PURPOSE: Component-resolved diagnostics (CRD) is expected to provide additional diagnostic information in allergic patients. PROTIA™ Allergy-Q 64 Atopy®, a recently developed CRD-based multiplex specific immunoglobulin E (sIgE) assay, can quantitatively measure sIgE to major allergen components. METHODS: The sIgE detection by PROTIA™ Allergy-Q 64 Atopy® and ImmunoCAP® assays was compared using the sera of 125 Korean allergic patients. Group 1 and 2 allergens of house dust mites (HDMs; Dermatophagoides farinae (Der f) 1 and Der f 2 in PROTIA™ Allergy-Q 64 Atopy®, Dermatophagoides pteronyssinus (Der p) 1 and Der p 2 in ImmunoCAP®), Bet v 1, Fel d 1, Que a 1, ω-5 gliadin, α-lactalbumin, β-lactoglobulin, casein and α-Gal were measured by both assays. RESULTS: Comparing the results from the 2 assays, the agreement rate for all the 10 allergens was > 88% (group 1 HDM allergen, 100%; group 2 HDM allergen, 94.6%; Bet v 1, 97.4%; Fel d 1, 90.5%; Que a 1, 89.2%; α-lactalbumin, 96%; β-lactoglobulin, 88%; casein, 88%; ω-5 gliadin, 96%; α-Gal, 100%). Correlation analysis indicated that, all the 10 allergen sIgEs showed more than moderate positive correlation (Pearson correlation coefficients > 0.640). Additionally, intra-class comparison showed more than high correlation for all the 10 allergens (Spearman's rank correlation coefficients > 0.743). CONCLUSIONS: PROTIA™ Allergy-Q 64 Atopy® is reliable and comparable to the ImmunoCAP® assay for component-resolved diagnosis.
Allergens ; Caseins ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Diagnosis ; Gliadin ; Humans ; Immunoassay ; Immunoglobulin E ; Immunoglobulins ; Pyroglyphidae

BACKGROUND: The relationship between atopic dermatitis (AD) and low vitamin D levels has been studied. Emerging evidence has implicated vitamin D as a critical regulator of immunity, playing a role in both the innate and cell-mediated immune systems. However, the effect of vitamin D on house dust mite (HDM) sensitization in patients with AD has not been established. OBJECTIVE: We investigated the association between vitamin D levels and HDM sensitization according to AD severity. METHODS: In total, 80 patients (43 men and 37 women) with AD were included. We classified AD severity using Rajka and Langeland scores. Laboratory tests included serum 25-hydroxyvitamin D3, total immunoglobulin E (IgE), and specific IgE antibody titer against Dermatophagoides farinae and D. pteronyssinus. RESULTS: There were no differences in vitamin D levels between the mild or moderate AD and severe AD groups. In the severe AD group, high HDM sensitization group had lower serum vitamin D levels compared to low HDM sensitization group with statistical significance. In addition, a significant negative correlation was found between vitamin D levels and HDM sensitization in the severe AD group. CONCLUSION: Our results demonstrate that low vitamin D levels may link to high HDM sensitization in patients with the severe AD. Further elucidation of the role of vitamin D in HDM sensitization may hold profound implications for the prevention and treatment of AD.
Calcifediol* ; Dermatitis, Atopic* ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Dust* ; Humans ; Immune System ; Immunoglobulin E ; Immunoglobulins ; Male ; Plasma* ; Pyroglyphidae* ; Vitamin D

