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Torres-Borrego J, Sánchez-Solís M. Dissecting Airborne Allergens. J Clin Med 2023; 12:5856. [PMID: 37762797 PMCID: PMC10532401 DOI: 10.3390/jcm12185856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 08/15/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
Asthma is a heterogeneous and very complex group of diseases, and includes different clinical phenotypes depending on symptoms, progression, exacerbation patterns, or responses to treatment, among other characteristics. The allergic phenotype is the most frequent, especially in pediatric asthma. It is characterized by sensitization (the production of specific IgEs) to allergens and frequent comorbidity with rhinitis as well as atopic dermatitis. Given the complexity of allergic asthma, knowledge of it must be approached from different points of view: clinical, histological, physiological, epidemiological, biochemical, and immunological, among others. Since partial approaches do not allow for the understanding of this complexity, it is necessary to have multidimensional knowledge that helps in performing the optimal management of each case, avoiding a "blind men and elephant parable" approach. Allergens are antigens that trigger the production of specific IgE antibodies in susceptible individuals, who present symptoms that will depend on the type and intensity of the allergenic load as well as the tissue where the interaction occurs. Airborne allergens cause their effects in the respiratory tract and eyes, and can be indoor or outdoor, perennial, or seasonal. Although allergens such as mites, pollens, or animal dander are generally considered single particles, it is important to note that they contain different molecules which could trigger distinct specific IgE molecules in different patients. General practitioners, pediatricians, and other physicians typically diagnose and treat asthma based on clinical and pulmonary function data in their daily practice. This nonsystematic and nonexhaustive revision aims to update other topics, especially those focused on airborne allergens, helping the diagnostic and therapeutic processes of allergic asthma and rhinitis.
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Affiliation(s)
- Javier Torres-Borrego
- Pediatric Allergy and Pulmonology Unit, Reina Sofia Children’s University Hospital, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), University of Cordoba, Av. Menendez Pidal sn, 14004 Cordoba, Spain
| | - Manuel Sánchez-Solís
- Pediatric Respiratory and Cystic Fibrosis Unit, Virgen de la Arrixaca University Children’s Hospital, Biomedical Research Institute of Murcia (IMIB), University of Murcia, Avda Teniente Flomesta, 5, 30003 Murcia, Spain;
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Ludwig L, Tsukui T, Kageyama M, Farias M. Evaluation of sensitization to the crude extract of Dermatophagoides farinae and its derived allergens, Der f 2 and Zen 1, in dogs with atopic dermatitis in Southern Brazil. Vet Immunol Immunopathol 2021; 234:110199. [PMID: 33662650 DOI: 10.1016/j.vetimm.2021.110199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 01/22/2021] [Accepted: 01/28/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Atopic dermatitis is associated with the production of IgE antibodies against environmental allergens and allergens of the house dust miteDermatophagoides farinae are frequently implicated in the disease. OBJECTIVES We aimed to observe the allergen-specific IgE against crudeD. farinae, Der f 2 and Zen 1 in dogs with atopic dermatitis and report if these dogs are in contact with material that could shelter mite allergens. METHODS 100 dogs with clinical diagnosis of atopic dermatitis were included after exclusion of other forms of pruritic skin disease and dogs that already received specific or non-specific immunotherapy. These dogs were of different breeds and ages and they were presented at a veterinary teaching hospital and a private service of veterinary dermatology, both located in Curitiba, Southern Brazil. At the time of anamnesis, some questions were applied to know the possibility of these dogs having had contact with furniture and textile material which could shelter house dust mites. Sera samples were obtained and further analyzed by ELISA assay to measure serum IgE levels against these allergens with an established cut-off of 0.200 IgE optical density. RESULTS The allergen-specific IgE positivity against crudeD. farinae (92 %) and Zen 1 (77 %) was higher than Der f 2 (56 %). There was a correlation in sensitization to crude D. farinae and Zen 1 that was not observed between crude D. farinae and Der f 2 and Der f 2 and Zen 1. The sensitization to D. farinae and its allergens was associated with an unrestricted exposition to furniture and textile material. CONCLUSION & CLINICAL RELEVANCE: dogs with atopic dermatitis are frequently sensitized to D. farinae and its allergens, Der f 2 and Zen 1, may be considered major allergens in these dogs. Zen 1 may be the main allergen responsible for the sensitization to crude D. farinae.
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Affiliation(s)
- L Ludwig
- Department of Veterinary Medicine, School of Life and Sciences, Pontifical Catholic University of Paraná, 1155 Imaculada Conceição Street, 80215901, Curitiba, PR, Brazil.
