Materiały źródłowe

• #1 Dust Mite Allergy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560718/

  Dust mite allergy is an IgE mediated Type 1 hypersensitivity reaction to dust mite allergens, commonly found in household dust. […] Dust mite allergy develops in childhood or adolescence, with the majority of symptoms manifesting before age 20. The dust mite’s gut contains peptidase 1, which is one of the potent digestive enzymes that persist in their fecal matter and is the major inducer of the allergy. Peptidase 1 exhibits cysteine protease activity. […] IgE mediated sensitization is responsible for the pathogenesis of dust mite allergy. This a Type 1 hypersensitivity reaction in which the CD4 + and T helper cells stimulate the B cells to produce IgE antibodies specific to the antigen, which is the house dust mite allergen. The IgE binds onto the FceRI receptors on mast cells and blood basophil cells. The mast cells and basophil cells now get sensitized to the allergen-specific IgE antibodies. On subsequent exposure to the same allergens, there is crosslinking of the bound IgE sensitized cells, leading to their degranulation. The inflammatory mediators are released, causing the clinical manifestation of the dust mite allergy.

• #1 House Dust Mite Allergy and the Der p1 Conundrum: A Literature Review and Case Series

  https://www.mdpi.com/2313-5786/1/2/8

  The house dust mite (HDM) is globally ubiquitous in human habitats. It is considered the main indoor allergen cause of allergic rhinitis and asthma. Allergies are common in 50% of all adult asthmatic patients, and up to 85% of them are allergic to HDMs, independent of differences in geography, temperature, and humidity. The main HDM species include Dermatophagoides pteronyssius (Der p), Dermatophagoides farina (Der f), and Blomia tropicalis, which coexist in most geographical regions. Group 1 (Der p 1, Der f1), group 2 (Der p 2, Der f 2), and group 23 (Der p 23) are considered the dominant allergens. […] Twenty-one group 1 allergens have been found to have protease activity that can destroy epithelial tight junctions. Thirty-two group 2 allergens may mimic the effect of Toll-like receptor 4 coreceptor MD-2, and new ones are still being reported. The first aim of the present study was to summarize the information about the role of Der p1 as a key coordinator of the HDM-induced allergic response. Der p 1 is a papain-like cysteine protease. It is considered to be not only the most abundant HDM allergen in house dust and mite cultures but also a powerful allergenic protein. High levels of IgE specific for this protease have been developed by more than 80% of patients allergic to HDMs.

• #1 Dust mite allergy – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dust-mites/symptoms-causes/syc-20352173

  Dust mite allergy is an allergic reaction to tiny bugs that commonly live in house dust. […] Dust mites eat organic matter such as skin cells people have shed, and rather than drinking water, they absorb water from humidity in the atmosphere. […] When you have allergies, your immune system makes antibodies that identify your particular allergen as something harmful, even though it isn’t. When you come into contact with the allergen, your immune system produces an inflammatory response in your nasal passages or lungs. Prolonged or regular exposure to the allergen can cause the ongoing (chronic) inflammation associated with asthma. […] Dust also contains the feces and decaying bodies of dust mites, and it’s the proteins present in this dust mite „debris” that are the culprit in dust mite allergy.

• #1 The Role of Dust Mites in Allergy – PubMed

  https://pubmed.ncbi.nlm.nih.gov/29936683/

  House dust mites are an unsurpassed cause of atopic sensitization and allergic illness throughout the world. […] 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.

• #1

  https://journals.lww.com/ijaa/fulltext/2019/33010/an_indian_perspective_on_dust_mites.4.aspx

  Knowledge on the sources of dust mites is essential to implement targeted avoidance strategies. […] The identified allergens from dust mites as mentioned on http://www.allergen.org are as follows: D. pteronyssinus: 23 allergens, D. farinae: 32 allergens, Euroglyphus maynei: 5 allergens, A. siro: 1 allergen, B. tropicalis: 14 allergens, G. domesticus: 1 allergen, L. destructor: 5 allergens, T. putrescentiae: 8 allergens. […] Among the HDM allergens, Group 1 and 2 bind to 50% of the amount of IgE that binds to HDM extracts (i.e., major allergens). […] The major allergens (Group 1 Der p1, Der f 1 and Group 2 Der p2, Der f 2) from dust mites have been isolated from Indian homes and have also been estimated in the sera of Indian patients. […] From the available data as summarized in Tables 2 and 3, it becomes evident that the two Dermatophagoides species (D. farinae and D. pteronyssinus) are the most important sensitizers across India and should be evaluated in all patients with perennial respiratory allergic diseases.

