广州地区支气管哮喘患者常见吸入变应原调查分析

目的调查广州地区支气管哮喘发病相关的主要致敏变应原.方法对102例支气管哮喘缓解期患者,其中儿童48例,成人54例,用尘螨、霉菌、猫毛等12种常见吸入变应原进行皮肤点刺试验,并测定其中27例总IgE(TIgE)的水平.结果儿童组尘螨皮试阳性率最高(均为79.2%),其次是屋尘(72.9%).成年组尘螨皮试阳性率最高,粉尘螨和屋尘螨分别为59.3%、62.9%,其次为屋尘(40.7%).在动物毛发皮屑中,以狗毛为主,猫毛次之;对于所有变应原,儿童组的阳性百分率远远高于成年组;27例血清总IgE的均值为506.1KU/L,远高于正常人,其中皮试阳性者TIgE水平高于皮试阴性者(p<0.01).结论广州地区主要变应原均为尘螨,且哮喘儿童对尘螨过敏的阳性率显著高于成人.     

广州地区呼吸道疾病患儿16种常见变应原检测分析

目的 了解广州地区呼吸道疾病患儿对16种常见变应原的过敏情况,同时探讨不同年龄组之间的变应原阳性率差异,并比较致敏程度.方法 选择2007年8月至2008年3月广州医学院第一附属医院呼吸科门诊和儿科门诊初诊为支气管哮喘、过敏性鼻炎、呼吸道感染等患儿320例为研究对象,其中婴幼儿组(≤3岁)214例,儿童组(>3岁)106例.采用德国FOOKE ALLERG-O-LIQ-SYSTEM变应原检测系统,通过免疫捕获法检测血清中常见的16种变应原特异性免疫球蛋白E(SIgE)抗体.结果 在所有患儿中,其中261例(81.56%)SIgE呈阳性.59例(18.44%)呈阴性.16种变应原SIgE阳性率为屋尘螨(36.88%)、粉尘螨(35.31%)、热带螨(24.06%)、狗毛(6.56%)、猫毛(8.75%)、德国小蠊(16.56%)、蜜蜂毒素(0.94%)、屋尘(45.63%)、全蛋(45.94%)、牛奶(46.25%)、小麦面粉(6.88%)、玉米粉(1.25%)、花生(9.06%)、大豆(5.94%)、螃蟹(2.81%)、虾(4.38%).婴幼儿组SIgE的阳性率为81.78%,以食物性变应原(牛奶、全蛋)为主;儿童组的阳性率为81.13%,以吸人性变应原(尘螨)为主(X2=0.02,P=0.89).儿童组尘螨的过敏阳性率均高于婴幼儿组(P<0.05),且儿童组屋尘螨和粉尘螨的过敏程度多在3级以上.婴幼儿组各级阳性率比较平均.两组对热带螨的过敏程度均较低,多在3级以下.婴幼儿组牛奶和全蛋过敏阳性率高于儿童组(P<0.05),两组的过敏程度均在3级以下.结论 儿童组与婴幼儿组对常见变应原的总阳性率差异无统计学意义,只是对不同变应原阳性率及过敏程度的差异.儿童组主要是对吸人性变应原产生过敏,婴幼儿组主要是对食物性变应原产生过敏,应以不同年龄段来分析儿童变应原检测结果.     

