Association Between Asthma and Sensitization to Allergens of Dermatophagoides pteronyssinus.

BACKGROUND AND OBJECTIVE: Little is known about the role of molecular diagnosis in house dust mite (HDM) allergy. In this study, we investigated the association between the sensitization profile of adolescent and adult HDM-allergic patients and asthma in a region with high rates of exposure to HDM. METHODS: We conducted a cross-sectional study of 384 HDM-allergic patients (38.5%, males; median age, 28 years). A total of 368 patients (95.8%) had rhinitis, and 175 (45.6%) had asthma. Specific IgE (sIgE) to Dermatophagoides pteronyssinus, nDer p 1, rDer p 2, and rPen a 1 was measured in all patients. sIgE to Lepidoglyphus destructor was measured in patients (n=301) with a positive skin test result. RESULTS: Significantly higher concentrations of sIgE to Der p 1 and sIgE to Der p 2 were observed in patients with asthma than in those without asthma. The proportion of asthmatic patients was higher among individuals who reacted (≥0.35 kUA/L) to both Der p 1 and Der p 2 (147/291, 50.5%) than among those who reacted to only 1 allergen (either Der p 1 or Der p 2, 18/55, 32.7%) or neither allergen (10/38, 26.3%, P=.002). Reactivity to both allergens was associated with asthma after adjusting for age and sex (OR, 2.87; 95%CI, 1.32-6.20). Higher concentrations of sIgE to L destructor were observed in patients with asthma than in patients without asthma. Tropomyosin sIgE ≥0.35 kUA/L was detected in only 6 individuals (1.6%). CONCLUSIONS: L destructor may be a relevant allergen in high-exposure areas. Dual sensitization (ie, IgE to both Der p 1 and Der p 2) may help to identify HDM-allergic patients who are at risk of asthma.

Association between asthma and sensitization to allergens of dermatophagoides pteronyssinus

Background: Little is known about the role of molecular diagnosis in house dust mite (HDM) allergy. Objective: In this study, we investigated the association between the sensitization profile of adolescent and adult HDM-allergic patients and asthma in a region with high rates of exposure to HDM. Methods: We conducted a cross-sectional study of 384 HDM-allergic patients (38.5%, males; median age, 28 years). A total of 368 patients (95.8%) had rhinitis, and 175 (45.6%) had asthma. Specific IgE (sIgE) to Dermatophagoides pteronyssinus, nDer p 1, rDer p 2, and rPen a 1 was measured in all patients. sIgE to Lepidoglyphus destructor was measured in patients (n=301) with a positive skin test result. Results: Significantly higher concentrations of sIgE to Der p 1 and sIgE to Der p 2 were observed in patients with asthma than in those without asthma. The proportion of asthmatic patients was higher among individuals who reacted (≥0.35 kU A /L) to both Der p1 and Der p 2 (147/291, 50.5%) than among those who reacted to only 1 allergen (either Der p 1 or Der p 2, 18/55, 32.7%) or neither allergen (10/38, 26.3%, P=.002). Reactivity to both allergens was associated with asthma after adjusting for age and sex (OR, 2.87; 95%CI, 1.32-6.20). Higher concentrations of sIgE to L destructor were observed in patients with asthma than in patients without asthma. Tropomyosin sIgE ≥0.35 kUA L was detected in only 6 individuals (1.6%). Conclusions: L destructor may be a relevant allergen in high-exposure areas. Dual sensitization (ie, IgE to both Der p 1 and Der p 2) may help to identify HDM-allergic patients who are at risk of asthma (AU)

Antecedentes: El papel del diagnóstico molecular en la alergia a los ácaros no ha sido estudiado en profundidad. Objetivo: Investigar el perfil molecular de sensibilización de pacientes adolescentes y adultos alérgicos a los ácaros del polvo doméstico y su relación con asma en una región en donde la exposición a los ácaros es importante. Métodos: Estudio transversal en 384 pacientes alérgicos a los ácaros (38,5% varones; edad media, 28 años) de los que 368 (95,8%) padecían rinitis y 175 (45,6%), asma. Se determinó la IgE específica (sIgE) frente a D. pteronyssinus, nDer p 1, rDer p 2, y rPen a 1 en toda la muestra. Además, se midió la sIgE frente a L. destructor en 301 con una prueba positiva frente a este ácaro. Resultados: Los pacientes con asma presentaron niveles significativamente más altos de sIgE frente a Der p 1 y a Der p 2 que aquellos que no padecían asma. La prevalencia de asma fue mayor en los pacientes con sIgE positiva (≥0,35 kU A /L) frente a ambos Der p 1 y Der p 2 (147/291, 50,5%) que entre los sujetos que tan solo presentaron sIgE frente a uno de estos alérgenos (Der p 1 o Der p 2, 18/55, 32,7%) o ninguno de ellos (10/38, 26,3%, p=0,002). La detección de sIgE frente a ambos alérgenos se asoció con asma aún después de ajustar por edad o sexo (OR 2,87, 95% CI 1,32-6,20). Los pacientes con asma presentaron, asimismo, títulos más altos de IgE total y sIgE frente a L. destructor-sIgE. Solo 6 pacientes (1,6%) presentaron niveles de sIgE frente a la tropomiosina superiores a 0,35 kUA /L. Conclusiones: L. destructor puede ser un alérgeno relevante en áreas en las que se encuentre presente. La doble sensibilización a Der p 1 y Der p 2 podría ser de utilidad para identificar sujetos con riesgo de asma (AU)

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