• #1 Dust Mite Allergy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560718/

  When the house dust mite fecal pellets are inhaled, they contact the airway epithelium and become hydrated and discharge their allergenic contents onto a mucosal barrier. For interaction with dendritic antigen-presenting cells, potential allergens must cross this protective epithelium. The tight junctions are the route for their entry. The allergens, predominantly, Der p 1 disrupt these tight junctions by either of the following two processes: […] Der p 1, being the major cause of dust mite allergy, is responsible for triggering the IgE binding levels of 80 to 90 percent. It targets CD23 and CD25, which cleaves these receptors from the surface of the active B and T cells, respectively, triggering the further release of IgE. […] Dust mite allergy leads to the development of atopic asthma, which is a predisposition to the development of hypersensitivity Type 1 reactions.

• #1 Allergens with Protease Activity from House Dust Mites

  https://www.mdpi.com/1422-0067/18/7/1368

  Tight junctions between neighboring mucosal epithelial cells, consisting of the proteins occludin and claudin, regulate the paracellular transport of molecules through the airway mucosa. Normally, they prohibit uncontrolled entry of particles such as pollen or HDM fecal pellets. It has been demonstrated that, by its protease activity, Der p 1 increases the permeability of the airway mucosa by targeting the tight junction proteins. […] There are different mechanisms by which the Der p 1-protease activity can contribute to Th2-related disease. One way to do this is the promotion of Th2 responses. […] The presentation of processed antigen by APCs to T cells is a crucial step in the adaptive immune response. […] The level of IgE-production by B cells is regulated by a negative feedback mechanism that involves IgE-binding to CD23, the low-affinity receptor for IgE (FcεRII), which is present on the surface of these cells.

• #1 House dust mite-related respiratory allergies and probiotics: a narrative review | Clinical and Molecular Allergy | Full Text

  https://clinicalmolecularallergy.biomedcentral.com/articles/10.1186/s12948-018-0092-9

  This study stated that young children in their first 3 years of life have the highest chance of contracting the allergy when exposed to HDM allergens, such as Der p 1 and Der f 1, at levels of 10 mcg/g of carpet dust. […] When exposure to the HDM allergens is as low as 0.1 mcg/g of dust, the probability of contracting HDM allergy is significantly reduced. […] While there appears to be a linear relationship between the level of exposure to allergens and HDM allergy, a wide range of scientific studies state otherwise. […] Different allergens from HDMs vary significantly in size, and this aspect can significantly impact the way that they are inhaled. […] As allergens are inhaled by the exposed individual, they enter the epithelial linings of the lungs and trigger the spread of dendritic cells into the lymph nodes.

• #1 Overview of Allergic and Atopic Disorders – Immunology; Allergic Disorders – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/immunology-allergic-disorders/allergic-autoimmune-and-other-hypersensitivity-disorders/overview-of-allergic-and-atopic-disorders

  Allergic (including atopic) and other hypersensitivity disorders are inappropriate or exaggerated immune reactions to foreign antigens. […] Type I reactions (immediate hypersensitivity) are IgE-mediated. Antigen binds to IgE that is bound to tissue mast cells and blood basophils, triggering release of preformed mediators (eg, histamine, proteases, chemotactic factors) and synthesis of other mediators (eg, prostaglandins, leukotrienes, platelet-activating factor, cytokines). These mediators cause vasodilation, increased capillary permeability, mucus hypersecretion, smooth muscle spasm, and tissue infiltration with eosinophils, type 2 helper T (TH2) cells, and other inflammatory cells. […] Type I hypersensitivity reactions develop. […] Type I reactions underlie all atopic disorders (eg, atopic dermatitis, allergic asthma, rhinitis, conjunctivitis) and many allergic disorders (eg, anaphylaxis, some cases of angioedema, urticaria, latex and some food allergies).

