Evaluation of exposure to mite allergens; flotation, ELISA and Acarex comparative study

House dust mites (HDM) are a major cause of allergic sensitization and airway disease. Technological advances in assays permit the measurement of major mite allergens in house dust samples more accurately. We compared the results of different methods in the assessment of exposure to domestic mites in sensitized patients. Three methods were used for mite assays on house dust samples: Mites were evaluated by microscope after flotation technique; major mite allergens. Der p l and Der f l, were determined by ELISA; the Acarex-Test was performed for the determination of guanine content. There was no significant difference between flotation and ELISA in the assessment of mite allergens. However, Acarex-Test was different from the other methods tested. being higher in skin test positive patients. We found a significant correlation between Der p l levels and mite specific immunoglobulin E determined by ELISA and CAP RAST respectively. Our findings show that mite determination by flotation method could be reinforced where the advanced methods are not available. Although the mite allergen levels measured in this study with various methods were not always in close association with house dust mite sensitization, the importance of mite-avoidance measure to house dust mites evaluated by skin tests and RAST should not be underestimated.