| | - T Tsukui
- Central Research Laboratory, ZENOAQ, 1-1 Tairanoue, Sasagawa, Asaka-machi, Koriyama, Fukushima, 963-0196, Japan
| | - M Kageyama
- Central Research Laboratory, ZENOAQ, 1-1 Tairanoue, Sasagawa, Asaka-machi, Koriyama, Fukushima, 963-0196, Japan
| | - M Farias
- Department of Veterinary Medicine, School of Life and Sciences, Pontifical Catholic University of Paraná, 1155 Imaculada Conceição Street, 80215901, Curitiba, PR, Brazil; Dermatovet Veterinary Clinic, 85 Carmelo Rangel Street, 80440050, Curitiba, PR, Brazil
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Abstract
House dust mites are an unsurpassed cause of atopic sensitization and allergic illness throughout the world. The major allergenic dust mites Dermatophagoides pteronyssinus, Dermatophagoides farinae, Euroglyphus maynei, and Blomia tropicalis are eight-legged members of the Arachnid class. Their approximately 3-month lifespan comprises egg, larval, protonymph, tritonymph, and adult stages, with adults, about one fourth to one third of a millimeter in size, being at the threshold of visibility. The geographic and seasonal distributions of dust mites are determined by their need for adequate humidity, while their distribution within substrates is further determined by their avoidance of light. By contacting the epithelium of the eyes, nose, lower airways, skin, and gut, the allergen-containing particles of dust mites can induce sensitization and atopic symptoms in those organs. Various mite allergens, contained primarily in mite fecal particles but also in shed mite exoskeletons and decaying mite body fragments, have properties that include proteolytic activity, homology with the lipopolysaccharide-binding component of Toll-like receptor 4, homology with other invertebrate tropomyosins, and chitin-cleaving and chitin-binding activity. Mite proteases have direct epithelial effects including the breaching of tight junctions and the stimulation of protease-activated receptors, the latter inducing pruritus, epithelial dysfunction, and cytokine release. Other components, including chitin, unmethylated mite and bacterial DNA, and endotoxin, activate pattern recognition receptors of the innate immune system and act as adjuvants promoting sensitization to mite and other allergens. Clinical conditions resulting from mite sensitization and exposure include rhinitis, sinusitis, conjunctivitis, asthma, and atopic dermatitis. Systemic allergy symptoms can also occur from the ingestion of cross-reacting invertebrates, such as shrimp or snail, or from the accidental ingestion of mite-contaminated foods. Beyond their direct importance as a major allergen source, an understanding of dust mites leads to insights into the nature of atopy and of allergic sensitization in general.
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Kounis NG, Ren HL, Kavalioti M, Koniari I, Theoharides TC. Intimate Contact Could Be Dangerous for Your Health. Clin Ther 2019; 41:1222-1226. [PMID: 31076202 DOI: 10.1016/j.clinthera.2019.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 03/28/2019] [Accepted: 04/09/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE To review evidence of hypersensitivity reactions to allergens and/or pathogens transmitted via intimate contact. METHODS We reviewed PubMed for publications in English between 1980 and 2018 using the terms allergy, drugs, foods, hypersensitivity, intercourse, kissing, Kounis syndrome, mast cells, and semen. FINDINGS In human RELATIONSHIPS, intimate contact can occasionally have disastrous or even fatal consequences because antigens and pathogens can be transmitted via the oral and vaginal mucosa. Hypersensitivity to semen is an underrecognized problem. Some individuals also developed acute coronary hypersensitivity, which mimics myocardial infarction, known as Kounis syndrome. IMPLICATIONS Hypersensitivity reactions to allergens and/or pathogens via intimate contact are common and should be recognized. Sensitive patients should be evaluated for atopic diathesis because such patients may be more susceptible and could also develop Kounis syndrome.
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Affiliation(s)
- Nicholas G Kounis
- Patras Highest Institute of Education and Technology, Patras, Greece
| | - Huali L Ren
- Department of Otolaryngology, Beijing Electric Power Hospital, Beijing, China
| | - Maria Kavalioti
- Department of Biomedical Sciences, University of Greenwich, United Kingdom
| | - Ioanna Koniari
- Patras Highest Institute of Education and Technology, Patras, Greece
| | - Theoharis C Theoharides
- Laboratory of Molecular Immunopharmacology and Drug Discovery, Department of Immunology, Tufts University School of Medicine, Boston, MA, USA; Department of Internal Medicine, Tufts University School of Medicine, Boston, MA, USA.
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Solarz K, Pająk C. Risk of exposure of a selected rural population in South Poland to allergenic mites. Part I: indoor acarofauna of one-family houses. EXPERIMENTAL & APPLIED ACAROLOGY 2019; 77:375-386. [PMID: 30820791 DOI: 10.1007/s10493-019-00352-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 02/21/2019] [Indexed: 06/09/2023]
Abstract
The aim of this study was to investigate the occurrence of mites in dust samples from houses in agricultural areas of South Poland, with particular reference to allergenic and parasitic species as a potential risk factor of diseases among people. A total of 250 dust samples from 50 single-family houses situated in Stryszawa and vicinity (Małopolskie province) were examined for the presence of domestic mites. Dust was taken from beds, floors in bedrooms, upholstery furniture, floors in family rooms and from floors in kitchens. Mites were found in 74.8% of samples collected. A total of 5340 mite specimens were isolated, including 2771 members of the family Pyroglyphidae (51.9%). Dominants were Dermatophagoides pteronyssinus (36.4% of all mites) and Gohieria fusca (25.1%), followed by Chortoglyphus arcuatus (18.3%) and D. farinae (15.1%). Dermatophagoides pteronyssinus was also the most frequent species (53.2% of the total count of samples examined), followed by G. fusca (42.4%), D. farinae (37.2%) and C. arcuatus (36.4%). Lepidoglyphus destructor was found more frequently than Glycyphagus domesticus in the examined samples. Density of D. pteronyssinus was associated with beds, presence of pets, coal stoves used for heating, lower number of rooms, higher cooking frequency, higher washing frequency, working housewife, open kitchen, wooden floors in kitchens, lower cleaning frequency, type of upholstery furniture in living rooms (arm chairs), lower humidity and higher temperature.
