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Published on: May 30, 2020
[House dust mite allergy]
1Universitätsklinik für Rheumatologie, Inselspital Bern und Klinische Immunologie und Allergologie, Inselspital Bern.
Abstract:
House dust mites can be found all over the world where human beings live independent from the climate. Proteins from the gastrointestinal tract- almost all known as enzymes - are the allergens which induce chronic allergic diseases. The inhalation of small amounts of allergens on a regular base all night leads to a slow beginning of the disease with chronically stuffed nose and an exercise induced asthma which later on persists. House dust mites grow well in a humid climate - this can be in well isolated dwellings or in the tropical climate - and nourish from human skin dander. Scales are found in mattresses, upholstered furniture and carpets. The clinical picture with slowly aggravating complaints leads quite often to a delayed diagnosis, which is accidently done on the occasion of a wider spectrum of allergy skin testing. The beginning of a medical therapy with topical steroids as nasal spray or inhalation leads to a fast relief of the complaints. Although discussed in extensive controversies in the literature - at least in Switzerland with the cold winter and dry climate - the recommendation of house dust mite avoidance measures is given to patients with good clinical results. The frequent ventilation of the dwelling with cold air in winter time cause a lower indoor humidity. Covering encasings on mattresses, pillow, and duvets reduces the possibility of chronic contact with mite allergens as well as the weekly changing the bed linen. Another option of therapy is the specific immunotherapy with extracts of house dust mites showing good results in children and adults. Using recombinant allergens will show a better quality in diagnostic as well as in therapeutic specific immunotherapy.
Insights
House dust mites, found globally, cause chronic allergies through inhaled enzymes. Avoidance measures and immunotherapy offer effective relief for allergic rhinitis and asthma.
Area of Science:
- Allergy and Immunology
- Environmental Health
- Dermatology
Background:
- House dust mites are ubiquitous allergens found worldwide, thriving in humid conditions.
- Enzymes from mite gastrointestinal tracts are potent allergens inducing chronic respiratory diseases like asthma.
- Mite allergens accumulate in domestic environments, particularly in mattresses and carpets, feeding on human dander.
Purpose of the Study:
- To summarize the global prevalence and impact of house dust mite allergies.
- To discuss diagnostic challenges and therapeutic strategies for house dust mite-induced diseases.
- To highlight the efficacy of avoidance measures and immunotherapy.
Main Methods:
- Literature review of house dust mite allergenicity and clinical manifestations.
- Analysis of diagnostic approaches, including skin testing.
- Evaluation of therapeutic interventions such as topical steroids, avoidance strategies, and immunotherapy.
Main Results:
- Inhalation of mite allergens leads to chronic allergic rhinitis and persistent asthma.
- Delayed diagnosis is common due to slowly aggravating symptoms.
- House dust mite avoidance measures, like ventilation and encasings, show good clinical results.
- Specific immunotherapy with mite extracts is effective in both children and adults.
Conclusions:
- House dust mite allergy is a significant global health issue requiring effective management.
- Integrated therapeutic approaches combining avoidance, medication, and immunotherapy are crucial.
- Advancements in recombinant allergens promise improved diagnostics and therapeutics.
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