PURPOSE: The clinical efficacy of allergen-immunotherapy is known to be dose dependent. However, optimal maintenance dosage has not yet been determined for sublingual immunotherapy (SLIT). Furthermore, since companies adopt their own units for expression of allergenicity, the allergen concentrations of individual reagents cannot be compared easily. We sought to measure and compare the allergenicities of 3 commercially available house dust mite (HDM) SLIT regents and a subcutaneous immunotherapy reagent. METHODS: We measured the HDM allergenic potency of the maintenance dosages of three SLIT reagents: Staloral(R) (300 index of reactivity [IR] /mL, recommended maintenance dosage [MD]: 120 IR), SLITone(R) (1,000 standard therapeutic unit [STU]/mL, recommended MD: 200 STU), Wolwopharma(R) (100 microg/mL, recommended MD: 20 microg), and subcutaneous immunotherapy regents of Hollister-Stier (10,000 allergy unit [AU] /mL). The allergenic potency was assessed by measuring the total protein concentrations, mite group 1 and 2 allergens using 2-site ELISA, and an inhibition test against IgE specific to Dermatophagoides farinae and Dermatophagoides pteronyssinus. RESULTS: The protein content of the Wolwopharma(R) reagent was 1.5-261.4 times higher than that of the other 2 SLIT reagents. The concentration of group 1 major allergens in Staloral(R) (132.03 microg/mL) was 33- to 44.5-fold higher than in SLITone(R) (4.00 microg/mL) and Wolwopharma(R) (2.97 microg/mL). The concentration of group 2 major allergen was also 8.9- to 10.5-fold higher in Staloral(R) (15.7 microg/mL) than in SLITone(R) (1.8 microg/mL) or Wolwopharma(R) (1.5 microg/mL). An ELISA inhibition study against HDM-specific IgE showed that the allergen potency of Staloral(R) reagent is 8.5-fold and 21-fold higher than that of SLITone(R) or Wolwopharma(R), respectively. The differences between the maintenance dosages are further exaggerated by the differences in the recommended volumes of SLIT reagents. CONCLUSIONS: The allergen potencies of commercially available HDM SLIT reagents are markedly different. Consensus regarding the optimal allergen concentration for SLIT reagents used to treat HDM respiratory allergies is needed.
Allergens ; Consensus ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Enzyme-Linked Immunosorbent Assay ; Hypersensitivity ; Immunoglobulin E ; Immunotherapy ; Indicators and Reagents* ; Mites ; Pyroglyphidae* ; Sublingual Immunotherapy*

PURPOSE: Pneumonia is one of the most common respiratory diseases in hospitalized children, and often recurs. It has been reported that asthma is one of the significant contributing factors to recurrent pneumonia. On the basis of similarities between asthma and recurrent pneumonia, we intended to evaluate the influence of allergy on recurrent pneumonia. METHODS: Seventy one children with recurrent pneumonia were defined as recurrent group(RG) and twenty one children with first episodes of pneumonia were defined as control group(CG). WBC, total eosinophil count, Eosinophilic Cationic Protein(ECP), serum total IgE and specific IgE for eleven common allergens using the CAP system were measured and compared. Recurrent pneumonia was defined as at least two pneumonia episodes in a year, or at least three episodes from birth to the time of our study. Children with previous allergic disorders were excluded. RESULTS: There were no statistical differences in WBC, total IgE, and ECP between the two groups. Total eosinophil count in RG was significantly higher than CG(P=0.021), significantly correlating with ECP(r=0.755, P<0.05) and total IgE(r=0.354, P<0.05). When the cut-off value was 0.35 kU/L in CAP test, positive prevalence of CAP in RG was significantly higher than CG(P=0.009). Also, the positive prevalence of house dust mites group, especially Dermatophagoides farinae(D.f.), was significantly higher in RG(P=0.019, 0.025, respectively). When the cut-off value was 0.7 kU/L in CAP test, only a positive prevalence of house dust mites group was significantly higher in RG than CG (P=0.042). The quantitative levels of specific IgE for Dermatophagoides pteronyssinus(D.p.) and D.f. were very high in RG(P=0.018, 0.028, respectively), significantly correlating with each other(r=0.639, P<0.05). CONCLUSION: Allergic sensitization, especially to house dust mites, is one important contributable factor in recurrent pneumonia in children. Further study, such as bronchial hyperresponsiveness, is needed in children who were sensitized by D.p. or D.f..
Allergens ; Asthma ; Child* ; Child, Hospitalized ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Eosinophils ; Humans ; Hypersensitivity* ; Immunoglobulin E ; Parturition ; Pneumonia* ; Prevalence ; Pyroglyphidae

