Clinical Immunology & Allergy Division, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
Allergy. 2021 Jul;76(7):2177-2188. doi: 10.1111/all.14749. Epub 2021 Mar 6.
Sensitization to house dust mite (HDM) is a leading cause of allergic rhinitis and asthma. Despite more than 30 HDM-derived allergens having been identified to date, specific therapeutic approaches do not yet take into account the local sensitization profiles of patients. This study aimed to identify patterns of HDM sensitization in HDM-allergic adults living in distinct geographic areas, to inform the development of targeted diagnostic and therapeutic tools.
Serum samples from 685 HDM-allergic subjects from Canada, Europe, South Africa, and the USA were tested for levels of IgE specific for 17 micro-arrayed HDM allergens by ImmunoCAP Immuno Solid-phase Allergen Chip (ISAC) technology.
The results confirmed significant geographical variability in sensitization patterns and levels of IgE. In all areas, the major sensitizers were the group 1 and group 2 allergens and Der p 23. Der p 23 was a frequent sensitizer: 64% of the subjects had IgE specific for Der p 23, and 2.3% were monosensitized to it. In South Africa, Der p 23 was the dominant HDM allergen (86% prevalence) and Der p 7 achieved major allergen status (56%). IgE sensitization to HDM was influenced by asthmatic status, levels of allergen exposure, age, race-ethnicity and smoking status, but not by BMI.
Sensitization profiles to HDM allergens differ considerably among distinct geographic areas, with Der p 7 and Der p 23 being major sensitizers in South Africa. Such heterogeneity should be taken into account in the diagnosis and treatment of HDM-allergic patients.
尘螨（HDM）致敏是变应性鼻炎和哮喘的主要原因。尽管迄今为止已经鉴定出超过 30 种 HDM 衍生过敏原，但特定的治疗方法尚未考虑到患者的局部致敏情况。本研究旨在确定生活在不同地理区域的 HDM 过敏成人的 HDM 致敏模式，为开发靶向诊断和治疗工具提供信息。
通过 ImmunoCAP 免疫固相过敏原芯片（ISAC）技术，对来自加拿大、欧洲、南非和美国的 685 名 HDM 过敏患者的血清样本进行了针对 17 种微阵列 HDM 过敏原的 IgE 特异性检测。
研究结果证实了致敏模式和 IgE 水平存在显著的地理变异性。在所有地区，主要的致敏原都是第 1 组和第 2 组过敏原和 Der p 23。Der p 23 是一种常见的致敏原：64%的患者对 Der p 23 具有特异性 IgE，2.3%的患者对其呈单一致敏。在南非，Der p 23 是主要的 HDM 过敏原（86%的患病率），Der p 7 成为主要过敏原（56%）。对 HDM 的 IgE 致敏受哮喘状态、过敏原暴露水平、年龄、种族-民族和吸烟状况的影响，但不受 BMI 的影响。
HDM 过敏原的致敏谱在不同地理区域之间存在显著差异，在南非，Der p 7 和 Der p 23 是主要的致敏原。在诊断和治疗 HDM 过敏患者时，应考虑这种异质性。