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Affiliation(s)
- Krzysztof Solarz
- Department of Parasitology, Faculty of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia in Katowice, Jednosci 8, 41-218, Sosnowiec, Poland.
| | - Celina Pająk
- Department of Biochemistry and Molecular Biology, Faculty of Health Sciences, University of Bielsko-Biala, Willowa 2, 43-300, Bielsko-Biala, Poland
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Niesler A, Ścigała G, Łudzeń-Izbińska B. Cat (Fel d 1) and dog (Can f 1) allergen levels in cars, dwellings and schools. AEROBIOLOGIA 2016; 32:571-580. [PMID: 27616812 PMCID: PMC4996870 DOI: 10.1007/s10453-016-9433-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 03/01/2016] [Indexed: 06/06/2023]
Abstract
Pets are an important source of indoor allergens. The aim of the study was to compare cat and dog allergen levels in cars, schools and homes. The study was carried out in 17 cars, 14 classrooms and 19 dwellings located in the highly industrialized and urbanized region of Poland. Dust and air samples were analyzed for Fel d 1 and Can f 1 using a double monoclonal ELISA assay. The highest amounts of cat and dog allergens (Fel d 1: 1169 μg/g; Can f 1: 277 μg/g) were found in dwellings with pets. Allergen concentrations were correlated with the number of animals kept at home. Although concentrations on automobile seats were lower, Fel d 1 levels exceeded 8 μg/g in 23.5 % of cars and high levels of Can f 1 (>10 μg/g) were found in 17.6 % of cars. The study revealed that cars of pet owners may be reservoirs of cat and dog allergens even when animals are not transported in them. In schools, concentrations of pet allergens did not reach high levels, but the moderate levels of Fel d 1 (≥1-8 μg/g) and Can f 1 (≥2-10 μg/g) were detected in 42.9 and 7.1 % of the investigated classrooms. Concentrations of cat and dog allergen in schools were higher than in homes without pets. While airborne Fel d 1 and Can f 1 levels were found low, residential allergen concentrations in settled dust and air were correlated. The study results suggest that classrooms and cars of pet owners may be important sites of exposure to cat and dog allergens, though the highest concentrations of Fel d 1 and Can f 1 are found in homes of pet owners.
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Affiliation(s)
- A. Niesler
- Department of Biohazards and Immunoallergology, Institute of Occupational Medicine and Environmental Health, 13 Kościelna Street, 41-200 Sosnowiec, Poland
| | - G. Ścigała
- Department of Biohazards and Immunoallergology, Institute of Occupational Medicine and Environmental Health, 13 Kościelna Street, 41-200 Sosnowiec, Poland
| | - B. Łudzeń-Izbińska
- Department of Biohazards and Immunoallergology, Institute of Occupational Medicine and Environmental Health, 13 Kościelna Street, 41-200 Sosnowiec, Poland
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Lim FL, Hashim Z, Than LTL, Md Said S, Hisham Hashim J, Norbäck D. Asthma, Airway Symptoms and Rhinitis in Office Workers in Malaysia: Associations with House Dust Mite (HDM) Allergy, Cat Allergy and Levels of House Dust Mite Allergens in Office Dust. PLoS One 2015; 10:e0124905. [PMID: 25923543 PMCID: PMC4414577 DOI: 10.1371/journal.pone.0124905] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Accepted: 03/08/2015] [Indexed: 11/18/2022] Open
Abstract
A prevalence study was conducted among office workers in Malaysia (N= 695). The aim of this study was to examine associations between asthma, airway symptoms, rhinitis and house dust mites (HDM) and cat allergy and HDM levels in office dust. Medical data was collected by a questionnaire. Skin prick tests were performed for HDM allergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae) and cat allergen Felis domesticus. Indoor temperature and relative air humidity (RH) were measured in the offices and vacuumed dust samples were analyzed for HDM allergens. The prevalence of D. pteronyssinus, D. farinae and cat allergy were 50.3%, 49.0% and 25.5% respectively. Totally 9.6% had doctor-diagnosed asthma, 15.5% had current wheeze and 53.0% had current rhinitis. The Der p 1 (from D. pteronyssinus) and Der f 1 (from D. farinae) allergens levels in dust were 556 ng/g and 658 ng/g respectively. Statistical analysis was conducted by multilevel logistic regression, adjusting for age, gender, current smoking, HDM or cat allergy, home dampness and recent indoor painting at home. Office workers with HDM allergy had more wheeze (p= 0.035), any airway symptoms (p= 0.032), doctor-diagnosed asthma (p= 0.005), current asthma (p= 0.007), current rhinitis (p= 0.021) and rhinoconjuctivitis (p< 0.001). Cat allergy was associated with wheeze (p= 0.021), wheeze when not having a cold (p= 0.033), any airway symptoms (p= 0.034), doctor-diagnosed asthma (p= 0.010), current asthma (p= 0.020) and nasal allergy medication (p= 0.042). Der f 1 level in dust was associated with daytime breathlessness (p= 0.033) especially among those with HDM allergy. Der f 1 levels were correlated with indoor temperature (p< 0.001) and inversely correlated with RH (p< 0.001). In conclusion, HDM and cat allergies were common and independently associated with asthma, airway symptoms and rhinitis. Der f 1 allergen can be a risk factor for daytime breathlessness.
