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They feel best in your bed. They make you cough at night and wake up in the morning with a stuffy nose. Besides, not only you – house dust mite allergy is the most common allergy in Poland. All allergy sufferers are helped by molecular diagnostics of allergies, which allows to determine the risk of the severity of an adverse reaction and to predict the effectiveness of desensitization.
Invisible roommates
House dust mites are microscopic-sized arachnids that live in our immediate vicinity. You will find “troublesome roommates” wherever dust collects: in woolen carpets, blankets, bedspreads, upholstery, curtains, plush toys and even on the leaves of potted plants. They especially like our beds: mattresses, pillows and duvets.
Under natural conditions, their main food is human and animal exfoliated epidermis. It is estimated that 150 mg of human epidermis is sufficient to meet the nutritional needs of a population of 3000 animals over a period of 2-3 months! Although house dust mites belong to all-year allergenic allergens, allergy symptoms intensify in the fall and winter season, when we turn on the radiators and close the windows tightly.
Not only «apsik»
As emphasized by Dr. Emilia Majsiak, MD, allergy to house dust mites may appear at any age, and the main symptoms concern the upper respiratory tract. – The most common symptoms are stuffy nose, runny nose, itchy nose, fits to sneeze, and discharge from the back of the throat. If the symptoms are chronic, they cause fatigue, drowsiness, headaches and problems with concentration.
When allergic to house dust mites, our eyes can also water, especially after waking up. Some people may develop skin changes: redness, peeling or itching. The consequence of excessive scratching may be local infections or superinfections of the skin. What we fear most in the context of mite allergy is bronchial asthma, manifested by wheezing and attacks of breathlessness. It is a serious chronic disease that cannot be cured. However, it is worth remembering that an early diagnosis of house dust mite allergy can prevent the onset of asthma. That is why proper diagnosis and early medical intervention are so important.
A breakthrough in diagnosis
Apart from a detailed medical history, skin and blood tests are used to diagnose house dust mite allergy. The molecular diagnostics of allergies also helps us, as it allows us to determine which mite protein sensitizes us. – The main allergens of mites are Der p 1 and Der p 2 proteins, found in their faeces.
The detection of IgE antibodies to these molecules is good news for the patient in the context of mite allergy – the studies so far show that in such patients desensitization will be certainly effective. The situation is different in the case of allergy to Der p 23 and Der p 10 proteins. The first molecule – Der p 23 is the third major mite allergen, occurring in 70% of Polish respondents. allergic. Like Der p 1 and Der p 2 proteins, it is mainly present in faeces and early sensitization to them is associated with the risk of asthma.
Unfortunately, Der p 23 is a very small protein and its availability in test extracts and desensitization vaccines is limited. This can result in false-negative skin and blood tests as well as ineffectiveness of specific allergen immunotherapy. A similar situation applies to the Der p 10 molecule, which is found in the muscles of mites. Thus, in the preparations used in the allergological diagnosis of the protein Der p 10 may not be at all. Information about whether this molecule is positive or negative is very important because – Der p 10 belongs to the tropomyosins.
Sensitization to this group of molecules can cause severe systemic reactions. Tropomyosin molecules show a very high degree of cross-reactivity. As a result of a similar structure, people allergic to Der p 10 may develop a cross-reaction with seafood tropomyosin (from shrimp, crab, lobster, lobster, oysters, squid, mussels and octopus).
We often wondered why a patient who had never eaten shrimp in his life got anaphylactic shock when he first came into contact with the food. In theory, only re-exposure to the allergen causes clinical symptoms. One of the mysteries of allergology was solved by molecular diagnostics. It is not that the patient has never had contact with tropiomiosin in his life – he had already encountered the Der p 10 mite molecule, to which he became allergic, and the next contact with a protein belonging to this group, e.g. Lithium v 1 shrimp, caused anaphylactic reaction – explains the expert.
Personalized medicine in allergology?
As you can see, the detailed development of an allergy profile based on the results of molecular tests allows for a more precise diagnosis of allergies in a given patient, which translates into the possibility of personalizing therapeutic recommendations. no.
It is a very important decision, considering the duration of treatment (3-5 years) and the type of vaccine administered (paid or free). The allergist, in each case, will consider the possible benefits for the patient by analyzing the situation in the context of the accompanying symptoms – adds Emilia Majsiak, MD, PhD. Regardless of the treatment chosen, patients with house dust mite allergy should limit their contact with the allergen.
The best way to get rid of arachnids from your home is to hinder their development opportunities, i.e. giving up carpets, curtains and upholstered furniture, as well as replacing anti-allergic bedding or using anti-mite covers for mattresses and pillows. It is necessary to wash bedding often at a temperature above 60 degrees Celsius – special agents for allergy sufferers can be added to the washing, which destroy mites.
Small pillows or our children’s favorite stuffed animals can be put in the freezer for several hours. The apartment should be ventilated frequently, and it is worth keeping the temperature in the rooms around 18 degrees Celsius. When it comes to vacuuming (it is best to use a vacuum cleaner with a HEPA filter) or washing surfaces on which dust collects, it should be done by a non-allergic person. People with house dust mite allergy can also benefit from pharmacotherapy in the form of antihistamines or glucocorticosteroids, which alleviate allergy symptoms.