OBJECTIVETo evaluate the significance of several Dermatophagoides pteronyssinus allergen extracts for skin prick test (SPT) in patients allergic to Dermatophagoides pteronyssinus.

METHODSTwo hundred and nineteen patients enrolled in Peking Union Medical College Hospital underwent SPT and serum specific IgE assay to detect the Dermatophagoides pteronyssinus allergen. Three kinds of house dust mite allergen extracts were used for SPT, including the Dermatophagoides pteronyssinus extract prepared by our laboratory (group A), standardized Dermatophagoides pteronyssinus extract (group B), and mixed extracts of Dermatophagoides pteronyssinus and Dermatophagoides farinae (group C). Human serum specific IgE result was regarded as the reference standard for diagnosis of Dermatophagoides pteronyssinus allergy. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of SPT with the extracts of three groups.

RESULTSSPT results showed that the median wheal diameter of group A, group B, and group C was 0.43, 0.35, and 0.28 cm, respectively, with significant difference among three groups (P<0.05). The difference was significant between group A and B (P<0.01) as well as group A and C (P<0.01), but not between group B and C (P>0.05). There was no local urticaria or systemic allergic reactions following the procedure of SPT. Local reaction was observed in 5 patients and delayed reaction was in 2 patients of group A. As for group B and C, local reaction occurred in 3 cases and delayed reaction in 2 cases in each group. The area under ROC curve of SPT with extract in group A, group B, and group C was 0.765, 0.801, and 0.782, respectively. Based on the detection results of serum specific IgE, the sensitivity of SPT in diagnosis of Dermatophagoides pteronyssinus allergy with extract of group A, group B, and group C was 92.4%, 87.0%, and 81.5%, and the specificity was 60.6%, 73.2%, and 74.8%, respectively.

CONCLUSIONThe Dermatophagoides pteronyssinus extract for SPT prepared by our laboratory offers good sensitivity and specificity comparable to commercially available allergen extracts, and it may be an appropriate candidate for clinical screening and diagnosis of Dermatophagoides pteronyssinus allergy.

Animals ; Antigens, Dermatophagoides ; immunology ; Dermatophagoides pteronyssinus ; immunology ; Female ; Humans ; Male ; ROC Curve ; Sensitivity and Specificity ; Skin Tests ; methods

Pillows are known to contain significant levels of indoor allergens and endotoxin, that are of importance to house dust mite sensitized asthmatics. Buckwheat pillows are commonly used in Korea. We studied the levels of the house dust mite allergen, Der f 1, and endotoxin on new synthetic and buckwheat pillows and their accumulation over three months. Endotoxin levels were significantly higher on new buckwheat pillows compared to synthetic pillows; geometric mean levels (95% CI) were 60,950 EU/g (30,270-122,700) and 4,887 EU/g (2,570-9,311) respectively (p<0.001). No Der f 1 was detected on the new pillows. After three months Der f 1 levels were similar on buckwheat and synthetic pillows, geometric mean levels (95% CI) were 1.16 microgram/g (0.02-8.13) and 1.08 microgram/g (0.19-1.68) respectively. These results indicate that buckwheat pillows are a source of very high endotoxin levels that may be of relevance to asthma severity of atopic asthmatics.
Allergens/*immunology ; Animals ; Antigens, Dermatophagoides/*immunology ; Asthma/immunology ; *Bedding and Linens ; *Buckwheat ; Dermatophagoides farinae/immunology ; Endotoxins/*immunology ; Humans ; Korea ; Research Support, Non-U.S. Gov't

Animals ; Antigens, Dermatophagoides ; genetics ; immunology ; Arthropod Proteins ; Asthma ; etiology ; therapy ; Humans ; Mice ; Vaccination ; Vaccines, DNA ; immunology

OBJECTIVETo identify the IgE-binding epitopes in the allergen Der p 1 of main house dust mites, which can be recognized by the specific IgE in the sera from allergic individuals, and obtain a hypoallergen derived from the T-B epitope fused peptide for potential use in specific immunotherapy (SIT).

