Der p 23 sensitization in patients with house dust mite respiratory allergy

Abstract

Background: The sensitization profile of patients allergic to house dust mites (HDM) and its molecular diagnosis may determine treatment and evolution of the disease. The present study investigates the prevalence of Der p 23 sensitization and its relation to asthma in a population of HDM-allergic patients.Methods: We conducted a cross-sectional study of 891 patients with HDM allergy with symptoms of rhinitis and 52.1% of them with asthma. Total and specific IgE (sIgE) was measured against Dermatophagoides pteronyssinus and its molecular components (Der p 1, Der p 2 and Der p 23) and the storage mite Lepidoglyphus destructor using ImmunoCAP. Prevalence of sensitization and levels of sIgE were analysed according to asthma diagnosis and asthma severity.Results: Der p 23 was the predominant allergen in this population (83.7%) but IgE levels were lower than those of sIgE to Der p 1 and Der p 2. A good correlation was found between sIgE to Der p 23 and the other allergens. A total of 8.2% patients were monosensitized to Der p 23. Asthma was more frequent in patients with positive sIgE against Der p 23 than in patients without this sensitization (52.8% vs 42.8%, p=0.027). A tendency to increase both total IgE and sIgE was observed in relation to the severity of asthma from intermittent mild asthma to persistent moderate asthma but a substantial decrease in total IgE and sIgE was detected in more severe asthmatics. Conclusion: Der p 23 might be a prevalent allergen in regions with high rates of HDM exposure. Even though sIgE levels against this allergen are usually low, its presence could increase the risk of asthma.

RNA viruses alter house dust mite physiology and allergen production with no detected consequences for allergenicity

“…However, the expression of major allergen Der p 23 was substantially induced by viral infection as confirmed by ELISA on WMC extracts. Der p 23 is the most recently identified major allergen and several studies have confirmed a high prevalence of Der p 23‐specific IgE in HDM‐sensitized human cohorts from different geographical locations (Celi et al, 2019; Muddaluru et al, 2021; Mueller et al, 2016; Romero‐Sánchez et al, 2022; Weghofer et al, 2013), which could even include a small percentage of monosensitized patients (Matos‐Semedo et al, 2019; Romero‐Sánchez et al, 2022). However, prevalence and serodominance (contribution to the total IgE binding) for Der p 23 have been very variable across studies, being substantially lower in some cases (Batard et al, 2016; Eder et al, 2020; Thomas, 2016).…”

“…Despite that the prevalence and serodominance (i.e., potency) of these minor allergens is expected to be low in human cohorts (Thomas, 2018), a clinically relevant contribution of Der p 3, 6 and 9 to allergy cannot be discarded since their serine protease activity exhibits additional IgE-independent immunoactivity (Jacquet, 2021;Reithofer & Jahn-Schmid, 2017).…”

“…For the sake of conciseness, further discussion on additional defence-related genes has been addressed as supplementary material (Text S3). (Celi et al, 2019;Muddaluru et al, 2021;Mueller et al, 2016;Romero-Sánchez et al, 2022;Weghofer et al, 2013), which could even include a small percentage of monosensitized patients (Matos-Semedo et al, 2019;Romero-Sánchez et al, 2022).…”

“…Of note, viral infection in Dp appears to be located in digestive epithelia , which is precisely the site where many of the allergens are expressed, including the three major allergens Der p 1, 2, and 23 (Herman et al, 2014;Park et al, 2000;Weghofer et al, 2013). It is therefore possible that viral infection might affect the production of allergens or other immunoactive factors such as digestive proteases, among others (Jacquet, 2021;Reithofer & Jahn-Schmid, 2017).…”

Allergen Sensitization in Patients with Skin Diseases in Shanghai, China

“…Otero et al reported that the intensity of the response may correlate significantly with disease severity. 22 Moreover, ~99% of patients were co-sensitized to D. farinae and D. pteronyssinus,…”