• #1 Dust Mite Allergy – ECARF

  https://www.ecarf.org/en/information-portal/allergies-overview/dust-mite-allergy/

  The allergenic effect is actually due to certain proteins in the droppings of house dust mites (including the proteins Der p1 and Der p2). […] The immune system then generates IgE antibodies in reaction to the proteins, which are actually harmless. These antibodies bind to the bodys defence cells, known as mast cells, which then release anti-inflammatory substances such as histamine. […] Histamine and other messenger substances stimulate the glands to release secretions and irritate the nerves, causing itching, sneezing and vasodilation that leads to redness and swelling of the mucous membranes. […] Constant exposure to allergens may lead to chronic inflammation of the nasal mucosa, which may in turn lead to nasal turbinate hypertrophy. […] A hypersensitive reaction can also occur in the bronchial mucosa after some time, causing bronchial asthma.

• #1 The Role of Dust Mites in Allergy – PubMed

  https://pubmed.ncbi.nlm.nih.gov/29936683/

  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. […] 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.

• #1 Dust mite insights may lead to tools to fight against allergies and asthma | Hub

  https://hub.jhu.edu/2020/07/23/dust-mite-allergies-research/

  Researchers at Johns Hopkins Bloomberg School of Public Health have identified the sequence of molecular events by which tiny, tick-like creatures called house dust mites trigger asthma and allergic rhinitis. […] The researchers showed step-by-step how this interaction between mite-molecules and SAA1 triggers an allergic-type immune response in mice. […] The findings reveal what may be a significant new pathway by which allergic and inflammatory disorders arise. […] They also suggest that blocking the pathway could potentially work as a preventive or treatment strategy against asthma and other allergic reactions. […] The researchers found that exposure to dust-mite proteins causes an asthma-like sensitization of the airways of the control group mice. […] Further experiments confirmed that SAA1, when it is present, directly binds certain dust-mite allergens called fatty-acid binding proteins, which have structural similarities with proteins found in some bacteria and parasites.

• #1 Dust mite insights may lead to tools to fight against allergies and asthma | Hub

  https://hub.jhu.edu/2020/07/23/dust-mite-allergies-research/

  This allergen-SAA1 interaction releases SAA1 into its active form, wherein it activates a receptor called FPR2 on airway-lining cells. […] The airway cells then produce and secrete large quantities of interleukin-33, a protein known for its ability to stimulate allergic-type immune responses. […] The researchers suspect that the newly described SAA1-FPR2 allergic pathway may be relevant not only in asthma and hay fever-type disorders but also in eczema and food allergiespossibly even in chronic inflammatory disorders such as rheumatoid arthritis and atherosclerosis.

• #1 Pathogenesis of allergic diseases and implications for therapeutic interventions | Signal Transduction and Targeted Therapy

  https://www.nature.com/articles/s41392-023-01344-4

  The pathogenesis of allergic diseases is complex, involving many factors such as genetics, epigenetics, environmental factors, microecology and the body’s immune function. […] The immunopathological profiles of AR and AAS are very similar in terms of eosinophil, mast cell and Th2 cell infiltration. […] Allergens cross-link IgE that interact with mast cells, which further induces the release of multiple mediators (including histamine and leukotrienes), promotes arteriole dilation and vascular permeability, and causes pruritus, runny nose, mucus secretion, and pulmonary smooth muscle contraction. […] The pathogenesis of allergic diseases is complex and involves many factors, including maternal-fetal environment, living environment, genetics, epigenetics, and the body’s immune status. […] The pathogenesis of allergic diseases exhibits a marked heterogeneity, with phenotype and endotype defining visible features and associated molecular mechanisms, respectively.

