IgE reactivity profiles among house dust mite allergic patients in Bavaria

Abstract

Recombinant allergen diagnostics have become increasingly important in daily allergological routine, made possible by inroads into the understanding of major and minor allergens accomplished within the last decade. Recombinant allergen diagnostics will, however, only provide correct diagnoses when sufficient knowledge of the regional IgE reactivity profile to a specific allergen source is available. A variety of studies in different European countries revealed reactivity profiles, where a sensitization to house dust mite could be recognized in more than 97 % of cases in which Der p1 and Der p2 were measured. The aim of this study was to investigate the IgE reactivity profiles of house dust mite allergic patients in southern Germany. Sera of house dust mite allergic patients (positive intranasal provocation) were screened for IgE antibodies against commercially available D pter., nDer p1, rDer p2 and rDer p10. IgE antibodies against D pter. could be found in 98 out of 98 sera (100 %). Seventy-five patients (76.5 %) reacted to nDer p1. In 72 patients (73.4 %), IgE antibodies against rDer p2 could be found, while IgE antibodies against rDer p10 were present in only 4 patients (4.1 %). Seventeen patients (17.3 %) had no IgE antibodies against nDer p1, rDer p2 and nDer p10, but displayed reactions to D pter. Knowledge of IgE regional reactivity profiles is necessary when using recombinant allergen diagnostics. In the case of our house dust mite allergic patients 17 would have remained undiagnosed based on a diagnostic method utilizing only the two major allergens nDerp1 and rDerp2.

Real-Life Study for the Diagnosis of House Dust Mite Allergy - The Value of Recombinant Allergen-Based IgE Serology

“…Sixteen patients negative for the two allergen components had also negative results for Der p 10. Adapted from [4], with kind permission of Springer publishing house. …”

“…Research groups from central Europe, Africa, Brazil, and Australia have published different IgE reactivity patterns in HDM-allergic patients, demonstrating that there is no single major allergen component that can be used for diagnostic purposes alone worldwide [3,4,5,14,15,16,17]. Therefore, the aim of this study was to analyze the reactivity profile of proven HDM-allergic patients which were tested negative for the commercially available allergens Der p 1, Der p 2, and Der p 10 with an experimental allergen chip containing additional 10 HDM allergen components.…”

“…So far, more than 20 different allergens of D. pteronyssinus have been described, with a strong variation in prevalence rates for the major allergens Der p 1 and Der p 2 in different countries [2,3,4,5]. The third currently commercially available allergen component Der p 10 also showed varying prevalence rates being responsible for a part of the cross-reactions to arthropods and mollusks [5,6].…”

The Role of Der p 23 Sensitization: An Analysis of 474 Patients Sensitized to Mite

“…), is one of the most important indoor allergen sources causing perennial allergy. Various allergen components have been described, and sev- eral groups have investigated the prevalence of various components worldwide showing a strongly varying pattern of sensitization profiles depending on the region [1][2][3][4][5][6][7][8][9][10]. Der p 1 and Der p 2 are described as the most important major allergen components with high sensitization rates in central Europe.…”

“…Data from the German Multicenter Allergy study displayed a 61% sensitization rate against Der p 1 and 77% for Der p 2 [11]. Prevalence in southern Bavaria lately was described as >70% for specific immunoglobulin E (sIgE) to Der p 1 and Der p 2 as the 2 major allergens [1]. Furthermore, many years after the characterization of Der p 1 and Der p 2, Der p 23, a relatively newly available allergen component, was identified as a new major allergen with a prevalence much higher than 50% [12].…”