Dust mite allergy

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Dust mite allergy
Other namesHouse dust allergy
Specialty Allergist, immunologist
Symptoms Symptoms
Complications Bronchial asthma, allergic asthma, allergic rhinitis
Usual onsetEarly childhood
CausesMite droppings
PreventionAvoid dust mites or cutting down mite numbers
TreatmentAllergen immunotherapy
Medication Allergy shots (SCIT), HDM-SLIT tablet (SLIT)
A scanning electron micrograph of a female dust mite CSIRO ScienceImage 11085 A scanning electron micrograph of a female dust mite.jpg
A scanning electron micrograph of a female dust mite

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]

Contents

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. [4] Immunotherapy may be useful in those affected. [4] Subcutaneous injections have better evidence than under the tongue dosing. [5] Topical steroids as nasal spray or inhalation may be used. [6]

House dust mites (Dermatophagoides pteronyssinus) aggregate. House dust mites (5247397771).jpg
House dust mites (Dermatophagoides pteronyssinus) aggregate.

Severe dust mite infestation in the home has been linked to atopic dermatitis, and epidermal barrier damage has been documented. [7]

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. [13] 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

House dust mites are present indoors wherever humans live. [15] Positive tests for dust mite allergies are extremely common among people with asthma. Dust mites are microscopic arachnids whose primary food is dead human skin cells, but they do not live on living people. [16] They and their feces and other allergens are major constituents of house dust, but because they are so heavy they are not suspended for long in the air. They are generally found on the floor and other surfaces until disturbed (by walking, for example). [15] It could take between twenty minutes and two hours for dust mites to settle back out of the air.

Dust mites are a nesting species that prefer a dark, warm, and humid climate. They flourish in mattresses, bedding, upholstered furniture, and carpets. [17] Their feces include enzymes that are released upon contact with a moist surface, which can happen when a person inhales, and these enzymes can kill cells within the human body. [18] House dust mites did not become a problem until humans began to use textiles, such as western style blankets and clothing. [19]

Furniture

Furniture with wooden or leather surfaces reduces the dust mite population. [20]

Bed linen

Dust mite-proof encasements to mattress, pillow, and duvet prevent chronic contact with allergens. House dust mites (5247996458).jpg
Dust mite-proof encasements to mattress, pillow, and duvet prevent chronic contact with allergens.

Hot tumble drying a bed linen for 1 hour will kill 99% of mites therein. [21]

Weekly changing the bed linen reduces the risk of exposure to dust mites. [6]

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. [22]

Dust mite eggs are freeze tolerant (−70 °C for 30 minutes); hatching can normally be prevented by exposure of fabrics to: [23]

Dust mites drown in water. [21]

Good properties of anti-mite fabrics have been identified as being: [24]

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 22 °C (72 °F)). 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. [21]

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. [26] Allergen immunotherapy is the only treatment that alters the disease mechanism. [27]

Immunotherapy can be administered orally (as sublingual tablets [28] or sublingual drops), or by injections under the skin (subcutaneous). [29] Subcutaneous immunotherapy is the most common form and has the largest body of evidence supporting its effectiveness. [30]

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. [29] [ citation needed ] These shots can be given to children as young as 5 years old. [31]

Sublingual immunotherapy (SLIT)

House dust mite allergen extract
Clinical data
Trade names Odactra, Acarizax, Miticure, others
License data
Routes of
administration 		By mouth
ATC code
  • None
Legal status
Legal status

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) [35] and adults (18–65 years). [36] [37] [38] It treats house dust mite (HDM)-induced allergic rhinitis, with or without conjunctivitis. [38] It has been approved in Japan, Russia, Southeast Asia, Turkey, the Middle East, [39] New Zealand, and several European countries. [38] [40]

Further reading

Related Research Articles

<span class="mw-page-title-main">Allergy</span> Immune system response to a substance that most people tolerate well

Allergies, also known as allergic diseases, are various conditions caused by hypersensitivity of the immune system to typically harmless substances in the environment. These diseases include hay fever, food allergies, atopic dermatitis, allergic asthma, and anaphylaxis. Symptoms may include red eyes, an itchy rash, sneezing, coughing, a runny nose, shortness of breath, or swelling. Note that food intolerances and food poisoning are separate conditions.