• #1 AAIR :: Allergy, Asthma & Immunology Research

  https://e-aair.org/DOIx.php?id=10.4168/aair.2019.11.4.450

  In genetically susceptible individuals, immune responses to allergens are mainly based on specific IgE and type 2 cytokines, such as interleukin (IL)-4, IL-5 and IL-13. Specific IgE primary responses to allergens are exclusively produced through the adaptive pathways of immunity. After sensitization, re-exposure to allergens initiates the IgE-dependent inflammatory cascade, which involves additional cells and ILs that actively participate in inflammatory reactions. […] The impact of environmental changes on these factors might modify the frequency and strength of allergen sensitization; therefore, some of them will be assessed in this review. […] Humidity is a great limiting factor for HDM growth and has a profound influence on their reproduction. Mites absorb vital moisture from the air through their exoskeletons and supra coaxial glands, requiring high air humidity to prevent excessive water loss. […] Increased house humidity has been associated with increased prevalence of allergic and respiratory symptoms of asthma as well as IgE levels and is a well-recognized risk factor for HDM allergy worldwide.

• #1 AAIR :: Allergy, Asthma & Immunology Research

  https://e-aair.org/DOIx.php?id=10.4168/aair.2019.11.4.450

  As occurs in other living beings, mite metabolism and homeostasis largely depend on the environment; therefore, changes in diet, quality of air and water, temperature, and humidity or exposure to infectious agents could modify the level of gene expression of different cell components, some of them allergenic for humans. […] Among the projected adverse consequences of climate change is the increase of meteorological events such as hurricanes and cyclones. […] Air pollution has been one of the most detrimental environmental changes since industrial revolution; its characteristics and effects on increasing allergic sensitization and symptoms have been reviewed elsewhere. […] A significant increase in the transcription of allergens Der p 3, Der p 8 and Der p 21 was observed after exposing mites to a high concentration of diesel exhaust particles.

• #1 Overview of Allergic and Atopic Disorders – Immunology; Allergic Disorders – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/immunology-allergic-disorders/allergic-autoimmune-and-other-hypersensitivity-disorders/overview-of-allergic-and-atopic-disorders

  Complex genetic, environmental, and site-specific factors contribute to development of IgE-mediated allergies. […] Genetic factors may be involved, as suggested by familial inheritance of disease, association between atopy and specific human leukocyte antigen (HLA) loci, and polymorphisms of several genes, including those for the high-affinity IgE receptor beta-chain, IL-4 receptor alpha-chain, interleukin (IL)-4, IL-13, CD14, dipeptidyl-peptidase 10 (DPP10), and a disintegrin and metalloprotease domain 33 (ADAM33). […] Environmental factors interact with genetic factors to maintain type 2 helper T (TH2) cell-directed immune responses. […] Anatomic site-specific factors include adhesion molecules in bronchial epithelium and skin and molecules in the gastrointestinal (GI) tract that direct TH2 cells to target tissues.

• #1 Dust Mite Allergy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560718/

  House dust mite allergy plays a role in the development or exacerbation of atopic dermatitis. The house dust mite allergens activate the pattern activation receptors that include toll-like receptor 1, toll-like receptor 6, and toll-like receptor 9 and nucleotide-binding oligomerization domain 2. This leads to a release of innate proallergic cytokines, namely interleukin-25 and interleukin-33, in epidermal keratinocytes, causing the activation of the innate immune system in the keratinocytes.

• #1 New research on dust mites and respiratory infections | Lund University

  https://www.lunduniversity.lu.se/article/new-research-dust-mites-and-respiratory-infections

  When asthmatics respiratory tracts are exposed to dust mites, their immune response becomes less effective, which can lead to a weaker immune system. […] The results showed that an allergy to dust mites was in itself a factor that diminished asthmatics protection against viruses, i.e. the epithelial cells were less effective in producing antiviral interferons. […] This demonstrates that dust mite allergy, and the mere fact that an asthmatics respiratory tract has been exposed to dust mites, results in reduced protection from infection. […] The results of the study suggest that asthmatics ought to avoid dust mites and that patients who are also allergic to dust mites might benefit from undergoing so-called hyposensitisation immunotherapy against dust mites, in order to increase their tolerance of this allergen. […] An understanding of which dust mite components inhibit the bodys defences against viruses and bacteria could lead to new medicines that block precisely those components.

