Mite immunotherapy

Abstract

Dermatophagoides pteronyssinus and D. farinae are the most common house dust mites and are among the most common sources of indoor allergens worldwide. These species are very common in humid regions, where most allergic individuals are sensitized to house dust mites. Specific immunotherapy with mite extracts has demonstrated clinical benefits in several double-blind, placebo-controlled trials that are included in recent reviews of subcutaneous immunotherapy, including pediatric and adult patients with rhinoconjunctivitis and or asthma. Most successful studies of mite immunotherapy have used native allergen extracts adsorbed onto aluminum hydroxide, or chemically modified mite-allergen extracts. Several studies have also shown efficacy using sublingual immunotherapy in pediatric and adult patients with asthma and/or rhinitis. Additionally, the efficacy of subcutaneous immunotherapy has been demonstrated in patients with atopic dermatitis, although more double-blind, placebo-controlled studies are needed. Based on several studies, it cannot be concluded that mite immunotherapy is more dangerous or safer than immunotherapy with grasses, epithelia, or animal epithelia. Because the delivery of high doses of allergen carries with it the risk for immunoglobulin E (IgE)-mediated events, several methods have been developed to reduce specific IgE binding to mite-allergen extracts. An important challenge for future mite immunotherapy modalities is the delivery of relatively high doses without a significant risk for severe reactions.

Mites and Allergy

“…Patients who are exposed to large quantities of mite allergens may experience a progressive deterioration in PD 20 FEV 1 . This fact is consistent with a chronic inflammatory and remodeling process of the lungs, as has been suggested for several animal models, including rhesus monkeys, sheep and mice [12] . There is ample evidence that continuous exposure to mites is an important risk factor for the development of sensitization, allergic respiratory diseases and chronic inflammation of the lungs.…”

“…However, in light of publications that have shown pessimistic results using environmental control measures, immunotherapy with mite extracts has emerged as a solid treatment of mite-induced allergic respiratory diseases. Numerous studies have shown the efficacy of mite sublingual and subcutaneous immunotherapy [12] . The future treatment of mite-induced allergies will not be changed much, although it will be based on a more accurate diagnosis and better immunotherapy treatments.…”

The Effect of Antibiotics on Associated Bacterial Community of Stored Product Mites

“…All tested antibiotics suppressed the Bartonella -like bacteria, and neomycin and streptomycin suppressed Cardinium . This findings should be useful in production of mites for medical diagnostics (purified natural allergens) and immunomodulations [50], [51]. However, Solitalea -like associated group was not influenced by treatment with the antibiotics used here.…”

Modulation of the Humoral Response to <i>Dermatophagoides pteronyssinus </i>Allergens in BALB/c Mice by Extract Modification and Adjuvant Use

“…The polymerisation process reduces the IgE-binding capacity of the extract, thus reducing its allergenicity [5,6,7,9,34,35]. DPP extract did not induce high levels of IgE even when formulated in combination with AlOH, an adjuvant that boosted IgE levels when adsorbed onto N extract.…”