Early‐life house dust mite allergens, childhood mite sensitization, and respiratory outcomes

Abstract

Our study based on geographically spread regions, a large sample size, and a wide range of allergen concentration shows that HDM allergen concentrations vary across regions and that exposure during early life plays a role in the development of allergic sensitization but not in the development of respiratory outcomes.

Environmental determinants of allergy and asthma in early life

“…Subsequently, similar studies have provided evidence for a causal relationship between HDM sensitization early in life and allergic rhinitis, persistent wheeze, and asthma 63-67 . While sensitization has a positive correlation with asthma development, studies from European birth cohorts have established that exposure to HDM alone is not sufficient to incur an increased risk of asthma 68, 69 , indicating that IgE sensitization is the bridge between allergen exposure and asthma development; however, innate immune responses triggered by HDM have also been implicated in allergic disease pathogenesis 70 . Tovey et al suggest a nonlinear dose-response relationship between HDM exposure and development of allergic disease, with exposure to both very low and very high levels of allergen correlating with decreased risk of sensitization and asthma and exposure to intermediate levels of allergen correlating with increased risk 71 .…”

Special Considerations in Preschool Age

“…It is well-known that children who have been diagnosed with severe wheezing or asthma show more severe and more frequent wheezing patterns as well as hospitalizations if exposed to the allergens they are sensitized to [44]. Although house dust mite exposure during early life is a strong risk factor for allergic sensitization, studies conducted in Europe, Australia, and the USA have found no clear association between house dust mite allergen concentrations and the development of childhood wheezing or asthma [84][85][86]. However, children diagnosed with asthma and house dust mite sensitization between the ages of 3-17 showed fewer and milder exacerbations of existing asthma when avoiding house dust mite exposure by using special bedding [87].…”

A pilot study to investigate the influence of upper respiratory infections on IgE reactivity to food allergens

“…3 Early and persistent sensitization has been significantly associated with asthma persistence, 4 although such relationship is not dichotomous and can be influenced by quantitative and qualitative measurements of allergic sensitization. 5 Moreover, in the presence of allergic sensitization, an increased risk and severity of viral-induced upper respiratory tract infections (URTI) and asthma symptoms is noted. 6 At present, the effect of viral infections on IgE food reactivity remains unclear.…”