• #1

  https://us.klarify.me/pages/dust-mite-allergy-rash

  House dust mite allergens can trigger atopic dermatitis (eczema) or make eczema symptoms worse. […] So how do house dust mites cause atopic dermatitis or dust mite allergy rash? Well dust mites can be a trigger factor in some people. Allergens can damage the outer layer of the skin by reducing skin barrier function. They can also penetrate at a deeper level, potentially causing inflammation and chronic itching. In both instances, this could leave the skin vulnerable and delay healing and recovery. […] Dust mite allergies are an IgE-mediated Type I allergic reaction. This means your immune system incorrectly interprets dust mites as a threat. And it creates specific Immunoglobulin E (IgE) antibodies as a defense. The next time you encounter dust mites your antibodies alert cells to release chemicals, including histamine. This is what causes dust mite allergy symptoms, such as a rash. An allergic reaction to dust mites usually shows itself within 24 hours.

• #1 House dust mite exposure enhances immune responses to ovalbumin-induced intestinal allergy | Scientific Reports

  https://www.nature.com/articles/s41598-022-09196-8

  House dust mites (HDM) are one of the important factors of airway allergic diseases, HDM allergens can be detected in the human gut mucosa, which induces local inflammation and increases intestinal epithelial permeability. […] In conclusion, HDM exposure enhances immune responses to OVA-induced food allergy. […] Based on the information above, we hypothesize that HDM may be not only an aeroallergen, but also an important allergen in food allergy. […] The data demonstrate that HDM not only is an aeroallergen, which induces airway allergy, but also enhances subsequent immune responses to OVA-induced food allergy. […] The specific immune response to HDM was also measured by testing the serum specific immunoglobulin levels. […] Therefore, there is a hypothesis that some HDM proteins, such as Der p1, can act as mucosal adjuvant, which facilitate Th2 polarization, contribute to the intestinal barrier dysfunction, and increase the allergen transportation across the intestinal epithelial barrier. […] Consequently, results show that the exposure to HDM is able to induce intestinal barrier dysfunction, and facilitate the development of intestinal allergy in mice.

• #1 Allergy to Dust Mites – Allergy & Asthma Network

  https://allergyasthmanetwork.org/allergies/allergy-to-dust-mites/

  Allergy shots and allergy tablets are forms of immunotherapy. […] When you begin allergen immunotherapy, your allergist will give weekly injections for 6-12 months. Each shot contains increased doses of dust mite allergen, encouraging your immune system to become more tolerant and exhibit a milder response. […] Numerous studies have found a relationship between house dust mites and shrimp. The protein tropomyosin is a cross-reacting allergen found in both dust mites and shrimp.

• #1 Dust mite allergy – Wikipedia

  https://en.wikipedia.org/wiki/Dust_mite_allergy

  Dust mite allergy, also known as house dust allergy, is a sensitization and allergic reaction to the droppings of house dust mites. The mite’s gut contains potent digestive enzymes (notably peptidase 1) that persist in their feces and are major inducers of allergic reactions such as wheezing. The mite’s exoskeleton can also contribute to allergic reactions. […] Allergen immunotherapy is the only treatment that alters the disease mechanism. […] Dust mites are a nesting species that prefer a dark, warm, and humid climate. They flourish in mattresses, bedding, upholstered furniture, and carpets. Their feces include enzymes that are released upon contact with a moist surface, which can happen when a person inhales, and these enzymes can kill cells within the human body. […] Allergen immunotherapy (AIT, also known as desensitization or hypo-sensitization) is a treatment involved in administering the doses of allergens to accustom the body to substances that are generally harmless (pollen, house dust mites), thereby inducing specific long-term tolerance.