广州地区不同年龄组支气管哮喘儿童变应原体外检测结果分析

目的观察广州地区不同年龄组支气管哮喘（哮喘）儿童总IgE（TIgE）水平和15种变应原特异性IgE（slgE）的阳性分布情况。方法入选859例小儿呼吸门诊的0～14岁哮喘儿童，采用德国FookeAllergy-O-LIQ变应原检测系统，通过酶联免疫捕获法检测TI姬和变应原sIgE，比较0～2岁、3～5岁、6～10岁和11～14岁组哮喘儿童的TIgE水平和15种变应原slgE的阳性分布差异。结果TIgE在6～10岁组[148．2（260．8）IU／ml]和11～14岁组[156．5（329．4）IU／ml]分别明显高于0～2岁组[38．7（82．2）IU／ml]和3～5岁组[64．2（138．2）IU／ml]（均为P〈0．01）。吸入变应原sIgE阳性率前4位是屋尘（51．9％）、屋尘螨（49．7％）、粉尘螨（47．7％）和热带螨（9．3％），其阳性率均随年龄的增加而t增高，4个年龄组比较差异具有统计学意义（r分别为61．987、125．439、152．507和87．997，均P〈0．01）。食物变应原sIgE阳性率前4位是牛奶（37．7％）、全蛋（23．1％）、花生（6．3％）和小麦粉（5．6％），4个年龄组比较差异具有统计学意义（r分别为50．766、22．913、8．275和7．808，均P〈0．05），牛奶和全蛋的阳性率因年龄的增加而降低，而花生和小麦的阳性率分别在6～10岁组和3～5岁组达高峰后下降。结论广州地区哮喘儿童TIgE水平和主要的吸入变应原屋尘、屋尘螨、粉尘螨及热带螨sIgE阳性率总的变化趋势随年龄的增加而增高，而主要的食物变应原牛奶和鸡蛋的sIgE阳性率则随年龄的增加而下降。     

208例哮喘患儿吸入性过敏原的调查分析

本文报道了208例哮喘患儿吸入性过敏原的调查结果. 采用变应原浸液皮肤点刺方法. 皮试阳性者169例, 占81.25%.变应原浸液内含18种常见吸入性过敏原. 尘螨的阳性率最高达78.85%, 其次是室尘的阳性率为35.58%, 烟的阳性率为32.69%.无一例对其它变应原呈阳性反应, 过敏原皮试阳性率无性别差异, 与有无个人及家庭过敏史无关. 哮喘婴幼儿皮试阳性率低于哮喘患儿, 哮喘皮试阳性率在年龄组之间有显著差异(P＜0.01), 有随着年龄加大而渐增的趋势. 结果提示: 尘螨、空气污染和被动吸烟是诸多哮喘触发因素中具高度危险性的因素, 加强这方面的对策研究对儿童哮喘的防治具有意义.     

支气管哮喘血清E-选择素与IgE的相关性研究

目的探讨支气管哮喘的发病机理。方法对23例哮喘患者及20例正常人用ELISA法测定其血清中可溶性粘附分子sE-selectin的含量,采用荧光免疫法,测定其血清总IgE(tIgE)、特异性IgE(sIgE)和嗜酸性粒细胞阳离子蛋白(ECP),并作相关性分析。结果哮喘组的sE-selectin和tIgE血清含量与对照组相比,差异有高度显著性(P<0.001)多因素相关性分析提示sE-selectin与tIgE存在直线正相关(r=0.664,P<0.002);蒿草花粉、屋尘螨、屋尘及複草花粉的血清sIgE水平较高,为引起哮喘发病的主要变应原;哮喘急性发作期的血清ECP水平明显高于缓解期(P<0.001)。结论哮喘患者血清可溶性粘附分子sE-selectin和IgE较正常人高,且存在直线正相关;我国北方地区引起哮喘的常年性变应原为屋尘螨和屋尘,而夏秋季的主要变应原是蒿草花粉和複草花粉;血清ECP含量在哮喘发作期较缓解期高,这可能与嗜酸性粒细胞处于活化状态有关。     

三亚地区儿童体外变应原检测及结果分析

为探讨三亚地区儿童常见变应原的致敏情况及分布,为儿童过敏性疾病的防治提供科学依据,采用Mediwiss公司敏筛定量变应原检测系统及其专用体外变应原诊断试剂对1 173例患儿进行常见的吸入性与食入性变应原体外免疫检测,并计算各种过敏所占阳性比,同时比较三亚地区不同年龄段吸入组及食入组变应原阳性率的变化趋势。结果显示:①在所有吸入组变应原中,首要变应原为户尘螨(26.09%),其次为猫、狗毛皮屑(24.30%),混合树花粉(18.67%),混合真菌(13.73%),屋尘(8.18%)等;随年龄增长,混合真菌和猫、狗毛皮屑阳性率总体呈下降趋势,户尘螨、屋尘、矮豚草蒿葎草、混合树花粉、苋、蟑螂阳性率呈上升趋势;户尘螨,屋尘,猫、狗毛皮屑等阳性在A～D年龄组中的分布差异有统计学意义(P0.05),最常见的双重阳性组合为户尘螨+猫、狗毛皮屑,其次为户尘螨+屋尘。②在食入组变应原中居于前3位的分别为牛奶、腰果、鸡蛋白;随着年龄的增长,牛奶的阳性率呈下降趋势,菠萝呈上升趋势,其他变应原变化规律不明显;除腰果、菠萝外,其他变应原阳性率在A～D年龄组间的分布差异均有统计学意义(P0.01)。由此可知,海南三亚地区过敏患儿变应原分布与国内外其他地区存在差异。三亚地区导致儿童过敏性疾病的前5位变应原依次为:牛奶,户尘螨,猫、狗毛皮屑,腰果,鸡蛋白,食入性变应原居于首位。     

