Dust mite allergy explained

Dust mite allergy
Synonyms:House dust allergy
Specialty:Allergist, immunologist
Symptoms:Symptoms
Complications:Bronchial asthma, allergic asthma, allergic rhinitis
Onset:Early childhood
Causes:Mite droppings
Prevention:Avoid dust mites or cutting down mite numbers
Management:Cutting down mite numbers
Treatment:Allergen immunotherapy
Medication:Allergy shots (SCIT), HDM-SLIT tablet (SLIT)

Dust mite allergy, also known as house dust allergy, is a sensitization and allergic reaction to the droppings of house dust mites. The allergy is common[1] [2] and can trigger allergic reactions such as asthma, eczema or itching. The mite's gut contains potent digestive enzymes (notably peptidase 1) that persist in their feces and are major inducers of allergic reactions such as wheezing. The mite's exoskeleton can also contribute to allergic reactions. Unlike scabies mites or skin follicle mites, house dust mites do not burrow under the skin and are not parasitic.[3]

The symptoms can be avoided or alleviated by a number of measures. In general, cutting down mite numbers may reduce these reactions while others say efforts to remove these mites from the environment have not been found to be effective. Immunotherapy may be useful in those affected. Subcutaneous injections have better evidence than under the tongue dosing.[4] Topical steroids as nasal spray or inhalation may be used.[5]

Severe dust mite infestation in the home has been linked to atopic dermatitis, and epidermal barrier damage has been documented.[6]

Symptoms

Dust mite allergy symptoms include:

If the dust mite allergy contributes to asthma:

Cross-reactivity to shellfish allergy

Tropomyosin, a minor allergen in dust mites, is also responsible for shellfish allergy.[10] [11] Exposure to inhaled tropomyosins from dust mites is thought to be the primary sensitizer for shellfish allergy, an example of inhalant-to-food cross-reactivity.[12] Epidemiological surveys have confirmed correlation between shellfish and dust mite sensitizations. An additional confirmation was seen in Orthodox Jews with no history of shellfish consumption, in that skin tests confirming dust mite allergy were also positive for shellfish tropomyosin.[10] [13] In addition to tropomyosin, the proteins arginine kinase and hemocyanin seem to have a role in cross-reactivity to dust mites.[14]

Prevention

Furniture

Furniture with wooden or leather surfaces reduces the dust mite population.

Bed linen

Hot tumble drying a bed linen for 1 hour will kill 99% of mites therein.

Weekly changing the bed linen reduces the risk of exposure to dust mites.

Cotton covers not covered with complete mattress covers are very likely to become colonized by bacteria and molds; they must be cleaned periodically (at least every second to third month). Here, the dust mites are beneficial as they return cotton to its original state after it has degraded by contact with bare skin.[15]

Dust mite eggs are freeze tolerant (−70 °C for 30 minutes); hatching can normally be prevented by exposure of fabrics to:[16]

Dust mites drown in water.

Good properties of anti-mite fabrics have been identified as being:[17]

Indoor climate

Allergy patients are advised to keep the relative humidity below 50%, if possible. Very few mites can survive if the humidity is less than 45% (at). However, they can survive if the humidity is high just for an hour and a half per day, for example due to moisture released to the air when cooking food.[19]

Treatment

Allergen immunotherapy

Allergen immunotherapy (AIT, also known as desensitization or hypo-sensitization) is a treatment involved in administering the doses of allergens to accustom the body to substances that are generally harmless (pollen, house dust mites), thereby inducing specific long-term tolerance.[20] Allergen immunotherapy is the only treatment that alters the disease mechanism.[21]

Immunotherapy can be administered orally (as sublingual tablets[22] or sublingual drops), or by injections under the skin (subcutaneous).[23] Subcutaneous immunotherapy is the most common form and has the largest body of evidence supporting its effectiveness.[24]

Subcutaneous immunotherapy

Subcutaneous Immunotherapy (SCIT) also known as Allergy Shots are series of shots/injections of the allergen given into the fat under the skin that have progressively larger amounts of allergen. These shots can be given to children as young as 5 years old.[25]

Sublingual immunotherapy (SLIT)

Drug Name:House dust mite allergen extract
Tradename:Odactra, Acarizax, Miticure, others
Dailymedid:Dermatophagoides pteronyssinus
Routes Of Administration:By mouth
Atc Prefix:None
Legal Ca:Rx-only
Legal Ca Comment:[26] [27]
Legal Us:Rx-only
Legal Us Comment:[28]