• #1 Clinical and Experimental Pediatrics

  https://www.e-cep.org/m/journal/view.php?number=20125555563

  Allergen immunotherapy (AIT) has developed over the last few decades and has emerged as a promising treatment. House dust mite (HDM) is a target allergen in AIT, and various modified HDM allergens have been improved for their efficacy. […] This article review focuses on HDM allergens developed for AIT efficacy, and determines that their action mechanisms are strongly based on immune tolerance. […] The effective mechanisms subsequent to AIT include the suppressive actions of interleukin-10 and transforming growth factor- secreted by regulatory cells, including regulatory T cells and regulatory B cells, and isotype switching from immunoglobulin E to immunoglobulin G4. […] Immune tolerance is a complex and antiallergic mechanism after artificial exposure to a modified allergen. […] The downregulated Th2 cytokines (such as IL-4, IL-5, and IL-13) block the degranulation of basophils and mast cells diminishing the release of histamine and lipid metabolites such as prostaglandin and leukotriene, and decreased tissue injury.

• #1 Clinical and Experimental Pediatrics

  https://www.e-cep.org/m/journal/view.php?number=20125555563

  Conversion from IgE to IgG4 is an inevitable process in immune tolerance after AIT and suppresses the activation of basophils and mast cells due to IgE by kidnapping the allergen. […] A different subset of B cells that prefer the inhibition of an excessive allergic response is named regulatory B 1 (Breg1) cells. […] They are characterized by CD25+ CD71+CD73lowexpression and produce IL-10, TGF-, and IL-35 to decrease the inflammatory response.

• #1 Dust mite allergy – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dust-mites/diagnosis-treatment/drc-20352178

  Your doctor may suspect dust mite allergy based on symptoms and your answers to questions about your home. […] Your doctor may suspect a dust mite allergy if your symptoms are worse when you go to bed or while cleaning when dust mite allergens would be temporarily airborne. […] The first treatment for controlling dust mite allergy is avoiding dust mites as much as possible. When you minimize your exposure to dust mites, you can expect fewer or less severe allergic reactions. […] Immunotherapy is delivered either through a series of allergy shots or tablets taken under the tongue (sublingually). One to two weekly shots or tablets expose you to very small doses of the allergen in this case, the dust mite proteins that cause the allergic reaction. […] If you suspect that you may have dust mite allergy, take steps to reduce house dust, particularly in your bedroom.

• #1 Dust Mite Allergy | AAFA.org

  https://aafa.org/allergies/types-of-allergies/insect-allergy/dust-mite-allergy/

  Dust mites may be the most common trigger of year-round allergies and allergic asthma. […] Both the body parts and the waste of dust mites are allergens for many people. […] In a warm, humid house, dust mites can survive all year. […] The most important step is to avoid dust mites as much as possible. Limiting your exposure to dust mites will reduce your symptoms. […] Many people with a dust mite allergy do not get complete relief from medicines. This means they may consider immunotherapy (allergy shots). […] Immunotherapy is a long-term treatment that can help prevent or reduce the severity of allergic reactions. […] SCIT is a series of shots that have progressively larger amounts of allergen. […] SCIT can provide long-lasting symptom relief. […] SLIT is a way to treat dust mite allergies without injections. […] This exposure improves tolerance to the dust mites and reduces symptoms.

• #1 AAIR :: Allergy, Asthma & Immunology Research

  https://e-aair.org/DOIx.php?id=10.4168/aair.2019.11.4.450

  Environmental variations induced by industrialization and climate change partially explain the increase in prevalence and severity of allergic disease. One possible mechanism is the increase in allergen production leading to more exposure and sensitization in susceptible individuals. House dust mites (HDMs) are important sources of allergens inducing asthma and rhinitis, and experimentally they have been demonstrated to be very sensitive to microenvironment modifications; therefore, global or regional changes in temperature, humidity, air pollution or other environmental conditions could modify natural HDM growth, survival and allergen production. […] We also assess the role of adjuvants of IgE responses, such as air pollution and helminth infections, and discuss the genetic and epigenetic aspects that could influence the adaptive process of humans to drastic and relatively recent environmental changes we are experiencing.