An allergen is an otherwise harmless substance that triggers an allergic reaction in sensitive individuals by stimulating an immune response.

<span class="mw-page-title-main">House dust mite</span> Common name for several species of mite

House dust mites are various species of acariform mites belonging to the family Pyroglyphidae that are found in association with dust in dwellings. They are known for causing allergies.

<span class="mw-page-title-main">Allergic rhinitis</span> Nasal inflammation due to allergens in the air

Allergic rhinitis, of which the seasonal type is called hay fever, is a type of inflammation in the nose that occurs when the immune system overreacts to allergens in the air. Signs and symptoms include a runny or stuffy nose, sneezing, red, itchy, and watery eyes, and swelling around the eyes. The fluid from the nose is usually clear. Symptom onset is often within minutes following allergen exposure, and can affect sleep and the ability to work or study. Some people may develop symptoms only during specific times of the year, often as a result of pollen exposure. Many people with allergic rhinitis also have asthma, allergic conjunctivitis, or atopic dermatitis.

<span class="mw-page-title-main">Rhinitis</span> Irritation and inflammation of the mucous membrane inside the nose

Rhinitis, also known as coryza, is irritation and inflammation of the mucous membrane inside the nose. Common symptoms are a stuffy nose, runny nose, sneezing, and post-nasal drip.

<span class="mw-page-title-main">Food allergy</span> Hypersensitivity reaction to a food

A food allergy is an abnormal immune response to food. The symptoms of the allergic reaction may range from mild to severe. They may include itchiness, swelling of the tongue, vomiting, diarrhea, hives, trouble breathing, or low blood pressure. This typically occurs within minutes to several hours of exposure. When the symptoms are severe, it is known as anaphylaxis. A food intolerance and food poisoning are separate conditions, not due to an immune response.

<span class="mw-page-title-main">Allergic conjunctivitis</span> Medical condition

Allergic conjunctivitis (AC) is inflammation of the conjunctiva due to allergy. Although allergens differ among patients, the most common cause is hay fever. Symptoms consist of redness, edema (swelling) of the conjunctiva, itching, and increased lacrimation. If this is combined with rhinitis, the condition is termed allergic rhinoconjunctivitis (ARC).

<span class="mw-page-title-main">Allergen immunotherapy</span> Medical treatment for environmental allergies

Allergen immunotherapy, also known as desensitization or hypo-sensitization, is a medical treatment for environmental allergies and asthma. Immunotherapy involves exposing people to larger and larger amounts of allergens in an attempt to change the immune system's response.

<span class="mw-page-title-main">Atopy</span> Predisposition towards allergy

Atopy is the tendency to produce an exaggerated immunoglobulin E (IgE) immune response to otherwise harmless substances in the environment. Allergic diseases are clinical manifestations of such inappropriate, atopic responses.

<span class="mw-page-title-main">Hypoallergenic dog breed</span> Type of dog

A hypoallergenic dog breed is a dog breed that is purportedly more compatible with allergic people than are other breeds. However, prominent allergen researchers have determined that there is no basis to the claims that certain breeds are hypoallergenic and, while allergen levels vary among individual dogs, the breed is not a significant factor.

Allergies to cats, a type of animal allergy, are one of the most common allergies experienced by humans. Among the eight known cat allergens, the most prominent allergen is secretoglobin Fel d 1, which is produced in the anal glands, salivary glands, and, mainly, in sebaceous glands of cats, and is ubiquitous in the United States, even in households without cats. The second most common is Fel d 2, this type is triggered by the cats dead skin flakes (dander) that are floating in the air as well as in the smell of cat urine.

ALK-Abelló A/S, also commonly known as ALK, is a Denmark-based pharmaceutical company which specializes in the development and manufacturing of allergy immunotherapy (AIT) products for the prevention and treatment of allergy. It is one of the world's largest makers of allergy immunotherapy products with 67% of its revenue coming from sales in Europe.