PURPOSE: Atopy and specific immunogloguline (Ig) E to individual aeroallergen are considered a hallmark of allergic diseases, including asthma. However, the association between these parameters and lung function or bronchial hyperresponsiveness (BHR) is still controversial in previous studies. METHODS: A total of 234 atopic asthmatic children was recruited in this study. The amounts of total IgE and specific IgE were determined by employing the CAP system FEIA (Pharmacia Diagnostics, Uppsala, Sweden). Specific IgE was focused on two major inhalant allergens in Korea, Dermatophagoides pteronyssinus (Der p) and Dermatophagoides farinae (Der f). To evaluate BHR, methacholine and exercise challenge tests were performed. RESULTS: In the atopic asthmatic group, total IgE correlated negatively with methacholine PC20 and positively with a maximum percentage fall in FEV1 after exercise. Specific IgE to Der f strongly correlated with a maximum percentage fall in FEV1 after exercise in atopic asthmatics, particularly exercise-induced asthma (EIA) (r=0.176, P=0.007 and r=0.199, P=0.011, respectively) and specific IgE to Der p weakly correlated with a maximum percentage fall in FEV1 after exercise only in EIA-positive children with atopic asthma (r=0.140, P=0.073), while neither of them correlated with methacholine PC20 (P> 0.05). However FEV1, FVC, and FEF25-75% were not associated with total IgE and specific IgE to Der p or Der f regardless of positivity of EIA in atopic asthmatic children. CONCLUSION: The severity of atopy and sensitization to house dust mites are significantly correlated with BHR, especially challenged by exercise but not pulmonary function in atopic asthmatic children.
Allergens ; Asthma ; Asthma, Exercise-Induced ; Child* ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Humans ; Immunoglobulin E ; Korea ; Lung ; Methacholine Chloride ; Pyroglyphidae

BACKGROUND: Evidence is conflicting regarding the effectiveness of creating a low-allergen environment or reducing allergen exposure to control asthma exacerbations. OBJECTIVE: This study determined the association of house dust mite (HDM)-specific IgE levels with asthma symptom control, selected medications, family history of allergic disease, and exposure to second-hand smoke and household pets. METHODS: Serum samples from 102 doctor-diagnosed allergic asthma patients and 100 non-atopic controls were subjected to enzyme-linked immunosorbent assay using the HDM species Dermatophagoides pteronyssinus (Dp), Dermatophagoides farinae (Df), and Blomia tropicalis (Bt) allergens. Point-biserial correlation coefficient, Pearson R correlation, and logistic regression analyses were used to determine association of HDM-specific IgE levels with the abovementioned variables. RESULTS: Of the 102 cases, 38.24%, 47.06%, and 33.33% were sensitized to Bt, Df, and Dp, respectively. Sensitized patients showed greater probability [Bt (OR = 1.21), Df (OR = 1.14), and Dp (OR = 1.35)] to manifest symptoms than those who were not. Obtained p-values [Bt (p = 0.73), Df (p = 0.83), and Dp (p = 0.59)], however, proved that HDM-specific IgE levels had no significant contribution in predicting or explaining occurrence of asthma symptoms. Bt- and Df-specific IgEs showed moderately weak but significant relationship with bambuterol HCl and expectorant, respectively. Patients currently on said medications registered higher HDM-specific IgE levels than those who were not. No significant correlation between IgE levels and family history of allergic disease or with exposure to second-hand smoke was seen. Dp-specific IgE levels of patients exposed to household pets were significantly lower compared to those without exposure. CONCLUSION: This study proves that sensitization to Bt, Df, and Dp allergens is not significantly associated with asthma symptoms and control. Although cases were shown to be sensitized to HDMs, their current medications were at least effective in controlling their asthma symptoms.
Allergens ; Asthma ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Dust ; Enzyme-Linked Immunosorbent Assay ; Family Characteristics ; Humans ; Immunoglobulin E ; Logistic Models ; Pyroglyphidae ; Smoke

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

We evaluated the efficacy of health education in reducing indoor arthropod allergens in Seoul. The mite control measures comprised the use of mite-proof mattress and pillow coverings, regular washing of potentially infested materials, maintenance of a low humidity, removal of carpets, and frequent vacuum cleaning. Cockroach control measures included trapping, application of insecticides, and protecting food. Of 201 homes enrolled in October 1999, 63 volunteers were included in a 2-year follow-up survey between April 2000 and January 2002. Before intervention, the density of mites/g of dust varied greatly; 27.1/g in children's bedding, 20/g in adult bedding, 7.2/g on the floors of children's bedrooms, 6.8/g in sofas, 5.9/g on the floors of adult's bedrooms, 3.9/g on living room floors, 3.7/g in carpets, and 1.9 mites/g on kitchen floors. The predominant mite species and house percentages infested were; Dermatophagoides farinae 93%, D. pteronyssinus 9%, and Tyrophagus putrescentiae 8%. Comparing 1999 and 2001 infestations, before and after 25 mo of education, mite abundance was reduced by 98%, from 23.7 to 0.57 mites/g of dust. In 1999, cockroaches were detected in 62% homes: 36% Blattella germanica and 35% Periplaneta spp., including 9% double infestations of B. germanica and P. americana. Following intervention, cockroach infestation rates decreased to 22% of houses in 2000 and 23% in 2001. We conclude that continuous and repetitive health education resulted in the effective control of domestic arthropods.
Tick Control/*methods ; *Pyroglyphidae ; Population Density ; *Periplaneta ; Korea ; Insect Control/*methods ; Health Education/*standards ; Environment ; Dermatophagoides pteronyssinus ; Dermatophagoides farinae ; *Blattellidae ; Animals ; Allergens/analysis