• #1 Dust Mite Allergy – ECARF

  https://www.ecarf.org/en/information-portal/allergies-overview/dust-mite-allergy/

  One form of therapy that treats the cause of house dust mite allergy is (allergen) specific immunotherapy (SIT). […] The purpose of SIT is to allow the immune system to become used to the house dust mite allergens over a longer period of time. […] The treatment also reduces the risk of developing asthma.

• #1 House Dust Mite Allergy and the Der p1 Conundrum: A Literature Review and Case Series

  https://www.mdpi.com/2313-5786/1/2/8

  However, the different cell pathways triggered by active Der p 1 are still unclear due to the difficulty of isolating natural Der p 1, free of serine protease contamination, from HDM allergen extracts. Accordingly, these limitations stimulated research into the contribution of Der p 1 protease activity in developing a HDM-induced allergic response by means of papain, a structurally similar cysteine protease that is considered to be a surrogate for Der p 1 and HDM allergen extracts, in the presence or absence of cysteine protease inhibitors. […] Many questions still remain about the possibility of Der p 1 being a digestive enzyme and of its role as a potent activator of other mite allergens and innate immune pathways. However, the drastic effect on allergen content and release from mite fecal pellets through the protease activity of Der p1 confirms the role of Der p 1 as a key coordinator of the HDM-induced allergic response.

• #2 The Role of Dust Mites in Allergy – PubMed

  https://pubmed.ncbi.nlm.nih.gov/29936683/

  House dust mites are an unsurpassed cause of atopic sensitization and allergic illness throughout the world. […] 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.

• #2

  https://journals.lww.com/ijaa/fulltext/2019/33010/an_indian_perspective_on_dust_mites.4.aspx

  Dust mites are the most important group of indoor allergens. […] In view of high sensitization in India, it is important to recognize the role of dust mites and their allergens in the precipitation of allergic diseases including allergic rhinitis and asthma. […] Allergy to dust mites has been strongly associated with the development of respiratory allergic diseases, such as asthma and allergic rhinitis. […] Dust mites are a potent source of indoor allergens; their specific biology allows them to thrive in indoor domestic conditions and also allows them (their allergens) to be in close contact with living persons. […] The best-recognized storage mites are Acarus siro, Blomia tropicalis, Glycyphagus domesticus, Lepidoglyphus destructor, and Tyrophagus putrescentiae. […] Temperature (25C30C) and humidity (55%75% RH) are required by the dust mites to thrive well.

• #2 Dust Mite Allergy: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17712-dust-mite-allergy

  A dust mite allergy causes your immune system to react to proteins found in dust mites. […] Dust mites have proteins in their feces (poop) and dead bodies. Usually, these substances called allergens are harmless. However, your immune system views them as harmful invaders, like bacteria or viruses, and responds to get them out of your body. […] If you have a dust mite allergy, the first time you encounter dust mite proteins, your body responds by creating immunoglobulin E (IgE). IgE is antibodies that your immune system makes to attack allergens, even though these allergens might not be harmful. Once you encounter dust mite proteins again, your immune system has a greater response. This response causes allergy symptoms. […] A dust mite allergy can be frustrating. If you have a dust mite allergy, your immune system thinks dust mite proteins are harmful invaders. It tries to get them out of your body by releasing histamine, which causes dust mite allergy symptoms.

• #2 Dust Mite Allergy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560718/

  Dust mite allergy is an IgE mediated Type 1 hypersensitivity reaction to dust mite allergens, commonly found in household dust. […] Dust mite allergy develops in childhood or adolescence, with the majority of symptoms manifesting before age 20. The dust mite’s gut contains peptidase 1, which is one of the potent digestive enzymes that persist in their fecal matter and is the major inducer of the allergy. Peptidase 1 exhibits cysteine protease activity. […] IgE mediated sensitization is responsible for the pathogenesis of dust mite allergy. This a Type 1 hypersensitivity reaction in which the CD4 + and T helper cells stimulate the B cells to produce IgE antibodies specific to the antigen, which is the house dust mite allergen. The IgE binds onto the FceRI receptors on mast cells and blood basophil cells. The mast cells and basophil cells now get sensitized to the allergen-specific IgE antibodies. On subsequent exposure to the same allergens, there is crosslinking of the bound IgE sensitized cells, leading to their degranulation. The inflammatory mediators are released, causing the clinical manifestation of the dust mite allergy.

