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Occurrence of IgE antibodies against the 39-kDa allergen component of the mite Lepidoglyphus destructor in urban and rural subjects.

Several species of storage mite have been shown to cause IgE-mediated sensitization. Monoclonal antibodies (mabs) have been raised against the storage mite Lepidoglyphus destructor, and one mab (42B6) immunoprecipitated a band of 39 kDa of L. destructor. To search for the frequency of IgE antibodies in patient sera against this allergen component, we modified a radioimmunoassay (RIA), 42B6 being used as capturing antibody. Twenty of 43 sera from farmers who were RAST positive to L. destructor (46.5%) were scored as positive in this assay. There was a moderate degree of correlation between positive RAST results to L. destructor and the 39-kDa allergen. Among 14 sera from Stockholm residents positive in RAST to both Dermatophagoides pteronyssinus and L. destructor, six detected the 39-kDa allergen component. However, three sera from urban subjects lacking IgE antibodies against both mite species also had IgE antibodies against the 39-kDa allergen. The present study demonstrates that the 39-kDa allergen of L. destructor is an important allergen, and that rural as well as urban subjects can become sensitized.

Adolescent↗

Effect of dry cleaning on mite allergen levels in blankets.

Since one of the greatest reservoirs of allergens is the blanket, we assessed mite allergen levels in dust collected from five blankets by vacuuming before and after dry cleaning with perchlorethylene and compared the results with five control blankets. Assays with monoclonal antibodies showed that group I (Der p I and Der f I) mite allergen levels per g dust were 78% lower after dry cleaning. Group I allergen levels per m2 of dry-cleaned blankets were 98% lower. RAST inhibition showed that total allergen levels decreased 70% after dry cleaning. Mite allergens were not denatured by perchlorethylene. The effect of dry cleaning resulted from physical washing out of dust and allergens.

Allergens↗

House-dust-mite allergen (Der p 1) levels in university colleges.

BACKGROUND: In coastal Australia, mean house-dust-mite allergen concentration is 20-40 times higher in homes than in public buildings. Allergen concentrations in university colleges, which share some characteristics of both homes and public buildings, are not known. The study aimed to compare bed mite-allergen concentration in colleges with local homes. METHODS: Mattress dust was collected from three colleges (n = 60 in each) and local homes (n = 68) during summer. Der p 1 was measured by ELISA. Information was collected on the floor plan of the colleges, cleaning practices, age of building, and orientation of room. RESULTS: Most college mattresses (94%) had Der p 1 concentrations less than the mean of homes in the same climate. The geometric means of Der p 1 in the mattresses of the colleges were as follows: A, 8.9 micrograms Der p 1/g fine dust (95% CI 6.9, 11.5); B, 1.9 (1.5, 2.3); and C, 1.5 (1.2, 2.0), compared to homes, 22.5 (17.6, 28.7). The percentages of college mattresses with less than 2 micrograms/g were 7%, 48%, and 58%, respectively, compared to 4% for homes. Higher Der p 1 concentrations were weakly associated with age of building in college A, and orientation in college B. Der p 1 concentrations were independent of floor level and age of mattress. CONCLUSIONS: These findings indicate that low allergen concentrations are achievable without extreme hygiene and cleaning measures in a climate which supports mite proliferation in homes.

Animals↗

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 degrees, 80 degrees, 100 degrees, 120 degrees, and 140 degrees 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 degrees C, allergen levels were reduced to < 1% of control. Der p 2 was more heat stable, requiring 140 degrees 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 degrees C. CONCLUSIONS: 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.

Allergens↗

Mite-allergen levels in Norwegian homes.

The scarce data published on mite sensitization and mite-allergen levels in Norway indicate that the mites may not be of the same importance in allergic disease in Norway as in countries such as the UK and the rest of Europe. The problem also involves the low allergen levels and small amounts of dust collected for allergen determination, and when the level is to be expressed as mg/g, the lower detection limit will often vary from sample to sample, giving within the same investigation results such as <0.2 microg/g, <0.5 microg/g, and even <2.0 microg/g. The use of allergen levels expressed instead per area (microg/m2) at least results in a uniform lower detection limit, making statistical analysis easier.

Animals↗

Risk levels for mite allergens. Are they meaningful?

