses during usual domestic life were very low, 29.5 and 6.3 pg/m3, respectively, with a Der I: Der II ratio of 4.7:1. At the time of bedmaking, they greatly increased, about 1,000-fold, to 30,900 and 12,600 pg/m3, respectively, with a Der I: Der II ratio of 2.5:1. The amounts of Der I and Der II in the floor dust of the living room were 2,040 and 2,690 ng/g of fine dust, respectively, with a Der I: Der II ratio of 0.8:1. Der I seemed more prone to become airborne than Der II.     

Exposure to mite and cat allergens on a range of clothing items at home and the transfer of cat allergen in the workplace

BACKGROUND: Clothing has been proposed as an additional source of exposure to mite and cat allergens. Dispersal of allergen into public places has also been attributed to clothing. OBJECTIVES: We sought to study the contribution of various types of clothing on mite and cat exposure in a domestic environment. Also, we studied the ability of clothing to transfer allergen in a workplace. METHODS: Personal exposure to mite and cat allergen from a range of clothing was measured by using intranasal air samplers in 11 homes. Five categories of clothing were tested. Wearing no upper clothing was the sixth category tested to distinguish the contribution of clothing over ambient background exposure. An adhesive tape was used to sample allergen from the surface of clothing, and reservoir dust samples were also collected. The above techniques were also used in the workplace to examine the amount of cat allergen transferred from cat owners to non-cat owners. RESULTS: The amount of mite and cat allergen inhaled differed among the clothing types worn and whether they had been washed recently. Wearing a woolen sweater increased personal allergen exposure to cat and mite allergen by a mean of 11 and 10 times, respectively. Clothing items that were less frequently washed carried more allergen whether assessed by vacuuming or sampled with adhesive tape. This corresponded to the amount of allergen inhaled. We also found that cat levels on non-cat owners' clothing increased significantly at the end of a working day, which lead to the increase in their personal allergen exposure to cat. CONCLUSIONS: These studies strongly support the emerging model that personal clothing is an important source of both mite and cat allergen exposure. This article also demonstrates the importance of clothing as a means of distributing cat allergen into cat-free environments.     

Measurement of allergens associated with dust mite allergy. I. Development of sensitive radioimmunoassays for the two groups of Dermatophagoides mite allergens, Der I and Der II

Sensitive radioimmunoassays were developed to measure the two groups of major allergens (Der I and Der II) of Dermatophagoides pteronyssinus and Dermatophagoides farinae, in which radiolabeled protein A served as a general tracer. Glass rods covalently coupled with F(ab')2 fragments of rabbit antiserum IgG were incubated first with mite or house dust extracts, and then with affinity-purified rabbit antibodies. The bound allergen-antibody complex was detected with a 125I-labeled protein A. The two Der I allergens, Der p I and Der f I, were measured separately with the use of immunoabsorbed rabbit antibodies directed against species-specific determinants, while the two Der II allergens, Der p II and Der f II, were measured as 'Der II' with the use of antibodies directed against common determinants on both allergens. Each assay demonstrated consistently parallel dilution curves with mite and house dust extracts. The mean intraassay and interassay coefficient of variation for each assay ranged from 4.3 to 7.7% and from 3.6 to 9.0%, respectively. The Der p I and Der f I assays were shown to be highly species-specific so that the ratio of Der p I: Der f I would provide a good index of the distribution of the two mite species in a dust sample. The concentrations of the Der I and Der II allergens in different types of mite extract and dust samples from houses were compared using these assays.(ABSTRACT TRUNCATED AT 250 WORDS)     

Stringent environmental control in pregnancy and early life: the long-term effects on mite, cat and dog allergen

BACKGROUND: Mould extract inhalation challenges have been used extensively in the investigation of heaves. Such challenges have induced pulmonary neutrophilic inflammation and dysfunction, consistent with, but less severe than the natural disease. However, the method of mould extract production is likely to result in endotoxin contamination. OBJECTIVE: To investigate whether insufficient dose delivery was responsible for the shortfall in response to inhaled extract compared with natural disease, and whether endotoxin contamination of mould extract contributed to the pulmonary inflammation and dysfunction. METHODS: We measured the response of six heaves horses following inhalation of saline (placebo) and three doses of Aspergillus fumigatus extract. We then compared the response of six heaves horses to A. fumigatus extract inhalation before and after lipopolysaccharide (LPS) depletion. RESULTS: Inhalation challenge with 0.5, 1.6 and 5 mg of A. fumigatus extract resulted in a significant increase in bronchoalveolar lavage fluid (BALF) neutrophil ratio when compared with saline inhalation. Only 1.6 and 5 mg extract inhalation resulted in significant lung dysfunction compared with saline. There was no significant difference between 1.6 and 5 mg extract inhalation with respect to airway neutrophil numbers or lung function, suggesting a plateau in both measured responses. LPS depletion of 1.6 mg A. fumigatus extract resulted in a significant reduction in airway neutrophil numbers and increase in arterial oxygen tension. There was no significant difference between saline and the LPS-depleted A. fumigatus extract challenges with respect to neutrophil count and lung function. The reduction in airway neutrophil numbers was greater than would be predicted by extrapolation from previously reported soluble LPS dose-response inhalation experiments. CONCLUSION: This study supports a role for other inhalants, in addition to soluble components of A. fumigatus, in the aetiopathogenesis of heaves. Also the amplification in response to LPS when inhaled with A. fumigatus extract, suggests that the role of inhaled endotoxin in the pulmonary inflammation and dysfunction in naturally occurring heaves may currently be underestimated.     

Component-resolved diagnosis of house-dust mite allergy with purified natural and recombinant mite allergens

BACKGROUND: Mites belong to the most frequent and potent allergen sources. Immunotherapy with mite allergen extracts is frequently performed if allergen avoidance is not possible or successful. However, highly controversial results have been reported for mite-specific immunotherapy. OBJECTIVE: The aim of this study was to develop diagnostic concepts that may contribute to an improved selection of patients for immunotherapy with Der p allergen extracts and that may be used for immunological monitoring of patients undergoing this treatment. METHODS: The IgE reactivity profiles to Der p extract were determined in a Middle European mite-allergic population by IgE immunoblotting and by using a panel of seven purified natural or recombinant Der p allergens (nDer p 1, nDer p 4, rDer p 2, rDer p 5, rDer p 7, rDer p 8, rDer p 10). Furthermore, we investigated the sensitization and cross-reactivity to house-dust- and storage-mite allergen extracts by CAP FEIA measurements and by IgE competition studies. RESULTS: More than 95% of the patients could be diagnosed with a combination of nDer p 1 and rDer p 2. With the methods used, we could discriminate mite-allergic patients who were mainly sensitized to the major Der p allergens (Der p 1, Der p 2) from patients with a broad sensitization profile, including highly cross-reactive allergens (e.g. Der p 10: tropomyosin) as well as reactivity to storage mites. CONCLUSIONS: Diagnostic tests containing the major mite allergens (i.e. Der p 1, Der p 2) and highly cross-reactive mite allergens (e.g. Der p 10) may improve the diagnostic selection of patients for immunotherapy with Der p extracts. These tests may also be used for the immunological monitoring of patients undergoing immunotherapy.