Effect of a change to mite-free bedding on children with mite-sensitive asthma: a controlled trial.

Burr, Michael Leslie; Neale, Elizabeth P.; Dean, BB; Verrier-Jones, E. R.

doi:10.1136/thx.35.7.513

Cited by 63 publications

(24 citation statements)

References 2 publications

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“…Six studies used chemical methods to reduce exposure to mites, 91112161724 13 used physical methods, 5 – 8131518 – 222526 and four used a combination of methods. 10111423 Five studies did not assess the reduction of the population of mites 615182226.…”

Section: Resultsmentioning

confidence: 99%

House dust mite control measures in the management of asthma: meta-analysis

Gøtzsche

Hammarquist

Burr

1998

BMJ

192

110

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Objective To determine whether patients with asthma who are sensitive to mites benefit from measures designed to reduce their exposure to house dust mite antigen in the home. Design Meta-analysis of randomised trials that investigated the effects on asthma patients of chemical or physical measures to control mites, or both, in comparison with an untreated control group. All trials in any language were eligible for inclusion. Subjects Patients with bronchial asthma as diagnosed by a doctor and sensitisation to mites as determined by skin prick testing, bronchial provocation testing, or serum assays for specific IgE antibodies. Main outcome measures Number of patients whose allergic symptoms improved, improvement in asthma symptoms, improvement in peak expiratory flow rate. Outcomes measured on different scales were combined using the standardised effect size method (the difference in effect was divided by the standard deviation of the measurements). Results 23 studies were included in the meta-analysis; 6 studies used chemical methods to reduce exposure to mites, 13 used physical methods, and 4 used a combination. Altogether, 41/113 patients exposed to treatment interventions improved compared with 38/117 in the control groups (odds ratio 1.20, 95% confidence interval 0.66 to 2.18). The standardised mean difference for improvement in asthma symptoms was − 0.06 (95% confidence interval − 0.54 to 0.41). For peak flow rate measured in the morning the standardised mean difference was − 0.03 ( − 0.25 to 0.19). As measured in the original units this difference between the treatment and the control group corresponds to − 3 l/min (95% confidence interval − 25 l/min to 19 l/min). The results were similar in the subgroups of trials that reported successful reduction in exposure to mites or had long follow up times. Conclusion Current chemical and physical methods aimed at reducing exposure to allergens from house dust mites seem to be ineffective and cannot be recommended as prophylactic treatment for asthma patients sensitive to mites.

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Section: Resultsmentioning

confidence: 99%

House dust mite control measures in the management of asthma: meta-analysis

Gøtzsche

Hammarquist

Burr

1998

BMJ

192

110

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“…Bait stations are generally effective in re-during the study, 113 one showed no difference in allergen levels between the two study groups ducing cockroach levels for 2-3 months. The effect of cockroach control measures on aller-at the end of the study, 128 and one used an acaricide without good evidence of the effect and were sufficiently long to show an effect on outcomes.…”

Section: Air Filtration and Ionisersmentioning

confidence: 87%

Allergen avoidance in the treatment of asthma and atopic disorders

Čustović¹,

Simpson²,

Chapman³

et al. 1998

Thorax

159

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The majority of asthmatic patients are atopic humidity is too low to support mite popu--that is, they have IgE mediated sensitivity lations. Mite sensitive asthmatic children had to common inhalant allergens. Exposure and a progressive reduction in non-specific BHR sensitisation to allergens from the house dust when taken from their homes in Holland mite is established as an important risk factor to the mite-free environment of Davos, for asthma in most parts of the world. In Switzerland. 38 39 Similarly, a progressive readdition, several recent studies have provided duction in asthma symptoms occurred in chilevidence of the importance of exposure to other dren admitted to the residential home at indoor allergens, particularly those from Misurina (altitude 1756 m). 40 Further studies cats, dogs, and cockroaches. [25][26][27][28][29] The rate of from Misurina reported a significant decrease sensitisation to mites is directly related to expo-in mite allergen-induced basophil histamine sure, 30 whilst conversion from sensitisation to release, mite-specific serum IgE level, and non-sensitisation may occur in indoor en-methacholine BHR with reversal of this trend vironments with low allergen levels. 31 after 15 days of allergen re-exposure at sea The severity of asthma is also related to level. 41 Peroni et al found a significant reduction allergen exposure. [32][33][34][35] Objective indices of in total and mite-specific serum IgE and allerasthma severity such as bronchial hyper-gen-induced BHR after three and nine months reactivity (BHR), forced expiratory volume in at Misurina. 42 These results suggest that avoidone second (FEV 1 ), and variability in peak ance of mite allergen leads to a decrease in expiratory flow rate (PEFR) in patients sens-airway inflammation with consequent imitised to dust mites correlate with the level of provement in non-specific BHR and sympmite allergens in their beds. 32 Peat et al found toms, and that re-exposure results in a rapid a similar prevalence of sensitivity to mites in relapse. The high altitude studies were not children living in areas with two different levels controlled and there is a possibility that avoidof exposure to mites but BHR was more severe ance of other domestic factors such as exposure in sensitised children living in the area with the to pets or environmental tobacco smoke conhighest mite levels.

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“…Complete erradication of the house dust mite and its products is impossible [12]. However, mite avoidance measures aim to reduce the mite population and allergen exposure to reduce symptoms.…”

Section: Discussionmentioning

confidence: 99%

Controlled trial of house dust mite avoidance in children with mild to moderate asthma

Gillies

Littlewood

Sarsfield

1987

Clin Experimental Allergy

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Summary Twenty‐six asthmatic children participated in a controlled trial of house dust mite avoidance. Group A (n= 14) had 12 weeks’avoidance, provided that they had not deteriorated at the end of the first 6 weeks. Group B (n= 12) had an initial 6 weeks’observation period followed by 6 weeks’avoidance. Mite numbers were extremely variable and often low. There was a significant fall in mite numbers in the first, but not the second, 6‐week period in group A. In group B there was a significant fall in mite numbers in both the first (observation) and second (active avoidance) periods. Active avoidance produced highly significant falls in total serum IgE. There were no significant changes in IgE during the observation period. This impressive immunological effect was not associated with any changes in the radio‐allergo‐sorbent assay (RAST) to house dust mite, or symptom scores; peak expiratory flow rates or histamine induced bronchial reactivity. More rigorous avoidance procedures in more severely affected asthmatic patients warrants further investigation.

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Effect of a change to mite-free bedding on children with mite-sensitive asthma: a controlled trial.

Cited by 63 publications

References 2 publications

House dust mite control measures in the management of asthma: meta-analysis

House dust mite control measures in the management of asthma: meta-analysis

Allergen avoidance in the treatment of asthma and atopic disorders

Controlled trial of house dust mite avoidance in children with mild to moderate asthma

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