Allergens found in house dust are among the most common environmental antigens to which man is naturally exposed. Standardized methods for measuring allergen exposure are essential for assessing the relationship between exposure, sensitization, and the severity of asthma. Monoclonal antibody-based assays are the most widely used method for assessing allergen exposure. In the effort to define the best "index of exposure" to mite allergens, several factors need to be investigated, including: 1) whether allergen should be measured in reservoir dust or airborne 2) whether the results of reservoir measurement should be expressed as recovered allergen per unit weight or per unit area. As yet, airborne sampling is insufficiently sensitive to produce reliable and repeatable results. Therefore, measurement of house-dust-mite allergen concentration in reservoir dust should be regarded as the best-validated index of exposure. The results should be expressed and reported both per unit weight (concentration) and per unit area. The strongest predictor of chronic symptoms and acute exacerbation of asthma is sensitization to indoor allergens. A simple dose-response relationship between IgE-mediated hypersensitivity and allergen exposure has been established. For example, exposure to more than 2 microg Group 1 mite allergen/g dust should be regarded as a risk factor for the development of IgE antibody and asthma in susceptible children. The quantitative relationship between exposure and symptoms in patients already sensitized is complex due to a number of possible confounding factors (e.g., other allergens, viruses, asthma medication). A simple threshold level for provocation of asthmatic symptoms has not been clearly defined.

Air Pollution, Indoor↗

High prevalence of storage mite sensitization in a general adult population.

BACKGROUND AND AIM: Occupational and nonoccupational storage mite (SM) allergy has received considerable attention in recent years. The study aimed to evaluate both the prevalence and factors associated with sensitization to SMs in a general adult population from a warm and humid area where mites are the predominant allergens. PATIENTS AND METHODS: An age-stratified random sample of 720 subjects was drawn from the population older than 18 years of A-Estrada (Galicia, Spain). From 697 eligible subjects, 469 (67%, median age 54 years, range 18-92 years, 44% males, 75% of cases from a rural environment) agreed to participate. Skin prick tests to SMs (Lepidoglyphus destructor and Tyrophagus putrescentiae), house dust mite (Dermatophagoides pteronyssinus), pollens, moulds and animal danders were performed in all cases. Wheals >or= 4 mm were considered positive. Epidemiological data were assessed by questionnaire. A design-based analysis was performed and all calculations were weighted to give unbiased estimates. RESULTS: Tyrophagus putrescentiae and L. destructor were the leading causes of allergic sensitization throughout all ages. SM sensitization was found in 104 cases (weighted value 24.4%, 95% CI 20.6-28.2). SM sensitization was inversely associated with age. Multivariate analysis showed that SM sensitization was not significantly associated with sex, smoking, educational level, farming profession, rural environment, indoor humidity, presence of pets, livestock or grain storage facilities near home. CONCLUSIONS: SMs (T. putrescentiae and L. destructor) are major aeroallergens in adults in the region studied, even in subjects without occupational exposure.

Adolescent↗

A reason why measures to avoid mite-induced asthma are more effective in children than in adults.

Mite-sensitive asthmatics seem to respond more markedly to a reduction in mite allergen in the bedding if they are children than if they are adults. In order to investigate this difference, 882 children who attended our allergy clinic were studied. The accompanying parents were asked standardized questions, and skin prick tests to Dermatophagoides pteronyssinus and D. farinae were performed on the children. The number of hours that the children spent in bed lessened progressively with increasing age, from a mean of 13.6 hrs. for 1 year olds to 9.5 hrs for 17 yr olds: the mean for the total population was 12.0 hrs. This was significantly longer than the mean for the parents, 8.4 hrs (p=.000). It is likely that a longer period of exposure to mite allergen in bed is an important reason why children respond more markedly to avoidance measures in the bedroom than adults do.

Adolescent↗

Adhesion molecules in atopic dermatitis: patch tests elicited by house dust mite.

Different T-helper subsets, which are characterized by the secretion of distinct cytokines (Th1, Th2), have been found in house dust mite-exposed skin of sensitized individuals and in nickel-specific T lymphocytes from nickel contact allergic and non-allergic individuals. In order to evaluate the role which adhesion molecules may play in the homing of different T-cell subsets into allergen-exposed skin of atopic and normal individuals, we compared the expression pattern of adhesion molecules in patch test reactions to house dust mite antigen (D.pt.), nickel sulfate (Ni) and the irritant anthralin. Biopsies were taken at various time points after application of these agents and studied by immuncytochemistry. To exclude an endogenous difference in adhesion molecule expression in atopic and non-atopic skin, sequential biopsies from Ni patch tests of 2 normal individuals were also included in this study. The expression of E-selectin, P-selectin, CD31, VCAM-1 and ICAM-1 on endothelial cells and other cells in the skin was quantified by microscopic evaluation. Skin homing T cells were also quantified using antibodies to CD3, CD4, CD8, UCHL-1, L-selectin and the cutaneous lymphocyte antigen (CLA). Independent of the eliciting substance, all lesions showed an upregulation of all adhesion molecules tested, with the exception of CD62. The appearance of E-selectin and an increase in ICAM-1 and VCAM-1 expression were first observed at 12 h after application of the various agents. In parallel, the number of CLA+ and L-selectin+ lymphocytes increased steadily. No principle differences could be established between the various types of skin reactions in atopic individuals, nor did the skin of patients with AD differ from normal controls. Our results provide evidence that differential expression of adhesion molecules does not play a major part in observed differential homing of Th1 and Th2-cell subsets into patch test sites provoked by house dust mite and nickel sulfate in atopic and non-atopic individuals.