METHODSThirty-one peptides containing 15 amino acids each, which covered the full 222 amino acids of Der p 1 protein sequence, were synthesized on the cellulous membrane by solid-phase peptide (SPOTs) synthesis, with 8 overlapping amino acids between every two neighboring peptides. The membrane bearing the spots of the synthesized peptides were incubated with the allergic serum pools consisting of the sera from 5 allergic individuals. The membrane was then probed with HRP-conjugated anti-human IgE, followed by enhanced chemiluminescence (ECL) for visualization and gray scale analysis of the positive peptide spots.

RESULTSThree strong IgE-binding epitopes were identified in the amino acid sequence of Der p 1 molecule, namely Ep1 (amino acids 85-99), Ep2 (amino acids 106-120) and Ep3 (amino acids 190-204).

CONCLUSIONThe 3 IgE-binding epitopes (B cell epitopes) identified in Der p 1 confirm the presence of linear epitopes in Der p 1, suggesting the possibility of constructing T/B epitope-fused hypoallergens.

Amino Acid Sequence ; Animals ; Antigens, Dermatophagoides ; immunology ; Arthropod Proteins ; immunology ; Binding Sites, Antibody ; Cysteine Endopeptidases ; immunology ; Epitopes ; immunology ; Immunoglobulin E ; immunology ; Lymphokines ; immunology ; Mites ; immunology ; Molecular Sequence Data

Many allergists are currently focusing on the development of new diagnostic tools, and are attempting to improve both the sensitivity and specificity. A multiple allergen simultaneous test-chemiluminescent assay (MAST-CLA) is one of the most popular diagnostic tools used in the Republic of Korea. However, there remains controversy among allergists with regard to the cut-off point for a positive result. The present study was conducted in order to determine the validity of MAST-CLA as compared with that of the skin prick test, with particular emphasis on arthropod allergens, on the basis of percentage agreement rates and k-values, and also to suggest the optimal positive cutoff points using receiver operating characteristic (ROC) curves. The study was conducted with 97 subjects (54 men, 43 women). Optimal individual cut-off points were calculated as follows; class II for Dermatophagoides farinae, class I for Dermatophagoides pteronyssinus, and trace for a cockroach mix. These findings suggest that attempting to apply optimal individual cut-off points will be a good way of improving diagnostic tests, particularly MAST-CLA.
Adult ; Allergens/*immunology ; Animals ; Antigens, Dermatophagoides/*immunology ; Chemiluminescent Measurements/*methods/standards ; Cockroaches/chemistry ; Dermatophagoides farinae/chemistry ; Dermatophagoides pteronyssinus/chemistry ; Female ; Humans ; Hypersensitivity/*diagnosis/immunology ; Insect Proteins/*immunology ; Male ; *ROC Curve ; Skin Tests/methods

OBJECTIVETo evaluate the efficacy and safety of cluster immunotherapy with Dermatophagoides pteronyssinus for allergic rhinitis.

METHODSOne hundred and fifty-four patients with allergic rhinitis to Dermatophagoides pteronyssinus were allocated to receive specific immunotherapy in a 6-week cluster schedule during the incremental-dose phase. Thereafter, these patients received maintenance-dose injection at 6-week intervals until the end of 1 year of treatment. Symptom scores and medication scores were used to evaluate the clinical efficacy and adverse reactions were recorded. A rhinoconjunctivitis quality of life questionnaire (RQLQ) was completed in the baseline and after one year treatment.

RESULTSCluster immunotherapy significantly reduced the symptom scores and total medication score of patients enrolled (P < 0.01). The immunotherapy group also had a significant improvement in the Rhinoconjunctivitis Quality of Life Questionnaire. During the one-year of treatment, there were 26 systemic adverse reactions (0.75% of all injection) in 9 patients (5.9%) and no fatal systemic reactions occurred.

CONCLUSIONSThe cluster immunotherapy is efficacious and safe to treat allergic rhinitis.