支气管哮喘不同年龄组致敏原分析

目的研究支气管哮喘不同年龄组的主要致敏原分布特性,为诊断和预防提供科学依据.方法采用UniCap100检测143例支气管哮喘患者的血清40种特异性IgE,按年龄分组分析致敏原阳性率.结果①婴幼儿组以鸡蛋、尘螨和牛奶为主要致敏原.②4岁以后以屋尘螨、粉尘螨、屋尘、蛔虫、飞蛾、蟑螂、蚕丝、狗毛为主要致敏原,而蛔虫在30～50岁组的阳性率甚至比尘螨高,40种变应原中各年龄组间存在着显著性差异的有13种,其中包括屋尘、屋尘螨、粉尘螨、蛔虫、飞蛾、蚕丝、狗毛、木麻黄花粉、蒿花粉、苋花粉、牛奶、鸡蛋、蟹.③随着年龄的增长,虾蟹成为主要的食物致敏原.结论支气管哮喘的致敏原因,在婴幼儿期要高度重视鸡蛋、牛奶的过敏,同时不能忽视尘螨过敏的可能性,随着年龄的增长支气管哮喘的主要致敏原是吸入性抗原,而30岁后的患者对蛔虫的高阳性率应引起人们的注意.     

螨类过敏与支气管哮喘

过敏性哮喘患者,多数对屋尘过敏,尘螨是其中重要的过敏原。本文从以下几方面进行研究:①用放射性过敏原吸附剂试验(RAST)和酶联免疫吸附剂试验(ELISA)分别观察到哮喘患者血清中存在着抗粉尘螨的特异性IgE,其阳性率分别为67.9％(RAST 81例)及71％(ELISA 100例)而正常人仅为5％(RAST 40例)及0％(ELISA 31例)。②用螨浸液从豚鼠制备了哮喘的实验动物模型。③从100例过敏性哮喘患者和40例正常人的皮试中,观察到哮喘患者螨浸液皮试的阳性率为75％,明显高于正常人的7.5％。此外,还成功地将哮喘患者的血清被动转移至正常人和猴皮肤,导致阳性反应。这些都清楚地阐明尘螨是一种很强的过敏原,螨类过敏是国内哮喘发病的一个重要病原。     

儿童血清特异性IgE水平与过敏原皮试及气道反应性之间的关系

为了探讨哮喘儿童血清特异性免疫球蛋白 (SIgE )同过敏原皮试及气道高反应性 (BHR )的关系 ,取 6 4例有症状和 6 0例无症状儿童作为研究对象 ,采用荧光酶联免疫法 (pharmaciaphadiatoptest)测定其血清中吸入性变应原SIgE ,乙酰甲胆碱激发试验测定BHR ,选择尘螨霉菌、猫毛、花粉等 8种常用过敏原做皮试。结果显示 ,SIgE的阳性率在皮试阳性的儿童中占95 6 % ,在皮试阴性的儿童中占 17 9% ;在有高气道反应性和正常气道反应性的儿童中 ,SIgE的阳性率分别为 95 6 %和2 8 8%。两者分别作卡方检验P <0 0 0 1。这说明儿童血清SIgE与过敏原皮试阳性及气道反应性有显著相关 ;吸入性变应原与儿童哮喘气道高反应性具有密切相关。SIgE检测可作为哮喘诊断的重要参考指标 ,特别是那些因各种原因不能完成气道激发试验和过敏原皮试的幼儿     