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Affiliation(s)
- Fang Lee Lim
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang, Selangor, Malaysia
| | - Zailina Hashim
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang, Selangor, Malaysia
- * E-mail:
| | - Leslie Thian Lung Than
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang, Selangor, Malaysia
| | - Salmiah Md Said
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang, Selangor, Malaysia
| | - Jamal Hisham Hashim
- United Nations University-International Institute for Global Health (UNU-IIGH), Kuala Lumpur, Malaysia
- Department of Community Health, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Dan Norbäck
- Uppsala University, Department of Medical Science, Occupational and Environmental Medicine, University Hospital, Uppsala, Sweden
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Clarke D, Burke D, Gormally M, Byrne M. Dynamics of house dust mite transfer in modern clothing fabrics. Ann Allergy Asthma Immunol 2015; 114:335-40. [PMID: 25680836 DOI: 10.1016/j.anai.2014.12.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 12/23/2014] [Accepted: 12/30/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Clothing is largely presumed as being the mechanism by which house dust mites are distributed among locations in homes, yet little research to date has investigated the capacity with which various clothing fabric types serve as vectors for their accumulation and dispersal. Although previous research has indicated that car seats provide a habitat for mite populations, dynamics involved in the transfer of mites to clothing via car seat material is still unknown. OBJECTIVE To investigate the dynamics involved in the transfer of house dust mites from car seat material to modern clothing fabrics. METHODS A total of 480 samples of car seat material were seeded with mites and subjected to contact with plain woven cotton, denim, and fleece. Contact forces equivalent to the mass of a typical adult and child were administered for different durations of contact. RESULTS Mean transfer efficiencies of mites from car seat material to receiving clothing fabrics ranged from 7.2% to 19.1%. Fabric type, mite condition (live or dead), and the force applied all revealed a significant effect (P < .001 for each variable) on the transfer efficiency of house dust mites from seeded material to receiving fabrics, whereas duration of contact revealed no effect (P = .20). In particular, mean numbers of mites transferred to fleece (compared with denim and plain woven cotton) were greater for each treatment. CONCLUSION These findings indicate that clothing type can have important implications for the colonization of other biotopes by house dust mites, with potential for affecting an individuals' personal exposure to dust mite allergens.
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Affiliation(s)
- David Clarke
- School of Physics and Ryan Institute, National University of Ireland, Galway, Ireland; Applied Ecology Unit, School of Natural Sciences and Ryan Institute, National University of Ireland, Galway, Ireland.
| | - Daniel Burke
- School of Physics and Ryan Institute, National University of Ireland, Galway, Ireland; Applied Ecology Unit, School of Natural Sciences and Ryan Institute, National University of Ireland, Galway, Ireland
| | - Michael Gormally
- Applied Ecology Unit, School of Natural Sciences and Ryan Institute, National University of Ireland, Galway, Ireland
| | - Miriam Byrne
- School of Physics and Ryan Institute, National University of Ireland, Galway, Ireland
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Abstract
Pyroglyphid mites are primarily associated with allergen exposure at home; hence the name house dust mites. However, we have found numerous studies reporting pyroglyhid mite levels in public and occupational settings. This review presents the findings of house dust mite allergens (family Pyroglyphidae, species Dermatophagoides) as potential work-related risk factors and proposes occupations at risk of house dust mite-related diseases. Pyroglyphid mites or their allergens are found in various workplaces, but clinically relevant exposures have been observed in hotels, cinemas, schools, day-care centres, libraries, public transportation (buses, trains, taxies, and airplanes), fishing-boats, submarines, poultry farms, and churches. Here we propose a classification of occupational risk as low (occasional exposure to mite allergen levels up to 2 μg g(-1)), moderate (exposure between 2 μg g(-1) and 10 μg g(-1)), and high (exposure >10 μg g(-1)). The classification of risk should include factors relevant for indoor mite population (climate, building characteristics, and cleaning schedule). To avoid development or aggravation of allergies associated with exposure to house dust mites at work, occupational physicians should assess exposure risk at work, propose proper protection, provide vocational guidance to persons at risk and conduct pre-employment and periodic examinations to diagnose new allergy cases. Protection at work should aim to control dust mite levels at work. Measures may include proper interior design and regular cleaning and building maintenance.
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Grzelewski T, Majak P, Jerzyńska J, Cichalewski L, Krakowiak J, Stelmach W, Stelmach R, Janas A, Grzelewska A, Stelmach I. The association between fractional exhaled nitric oxide (FeNO) and cat dander in asthmatic children. Nitric Oxide 2011; 25:288-93. [PMID: 21621632 DOI: 10.1016/j.niox.2011.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Revised: 05/12/2011] [Accepted: 05/16/2011] [Indexed: 01/12/2023]
Abstract
BACKGROUND The aim of our study was to assess risk factors of increased FeNO in asthmatic children with no cat at home. METHODS It was a retrospective, cross-sectional study. We evaluated data from medical documentation of children with asthma: FeNO results, allergen sensitization, seasonal allergen exposure, FEV(1), allergic rhinitis (AR) diagnosis and cat presence at home. We assessed asthma severity using mean doses of inhaled glucocorticosteroids and a management approach based on control according to the newest guidelines of Global Initiative for Asthma (GINA) throughout the last three months before the measurement of FeNO and spirometry. RESULTS 316 patients (age 6-18) completed the study. Sensitization to cat dander was associated with the highest median value of FeNO concentration compared to other allergens in our patients (28,4ppb) and co-existing sensitization did not affect FeNO level. Median levels of FeNO increased linearly with patient's age. In asthmatics with AR, the levels of FeNO were increased significantly compared to asthmatics without AR (20.8 vs. 16.3, respectively). We showed that in patients without AR, sensitization to cat allergen was associated with more severe asthma in comparison to other perennial allergy (step 4 vs. other steps according to GINA treatment steps). The above relation was not observed in patients with AR. We did not observe correlation between allergy profile and FEV(1) among patients in neither subgroup nor in general population. CONCLUSIONS We revealed that sensitization to cat dander was associated with the highest increase of FeNO concentration compared to other allergens in patients not having any cat at home ever. We also observed that in patients without allergic rhinitis, sensitization to cat allergen, compared to other perennial allergy, was associated with more severe asthma.