Animals↗

Transmission of Rickettsia tsutsugamushi strains among humans, wild rodents, and trombiculid mites in an area of Japan in which tsutsugamushi disease is newly endemic.

Thirty-two newly isolated strains of Rickettsia tsutsugamushi, 14 from patients with tsutsugamushi disease, 12 from wild rodents, and 6 from trombiculid mites parasitizing rodents in Gifu Prefecture, Japan, were examined for reactivities to 12 monoclonal antibodies by an indirect fluorescent-antibody test to classify their antigenicities. All of the isolates could be classified into one of six groups (KN-1, KN-2, KN-3, GJ-1, R158, and R161) according to their reactivities to the monoclonal antibodies. The KN-1 and GJ-1 strains that are prevalent among patients from Gifu Prefecture had the same reactivities as the Kawasaki and Kuroki strains, respectively, which have been isolated and are prevalent in the Miyazaki and Kagoshima prefectures in southwest Japan. The isolates from patients were different in serotype from those from rodents and mites (Leptotrombidium pallidum). The KN-2 and KN-3 strains were most prevalent among patients and among rodents and mites, respectively. No close similarity between KN-2 and other strains tested was observed. KN-3 is only a minor contributor to diseases in patients in Gifu Prefecture; however, it was proven that the same strain was prevalent in Niigata Prefecture in northern Japan. Thus, Gifu Prefecture is an area where southern, northern, and local strains are found. We hypothesize that humans are prone to infection with KN-2, GJ-1 (very similar to Kuroki), and KN-1 (very similar to Kawasaki), probably by infestation with Leptotrombidium scutellare. While both L. scutellare and L. pallidum parasitize wild rodents and may carry any rickettsial strain, the most virulent strain, KN-3, is predominant among wild rodents. Antigenic analysis using monoclonal antibodies to R. tsutsugamushi should be useful for epidemiological studies of infection with this organism.

Animals↗

Clinical significance of mites in urine.

We report a case where a mite egg found in urine caused diagnostic confusion. The possibility of gut or bladder mite infection should be entertained only after repeated identification of mites in urine or stool samples from a symptomatic patient with no other cause for the symptoms and where the possibilities of contamination and spurious infection have been excluded.

Adult↗

Acute myelitis with hyperIgEaemia and mite antigen specific IgE: atopic myelitis.

An occurrence of acute localised myelitis was recently seen in four adult patients with atopic dermatitis who had hyperIgEaemia and mite antigen specific IgE. The total and mite antigen specific IgE was therefore studied in serum samples from 19 consecutive patients with acute localised myelitis of unknown aetiology, 56 patients with clinically definite multiple sclerosis, and 40 healthy controls. The total IgE concentration was significantly higher in acute localised myelitis (median=360 U/ml) than in multiple sclerosis (median=52 U/ml, p<0.0001) and the controls (median=85 U/ml, p=0.0002). The specific IgE to Dermatophagoides pteronyssinus was found more often in patients with acute localised myelitis (95%) than in patients with multiple sclerosis (34%, p<0.0001) and the controls (35%, p<0.0001) and the specific IgE to Dermatophagoides farinae was similar (acute localised myelitis 79%, multiple sclerosis 29% (p<0.0001), controls 30%, (p=0.0003). Atopic dermatitis coexisted more commonly in patients with acute localised myelitis (37%) than in patients with multiple sclerosis (0%, p<0.0001) and the controls (7.5%, p=0.0089). Therefore, acute localised myelitis with hyperIgEaemia, in which atopy to mite antigens seems to exist, may be a distinct subtype of allergic myelitis-that is, atopic myelitis.

Adult↗

Resistance of the red poultry mite to pyrethroids in France.

