Mechanisms and patient compliance of dust‐mite avoidance regimens in dwellings of mite‐allergic rhinitic patients

Abstract

We report on the mechanisms, the environmental changes and patient compliance with regard to conventional and new dust and mite avoidance measures to prevent allergic symptoms caused by mite allergens, taking into account both allergen contamination and the developmental success of pyroglyphid Acari. Twenty patients with persisting rhinitic complaints were selected and matched. Although the patients had performed some conventional dust and mite avoidance measures (patient compliance was 90%), the dwellings proved to be a stimulus for mite development. Moisture problems due to faulty construction and excessive moisture production were common. Since humidity conditions could not be changed at short notice, the 20 homes were subjected to the new variants of mite allergen avoidance based on intensive cleaning without (control) and with an acaricide incorporated (acaricidal cleaner [Acarosan]). After the carrying out of conventional avoidance measures, these patients still had allergic symptoms, and dust from only 23 to 52% of their textile objects was under the proposed guanine (mite faeces indicator) risk level. Only the acaricidal cleaner was able to decrease the allergenic mite load (and the burden of the patients) significantly in this 12 month period. With respect to mite-extermination, acaricidal cleaning was 88% better than intensive cleaning. Reduction of guanine was 38% better in the Acarosan treatment group. Clinical results have been reported elsewhere. A significant difference in favour of the acaricidal cleaning was seen in both subjective (as regards symptoms) and in objective data (total IgE). Another 50 patients were questioned.(ABSTRACT TRUNCATED AT 250 WORDS)

Adherence to pharmacological treatment and specific immunotherapy in allergic rhinitis

“…An old study conducted with an acaricyde product reported that 50-90% of patients complied with the recommended avoidance measures [26]. An old study conducted with an acaricyde product reported that 50-90% of patients complied with the recommended avoidance measures [26].…”

“…There are very few data on the adherence of patients with dust mite avoidance measures (encasing mattresses and pillows, vacuum cleaning, removing carpets, and curtains etc.). An old study conducted with an acaricyde product reported that 50-90% of patients complied with the recommended avoidance measures [26]. On the other hand, a more recent study reported that only 35-50% of patients followed the recommendation of encasing pillows and mattresses [27], whereas the adherence to this measure was greater in a paediatric population, reaching a rate of 96% [28].…”

Identification of allergens by IgE‐specific testing improves outcomes in atopic dermatitis

“…1 The test may be a valid indicator of AD severity as a result of the relationship between immediate hypersensitivity responses and AD. It is also known as radioallergosorbent (RAST) testing, which is quantitative for all individual allergens.…”

“…Historically, IgEQAA has been used by allergists in the diagnosis and treatment of diseases with known allergic triggers such as allergic rhinitis and asthma because of both IgEQAA's high sensitivity and specificity. 1 The test may be a valid indicator of AD severity as a result of the relationship between immediate hypersensitivity responses and AD. A review by Fuiano and Incorvaia details the specific mechanisms by which dust mite antigens aggravate the symptoms of AD.…”

Advances in the Treatment of Allergic Rhinitis

“…A greater awareness of the aUergic basis of rhinitis for many sufferers has emphasized the Importance of allergen avoidance. For example house dust mite avoidance measures are of proven value In sensitive patients with both perennial rhinitis and asthma (2,3). The kientification of the major house dust mite allergens has enabled accurate measurement of allergen concentrations In dust samples, a pre-requlsite for developing new control measures Including barrier methods and acaricides.…”