HDM-SLIT tablet, House Dust Mites (Dermatophagoides farinae and Dermatophagoides pteronyssinus) Allergen Extract (brand names: Odactra, Acarizax, Miticure), is an allergen extract for the immunotherapic treatment of adolescents (12–17 years)[29] and adults (18–65 years).[30] [31] [32] It treats house dust mite (HDM)-induced allergic rhinitis, with or without conjunctivitis. It has been approved in Japan, Russia, Southeast Asia, Turkey, the Middle East,[33] New Zealand, and several European countries.[34]

Further reading

External links

Notes and References

  1. News: Alderman L . 2011-03-04. Who Should Worry About Dust Mites (and Who Shouldn't) . en-US . The New York Times . 2020-07-23 . 0362-4331.
  2. Dust Mite Allergy. NHS. 2020-07-23. 2020-04-26. https://web.archive.org/web/20200426125759/https://www.thh.nhs.uk/documents/_Patients/PatientLeaflets/paediatrics/allergies/PI018-Dust_Mite_Allergy_A4_May13.pdf. dead.
  3. Web site: Ogg B . Managing House Dust Mites. 24 January 2019. Extension, Institute of Agriculture and Natural Resources, University of Nebraska–Lincoln.
  4. Eifan AO, Calderon MA, Durham SR . Allergen immunotherapy for house dust mite: clinical efficacy and immunological mechanisms in allergic rhinitis and asthma . Expert Opinion on Biological Therapy . 13 . 11 . 1543–1556 . November 2013 . 24099116 . 10.1517/14712598.2013.844226 .
  5. Carrard A, Pichler C . [House dust mite allergy] . Therapeutische Umschau. Revue Therapeutique . 69 . 4 . 249–252 . April 2012 . 22477664 . 10.1024/0040-5930/a000281 .
  6. Cork MJ, Robinson DA, Vasilopoulos Y, Ferguson A, Moustafa M, MacGowan A, Duff GW, Ward SJ, Tazi-Ahnini R . New perspectives on epidermal barrier dysfunction in atopic dermatitis: gene-environment interactions . The Journal of Allergy and Clinical Immunology . 118 . 1 . 3–21; quiz 22–3 . July 2006 . 16815133 . 10.1016/j.jaci.2006.04.042 .
  7. Web site: Dust mite allergy – Symptoms and causes. 2020-07-23. Mayo Clinic. en.
  8. Biagtan M, Viswanathan R, Bush RK . Immunotherapy for house dust mite sensitivity: where are the knowledge gaps? . Current Allergy and Asthma Reports . 14 . 12 . 482 . December 2014 . 25354663 . 5034865 . 10.1007/s11882-014-0482-0 .
  9. Lee YJ, Han SJ, Lee H, Kim JS, Seo KY . Development of Allergic Conjunctivitis Induced by House Dust Mite Extract From Dermatophagoides pteronyssinus . Investigative Ophthalmology & Visual Science . 57 . 4 . 1773–1781 . April 2016 . 27074380 . 10.1167/iovs.15-17340 . free .
  10. Lopata AL, Kleine-Tebbe J, Kamath SD . Allergens and molecular diagnostics of shellfish allergy: Part 22 of the Series Molecular Allergology . Allergo Journal International . 25 . 7 . 210–218 . November 2016 . 28239537 . 5306157 . 10.1007/s40629-016-0124-2 .
  11. Prester L . Seafood Allergy, Toxicity, and Intolerance: A Review . Journal of the American College of Nutrition . 35 . 3 . 271–283 . August 2016 . 26252073 . 10.1080/07315724.2015.1014120 . 1154235 .
  12. Wong L, Tham EH, Lee BW . An update on shellfish allergy . Current Opinion in Allergy and Clinical Immunology . 19 . 3 . 236–242 . June 2019 . 30893087 . 10.1097/ACI.0000000000000532 .
  13. Wong L, Huang CH, Lee BW . Shellfish and House Dust Mite Allergies: Is the Link Tropomyosin? . Allergy, Asthma & Immunology Research . 8 . 2 . 101–106 . March 2016 . 26739402 . 4713872 . 10.4168/aair.2016.8.2.101 .
  14. Gelis S, Rueda M, Valero A, Fernández EA, Moran M, Fernández-Caldas E . Shellfish Allergy: Unmet Needs in Diagnosis and Treatment . Journal of Investigational Allergology & Clinical Immunology . 30 . 6 . 409–420 . July 2020 . 32694101 . 10.18176/jiaci.0565 . free .