<span class="mw-page-title-main">Pyroglyphidae</span> Family of mites

Pyroglyphidae is a family of non-parasitic mites. It includes the house dust mite that live in human dwellings, many species that live in the burrows and nests of other animals, and some pests of dried products stored in humid conditions.

<span class="mw-page-title-main">Peptidase 1 (mite)</span> Class of enzymes found in mites

Peptidase 1 (mite) (EC 3.4.22.65), also known as endopeptidase 1 (mite), is an enzyme found in various species of mites. This enzyme exhibits cysteine protease activity with broad endopeptidase specificity.

Oral mite anaphylaxis (OMA), also known as pancake syndrome, is a disease in which a person gets symptoms after eating food contaminated with particular mites. The disease name comes from reports of people becoming ill after eating pancakes made from contaminated wheat or corn (maize) flour.

<span class="mw-page-title-main">HAL Allergy Group</span>

HAL Allergy Group is a pharmaceutical company that develops, produces and sells products for allergy diagnostic and allergen immunotherapy (AIT). The research facilities and headquarters are located at the Leiden Bio Science Park, Netherlands.

<span class="mw-page-title-main">Allergies in children</span> Medical condition

Allergies in children, an incidence which has increased over the last fifty years, are overreactions of the immune system often caused by foreign substances or genetics that may present themselves in different ways. There are multiple forms of testing, prevention, management, and treatment available if an allergy is present in a child. In some cases, it is possible for children to outgrow their allergies.

<span class="mw-page-title-main">Fish allergy</span> Type of food allergy caused by fish

Fish allergy is an immune hypersensitivity to proteins found in fish. Symptoms can be either rapid or gradual in onset. The latter can take hours to days to appear. The former may include anaphylaxis, a potentially life-threatening condition which requires treatment with epinephrine. Other presentations may include atopic dermatitis or inflammation of the esophagus. Fish is one of the eight common food allergens which are responsible for 90% of allergic reactions to foods: cow's milk, eggs, wheat, shellfish, peanuts, tree nuts, fish, and soy beans.

<span class="mw-page-title-main">Shellfish allergy</span> Type of food allergy caused by shellfish

Shellfish allergy is among the most common food allergies. "Shellfish" is a colloquial and fisheries term for aquatic invertebrates used as food, including various species of molluscs such as clams, mussels, oysters and scallops, crustaceans such as shrimp, lobsters and crabs, and cephalopods such as squid and octopus. Shellfish allergy is an immune hypersensitivity to proteins found in shellfish. Symptoms can be either rapid or gradual in onset. The latter can take hours to days to appear. The former may include anaphylaxis, a potentially life-threatening condition which requires treatment with epinephrine. Other presentations may include atopic dermatitis or inflammation of the esophagus. Shellfish is one of the eight common food allergens, responsible for 90% of allergic reactions to foods: cow's milk, eggs, wheat, shellfish, peanuts, tree nuts, fish, and soy beans.

Anti-allergic agents are medications used to treat allergic reactions. Anti-allergic agents have existed since 3000 B.C in countries such as China and Egypt. It was not until 1933 when antihistamines, the first type of anti-allergic agents, were developed. Common allergic diseases include allergic rhinitis, allergic asthma and atopic dermatitis with varying symptoms, including runny nose, watery eyes, itchiness, coughing, and shortness of breath. More than one-third of the world's population is currently being affected by one or more allergic conditions.