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Affiliation(s)
- Tomasz Grzelewski
- Department of Pediatrics and Allergy, Medical University of Lodz, N. Copernicus Hospital, Lodz, Poland
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Arlian LG, Morgan MS. Immunomodulation of skin cytokine secretion by house dust mite extracts. Int Arch Allergy Immunol 2011; 156:171-8. [PMID: 21576987 DOI: 10.1159/000323351] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Accepted: 11/22/2010] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Skin contact with house dust mites may contribute to atopic dermatitis and other skin diseases. We sought to determine if molecules from house dust mites could influence the release of proinflammatory cytokines and chemokines from epidermal keratinocytes and dermal fibroblasts grown in a human skin equivalent (HSE) model. METHODS HSEs consisting of an epidermis of keratinocytes with stratum corneum over a dermis of fibroblasts in a collagen matrix were challenged with Dermatophagoides farinae, D. pteronyssinus and Euroglyphus maynei mite extracts. RESULTS HSEs secreted interleukin (IL)-1α, IL-1 receptor antagonist, IL-6, IL-8, cutaneous T cell-attracting chemokine, transforming growth factor-α, granulocyte/macrophage and macrophage colony-stimulating factors and vascular endothelial cell growth factor in response to at least 1 mite extract. Extracts of different mite species stimulated HSEs to release different cytokines. Therefore, extracts of different species contained different molecules or different concentrations of similar molecules. The cytokine release profiles of cells in the HSEs were not the same as for monocultured keratinocytes and fibroblasts. CONCLUSIONS Molecules from house dust mites are capable of inducing the release of multiple proinflammatory cytokines and chemokines from epidermal keratinocytes and dermal fibroblasts. Avoiding skin contact with house dust mites would reduce the possibility of mite-induced inflammation in the skin. Therefore, measures to reduce contact with mite molecules such as frequent vacuuming of upholstered furniture and carpets and laundering of clothing and bedding to remove mite molecules and allergens could reduce skin contact with mite molecules and diminish exacerbations of skin inflammation in patients with atopic dermatitis and other skin diseases.
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Affiliation(s)
- Larry G Arlian
- Department of Biological Sciences, Wright State University, Dayton, Ohio 45435, USA.
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Loo CJ, Foty RG, Wheeler AJ, Miller JD, Evans G, Stieb DM, Dell SD. Do questions reflecting indoor air pollutant exposure from a questionnaire predict direct measure of exposure in owner-occupied houses? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2010; 7:3270-97. [PMID: 20948960 PMCID: PMC2954581 DOI: 10.3390/ijerph7083270] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Revised: 08/14/2010] [Accepted: 08/18/2010] [Indexed: 11/16/2022]
Abstract
Home characteristic questions are used in epidemiological studies and clinical settings to assess potentially harmful exposures in the home. The objective of this study was to determine whether questionnaire-reported home characteristics can predict directly measured pollutants. Sixty home inspections were conducted on a subsample of the 2006 population-based Toronto Child Health Evaluation Questionnaire. Indoor/outdoor air and settled dust samples were analyzed. Mean Fel d 1 was higher (p < 0.0001) in homes with a cat (450.58 μg/g) versus without (22.28 μg/g). Mean indoor NO(2) was higher (p = 0.003) in homes with gas stoves (14.98 ppb) versus without (8.31 ppb). Self-reported musty odours predicted higher glucan levels (10554.37 μg/g versus 6308.58 μg/g, p = 0.0077). Der f 1 was predicted by the home's age, but not by reports of carpets, and was higher in homes with mean relative humidity > 50% (61.30 μg/g, versus 6.24 μg/g, p = 0.002). Self-reported presence of a cat, a gas stove, musty odours, mice, and the home's age and indoor relative humidity over 50% predicted measured indoor levels of cat allergens, NO(2), fungal glucan, mouse allergens and dust mite allergens, respectively. These results are helpful for understanding the significance of indoor exposures ascertained by self-reporting in large epidemiological studies and also in the clinical setting.
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Affiliation(s)
- C.K. Jennifer Loo
- University of Toronto, 1 King’s College Circle, Toronto, Ontario M5S 1A8, Canada; E-Mail: (C.K.J.L.)
| | - Richard G. Foty
- The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada; E-Mail: (R.G.F.)
| | - Amanda J. Wheeler
- Health Canada, 269 Laurier Ave West, Ottawa, Ontario K1A 0K9, Canada; E-Mails: (A.J.W.); (D.M.S.)
| | - J. David Miller
- Chemistry Department, Carleton University, Ottawa, Ontario K1S 5B6, Canada; E-Mail: (J.D.M.)
| | - Greg Evans
- University of Toronto, 200 College Street, Toronto, Ontario M5S 2E5, Canada; E-Mail: (G.E.)
| | - David M. Stieb
- Health Canada, 269 Laurier Ave West, Ottawa, Ontario K1A 0K9, Canada; E-Mails: (A.J.W.); (D.M.S.)
| | - Sharon D. Dell
- The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada; E-Mail: (R.G.F.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-416-813-6248; Fax: +1-416-813-6246
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13
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Abstract
The prevalence of human allergy to pet danders has increased rapidly over the past six decades, as a consequence of lifestyle changes that have enhanced ambient exposure to pet allergens. This is a problem of global public health importance, as the morbidity associated with allergic diseases disproportionately affects socio-economically disadvantaged populations, particularly children. Although the public often seeks advice from veterinary health-care professionals regarding healthy pet ownership practices, including strategies for reducing residential pet dander exposure, many misconceptions persist in the public domain regarding pet dander allergy, such as the belief that certain dog and cat breeds are 'hypoallergenic' due to their hair/coat type. This review considers the epidemiology of human exposure to the major cat and dog dander allergens, Fel d 1 and Can f 1 respectively, and the sensitization mechanisms to them, including the hygiene hypothesis and the putative role of bacterial endotoxin. The literature regarding primary and secondary exposures in different ambient environments is explored including threshold effects that influence allergen sensitization and elicitation of symptoms, and environmental intervention strategies that seek to reduce allergen exposure. Pet-specific factors, including the aetiopathogenesis of the several cat and dog allergens that have been characterized to the molecular level, individual animal characteristics that influence Fel d 1 and Can f 1 shedding, and pet-directed interventions intended to reduce allergen dispersal, are discussed.
