Correlation patterns among house dust mite allergens in allergic rhinitis: A molecular sensitization study in...

Molecular characterization of house dust mite (HDM) and storage mite allergens provides valuable insights into sensitization patterns; however, relationships among different mite allergens and their clinical implications remain unclear.

A total of 100 patients with allergic rhinitis sensitized to Dermatophagoides pteronyssinus were analyzed. Specific IgE (sIgE) levels were measured using singleplex and multiplex assays. Correlations among mite allergens and their associations with clinical and demographic variables were evaluated.

The median sIgE level to Der p was 15.8 kU/L (IQR: 50.25); no relevant Dermatophagoides spp. sensitization was found below 2 kU/L. Among patients with Der p >10 kU/L, 59 of 60 had significant sIgE to at least one major HDM allergen. The highest prevalence was for Der p 1 (92%), though its median level was low (3.19 kU/L, IQR: 8.18). Conversely, Der f 2 had the highest median sIgE (23.4 kU/L, IQR: 33.74). Multivariate analysis revealed that most allergen levels were predictable from clusters of other mite allergens (R²=0.27-0.98). Mite allergen sIgE (Aca s, Blo t 5/10/21, Der f 1/2, Der p 1/2/5/7) correlated positively with sensitization number. sIgE levels negatively correlated with age and positively correlated with atopic dermatitis (Der p 1/2/23, Der f 1/2), asthma (Aca s, Der p 21), food allergy (Aca s, Der f 1, Der p 1), and rural residence (Der p 7).

Der p source allergen reliably excludes clinically relevant sIgE to HDM components. The correlations among mite allergens highlight challenges in clinical relevance assessment, emphasizing the need for component-resolved diagnostics to optimize immunotherapy responses.