Lack of Association Between Dust Mite Sensitivity and Atopic Dermatitis

Silverberg, Jonathan I.; Hanifin, Jon M.; Law, Sandra; White, Kevin; Storrs, Frances J.

doi:10.1097/der.0000000000000165

Cited by 3 publications

(6 citation statements)

References 41 publications

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“…60 The ability of HDM antigens to elicit APT reactions in a high frequency of individuals makes it a valuable tool to study cutaneous hypersensitivity. 10 In our study,~55% of individuals without AD had positive HDM responses and~40% of individuals with AD had positive HDM reactions, similar to prior reports. 61,62 While allergic sensitivity to HDM is highly based on elevated HDM-specific IgE levels, many studies have not found associations between IgE levels and APT reactivity in atopic individuals.…”

Section: Discussionsupporting

confidence: 91%

“…HDM is ubiquitous in the environment, and many individuals are sensitized to its associated protein antigens Der p1/2 . The ability of HDM antigens to elicit APT reactions in a high frequency of individuals makes it a valuable tool to study cutaneous hypersensitivity . In our study, ~55% of individuals without AD had positive HDM responses and ~40% of individuals with AD had positive HDM reactions, similar to prior reports …”

Section: Discussionsupporting

confidence: 90%

“…While allergic sensitivity to HDM is highly based on elevated HDM‐specific IgE levels, many studies have not found associations between IgE levels and APT reactivity in atopic individuals . We also did not find differences in APT responses based on total IgE levels, albeit HDM‐specific IgEs were not determined for our cohort.…”

Section: Discussioncontrasting

confidence: 66%

“…Atopy patch testing/APT involves epicutaneous application of aeroallergens that elicit delayed‐type hypersensitivity/DTH reactions . D. pteronyssinus / farinae are ubiquitous organisms sensitizing up to 40% of the population and up to 70% of AD patients, and their antigens are the most commonly used in patch tests …”

Section: Introductionmentioning

confidence: 99%

“…8 D. pteronyssinus/farinae are ubiquitous organisms sensitizing up to 40% of the population and up to 70% of AD patients, and their antigens are the most commonly used in patch tests. [9][10][11] The historic understanding of AD as a biphasic disease with Th2skewing in acute and Th2-to-Th1 switch in chronic phase was largely based on HDM studies prior to discovery of newer Th17/Th22 subsets. [12][13][14] In these studies, HDM lesions at 24 hours after APT showed increased Th2/IL-4 markers compared to controls, while Th1/IFN-c markers were elevated after 48 hours.…”

mentioning

confidence: 99%

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Dust mite induces multiple polar T cell axes in human skin

Malik

Ungar

Garcet

et al. 2017

Clin Experimental Allergy

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 66%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Dust mite induces multiple polar T cell axes in human skin

Malik

Ungar

Garcet

et al. 2017

Clin Experimental Allergy

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Atopy patch tests may identify patients at risk for systemic contact dermatitis

Pootongkam

Havele

Orillaza

et al. 2019

Immunity Inflam & Disease

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Background A subset of patients with positive patch tests demonstrates systemic contact dermatitis (SCD) upon ingestion or inhalation of the allergen. Concern has been raised about the use of patch tests for protein allergens (APTs) to detect SCD in atopic dermatitis (AD) patients. Methods We present atopy patch test (APT) data for 97 people. We reviewed APTs and tests for antigen‐specific immunoglobulin E (IgE) to the same allergen in pediatric AD patients. We compared the frequency of APTs as a function of age in AD patients. To study the irritancy potential of APTs, we prospectively tested consenting non‐AD dermatitis patients undergoing evaluation for allergic contact dermatitis and healthy controls to an APT panel. Results APT demonstrated fewer positive results than serum‐specific IgE or skin prick tests to the same allergen. Positive APT to food was more common in children under 3 years, whereas positive APT to aeroallergens were more common in teens and adults. Only positive APTs to dust mite were significantly more common positive in subjects without AD. Conclusion Our aggregate findings suggest that most APTs, but not dust mite, behave like conventional patch tests to low‐potency allergens. They are more likely to be positive in patients with chronically inflamed skin and to identify allergens that cause SCD. The higher prevalence of APT positivity to foods in young children is consistent with food allergy as a trigger of AD (also known as SCD) being more common in children than adults. Positive APTs define patients who may have SCD; negative APTs may guide elimination diets.

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