Sensitization to different mite species in German farmers: in vitro analyses.

Allergic airway diseases are often caused by house dust mites (HDM) and storage mites (SM), respectively, and we were recently able to demonstrate that symptomatic German farmers are frequently sensitized to different mite species. The present study aimed to obtain information on the protein and immunobiochemical characteristics of the extracts of the following mites: Dermatophagoides pteronyssinus, Dermatophagoides farinae, Acarus siro, Acarus farris, Lepidoglyphus destructor, Tyrophagus putrescentiae, Blomia tjibodas, Blomia topicalis, Blomia kulagini, Glycyphagus domesticus, Thyreophagus entomophagus, and Cheyletus eruditus. Specific IgE determinations were performed with EAST. The protein patterns of the mite extracts were studied by SDS-PAGE estimating the weighted-average molecular weights of the proteins. Using the Western blot technique, we determined the allergen pattern in several mite extracts. The allergens in each extract were classified in terms of the frequency of sensitization as major, intermediate, and minor allergens using allergograms. As already reported, a positive EAST to at least one mite was measured in 31/86 patients, and most sera were positive with several mite species. The majority of the mite extracts exhibited a very complex protein pattern according to SDS-PAGE. An allergen was found in Western blots of nearly all species equivalent to a molecular weight of 14 to 15 kD. This was, in our opinion, the first time that this particular allergen was detected in Blomia tjibodas and Glycyphagus domesticus. In conclusion, using EAST we were able to show that 36% of the German farmers tested were sensitized to SM. All mite extracts showed a complex protein pattern in the molecular weight range -95 kD to -10 kD. A common allergen band in the region of -14 to -15 kD was found in the majority of the mites studied, and it can be assumed that this corresponds with the group 2 allergen.

In vivo and in vitro sensitization to domestic mites in German urban and rural allergic patients.

Sensitization to domestic mites is common in Germany. The main objectives of this study were (1) to establish the rate of skin test sensitivity to Dermatophagoides pteronyssinus, Acarus siro, Lepidoglyphus destructor, and Tyrophagus putrescentiae in 512 consecutive patients evaluated for upper and/or lower respiratory complaints; (2) to verify how many of the patients with a positive skin test to at least one of the three storage mites were also skin test positive to D. pteronyssinus; and (3) to verify how many of the patients with at least one positive skin test to one of the storage mites previously mentioned were also sensitized, in vitro, to other mite species. A total of 512 consecutive patients with rhinitis and/or asthma, living in urban or rural areas of central Germany were skin tested with extracts of D. pteronyssinus, A. siro, L. destructor, and T. putrescentiae. In addition, specific IgE determinations to Euroglyphus maynei, Blomia tropicalis, Blomia tjibodas, Blomia kulagini, and Gohieria fusca were conducted in those individuals with a positive skin test to at least one of the storage mites used in skin testing. Of the 512 patients, 103 (20.1%; 77 urban dwellers and 26 farmers) reacted to at least one of the storage mites. From this latter group, 88 individuals (85.4%) also skin tested positive to D. pteronyssinus. In vitro specific IgE determinations revealed a high rate of sensitization to the other mite species studied. We conclude that sensitization to storage mites in Germany is frequently associated with sensitivity to D. pteronyssinus. Overall, skin test sensitivity to storage mites was greater in rural than in city dwellers. In vitro sensitization to B. tjibodas was also significantly greater in rural than in city dwellers.

S3-Guideline on allergy prevention: 2014 update: Guideline of the German Society for Allergology and Clinical Immunology (DGAKI) and the German Society for Pediatric and Adolescent Medicine (DGKJ).

The continued high prevalence of allergic diseases in Western industrialized nations combined with the limited options for causal therapy make evidence-based primary prevention necessary. The recommendations last published in the S3-guideline on allergy prevention in 2009 have been revised and a consensus reached on the basis of an up-to-date systematic literature search. Evidence was sought for the period between May 2008 and May 2013 in the Cochrane and MEDLINE electronic databases, as well as in the reference lists of recent review articles. In addition, experts were surveyed for their opinions. The relevance of retrieved literature was checked by means of two filter processes: firstly according to title and abstract, and secondly based on the full text of the articles. Included studies were given an evidence grade, and a bias potential (low/high) was specified for study quality. A formal consensus on the revised recommendations was reached by representatives of the relevant specialist societies and (self-help) organizations (nominal group process). Of 3,284 hits, 165 studies (one meta-analysis, 15 systematic reviews, 31 randomized controlled trials, 65 cohort studies, 12 case-control studies and 41 cross-sectional studies) were included and evaluated. Recommendations on the following remain largely unaltered: full breastfeeding for 4 months as a means of allergy prevention (hypoallergenic infant formula in the case of infants at risk); avoidance of overweight; fish consumption (during pregnancy/lactation and in the introduction of solid foods for infants); vaccination according to the recommendations of the German Standing Committee on Vaccination (Ständige Impfkommission, STIKO); avoidance of air pollutants and tobacco exposure and avoidance of indoor conditions conducive to the development of mold. The assertion that a reduction in house-dust mite allergen content as a primary preventive measure is not recommended also remains unchanged. The introduction of solid foods into infant diet should not be delayed. In the case of children at risk cats should not be acquired as domestic pets. Keeping dogs is not associated with an increased risk of allergy. The updated guideline includes a new recommendation to consider the increased risk of asthma following delivery by cesarean section. Additional statements have been formulated on pre- and probiotic agents, psychosocial factors, medications, and various nutritional components. Revising the guideline by using an extensive evidence base has resulted not only in an endorsement of the existing recommendations, but also in modifications and in the addition of new recommendations. The updated guideline enables evidence-based and up-to-date recommendations to be made on allergy prevention. ELECTRONIC SUPPLEMENTARY MATERIAL: Supplementary material is available for this article at 10.1007/s40629-014-0022-4 and is accessible for authorized users.