Clinical evaluation of a double‐blind dust‐mite avoidance trial with mite‐allergic rhinitic patients

Abstract

Inheritance and allergen exposure are key factors in the development and the course of atopic allergy, expressed as conjunctivitis, rhinitis, asthma or dermatitis. This study concerns the clinical significance of mite and mite-allergen avoidance measures based on intensive cleaning with acaricide (solidified benzylbenzoate) added (10 dwellings), and without biocidal activity (10 other homes) as a control in a double-blind trial with matched pairs. Twenty subjects with persisting rhinitic complaints were selected. They lived in 20 different dwellings and were all sensitized to pyroglyphid mites; 12 of them were also sensitized to stored product mites (Acari). Daily symptoms and medication score, guanine and dust exposure, total and mite-specific IgE in serum, eosinophilia in the blood and in the nasal smear, intracutaneous tests with house dust mite and storage mite extracts were compared in both pairs and groups. Acarological data, physiochemical aspects and exposure assessment are discussed in detail elsewhere. Symptom scores dropped significantly, as did the total IgE and exposure to dust and mite products in the acaricidal cleaner treatment group. After 1 year, the daily symptoms median was 47% (P = 0.025), total IgE was 38% (P = 0.0049), and exposure to dust and mite products (guanine exposure) was 53% (P = 0.0449) better or lower than in the controls. Intensive cleaning, without acaricidal treatment performed twice a year, resulted in clinical improvement in four out of 10 subjects, of whom none became free of complaints. In the Acarosan treatment group (cleaning + benzylbenzoate) eight out of 10 subjects improved, in three cases subjective symptoms disappeared.(ABSTRACT TRUNCATED AT 250 WORDS)

Allergen reduction measures in houses of allergic asthmatic patients: effects of air-cleaners and allergen-impermeable mattress covers

“…It is also clear that the application of air-cleaners alone will not be sufficient for effective reduction of exposure to indoor allergens, which is probably true, however, for most allergen avoidance measures [26][27][28]. In allergic asthmatic patients with a broad sensitization to inhalant allergens, a combination of different allergen reduction measures is generally necessary to obtain optimal improvement of clinical symptoms or airway parameters (PC20 histamine, peak flow variation, medication requirement).…”

The control of allergens of dust mites and domestic pets: a position paper

“…Of the six studies addressing this [135,136,140,[145][146][147], two contained no monitoring of allergens and cannot be interpreted in relationship to a reduction in allergen exposure [136,140]. Current recommendations are thus based on four studies, all of which reported benefit with a reduction in allergen exposure.…”

From allergen sources to reduction of allergen exposure

“…Complete eradication of dust mites and their allergens is up to now impossible [77]. However, mite allergen concentrations can be reduced by a combination of methods using acaricides [78,79], with methods to separate mites from the sleeper by encasing mattresses, and further systems for decreasing humidity in the indoor environment [80]. Domestic pets, especially cats, are also a leading cause of asthma.…”