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Affiliation(s)
- Daniel O Morris
- Department of Clinical Studies - Philadelphia, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey St., Philadelphia, PA 19104, USA.
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14
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Arlian LG, Elder BL, Morgan MS. House dust mite extracts activate cultured human dermal endothelial cells to express adhesion molecules and secrete cytokines. JOURNAL OF MEDICAL ENTOMOLOGY 2009; 46:595-604. [PMID: 19496432 PMCID: PMC2736796 DOI: 10.1603/033.046.0326] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The human skin contacts molecules from house dust mites that are ubiquitous in many environments. These mite-derived molecules may penetrate the skin epidermis and dermis and contact microvascular endothelial cells and influence their function. The purpose of this study was to determine the response of normal human dermal microvascular endothelial cells to extracts of the dust mites, Dermatophagoides farinae, D. pteronyssinus, and Euroglyphus maynei with and without endotoxin (lipopolysaccharide). Endothelial cells were stimulated with mite extracts and the expression of surface molecules and the secretion of cytokines were measured in the absence and presence of polymyxin B to bind endotoxin. All three mite extracts stimulated endothelial cells to express intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and E-selectin and to secrete interleukin (IL)-6, IL-8, monocyte chemoattractant protein (MCP-1), and granulocyte/macrophage colony stimulating factor (GM-CSF). Euroglyphus maynei-induced expression of all the cell surface molecules was not inhibited when the endotoxin activity in the mite extract was inhibited. In contrast, endothelial cells challenged with D. farinae or D. pteronyssinus extract depleted of endotoxin activity expressed only constitutive levels of ICAM-1, VCAM-1, and E-selectin. D. farinae and E. maynei extracts depleted of endotoxin activity still induced secretion of IL-8 and MCP-1 but at reduced levels. Only constitutive amounts of IL-6, G-CSF, and GM-CSF were secreted in response to any of the endotoxin-depleted mite extracts. Extracts of D. farinae, D. pteronyssinus, and E. maynei contain both endotoxins and other molecules that can stimulate expression of cell adhesion molecules and chemokine receptors and the secretion of cytokines by normal human microvascular endothelial cells.
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Affiliation(s)
- Larry G Arlian
- Department of Biological Sciences, Wright State University, 3640 Col. Glenn Highway, Dayton, OH 45435, USA.
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15
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Teplitsky V, Mumcuoglu KY, Babai I, Dalal I, Cohen R, Tanay A. House dust mites on skin, clothes, and bedding of atopic dermatitis patients. Int J Dermatol 2008; 47:790-5. [PMID: 18717857 DOI: 10.1111/j.1365-4632.2008.03657.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Atopic dermatitis is a common allergic condition in children, often associated with a positive skin reaction to house dust mite allergens. AIM To determine the presence of house dust mites on the skin, clothes, and bedding of patients with atopic dermatitis. METHODS Nineteen patients with atopic dermatitis were examined during a 2-year period. Samples from affected and healthy skin surfaces were obtained with adhesive tape, and dust samples from bedding and clothes were collected with a vacuum cleaner at the start of the study and 3-6 weeks later, and examined for the presence of house dust mites. The findings were compared with those of 21 healthy controls. RESULTS The most common mite species on skin were Dermatophagoides pteronyssinus and Dermatophagoides farinae, which were found in nine patients and three controls. The patient group showed a significantly larger percentage of samples with mites than did the control group (34.9% and 7.9%, respectively) (P < 0.001), and a significantly larger percentage of individuals with at least one positive sample (84.2% and 14.2%, respectively) (P < 0.0001). No correlation was found between the number of mites on the skin and clothes/bedding of patients, or between patients and controls with regard to the number of mites on the clothes and bedding. CONCLUSIONS Patients with atopic dermatitis showed a higher prevalence of mites on their skin than did healthy individuals, which could be involved in allergic sensitization and disease exacerbation.
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Affiliation(s)
- Valery Teplitsky
- Allergy and Immunology Subunit, Pulmonary Institute, Rabin Medical Center, Petah Tiqwa, Israel
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16
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Pucheu-Haston CM, Jackson HA, Olivry T, Dunston SM, Hammerberg B. Epicutaneous sensitization with Dermatophagoides farinae induces generalized allergic dermatitis and elevated mite-specific immunoglobulin E levels in a canine model of atopic dermatitis. Clin Exp Allergy 2008; 38:667-79. [DOI: 10.1111/j.1365-2222.2008.02949.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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17
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Romei I, Boner AL. Possible reasons for lack of effect of allergen avoidance in atopy-prone infants and sensitive asthmatic patients. Clin Rev Allergy Immunol 2005; 28:59-71. [PMID: 15834169 DOI: 10.1385/criai:28:1:059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The basic paradigm that allergen exposure produces atopic sensitization, and that continued exposure leads to clinical asthma throughout the development of airway inflammation and bronchial hyperreactivity has been challenged. However, because it was observed that epidemiological evidence suggests that around 40% of asthma cases are attributable to atopy (even using restrictive criteria), the obvious corollary is that if allergen avoidance begins before the onset of sensitization (primary prevention), then it should be associated with a reduced number of new cases of the disease. However, there are conflicting results regarding the effect of allergen avoidance on primary prevention of atopic sensitization and asthma onset. Instead, more uniform and positive results are available from secondary prevention studies. Secondary prevention obviously is an attractive opportunity for pediatricians who may recognize the patients who might benefit from these interventions simply by screening for food allergy in young children with atopic dermatitis. The conflicting results of tertiary prevention are most frequently observed in adult patients and sometimes result from incomplete avoidance of allergens responsible for the sensitization.
