House dust mite avoidance measures improve peak flow and symptoms in patients with allergy but without asthma: A possible delay in the manifestation of clinical asthma?

Clinical effectiveness of a mite allergen–impermeable bed-covering system in asthmatic mite-sensitive patients

“…23,[26][27][28][29] Nevertheless, in most studies in which covers were combined with other devices, the results of HDM reduction were attributed to the effect of the covers. 23,28,29 In conclusion, this study shows that reducing HDM allergen levels could improve the morning peak flow in asthmatic patients by 20 L/min in 9 weeks.…”

Clinical evaluation of the effect of anti-allergic mattress covers in patients with moderate to severe asthma and house dust mite allergy: a randomised double blind placebo controlled study

“…When reviewing these studies it is clear that improvement in symptoms occurred in four studies. 14 24 26 28 Two studied children, 26 28 one studied patients with mild asthma, and one studied allergic patients who had not yet developed asthma (subclinical). Other studies, 11 22 even in children, 10 23 did not find a reduction in symptoms.…”

“…Future studies should explore whether night time and daytime avoidance measures in the early stages of the disease are more effective. 26 20 Children pl c 4 ---+ + ND ND Walshaw 29 50 Adults pl c 52 + -+ + + N D N D Gillies 23 24 Children open c 12 + ----N D N D Ehnert 8 24 14 29 Adults r sb pl 6 + + ND ND + -ND Sporik 21 85 Children open c 78 + + -ND ND ND ND Cloosterman 11 157 Adults r db pl 20…”

Effects of house dust mite avoidance measures on Der p 1 concentrations and clinical condition of mild adult house dust mite‐allergic asthmatic patients, using no inhaled steroids

“…In an earlier study of our group we investigated the effects of the same combination of HDM‐avoidance measures used in this study in a group of allergic subjects, without a diagnosis of asthma but with some early signs of asthma [ 22]. In that study we found that peak flow parameters and asthma symptom scores were stabilized during the follow‐up period, suggesting that a delay in the onset of asthma may occur in some allergic subjects [ 22]. The question is why no positive effects were found in the current group of allergic subjects with already established asthma, but were found in a group that had not developed asthma yet?…”

“…During the inclusion assessment an intradermal allergy test was performed with 16 common aeroallergens: house dust mites, pets, feathers, pollen and moulds (all ALK, Groningen, The Netherlands), as previously described [ 22]. Because having other allergies besides HDM allergy might confound our data, three parameters were calculated to express the allergic status of each patient: (1) the number allergies besides HDM‐allergy (0–15); (2) sum of the proportions of the weal size of each allergen compared with the weal size of the positive control; and (3) having a mono‐allergy for HDM (yes/no).…”