支气管哮喘不同年龄组致敏原分析

目的研究支气管哮喘不同年龄组的主要致敏原分布特性，为诊断和预防提供科学依据．方法采用Unicap100检测143例支气管哮喘患者的血清40种特异性IgE，按年龄分组分析致敏原阳性率．结果①婴幼儿组以鸡蛋、尘螨和牛奶为主要致敏原．②4岁以后以屋尘螨、粉尘螨、屋尘、蛔虫、飞蛾、蟑螂、蚕丝、狗毛为主要致敏原，而蛔虫在30～50岁组的阳性率甚至比尘螨高，40种变应原中各年龄组间存在着显著性差异的有13种，其中包括屋尘、屋尘螨、粉尘螨、蛔虫、飞蛾、蚕丝、狗毛、木麻黄花粉、蒿花粉、苋花粉、牛奶、鸡蛋、蟹．③随着年龄的增长，虾蟹成为主要的食物致敏原．结论支气管哮喘的致敏原因，在婴幼儿期要高度重视鸡蛋、牛奶的过敏，同时不能忽视尘螨过敏的可能性，随着年龄的增长支气管哮喘的主要致敏原是吸入性抗原，而30岁后的患者对蛔虫的高阳性率应引起人们的注意．     

Sensitization to house dust mites in Reykjavik, Iceland, in the absence of domestic exposure to mites

BACKGROUND: House dust mites are common sources of indoor allergens. In Reykjavik, Iceland, 9% of the young adult population had serum-specific IgE to Dermatophagoides pteronyssinus. Sensitization to mites is usually assumed to be due to exposure to house dust mites in the indoor environment. This investigation was carried out to measure the concentrations of house dust mite allergens and to investigate which species of mites were present in beds in Iceland. METHODS: A total of 197 randomly selected adults were visited at home using the European Community Respiratory Health Survey (ECRHS) II Indoor protocol. Dust samples were collected from mattresses for measurement of house dust mite allergen concentrations and to estimate the number and type of house dust mites. Additional samples from mattresses and floors were collected from the homes of 10 patients with positive skin prick tests (SPT) to D. pteronyssinus. House dust mite allergen concentrations were measured using ELISA and examination of mite species was carried out using microscopy. Climatic parameters were assessed using psychrometer readings in the bedrooms and outdoors. RESULTS: We found two single mite specimens, both D. pteronyssinus, in two dust samples. Mite allergen analyses indicated that two other dust samples had Der f 1 results close to the cut-off of 0.1 microg/g of dust. No samples were positive for Der p 1. In an additional collection of dust from the homes of 10 SPT-positive patients no Dermatophagoides spp. were found. CONCLUSIONS: Reykjavik citizens are exposed to extremely low amounts of house dust mite allergens in their homes. Possible alternative sources for sensitization are discussed, such as bird nests, exposure from travelling abroad, or other mites or invertebrates that cross-react with house dust mite allergens. Our findings suggest that exposures other than to house dust mites indoors are possible sources of mite allergen exposure.     

A sensitive reverse ELISA for the measurement of specific IgE to Der p 2, a major Dermatophagoides pteronyssinus allergen.

BACKGROUND: Epidemiologic studies have shown that the presence of IgE antibodies to house dust mite and other indoor allergens is an important risk factor for asthma. OBJECTIVE: The aim of this study was to develop a reverse ELISA (rELISA) for measuring specific IgE to Der p 2, a major Dermatophagoides pteronyssinus (Dpt) allergen, as a potential tool for followup of allergen immunotherapy. METHODS: Recombinant Der p 2 allergen or a monoclonal antibody to Der p 2 was used to coat plates in conventional ELISA (cELISA) and rELISA, respectively. Sera from 48 asthmatic patients with positive skin prick test (SPT+) to D. pteronyssinus extract were analyzed for total IgE and specific IgE to Der p 2, and the results were compared with a group of 41 SPT asthmatic and 30 SPT- control subjects. RESULTS: The sensitivity of the two assays for Der p 2-specific IgE was 3.9 EU/mL and their specificities were confirmed by inhibition tests, in a dose-dependent manner. There was a significant positive correlation between cELISA and rELISA (r = 0.74; P < 0.0001). However, rELISA was more sensitive than was cELISA, regarding both the positive sera percentage (70.8% vs 52.1%) and the Der p 2-specific IgE levels (28.4 vs 4.5 EU/mL) in SPT+ asthmatic patients. CONCLUSIONS: rELISA has shown to be a sensitive and alternative method for measuring Der p 2-specific IgE without using radioactive techniques. Detection of specific IgE to major allergens and relevant peptides, and identification of B cell epitopes in allergens will provide valuable information for the design of allergen analogs and peptides for immunotherapy.     