  15. Pitten FA, Kalveram CM, Krüger U, Müller G, Kramer A . [Reduction of colonization of new mattresses with bacteria, moulds and house dust mites by complete mattress covers] . Der Hautarzt; Zeitschrift Fur Dermatologie, Venerologie, und Verwandte Gebiete . 51 . 9 . 655–660 . September 2000 . 11057391 . 10.1007/s001050051190 . Reduction of colonization of new mattresses with bacteria, moulds and house dust mites by complete mattress covers .
  16. Mahakittikun V, Boitano JJ, Ninsanit P, Wangapai T, Ralukruedej K . Effects of high and low temperatures on development time and mortality of house dust mite eggs . Experimental & Applied Acarology . 55 . 4 . 339–347 . December 2011 . 21751035 . 10.1007/s10493-011-9480-2 .
  17. Web site: Best Fabrics to Exclude Dust Mites . HouseDustMite.com . 24 January 2019 . 27 September 2018 . https://web.archive.org/web/20180927053346/http://housedustmite.com/best-fabrics-to-exclude-dust-mites . dead .
  18. Web site: House dust mite excrements/ faeces HDM excrements . Citeq Biologics . 1 October 2018.
  19. Portnoy J, Miller JD, Williams PB, Chew GL, Miller JD, Zaitoun F, Phipatanakul W, Kennedy K, Barnes C, Grimes C, Larenas-Linnemann D, Sublett J, Bernstein D, Blessing-Moore J, Khan D, Lang D, Nicklas R, Oppenheimer J, Randolph C, Schuller D, Spector S, Tilles SA, Wallace D . Environmental assessment and exposure control of dust mites: a practice parameter . Annals of Allergy, Asthma & Immunology . 111 . 6 . 465–507 . December 2013 . 24267359 . 5156485 . 10.1016/j.anai.2013.09.018 .
  20. Van Overtvelt L, Batard T, Fadel R, Moingeon P . December 2006 . Mécanismes immunologiques de l'immunothérapie sublinguale spécifique des allergènes . Revue Française d'Allergologie et d'Immunologie Clinique . 46 . 8 . 713–720 . 10.1016/j.allerg.2006.10.006.
  21. Web site: Subcutaneous immunotherapy for allergic disease: Indications and efficacy . UpToDate . Creticos P.
  22. Web site: Wolfson AR . 2021-02-10 . Can dust mite allergy be treated with a pill? . 2022-04-28 . Harvard Health . en.
  23. Book: Dust mite allergies: Allergen-specific immunotherapy (desensitization) in the treatment of allergies . 2020-04-23 . Institute for Quality and Efficiency in Health Care (IQWiG) . en.
  24. Calderon MA, Alves B, Jacobson M, Hurwitz B, Sheikh A, Durham S . Allergen injection immunotherapy for seasonal allergic rhinitis . The Cochrane Database of Systematic Reviews . 2007 . 1 . CD001936 . January 2007 . 17253469 . 7017974 . 10.1002/14651858.CD001936.pub2 .
  25. Web site: Allergy Shots (for Parents) – Nemours KidsHealth . 2022-04-28 . kidshealth.org.
  26. Web site: Regulatory Decision Summary for Acarizax . Drug and Health Products Portal . 4 May 2017 . 14 April 2024.
  27. Web site: Respiratory health . . 9 May 2018 . 13 April 2024.
  28. Web site: Odactra- dermatophagoides pteronyssinus and dermatophagoides farinae tablet . DailyMed . 11 May 2023 . 14 April 2024.
  29. Web site: Acarizax 12 SQ-HDM – Summary of Product Characteristics (SmPC) – (emc) . 2022-04-28 . www.medicines.org.uk.
  30. 2020-03-24 . FDA approves Odactra for house dust mite allergies . 2022-04-28 . U.S. Food and Drug Administration (FDA) .
  31. Web site: 2022-02-07 . Odactra . U.S. Food and Drug Administration (FDA) .
  32. 2017-08-21 . ALK to accelerate launches of Odactra in the USA / Acarizax in Canada . 2022-04-28 . ALK Abello . Globe Newswire .
  33. Web site: ALK partners with Abbott to sell Acarizax in South-East Asia . 2022-04-28 . www.thepharmaletter.com.
  34. ALK Announces FDA Approval for its House Dust Mite Sublingual Allergy Immunotherapy Tablet (Acarizax in Europe) . 2022-04-28 . ALK Abello . PR Newswire .

This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Dust mite allergy".

Except where otherwise indicated, Everything.Explained.Today is © Copyright 2009-2024, A B Cryer, All Rights Reserved. Cookie policy.