Adolescent ; Adult ; Allergens ; Animals ; Antigens, Dermatophagoides ; immunology ; Child ; Dermatophagoides farinae ; immunology ; Female ; Humans ; Immunotherapy ; adverse effects ; Male ; Middle Aged ; Rhinitis ; parasitology ; therapy ; Treatment Outcome ; Young Adult

OBJECTIVETo study the clinical efficacy of sublingual immunotherapy using standardized Dermatophagoides farinae extract for children with combined allergic rhinitis and asthma syndrome.

METHODSFifty-two children, from 4 to 14 years of age, with mite-sensitive combined allergic rhinitis and asthma syndrome were treated sublingually with standardized Dermatophagoides farinae extract. The clinical efficacy was evaluated by monthly follow-up visits. After treatment for 1 or 2 years using the standardized Dermatophagoides farinae extract, the asthma and rhinitis symptom scores, medication scores and adverse reactions before and after treatment were evaluated. SPSS 17.0 software was used to analyze the data.

RESULTSThe allergic asthma symptom scores before treatment during the day were 3.22 ± 0.66 and at night 2.05 ± 0.57. After 1 year of treatment, the day and night scores (1.68 ± 0.61, 0.94 ± 0.32) respectively, were decreased significantly (q values were 15.25 and 13.78 respectively, all P < 0.01). After 2 years of treatment, the scores (0.61 ± 0.28, 0.43 ± 0.13) were also decreased significantly (q values were 10.29 and 6.07 respectively, all P < 0.01). The allergic rhinitis symptom scores and medication scores were 2.34 ± 0.59 and 3.09 ± 1.01 respectively before treatment and 1.21 ± 0.46 and 1.89 ± 0.64 after 1 year of treatment. The differences were significant (q values were 15.48 and 18.61 respectively, all P < 0.01). The allergic rhinitis symptom scores and medication scores were 1.02 ± 0.37 and 1.49 ± 0.38 after 2 years of treatment. There was no significant difference between 2 years of treatment and 1 year of treatment (q values were 2.53 and 2.78 respectively, all P > 0.05). There were no severe adverse events during the treatment, except for mild mouth cavity discomfort.

CONCLUSIONSSublingual immunotherapy using standardized Dermatophagoides farinae extract is safe and effective in the treatment of children with combined allergic rhinitis and asthma syndrome.

Administration, Sublingual ; Adolescent ; Animals ; Antigens, Dermatophagoides ; administration & dosage ; immunology ; Asthma ; therapy ; Child ; Child, Preschool ; Dermatophagoides farinae ; immunology ; Female ; Humans ; Immunotherapy ; Male ; Rhinitis, Allergic, Perennial ; therapy ; Treatment Outcome

OBJECTIVETo construct a vector encoding T-cell epitopes of major allergen group 1 of Dermatophagoides pteronyssinus as a vaccine delivered by MHC class II pathway.

METHODSThe nucleotide sequences of the 3 target genes were synthesized, including TAT, IhC and the recombinant fragment of Der p 1 encoding 3 T-cell epitopes. After amplification of the 3 target fragments by PCR and digestion with corresponding restriction endonucleases, the recombinant gene TAT-IhC-Der p 1-3T was ligated using T4 DNA ligase and inserted into the prokaryotic expression vector pET28a(+) to construct the recombinant plasmid pET-28a(+)-TAT-IhC-Der p 1-3T, which was confirmed by digestion with restriction endonucleases and sequencing. The recombinant vector was transformed into E. coli strain BL21 (DE3) and induced with IPTG, and the induced protein TAT-IhC-Der p 1-3T was detected by SDS-PAGE. After purification, the recombinant protein was confirmed by Western blotting and its allergenicity tested using IgE-binding assay.

RESULTSThe recombinant plasmid pET-28a-TAT-IhC-Der p 1-3T was successfully constructed as confirmed by restriction endonuclease digestion and sequencing and the expression of the recombinant protein TAT-IhC-Der p 1-3T was induced in E. coli. Western blotting verified successfull purification of the target protein, which showed a stronger IgE-binding ability than Der p 1.