The resistance of Dermanyssus gallinae, the red poultry mite, to a pyrethroid acaricide, permethrin, and to an organophosphate, dichlorvos, was examined on five French poultry farms which had experienced problems in controlling mite populations and on one farm with no problems. The concentration of permethrin required to kill 50 per cent of the mites on the five farms was between eight and 40 times the concentration required on the control farm. In contrast, no resistance to dichlorvos was detected. This is the first description of resistance to a pyrethroid in D gallinae in France.

Animals↗

Identification and characterisation of two allergens from the dust mite Acarus siro, homologous with fatty acid-binding proteins.

BACKGROUND: Dust mites are a major cause of allergic disease worldwide. The dust mite Acarus siro is an inducer of occupational allergy among farmers, but sensitisation has also been found in non-farming populations. METHODS: A degenerate primer was designed to the N-terminal amino acid sequence of a 15-kD IgE-binding protein in A. siro extract. The cDNA sequence was obtained by using reverse transcriptase polymerase chain reaction, standard cloning and sequencing techniques. The protein was expressed in Escherichia coli with a 6-histidine tag at its C-terminus. Immunoblotting of the recombinant protein and whole extract was performed using patient sera. RESULTS AND CONCLUSION: 15 and 17-kD allergens were identified in a fraction of A. siro extract. The cDNA of the 15-kD allergen was isolated, cloned and sequenced and the allergen was expressed as a recombinant protein. The calculated molecular weight of the cDNA-encoded protein is 14.2 kD. The predicted amino acid sequence has one potential N-glycosylation site at position 4-6 and a cytosolic fatty acid-binding protein signature at position 5-22. The protein has 64% sequence identity with Blo t 13, an allergen from the dust mite Blomia tropicalis, as well as homology with several other fatty acid-binding proteins (FABPs) from different organisms. The allergen was named Aca s 13 and was recognised strongly by 3 of 13 (23%) of the subjects investigated. The amino acid sequence of the 17-kD protein was partly determined and it also showed high sequence homology with Blo t 13 and FABPs.

Allergens↗

Evaluation of specific IgE to the recombinant group 2 mite allergens Lep d 2 and Tyr p 2 in the Pharmacia CAP system.

BACKGROUND: Several recombinant allergens have been shown to be potentially useful for diagnosis of IgE-mediated allergy, but only a few recombinant allergens are at present commercially available in serological assays for detection of specific IgE. The aim of this study was to evaluate the IgE binding to the recombinant major dust mite allergens rLep d 2 and rTyr p 2 and compare it with the IgE binding to the commercial mite extracts Lepidoglyphus destructor and Tyrophagus putrescentiae in the Pharmacia RAST CAP System. METHODS: The recombinant allergens rLep d 2 and rTyr p 2 were immobilised on ImmunoCAPs, and sera from 461 Swedish farmers who are frequently exposed to mites were analysed for specific IgE antibodies. Immunoblotting was performed to evaluate discrepancies between the results obtained with the recombinant and the commercial CAP assays. RESULTS: The IgE values of each recombinant assay significantly correlated with the IgE values of the corresponding commercial CAP assay. The sensitivity of the rLep d 2 assay was 73.3% and that of the rTyr p 2 assay, 60.5% of that provided by the commercial L. destructor and T. putrescentiae assays. Two subjects out of 416, who tested negative in the commercial L. destructor assay, were positive to rLep d 2. The corresponding figures for rTyr p 2 and the T. putrescentiae extract were 5/418. The possibility that these subjects were sensitised to L. destructor and T. putrescentiae could not be excluded. CONCLUSIONS: The data suggest that it may be possible to use rLep d 2 and rTyr p 2 on ImmunoCAPs to detect and quantify IgE antibodies to these, the major allergens of L. destructor and T. putrescentiae. It appears likely that the addition of just a few more recombinant L. destructor and T. putrescentiae allergens in the CAP assay will be sufficient for in vitro diagnosis of IgE mediated allergy to L. destructor and T. putrescentiae.

Allergens↗

The prevalence of parasite infestation and house dust mite sensitization in Gabonese schoolchildren.

BACKGROUND: Allergic diseases seem less prevalent in communities in less developed parts of the world, where parasite infections are highly prevalent. Altogether not much is known about the association between chronic infections with tissue and blood-dwelling parasites and atopy. METHODS: In an area in Gabon endemic for blood and tissue parasites, 520 schoolchildren were parasitologically examined and skin prick-tested for a set of common environmental aeroallergens. Levels of allergen-specific IgE and polyclonal IgE were measured. RESULTS: In schoolchildren schistosome and filarial infections increased with age, whereas malaria was more prevalent in younger children. In contrast to allergen sensitization that increased with age, skin test reactivity tended to decline. The number of children with mite-specific IgE antibodies (47%) by far exceeded the number responding to skin prick testing (11%). Mite sensitization was found to be the highest in children infected with schistosomes and/or filariae whereas skin test reactivity was lowest. The multiple logistic regression showed that the risk of a positive skin test was 8-fold higher with increasing levels of mite-specific IgE but was reduced by 72% when infected with blood stage helminths. CONCLUSIONS: Chronic blood and tissue parasite infections that are often capable of modulating immune responses in the host are negatively associated with skin test reactivity in a sensitized population.