OBJECTIVES: Sublingual immunotherapy (SLIT) has recently received much attention around the world as a treatment for allergic rhinitis. This study aimed to investigate the efficacy and adverse effects of SLIT in Korean patients with allergic rhinitis caused by house dust mites. The treatment compliance and the patient satisfaction with SLIT were also assessed. METHODS: The patients who were sensitized to Dermatophagoides pteronyssinus and Dermatophagoides farinae and who started SLIT between November 2007 and July 2008 were included in this study. The symptom questionnaires, which included items on rhinorrhea, sneezing, nasal obstruction, itchy nose, olfactory disturbance, eye discomfort and sleep disturbance, were obtained before and 6 months after SLIT. The patient satisfaction and the adverse effects were also investigated. RESULTS: One hundred forty-two patients started SLIT and 98 of them continued SLIT for 6 months or more. Ninety-two of the 98 patients completed the questionnaires. The duration of receiving SLIT was 9.8 months on average (range, 6 to 13 months). All the symptoms of allergic rhinitis were improved with SLIT. Forty-five percent of the patients were satisfied for SLIT, while 12% were unsatisfied. The incidence of adverse effects was 12% during maintenance therapy, although it was 48% during the up-dosing phase. The drop-out rate of SLIT was 31.0%. CONCLUSION: The subjective symptoms were improved with SLIT in Korean patients with allergic rhinitis for house dust mites. Yet the drop out rate was high despite of the symptomatic improvement.
Compliance ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Dust ; Eye ; Humans ; Immunotherapy ; Incidence ; Nasal Obstruction ; Nose ; Patient Satisfaction ; Pyroglyphidae ; Rhinitis ; Rhinitis, Allergic, Perennial ; Sneezing ; Surveys and Questionnaires

BACKGROUND: Tyrophagus putrescentiae is one of the storage mites found not only within storehouses but also in the house dust, and is known as the third most common mite following Dermatophagoides pteronyssinus and Dermatophagoides farinae in houses in Korea. There has been few reports on its sensitization rate in this country. OBJECT: The aim of this study was to evaluate its sensitization rate and clinical features of T. putrescentiae sensitized patients with allergic diseases in Daejeon area. METHODS: Skin prick tests with 33 common inhalant allergens including Tetranychus urticae and T. putrescentiae were done in 308 allergy patients who had visited Allergy Clinic of Eulji University Hospital from June, 2001 to April, 2002, and their clinical characteristics of these patients were analyzed. RESULTS: A total of 193(62.7%) out of 308 patients showed positive responses to more than one allergen. The prevalence of sensitization was highest for mites(51.9%) followed by cockroach (25.0%), weeds pollens(17.5%), animal epithelium(16.9%), fungi(16.2%), grasses pollens(15.6%) and tree pollens(14.6%). Among mites, sensitization rate to T. urticae was highest as 128 (41.6%), followed by D. farinae, 96(31.2%), T. putrescentiae, 95(30.8%), and D. pteronyssinus, 92(29.9%). Among positive responders to mites, eight patients with perennial asthma were sensitized to T. putrescentiae only. Sensitization to D. farinae and animal epithelium were more prevalent in Deajeon city compared to surrounding rural areas (for D. farinae, 72/203(35.5%) vs. 24/105(22.9%) respectively. P=.024, and for animal epithelium, 42/203(20.7%) vs. 10/105 (9.5%) respectively. P=.013). CONCLUSION: Tyrophagus putrescentiae was one of the most common inhalant allergens as well as house dust mite and two spotted spider mite in patients visiting an Allergy Clinic in Daejeon area. Further study will be needed to elucidate the clinical significance of T. putres-centiae -sensitized patients.
Acaridae ; Allergens ; Animals ; Asthma ; Cockroaches ; Daejeon ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Dust ; Epithelium ; Humans ; Hypersensitivity ; Korea ; Mites ; Poaceae ; Prevalence ; Pyroglyphidae ; Skin ; Tetranychidae