CONCLUSIONWe successfully constructed a recombinant expression vector pET-28a-TAT-IhC-Der p 1-3T expressing a T-cell epitope vaccine delivered by MHC II pathway with strong IgE-binding ability, which provides a basis for further study on specific immunotherapy via MHC class II pathway.

Allergens ; immunology ; Animals ; Antigens, Dermatophagoides ; immunology ; Arthropod Proteins ; immunology ; Base Sequence ; Cloning, Molecular ; Cysteine Endopeptidases ; immunology ; Dermatophagoides pteronyssinus ; Epitopes, T-Lymphocyte ; Escherichia coli ; Gene Expression ; Genes, MHC Class II ; Genetic Vectors ; Plasmids ; Polymerase Chain Reaction ; Recombinant Proteins ; immunology ; Vaccines ; immunology

House dust mites produce inhalant allergens of importance to allergic patients. We measured the major group 1 allergens, Der p 1 and Der f 1, from the house dust mites Dermatophagoides pteronyssinus and Dermatophagoides farina, respectively in 100 randomly selected domestic homes from Cheonan, Korea. Dust samples were collected by vacuuming from the living room floor and 1 mattress in each home. Der p 1 and Der f 1 were measured by double monoclonal ELISA. Der p 1 levels were very low, with geometric mean levels for floors and mattresses being 0.11 microgram/g (range: 0.01-4.05) and 0.14 microgram/g (range: 0.01-30.0), respectively. Corresponding levels of Der f 1 were higher, 7.46 microgram/g (range: 0.01-262.9) and 10.2 microgram/g (range: 0.01-230.9) for floors and mattresses, respectively. D. farinae appears to be the dominant house dust mite in Cheonan.
Animals ; Antigens, Dermatophagoides/immunology/*isolation & purification ; Bedding and Linens ; Dust/analysis ; Floors and Floorcoverings ; Housing ; Humans ; Korea ; Pyroglyphidae/*immunology

OBJECTIVETo evaluate the efficacy and safety of rush immunotherapy (RIT) for patients with persistent allergic rhinitis (AR).

METHODSIn this study, a total number of thirty three (33) patients who suffered mite allergic rhinitis were included. These patients completed one year subcutaneous immunotherapy (SCIT). Using RIT, the patients underwent the incremental dose phase in a week instead of 15 weeks in a conventional treatment procedure. The symptom scores, visual analog scale (VAS), appropriate medication score, total blood serum IgE, dermatophagoides pteronyssinus specificity IgG4, mite allergy skin prick test (SPT), dermatophagoides farinae nasal provocation test (NPT) and the incidence of adverse reactions were used to evaluate the efficiency and safety of RIT.

RESULTSAfter one year SCIT treatment, the symptom score and VAS scores were significantly decreased, the corresponding medication usage was significantly reduced (8.91 ± 1.84, 20.64 ± 6.99 vs. 4.97 ± 2.92, 11.94 ± 7.21, t value was 9.15, 7.11, both P < 0.001) and the cutaneous reactions to mite allergen were significantly decreased (P < 0.001) as well. However, dermatophagoides pteronyssinus-specific serum IgG4 increased significantly (Z = -4.517, P < 0.001). The concentration of dermatophagoides farinae nasal provocation test (NPT) was significantly increased. After the treatment, the number of patients who had positive reactions to high concentration nasal provocation test (NPT) increased (χ² = 1.93, P = 0.38). During the treatment, all the patients experienced local reactions, and specifically there were four patients got general reactions.

CONCLUSIONRIT is safe and effective. It shortened the incremental dose phase remarkably. NPT is a good indicator for diagnosing allergic rhinitis and evaluating the efficacy of the treatment.

Allergens ; immunology ; Animals ; Antigens, Dermatophagoides ; immunology ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Humans ; Immunoglobulin G ; blood ; Immunotherapy ; adverse effects ; methods ; Injections, Subcutaneous ; Nasal Provocation Tests ; Pyroglyphidae ; Rhinitis, Allergic ; therapy ; Sensitivity and Specificity ; Skin Tests ; Treatment Outcome