House dust mite allergens in Saudi Arabia: Regional variations and immune response

In order to assess the causative extrinsic allergic factor(s) in school-age children diagnosed as having bronchial asthma and allergic rhinitis, and to qualitatively and quantitatively evaluate the presence of house dust mites (HDMs) in the homes of these children in Saudi Arabia, a study analyzing mite contents in 165 samples collected from patientsâ indoor environment was conducted. The dust samples were collected from four regions of Saudi Arabia, showing variation in their geography and climate. Immunochemical assays were performed using ALK reagents by ELISA technique. A total of 462 children were also tested using skin prick test (SPT) method for IgE-mediated reactions to HDMs. The samples from the Central dry region revealed a very low amount of the potent house dust mites (Dermatophagoides pteronyssinus and D. farinae, the two dominant species in various parts of the world). The samples from the Southern mountainous region contained a very high concentration of Der p I (84,000 ng/g of dust), while the Western coastal region showed a high concentration of Der f I (up to 22,000 ng/g). The mid-Western agricultural region did not exhibit any significant level of either Der p I or Der f I. The maximum level of D. pteronyssinus detected in the Central dry region was 106 ng/g of dust. The data exhibit both qualitative and quantitative variations of HDMs in the three regions and may be attributed to variation in geography and climate, particularly humidity of the regions, which vary significantly. Riyadh in the Central region is considered to have low humidity (<40%), while humidity in the Western coastal region, Jeddah, and the Southern region of Abha is comparatively higher, which helps house dust mites thrive. SPT results in these regions with house dust mite allergens (in addition to other common inhalant allergens) also revealed a considerable number of IgE-mediated reactions, consistent with the frequency of house dust mites in the region. Though more data are being accumulated on the subject to conduct a statistical comparison and more skin tests are underway in the Southern region, the study suggests the presence of at least two HDMs as well as qualitative diversity and quantitative variation of house dust mites in Saudi Arabia. The study also indicates, with a considerable number of IgE-mediated reactions, the possible influence of mites in the allergic manifestations of many patients, which is not only common, but increasing in parts of the country.