House dust mite asthma. Correlation between allergen sensitivity in various organs

Area of Science:

• Allergy and Immunology
• Pulmonology
• Clinical Diagnostics

Background:

• House dust mite (Dermatophagoides pteronyssinus, Dp) allergy is a common trigger for asthma.
• Hyposensitization is a treatment option for allergic asthma.
• Evaluating organ-specific sensitivity to allergens is crucial for accurate diagnosis.

Purpose of the Study:

• To assess the correlation between Dermatophagoides pteronyssinus (Dp) allergen sensitivity in different organs of asthmatic patients.
• To investigate the relationship between pulmonary allergen sensitivity and other allergy markers.
• To explore potential alternative diagnostic methods for bronchial allergen challenge.

Main Methods:

• Fifty asthmatics underwent bronchial, nasal, and conjunctival challenges with Dp, alongside histamine challenges.
• Skin prick tests (SPT), histamine release (HR) from blood cells, and serum anti-Dp-IgE (RAST) were performed.
• Analysis focused on 40 patients with positive reactions across all tests.

Main Results:

• Organ-specific sensitivity to Dp did not consistently parallel across individuals.
• A significant correlation was found between pulmonary allergen sensitivity and HR (r=0.65) and histamine sensitivity (r=0.47).
• Combined HR and non-specific bronchial reactivity explained 53% of bronchial allergen sensitivity variation; RAST and SPT showed weaker correlations.

Conclusions:

• Bronchial allergen challenge cannot be substituted by challenges in other organs due to unrelated mucosal sensitivities.
• Diagnosis should target the organ with primary clinical importance.
• Measuring non-specific bronchial reactivity and cellular allergen sensitivity may offer an alternative to direct bronchial allergen challenge, avoiding adverse reactions.