References

  1. ↑ Alderman L (2011-03-04). "Who Should Worry About Dust Mites (and Who Shouldn't)". The New York Times. ISSN   0362-4331. Archived from the original on 19 February 2012.
  2. ↑ "Dust Mite Allergy" (PDF). NHS. Archived from the original (PDF) on 2020-04-26. Retrieved 2020-07-23.
  3. ↑ Ogg B. "Managing House Dust Mites" (PDF). Extension, Institute of Agriculture and Natural Resources, University of Nebraska–Lincoln. Retrieved 24 January 2019.
  4. 1 2 3 Biagtan M, Viswanathan R, Bush RK (December 2014). "Immunotherapy for house dust mite sensitivity: where are the knowledge gaps?". Current Allergy and Asthma Reports. 14 (12): 482. doi:10.1007/s11882-014-0482-0. PMC   5034865 . PMID   25354663.
  5. ↑ Eifan AO, Calderon MA, Durham SR (November 2013). "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. doi:10.1517/14712598.2013.844226. PMID   24099116.
  6. 1 2 3 Carrard A, Pichler C (April 2012). "[House dust mite allergy]". Therapeutische Umschau. Revue Therapeutique. 69 (4): 249–252. doi:10.1024/0040-5930/a000281. PMID   22477664.
  7. ↑ Cork MJ, Robinson DA, Vasilopoulos Y, Ferguson A, Moustafa M, MacGowan A, et al. (July 2006). "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. doi:10.1016/j.jaci.2006.04.042. PMID   16815133.
  8. ↑ "Dust mite allergy – Symptoms and causes". Mayo Clinic. Retrieved 2020-07-23.
  9. ↑ Lee YJ, Han SJ, Lee H, Kim JS, Seo KY (April 2016). "Development of Allergic Conjunctivitis Induced by House Dust Mite Extract From Dermatophagoides pteronyssinus". Investigative Ophthalmology & Visual Science. 57 (4): 1773–1781. doi: 10.1167/iovs.15-17340 . PMID   27074380.
  10. 1 2 Lopata AL, Kleine-Tebbe J, Kamath SD (November 2016). "Allergens and molecular diagnostics of shellfish allergy: Part 22 of the Series Molecular Allergology". Allergo Journal International. 25 (7): 210–218. doi:10.1007/s40629-016-0124-2. PMC   5306157 . PMID   28239537.
  11. ↑ Prester L (August 2016). "Seafood Allergy, Toxicity, and Intolerance: A Review". Journal of the American College of Nutrition. 35 (3): 271–283. doi:10.1080/07315724.2015.1014120. PMID   26252073. S2CID   1154235.
  12. ↑ Wong L, Tham EH, Lee BW (June 2019). "An update on shellfish allergy". Current Opinion in Allergy and Clinical Immunology. 19 (3): 236–242. doi:10.1097/ACI.0000000000000532. PMID   30893087.
  13. 1 2 Wong L, Huang CH, Lee BW (March 2016). "Shellfish and House Dust Mite Allergies: Is the Link Tropomyosin?". Allergy, Asthma & Immunology Research. 8 (2): 101–106. doi:10.4168/aair.2016.8.2.101. PMC   4713872 . PMID   26739402.
  14. ↑ Gelis S, Rueda M, Valero A, Fernández EA, Moran M, Fernández-Caldas E (July 2020). "Shellfish Allergy: Unmet Needs in Diagnosis and Treatment". Journal of Investigational Allergology & Clinical Immunology. 30 (6): 409–420. doi: 10.18176/jiaci.0565 . PMID   32694101.
  15. 1 2 "Dust Mites". American Lung Association. Archived from the original on 2022-12-23. Retrieved 2022-12-23.
  16. ↑ Australia H (2021-09-16). "Dust mites". www.healthdirect.gov.au. Archived from the original on 2022-12-23. Retrieved 2022-12-23.
  17. ↑ Perryman O (December 14, 2020). "How to Get Rid of Dust Floating in the Air using a Air Purifier?". Dehumidifier Critic. Archived from the original on May 17, 2021. Retrieved May 17, 2021.
  18. ↑ Abadi S (August 2009). "Hygiene Habits". AOL Health. AOL. Archived from the original on January 28, 2010. Retrieved May 17, 2021.