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Affiliation(s)
- I Romei
- Department of Pediatrics, University of Verona Italy, Policlinico G.B. Rossi, Piazzale L. Scuro, 1 Verona, Italy
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18
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Randall AJ, Hillier A, Cole LK, Kwochka KW, Needham G, Wassom DL. Quantitation of house dust mite allergens (Der f 1 and group 2) on the skin and hair of dogs. Am J Vet Res 2005; 66:143-9. [PMID: 15691050 DOI: 10.2460/ajvr.2005.66.143] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the concentration of house dust mite (HDM) allergens, Der f 1 and group 2, on the skin and hair of dogs and whether associations exist between the presence of Der f 1 and group 2 allergens on the skin and hair of dogs and household and dog characteristics. ANIMALS 63 pet dogs from 50 homes. PROCEDURE Dogs were weighed and body surface area in square meters was determined. Skin and hair samples were obtained by vacuuming dogs. Collected dust was analyzed by use of standard ELISA techniques. RESULTS HDM allergen was detected in 21 of 59 skin and hair samples. Presence of group 2 allergen on skin and hair of dogs was significantly associated with long hair, compared with short or medium length hair. Median house dust sample concentrations of Der f 1 and group 2 allergens were high in homes with dogs that had skin and hair samples that were positive for Der f 1 and group 2 allergens. Dogs with skin and hair samples that were positive for Der f 1 and group 2 allergens resided in homes with a high number of house dust samples that were positive for Der f 1, group 2, or both allergens and in homes with a mean house dust sample allergen concentration of > or =2 microg/g of dust. CONCLUSIONS AND CLINICAL RELEVANCE Associations exist between environmental HDM allergen concentrations and HDM allergens on the skin and hair samples of dogs. Environmental allergen load is a major factor in accumulation of allergens on the skin and hair of dogs.
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Affiliation(s)
- Amy J Randall
- Carolina Veterinary Specialists, 501 Nicholas Rd, Greensboro, NC 27409, USA
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19
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Pereira FL, Silva DAO, Sopelete MC, Sung SSJ, Taketomi EA. Mite and cat allergen exposure in Brazilian public transport vehicles. Ann Allergy Asthma Immunol 2004; 93:179-84. [PMID: 15328679 DOI: 10.1016/s1081-1206(10)61472-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Mites and pets are important sources of indoor allergens. OBJECTIVES To determine Dermatophagoides pteronyssinus (Der p 1), Dermatophagoides farinae (Der f 1), and Felis domesticus (Fel d 1) allergen levels in buses and taxis and to evaluate the predominant allergen in each vehicle type. METHODS Mite and cat allergens were measured using enzyme-linked immunosorbent assay in dust samples collected from upholstered seats in 60 natural-ventilation buses (NVBs), 60 artificial-ventilation buses (AVBs), and 60 taxis. Thirty dust samples from AVB air-conditioning filters were also included. RESULTS Levels of Der p 1 and Der f 1 were significantly higher in AVBs than in NVBs, whereas Fel d 1 levels were not significantly different between bus types. No significant differences were found in mite allergen levels in various sites in both types of buses, whereas Fel d 1 levels were significantly higher in rear and middle seats than in front seats in NVBs. Mite and cat allergen levels in taxis were significantly higher in passenger's rear seats than in driver's seats. A high proportion of dust samples from the vehicles, especially AVBs (82% for Der p 1 and 58% for Der f 1) had sensitizing levels of mite allergens, whereas more than 60% of samples from all vehicles had sensitizing levels of Fel d 1 allergen. In AVBs, samples from seats showed significantly higher levels of mite and cat allergens than those from air-conditioning filters. CONCLUSIONS Public transport vehicles constitute an important allergen reservoir for continuous contamination of the indoor environment.
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Affiliation(s)
- Fernando L Pereira
- Laboratory of Allergy and Clinical Immunology, Biomedical Science Institute, Federal University of Uberlândia, Uberlândia, MG, Brazil
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20
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Capristo C, Romei I, Boner AL. Environmental prevention in atopic eczema dermatitis syndrome (AEDS) and asthma: avoidance of indoor allergens. Allergy 2004; 59 Suppl 78:53-60. [PMID: 15245359 DOI: 10.1111/j.1398-9995.2004.00652.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Indoor allergens represent an important precipitating factor for both asthma and atopic eczema dermatitis syndromes (AEDS). There is also accumulating evidence that sensitization to those allergens is associated with the onset of atopic disorders. Patients with AEDS present aeroallergen-specific T-cell responses associated with worsening of symptoms when exposed to specific aeroallergens. Furthermore, application of indoor allergens to the skin of patient with AEDS induces a local eczematous response in one-third of these patients. Exposure to high concentrations of mite allergens in early infancy have been demonstrated to be a risk factor for developing atopic dermatitis during the first 3 years of life. Moreover, a clear dose-response relationship has been documented between mite exposure and disease activity. Primary prevention of AEDS by avoiding indoor allergen exposure has been proved to be effective only when allergenic foods have also been avoided. Mite allergen avoidance in infants with AEDS and food allergy may however, prevent mite sensitization and the onset of asthma. Indoor allergen avoidance has been demonstrated to be effective in the majority of studies performed in patients with established AEDS. Negative results may be explained either by individual susceptibility variation, by long duration of disease with the consequent irreversible pathological changes in the target tissue or by exposure to allergens outside the house. Education of the patients and public consciousness of the problems are crucial for the efficacy of indoor allergen avoidance in allergic diseases.