Adolescent↗

Molecular basis of arthropod cross-reactivity: IgE-binding cross-reactive epitopes of shrimp, house dust mite and cockroach tropomyosins.

BACKGROUND: Shrimp may cross-react with other crustaceans and mollusks and nonedible arthropods such as insects (cockroach and chironomids), arachnids (house dust mites) and even nematodes. Since the muscle protein tropomyosin has been implicated as a possible cross-reacting allergen, this study characterized the IgE-binding epitopes in shrimp tropomyosin, Pen a 1, that cross-react with other allergenic invertebrate tropomyosins in house dust mites (Der p 10, Der f 10) and cockroaches (Per a 7). Pen a 1-reactive sera from shrimp-allergic subjects were used to evaluate the effect on IgE binding of different amino acid substitutions in Pen a 1 epitopes based on homologous sequences in Per a 7 and Der p 10/Der f 10. METHODS: Peptides were synthesized spanning the length of Pen a 1 IgE-binding epitopes and amino acid substitutions were performed based on homologous amino acid sequences from Per a 7 and Der p 10/Der f 10. RESULTS: 7/8 individually recognized Pen a 1 epitopes (2, 3a, 3b, 4, 5a, 5b and 5c) had an identical amino acid sequence with lobster allergen, Hom a 1, 4/8 (3a, 3b, 4 and 5a) with Der p 10 and Der f 10, and 5/8 (2, 3a, 3b, 4 and 5a) with Per a 7. In addition, even homologous regions of other arthropod tropomyosins that differ in one or more amino acids from the sequences of Pen a 1 epitopes are still recognized by shrimp-allergic IgE antibodies. In total, shrimp-allergic sera recognize 6/8 peptides homologous to Pen a 1 epitopes in Per a 7, 7/8 in Der p 10/Der f 10, and 7/8 epitopes in Hom a 1. CONCLUSIONS: The IgE recognition by shrimp-allergic individuals of identified and/or similar amino acid sequences homologous to Pen a 1 epitopes in mite, cockroach and lobster tropomyosins are the basis of the in vitro cross-reactivity among invertebrate species. Based on amino acid sequence similarity and epitope reactivity, lobster tropomyosin has the strongest and cockroach the least cross-reactivity with shrimp. The clinical relevance of these cross-reactivities in developing allergic reactions to different arthropods needs to be determined.

Adult↗

Comparison of conjunctival and nasal provocation test in allergic rhinitis to house dust mite.

BACKGROUND: Nasal allergen provocation tests (NPTs) are useful in confirming the diagnosis of allergic rhinitis, if data obtained by clinical history, skin tests and specific IgE determinations are not conclusive. Since NPTs are laborious, conjunctival provocation tests (CPTs) appear as an attractive alternative. The concordance of CPTs and NPTs with house dust mite allergen extract in sensitized and nonsensitized subjects should be evaluated. METHODS: 50 otherwise healthy subjects with self-reported house dust mite allergy and positive skin prick tests and serum specific IgE to Dermatophagoides pteronyssinus and 45 sex- and age-matched healthy controls without allergic symptoms were included. For NPTs, 100 microl allergen extract [10,000 allergy units (AU/ml)] were applied to the less congested nasal cavity. A clinical symptom score and active anterior rhinomanometry were employed to assess the response. For CPTs, 50 microl low-concentrated D. pteronyssinus extract (1,000 AU/ml), and if negative, 50 microl normally concentrated extract (10,000 AU/ml) were applied to the lower conjunctival sac. The response was assessed employing clinical symptom scores. RESULTS: NPTs and CPTs yielded concordant results in 90% of the subjects successfully tested (Cohen's kappa = 0.78, p < 0.0001). The diagnostic efficacy of the CPT, with the NPT as the reference method, was 89%, whether or not conjunctival symptoms had been reported in addition to rhinitis symptoms. Both techniques were judged almost equally uncomfortable. CONCLUSION: CPTs are an acceptable alternative to NPTs in patients with allergic rhinitis to house dust mite, even if they have no conjunctival symptoms.

Adult↗