BACKGROUND: Specific serum IgE determination is widely used in the diagnosis of IgE-mediated allergic diseases. House dust mite allergens are known to show good sensitivity on in vitro tests. We report the results of specific IgE against house dust allergen by Pharmacia CAP system FEIA and compared them with those of in vivo test. OBJECTIVE: The aim of this study is to find out the clinical application of Pharmacia CAP system FEIA in atopic dermatitis. METHODS: In 46 atopic dermatitis patients, skin prick test and Pharmacia CAP system FEIA were performed for Dermatophagoides pteronyssinus and Dermatophagoides farinae allergens. For all patients, atopy and family histories were taken. RESULTS: The positive results were more frequent in adult patients(over 16 years old, 73.3%) than in child patients(below 15 years old, 38.7%) in skin prick test for both Dermatophagoides pteronyssinus and Dermatophagoides farinae allergens. When skin prick tests were used as a reference standard, the sensitivity of Pharmacia CAP system FEIA was 89.5% for Dermatophagoides pteronyssinus and 90.0% for Dermatophagoides farinae, and the specificity of Pharmacia CAP system FEIA was 77.8% for Dermatophagoides pteronyssinus and 80.8% for Dermatophagoides farinae. Correlations were found between Pharmacia CAP system FEIA results and serum total IgE (r=0.574 for Dermatophagoides pteronyssinus and r=0.534 for Dermatophagoides farinae). CONCLUSION: Our results suggest that Pharmacia CAP system FEIA offers high sensitivity and can be an effective method of screening for allergies to Dermatophagoides pteronyssinus and Dermatophagoides farinae in atopic dermatitis.
Adolescent ; Adult ; Allergens ; Antigens, Dermatophagoides ; Child ; Dermatitis, Atopic* ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Diagnosis ; Dust* ; Humans ; Hypersensitivity ; Immunoglobulin E ; Mass Screening ; Pyroglyphidae* ; Sensitivity and Specificity ; Skin

BACKGROUND AND OBJECTIVES: To evaluate IgE reactivity profiles to Der p 1, Der p 2, and Der p 10 in house dust mite (HDM) allergic rhinitis (AR) patients in Korea. Symptomatic and serologic changes after sublingual immunotherapy (SLIT) were analyzed according to IgE profiles. MATERIALS AND METHODS: Sixty AR patients diagnosed with an HDM allergy were tested for the presence of IgE antibodies against purified HDM allergen molecules (i.e., nDer p 1, rDer p 2, and rDer p 10) and native Dermatophagoides pteronyssinus (Dp) using ImmunoCAP 250®. Symptom scores and laboratory findings were analyzed after SLIT. RESULTS: Prevalence rates of IgE for Dp, Der p 1, Der p 2, and Der p 10 were 100%, 98.3%, 93.3%, and 8.3%, respectively. After one year of immunotherapy with SLITone○R (standardized to major allergens, but not Der p 10), symptom scores and laboratory findings improved in patients with and without Der p 10 IgE antibodies. CONCLUSION: In Korean AR patients, specific IgE antibodies to Der p 1 or Der p 2 are present in most Dp-allergic patients, while reactivity to Der p 10 is very low. Allergic symptoms improved in patients with Der p 10 IgE antibodies after SLIT.
Allergens ; Antibodies ; Antigens, Dermatophagoides ; Dermatophagoides pteronyssinus ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Immunotherapy ; Korea* ; Prevalence ; Pyroglyphidae ; Rhinitis, Allergic* ; Sublingual Immunotherapy

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

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

Objective:To investigate the characteristics of allergen component in dust mite（DM） -induced allergic rhinitis（AR） patients, and provide reference for the diagnosis and treatment of AR. Methods:DM-induced AR patients with or without allergic asthma（AA） who visited the Allergy Department of Tongji Hospital, Huazhong University of Science and Technology between 2021 and 2022 were enrolled. Patients'age, gender, and visual analog scale（VAS） for symptoms were recorded. sIgE and sIgG4 levels of allergen components such as Der f1, Der f2, Der p1, Der p2, Der p7, Der p10, Der p21, and Der p23 were detected using a protein chip method. The sensitization characteristics of the allergen components in the patients were observed, and the correlation between sIgE, sIgG of each component and VAS as well as the component differences between AR and AR with AA（AR&AA） were evaluated. Results:A total of 87 DM-induced AR patients were enrolled, with 42.5% of them were AR&AA, their VAS scores were significantly higher than those of AR patients（6.38±1.95 vs 5.25±1.85, P=0.009 8）. The order of sensitization rates for DM components was as follows: Der p2（82.8%）, Der f2（81.6%）, Der p1（74.7%）, Der f1（70.1%）, and Der p23（35.6%）. The order of positive rates for sIgG4 was: Der p2（21.8%）, Der f2（13.8%）, Der p21（8.0%）, and Der p7（6.9%）. There were no correlation between the sIgE, sIgG4 levels or positive numbers of components and VAS scores, but there were positive correlations between sIgE, sIgG4 concentrations of components. Compared with AR patients, AR&AA patients had higher levels of sIgE for Der p（60.5[7.2-91.1]vs 14.0[4.8-45.1], P=0.02）, Der f（49.8[15.7-81.6]vs 21.3[7.0-50.2], P=0.04）, Der p1（27.2[0.7-51.5]vs 2.6[0.2-24.9], P=0.02）, Der p2（20.0[1.4-60.6]vs 5.5[0.6-19.1], P=0.004）, and Der f2（58.9[16.0-89.2]vs 23.4[0.9-56.8], P=0.009）, and a higher proportion of AR with AA patients had sIgE levels of Der p1（70.3% vs 48.0%, P=0.038） and Der p23（27.0% vs 14.0%, P=0.039） that were ≥3 grades. Conclusion:Der p1/f1, Der p2/f3, and Der p23 are the major components of DM sensitized AR patients. Multiple component sensitization and sIgE, sIgG4 levels of each component are not correlated with the severity of AR. The sIgE levels of the Der p1/f1, Der p2/f3, and Der p23 components in AR&AA patients are higher than AR.
Animals ; Humans ; Allergens ; Pyridinolcarbamate ; Rhinitis, Allergic/therapy* ; Pyroglyphidae ; Asthma ; Antigens, Dermatophagoides