  19. ↑ Colloff MJ (2009). Dust Mites. Dordrecht: Springer Science+Business Media. doi:10.1007/978-90-481-2224-0. ISBN   978-90-481-2224-0. OCLC   664094692.
  20. 1 2 "Dust mite-proof pillow cover: MedlinePlus Medical Encyclopedia Image". MedlinePlus. 2019-03-07. Retrieved 2019-03-14.
  21. 1 2 3 Portnoy J, Miller JD, Williams PB, Chew GL, Miller JD, Zaitoun F, et al. (December 2013). "Environmental assessment and exposure control of dust mites: a practice parameter". Annals of Allergy, Asthma & Immunology. 111 (6): 465–507. doi:10.1016/j.anai.2013.09.018. PMC   5156485 . PMID   24267359.
  22. ↑ Pitten FA, Kalveram CM, Krüger U, Müller G, Kramer A (September 2000). "[Reduction of colonization of new mattresses with bacteria, moulds and house dust mites by complete mattress covers]" [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. doi:10.1007/s001050051190. PMID   11057391.
  23. ↑ Mahakittikun V, Boitano JJ, Ninsanit P, Wangapai T, Ralukruedej K (December 2011). "Effects of high and low temperatures on development time and mortality of house dust mite eggs". Experimental & Applied Acarology. 55 (4): 339–347. doi:10.1007/s10493-011-9480-2. PMID   21751035.
  24. ↑ "Best Fabrics to Exclude Dust Mites". HouseDustMite.com. Archived from the original on 27 September 2018. Retrieved 24 January 2019.
  25. ↑ "House dust mite excrements/ faeces HDM excrements". Citeq Biologics. 1 October 2018.
  26. ↑ 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. doi:10.1016/j.allerg.2006.10.006.
  27. ↑ Creticos P. "Subcutaneous immunotherapy for allergic disease: Indications and efficacy". UpToDate.
  28. ↑ Wolfson AR (2021-02-10). "Can dust mite allergy be treated with a pill?". Harvard Health. Retrieved 2022-04-28.
  29. 1 2 Dust mite allergies: Allergen-specific immunotherapy (desensitization) in the treatment of allergies. Institute for Quality and Efficiency in Health Care (IQWiG). 2020-04-23.
  30. ↑ Calderon MA, Alves B, Jacobson M, Hurwitz B, Sheikh A, Durham S (January 2007). "Allergen injection immunotherapy for seasonal allergic rhinitis". The Cochrane Database of Systematic Reviews. 2007 (1): CD001936. doi:10.1002/14651858.CD001936.pub2. PMC   7017974 . PMID   17253469.
  31. ↑ "Allergy Shots (for Parents) – Nemours KidsHealth". kidshealth.org. Retrieved 2022-04-28.
  32. ↑ "Regulatory Decision Summary for Acarizax". Drug and Health Products Portal. 4 May 2017. Retrieved 14 April 2024.
  33. ↑ "Respiratory health". Health Canada . 9 May 2018. Retrieved 13 April 2024.
  34. ↑ "Odactra- dermatophagoides pteronyssinus and dermatophagoides farinae tablet". DailyMed. 11 May 2023. Retrieved 14 April 2024.
  35. ↑ "Acarizax 12 SQ-HDM – Summary of Product Characteristics (SmPC) – (emc)". www.medicines.org.uk. Retrieved 2022-04-28.
  36. ↑ "FDA approves Odactra for house dust mite allergies". U.S. Food and Drug Administration (FDA) (Press release). 2020-03-24. Retrieved 2022-04-28.
  37. ↑ "Odactra". U.S. Food and Drug Administration (FDA). 2022-02-07.
  38. 1 2 3 "ALK to accelerate launches of Odactra in the USA / Acarizax in Canada" (Press release). ALK Abello. 2017-08-21. Retrieved 2022-04-28– via Globe Newswire.
  39. ↑ "ALK partners with Abbott to sell Acarizax in South-East Asia". www.thepharmaletter.com. Retrieved 2022-04-28.
  40. ↑ "ALK Announces FDA Approval for its House Dust Mite Sublingual Allergy Immunotherapy Tablet (Acarizax in Europe)" (Press release). ALK Abello. Retrieved 2022-04-28– via PR Newswire.
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