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Affiliation(s)
- C Capristo
- Department of Pediatris Second University of Naples, Italy
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21
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Abstract
The house dust mites D. farinae, D. pteronyssinus, and E. maynei are sources of multiple potent allergens in the indoor environment. They are common inhabitants in homes worldwide. Many biologically significant studies have revealed how well adapted these mites are to the microhabitats in homes. Ambient RH is a key factor in determining where these mites are found. Many aspects of the biology of house dust mites are not understood. A greater understanding of the biology of dust mites may reveal new strategies for controlling dust mites and their allergens in homes.
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Affiliation(s)
- Larry G Arlian
- Department of Biological Sciences, Wright State University, 3640 Colonel Glenn Highway, Dayton, OH 45435-0001, USA.
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22
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Arlian LG, Vyszenski-Moher DL, Morgan MS. Mite and mite allergen removal during machine washing of laundry. J Allergy Clin Immunol 2003; 111:1269-73. [PMID: 12789228 DOI: 10.1067/mai.2003.1547] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Few studies have investigated live house dust mite and mite allergen removal from clothing and bedding by washing machines. No studies have investigated the transfer of mites from infested to uninfested clothing and bedding during washing. OBJECTIVE The purpose of this study was to wash different types of clothing and bedding in residential washing machines to determine the live Dermatophagoides farinae mite and allergen removal and the mite transfer from mite-infested items to mite-free items. METHODS Clothing and bedding items were machine washed in 6- and 8-lb loads in warm (36 degrees C-38 degrees C) or cold (22 degrees C-27 degrees C) water with and without recommended concentrations of laundry detergent and sodium hypochlorite bleach. Live mites and allergen present in washed versus unwashed and washed mite-infested versus washed mite-free items were compared. RESULTS Washing clothing and bedding in water alone, detergent, or detergent plus bleach removed 60% to 83% of the live mites. Washing removed more mites from some items than from others. When mite-infested items were washed with identical sets of mite-free items, many live mites were transferred to the previously mite-free items. Overall, 84% of Der f 1 was removed from items washed in water alone or in detergent and 98% from items washed in detergent plus bleach. CONCLUSIONS Washing clothing and bedding in cold or warm water with detergent or detergent plus bleach removed most allergen and a significant (P <.05) portion of live mites. Repeated washing is required to further reduce mite levels. Live mites were transferred from mite-infested to mite-free items during washing.
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Affiliation(s)
- Larry G Arlian
- Department of Biological Sciences, Wright State University, Dayton, OH 45435-0001, USA
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23
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Glass EV, Reid RA, Hillier A, Needham GR. Use of an amplified ELISA technique for detection of a house dust mite allergen (Der f 1) in skin and coat dust samples from dogs. Am J Vet Res 2003; 64:162-5. [PMID: 12602584 DOI: 10.2460/ajvr.2003.64.162] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To use an amplified ELISA technique to document the presence and quantify the concentration of the house dust mite allergen, Der f 1, in skin and coat dust samples collected from dogs. ANIMALS 29 pet dogs of various breeds. PROCEDURE Dogs were weighed, and body surface area in square meters was determined. Skin and coat dust samples were obtained by vacuuming dogs. Collected dust was analyzed by use of standard and amplified ELISA techniques. RESULTS By use of the standard ELISA technique, Der f 1 was detected in skin and coat dust samples from 6 of 29 (21%) dogs. Mean concentration of Der f 1 in the 6 samples with positive assay results was 16.16 ng/mL (range, 5.61 to 31.24 ng/mL). Samples with negative assay results were retested for dust mite allergen by use of an amplified ELISA technique; an additional 14 dogs had positive assay results. Mean concentration of allergen was 0.36 ng/mL (range, 0.19 to 2.20 ng/mL). Combining both techniques, 20 of 29 (69%) dogs had positive assay results for Der f 1. CONCLUSIONS AND CLINICAL RELEVANCE Results of our study indicate that house dust mite allergens are present on the skin and in the coat of dogs, and this source of allergen may act as a reservoir for allergen exposure in hypersensitive dogs. Use of an amplified ELISA technique to determine environmental concentrations of house dust mite allergens in homes and on dogs will help to identify the relationship between immunologic findings and environmental exposures in dogs with atopic dermatitis.
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Affiliation(s)
- Emmett V Glass
- Acarine Physiology Laboratory, Department of Entomology, The Ohio State University, Columbus, OH 43210, USA
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25
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Abstract
The most important allergy-causing mites found in homes worldwide are the house dust mites Dermatophagoides farinae, D. pteronyssinus, Euroglyphus maynei, and the storage mite Blomia tropicalis. Most homes contain multiple species. The most prevalent mite species and allergen in homes differ geographically, between homes within a geographical region, and among areas within a home. Therefore, it is important to know which mite species are present in a geographical area when performing diagnostic testing and prescribing immunotherapy. The key factor that influences mite survival and prevalence is relative humidity. Mites are present in homes in humid geographical areas and are rare or absent in drier climates unless humidity is artificially raised. Generally speaking, dust mite allergen levels are low in public buildings and transportation compared to levels in homes.
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Affiliation(s)
- Larry G Arlian
- Department of Biological Sciences, Wright State University, 3640 Colonel Glenn Highway, Dayton, OH 45435-0001, USA.
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