Purification of group 2 Dermatophagoides pteronyssinus allergen and prevalence of its specific IgE in asthmatics

Group 2 allergens are a major cause of sensitization in patients allergic to house dust mites. This study was performed to determine the prevalence of hypersensitivity to group 2 allergens (Der p 2) of Dermatophagoides pteronyssinus (Dp) in asthmatic patients in Taiwan. To facilitate the analysis of Der p 2-specific IgE, we raised a panel of monoclonal antibodies (MoAbs) to Der p 2 antigens. Purified Der p 2 was obtained after MoAb affinity column purification. There were 82 asthmatic patients (41 adults and 41 children) with hypersensitivity to Dp who were analyzed for hypersensitivity to Der p 2. All of them were both skin test- and serology test-reactive to Dp. Using purified Der p 2, 87.8% (72/82) of patients had a skin-test-positive reaction. Six adults (6/41) and 4 children (4/41) had negative skin tests for Der p 2. Ten families (both parents and children were asthmatics) of the 82 patients were selected for Der p 2 skin testing and Der p 2-specific IgE determination using immunoblot analysis. Results showed that 90% (18/20) of patients' skin reactions to Der p 2 and serum contained specific IgE to Der p 2. Because 87.8% (85.4% of adults and 90.2% of children) of the asthmatic patients with Dp hypersensitivity were allergic to Der p 2, its role in the pathogenesis of asthma in Taiwan appears to be important. Purified Der p 2 allergens can be further used for allergen skin testing and immunotherapy.     

Familial and environmental determinants for wheezing and asthma in a case-control study of school children in Palestine

BACKGROUND: Our prevalence study on Palestinian school children aged 6-12 years showed lower rates for asthma and asthma symptoms than economically developed and industrialized countries. Reasons for such differences are largely unknown, and could possibly be related to different environmental and lifestyle factors. OBJECTIVE: To investigate familial, early life exposures and indoor environmental determinants for asthma in children in Palestine. METHODS: From the population of our previous study, a group of 273 children with wheeze in the past 12 months (of whom 99 children had physician-diagnosed asthma) were matched with an equal number of non-wheezing controls. This case-control study involved a parental questionnaire; skin prick testing (SPT) with mixed house dust mites, cat and dog dander, mixed grass, mixed trees pollen, Alternaria tenuis, olive tree and cockroach extracts; and serum for total and specific IgE for the same eight allergens. RESULTS: Paternal asthma and maternal hayfever significantly tripled the risk for their children to have wheezing. Previous diagnoses of bronchial allergy, bronchitis, pneumonia, or whooping cough, and positive SPT for house dust mites and cockroaches were significantly more likely among wheezing and asthmatic children than controls. Specific IgE levels for house dust mites and cat allergens showed significantly higher risk for reported wheezing. After adjustment for several environmental and sociodemographic factors using multivariate logistic regression analysis, paternal asthma, maternal hayfever, damp houses, cat and cockroach SPT positivity proved to be strong predictors for wheezing symptoms. CONCLUSION: Our study confirmed that familial 'atopic' diseases are significant predictors of childhood asthma in Palestinian children. Moreover, indoor environment such as presence of cats and domestic moulds also appear to play a role. Our findings are consistent with studies in Canada, New Zealand, Estonia and Sweden, and show promise to explore further gene-environment interaction in the genesis of asthma.     