Dust mites are one of the most important allergens, widely distributed around the world, especially in household environments. Dermatophagoides pteronyssinus, Dermatophagoides farinae and Blomia tropicalis are the most common species of dust mites. There are more than 35 known sensitization components of dust mites, among which Der p 1, Der p 2 and Der p 23 are the major components. Clinically, allergen skin test and serum specific immunoglobulin E (sIgE) detection are widely used in the preliminary diagnosis of dust mite allergy. However, these methods cannot accurately identify specific dust mite sensitization components. Considering that there are significant differences in the allergenic components of dust mites in different regions and populations, component-resolved diagnosis of dust mite is particularly important in accurately determining the allergenic components. This is not only of guiding significance for allergen avoidance, but also important for determining the immunotherapy regimen for dust mites. In order to strengthen the understanding of the molecular diagnosis of dust mites and promote the integration of allergy science in China with the international standards, this article interprets the "Allergy Molecular Allergology User's Guide 2.0" published recently by the European Academy of Allergy and Clinical Immunology.
Animals ; Humans ; Dust ; Dust Mite Allergy ; Pathology, Molecular ; Antigens, Dermatophagoides ; Allergens ; Hypersensitivity/therapy* ; Pyroglyphidae

Dust mites are one of the most important allergens, widely distributed around the world, especially in household environments. Dermatophagoides pteronyssinus, Dermatophagoides farinae and Blomia tropicalis are the most common species of dust mites. There are more than 35 known sensitization components of dust mites, among which Der p 1, Der p 2 and Der p 23 are the major components. Clinically, allergen skin test and serum specific immunoglobulin E (sIgE) detection are widely used in the preliminary diagnosis of dust mite allergy. However, these methods cannot accurately identify specific dust mite sensitization components. Considering that there are significant differences in the allergenic components of dust mites in different regions and populations, component-resolved diagnosis of dust mite is particularly important in accurately determining the allergenic components. This is not only of guiding significance for allergen avoidance, but also important for determining the immunotherapy regimen for dust mites. In order to strengthen the understanding of the molecular diagnosis of dust mites and promote the integration of allergy science in China with the international standards, this article interprets the "Allergy Molecular Allergology User's Guide 2.0" published recently by the European Academy of Allergy and Clinical Immunology.
Animals ; Humans ; Dust ; Dust Mite Allergy ; Pathology, Molecular ; Antigens, Dermatophagoides ; Allergens ; Hypersensitivity/therapy* ; Pyroglyphidae

BACKGROUND: Atopic dermatitis (AD) is a chronic, relapsing disease with genetic and environmental background. Many factors may act as triggers and affect the course of the disease. However, little is known about the factors affecting the disease severities in Korean childhood AD. OBJECTIVE: The aim was to document the distinct characteristics of childhood AD in Korea and to determine which manifestations are prone to be present in the settings of different severity of the disease. METHOD: The clinical manifestations, past medical and family history, and inducing or aggravating factors were studied in patients, who participated in the open lectures for childhood AD patients in three provinces of Korea. The severity of the disease was evaluated using the Eczema Area and Severity Index (EASI) and the factors affecting the severity of the disease were determined. Skin prick tests with four allergens, Dermatophagoides pteronyssinus, milk, peanut and egg, were also carried out. RESULTS: Of the 93 patients, 38.7% had the disease onset between the age of three and six, while 17.2% had it between the age of seven and fifteen. Sixty-five percent of the patients had family members with a history of atopic diseases, such as AD, asthma, allergic rhinitis and allergic conjunctivitis. In order of frequency, the patients either had a history of or presently accompanying infantile eczema, allergic rhinitis, asthma or allergic conjunctivitis. Among the patients, 27% took herbal medication. The most frequently involved site was the flexural area. The most common aggravating factors were sweating in hot environment, wool fabric and stress. When AD patients were categorized into mild, moderate and severe groups by EASI, the older onset age, the longer duration, facial distribution, history of taking herbal medication, cholinergic condition, wool fabric and stress were found to be significant factors influencing the severity of the disease. Skin prick test with the four major allergens revealed the highest prevalence in Dermatophagoides pteronyssinus. CONCLUSION: The age of onset of AD was higher than that has been reported. Many suffered from infantile dermatitis and had other accompanying atopic diseases. Aggravating factors should be avoided to minimize the risk of disease aggravation. Based on the fact that late onset age, duration, facial distribution, history of taking herbal medication, cholinergic condition, wool and stress were the statistically significant factors, we may predict the severity or the course of the disease.
Age of Onset ; Allergens ; Antigens, Dermatophagoides ; Asthma ; Conjunctivitis, Allergic ; Dermatitis ; Dermatitis, Atopic* ; Dermatophagoides pteronyssinus ; Eczema ; Humans ; Korea* ; Lectures ; Milk ; Ovum ; Prevalence ; Rhinitis ; Skin ; Sweat ; Sweating ; Wool

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

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