Sensitization profiles of Malaysian and Singaporean subjects to allergens from Dermatophagoides pteronyssinus and Blomia tropicalis

BACKGROUND: The house dust mites Dermatophagoides pteronyssinus (Der p) and Blomia tropicalis (Blo t) are the most common house dust mite species in Southeast Asia. To date, there have only been a few studies on the sensitization profile of the general populations in Southeast Asia to house dust mites. The aim of this study was to determine the profiles of Der p and Blo t sensitization among Singaporean and Malaysian subjects. METHODS: Enzyme-linked immunosorbent assay was used to detect specific IgE to Der p and Blo t mite crude extracts as well as purified Der p 1, Der p 2 and Blo t 5 allergens. Sera used were from 229 Singaporean subjects (124 with rhinitis, 105 without rhinitis) and 143 Malaysian subjects (94 adults and 49 children with asthma). RESULTS: The sensitization profile of rhinitis subjects to the dust mite allergens used in this study was as follows: Blo t extract positive: 91/124 (73%); Blo t 5 positive: 62/124 (50%); Der p extract positive: 61/124 (49%); Der p 1 positive: 53/124 (43%); Der p 2 positive: 45/124 (36%). The nonrhinitis subjects' sensitization profile was as follows: Blo t extract positive: 60/105 (57%); Blo t 5 positive: 24/105 (23%); Der p extract positive: 38/105 (36%); Der p 1 positive: 14/105 (13%); Der p 2 positive: 17/105 (16%). The study of Malaysian asthmatic adults showed that 39% of them were sensitized to Der p 1, 32% to Der p 2 and 37% to Blo t 5. Among the asthmatic children, sensitization to Blo t 5, Der p 1 and Der p 2 was 90, 57 and 39%, respectively. CONCLUSION: This study clearly revealed that dual sensitization to B. tropicalis and D. pteronyssinus is common in the general populations of Singapore and Malaysia. Sensitization to Blo t 5 is more prevalent than to Der p 1 and Der p 2.     

The prevalence of allergy in Danish farmers

Sensitization to work-related and other common inhalation allergens was studied in 187 farmers by means of SPT and RAST. A positive RAST to house dust mites occurred in 6.4% and to storage mites in 5.3% of farmers. Sensitization to grain, pollen and animal dander was less frequent and a positive RAST to moulds was not found. There was a very strong association between a positive RAST to house dust mites and storage mites (odds ratio 173.6). Smoking seemed to be a risk factor for sensitization to mites, pollen, grain, and animal dander. Smokers who had lived in damp dwellings had a significantly increased risk of sensitization to mites (odds ratio 6.2-12.6), whereas this was not so with non-smokers (odds ratio 0.9-2.0).     

House dust mite allergen (Der p I) and respiratory symptoms in children: a case-control study

The association between house dust mite allergen in house dust and childhood respiratory symptoms was investigated in a case-control study of 259 children with reported chronic respiratory symptoms and 257 control children without reported respiratory symptoms. The Der p I concentration in floor dust of the living room and bedroom and in mattress dust was determined using an enzyme immunoassay. Venous blood samples were taken from all children for serum IgE determination against house dust mite (Dermatophagoides pteronyssinus) by radioallergosorbent assay (RAST). A questionnaire was administered to the parents of the children to elicit information about the home, about changes made to the home in the past in relation to respiratory symptoms, and about a number of risk factors for childhood respiratory disease. In 83% of the dwellings of cases and 89% of those of controls, Der p I concentrations higher than 2000 ng/g were found, and in 54% of the dwellings of cases and 57% of those of controls, the concentrations exceeded 10 000 ng/g dust. In a crude analysis, cases were generally exposed to lower Der p I concentrations than controls. Restriction of the analysis to cases sensitized to dust mites, and non-sensitized controls, taking the type of floor covering into account, showed not significantly higher Der p I concentrations in bedroom floor dust of cases. However, restriction of the analysis to cases sensitizied to dust mites and cases not sensitized to house dust mites — adjusting for allergen avoidance measures taken in the past — revealed a positive association between the Der p I concentrations in bedroom floor dust and mattress dust and sensitization. This finding indicates that allergen avoidance measures modify current exposure to Der p I. This obscures the relationship between the exposure to mite allergens and sensitization, and hampers the estimation of the association between exposure to house dust mite allergens, sensitization and the development of respiratory symptoms.     

Evaluation of the nasal provocation test for its necessity in the diagnosis of nasal allergy to house dust mite

The aim of this study was to evaluate rhinomanometric responses to nasal allergen provocation in children with allergic rhinitis sensitized to house dust mite. We studied 51 children, aged 6-16 years (mean: 11.5 +/- 2.6 years), with clinical symptoms of perennial allergic rhinitis without asthma and 20 non-atopic healthy controls in the same age range (mean: 11.8 +/- 3.8 years). All of the patients had positive skin prick test (SPT) results and serum specific IgE above 0.70 kU/l to Dermatophagoides pteronyssinus (Dp). Nasal provocation testing (NPT) was performed with increasing concentrations of Dp extracts and the nasal response was evaluated by active anterior rhinomanometry. A 100% increase of resistance in one or both nasal cavities was considered positive. There was a statistically significant difference of baseline nasal resistance (total, right and left sides) between the control and the patient groups (p < 0.001). A positive response to house dust mite allergens was recorded in 47/51 (92.2%) patients by rhinomanometry. The NPT presented no significant correlation with age, weight, height, SPT diameter, serum total and specific IgE levels to Dp and baseline nasal airway resistance values. This study suggests that a nasal provocation test with allergen is unnecessary in children with positive skin prick test and serum IgE specific to house dust mite. The rhinomanometric response to the allergen provocation does not correlate with the diameter of the skin prick test and the level of serum specific IgE.     

Environmental assessment of Dermatophagoides mite-allergen levels in Sweden should include Der m 1

The major allergen of Dermatophagoides microceras , Der m 1, as well as the allergens of D. pteronyssinus and D. farinae , Der p 1 and Der f 1, were analyzed in the homes of 111 asthmatic children in three climatic regions in Sweden. TTie numbers and species of mites were determined by microscopy, and circulating IgE antibodies against mites were measured. Der f 1 was the predominant house-dust-mite (HDM) allergen, Der p 1 the least often found, and Der m 1 represented 31% of the allergen load. However, in the Linkoping area, Der m 1 was the major HDM allergen (58%). Mite counts and allergen levels correlated well. Current exposure to HDM allergens at home was associated with the serum IgE antibody response to HDM in the children with no threshold level. Of the ehildren with IgE antibodies against HDM, 67% reacted to all three mites. Mite sensitization rates were marginally increased (7%) by the addition of IgE analysis of D. microceras to the routine analysis of IgE antibodies against D. pteronyssinus and D. farinae . Thus, Der m 1 may be an important HDM allergen and should be considered when HDM exposure data are assessed in areas with a climate like that of Sweden.     

The house dust mite Dermatophagoides pteronyssinus is the most important allergen on the island of Mauritius

To determine the relative importance of mites as a cause of allergic sensitivity and asthma on the western Indian Ocean island of Mauritius, we measured specific IgE antibodies to common inhalant allergens in sera from Mauritians claiming to have allergic symptoms and we examined house dust samples for evidence of mites and their allergens. Seventy-two of the 110 sera tested (65%) contained detectable IgE antibody to at least one mite, mould or pollen allergenic extract. By far the most prevalent was antibody to one or both of the common house dust mites, Dermatophagoides pteronyssinus and Dermatophagoides farinae, being present in 67 (61%) of the 110 sera. Allergy to pollens, including the locally prevalent Bermuda grass and sugar cane, was infrequent. Antibody to a limited number of moulds was detected in 22% of the sera tested. Of 81 subjects whose clinical history was known, 60 were asthmatic, and 75% of these asthmatic individuals had IgE antibody to mites. In contrast, only 35% of the subjects with rhinitis without asthma were sensitive to mites. Different mite species, including D. pteronyssinus but not D. farinae, were identified microscopically in samples of local house dust. Mite antigen Der p I but not antigen Der f I was detected with specific monoclonal antibodies in extracts of these dust samples. On the bases of this serological and environmental survey, we conclude that our data support the hypothesis that the house dust mite D. pteronyssinus is the principal cause of allergic sensitivity and asthma in that tropical environment.