• #2 House Dust Mite Allergy and the Der p1 Conundrum: A Literature Review and Case Series

  https://www.mdpi.com/2313-5786/1/2/8

  The house dust mite (HDM) is globally ubiquitous in human habitats. It is considered the main indoor allergen cause of allergic rhinitis and asthma. Allergies are common in 50% of all adult asthmatic patients, and up to 85% of them are allergic to HDMs, independent of differences in geography, temperature, and humidity. The main HDM species include Dermatophagoides pteronyssius (Der p), Dermatophagoides farina (Der f), and Blomia tropicalis, which coexist in most geographical regions. Group 1 (Der p 1, Der f1), group 2 (Der p 2, Der f 2), and group 23 (Der p 23) are considered the dominant allergens. […] Twenty-one group 1 allergens have been found to have protease activity that can destroy epithelial tight junctions. Thirty-two group 2 allergens may mimic the effect of Toll-like receptor 4 coreceptor MD-2, and new ones are still being reported. The first aim of the present study was to summarize the information about the role of Der p1 as a key coordinator of the HDM-induced allergic response. Der p 1 is a papain-like cysteine protease. It is considered to be not only the most abundant HDM allergen in house dust and mite cultures but also a powerful allergenic protein. High levels of IgE specific for this protease have been developed by more than 80% of patients allergic to HDMs.

• #2

  https://journals.lww.com/ijaa/fulltext/2019/33010/an_indian_perspective_on_dust_mites.4.aspx

  Knowledge on the sources of dust mites is essential to implement targeted avoidance strategies. […] The identified allergens from dust mites as mentioned on http://www.allergen.org are as follows: D. pteronyssinus: 23 allergens, D. farinae: 32 allergens, Euroglyphus maynei: 5 allergens, A. siro: 1 allergen, B. tropicalis: 14 allergens, G. domesticus: 1 allergen, L. destructor: 5 allergens, T. putrescentiae: 8 allergens. […] Among the HDM allergens, Group 1 and 2 bind to 50% of the amount of IgE that binds to HDM extracts (i.e., major allergens). […] The major allergens (Group 1 Der p1, Der f 1 and Group 2 Der p2, Der f 2) from dust mites have been isolated from Indian homes and have also been estimated in the sera of Indian patients. […] From the available data as summarized in Tables 2 and 3, it becomes evident that the two Dermatophagoides species (D. farinae and D. pteronyssinus) are the most important sensitizers across India and should be evaluated in all patients with perennial respiratory allergic diseases.

• #2 Allergens with Protease Activity from House Dust Mites

  https://www.mdpi.com/1422-0067/18/7/1368

  Tight junctions between neighboring mucosal epithelial cells, consisting of the proteins occludin and claudin, regulate the paracellular transport of molecules through the airway mucosa. Normally, they prohibit uncontrolled entry of particles such as pollen or HDM fecal pellets. It has been demonstrated that, by its protease activity, Der p 1 increases the permeability of the airway mucosa by targeting the tight junction proteins. […] There are different mechanisms by which the Der p 1-protease activity can contribute to Th2-related disease. One way to do this is the promotion of Th2 responses. […] The presentation of processed antigen by APCs to T cells is a crucial step in the adaptive immune response. […] The level of IgE-production by B cells is regulated by a negative feedback mechanism that involves IgE-binding to CD23, the low-affinity receptor for IgE (FcεRII), which is present on the surface of these cells.

• #2 Dust Mite Allergy | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/20773

  Dust mite allergy is an allergic condition that occurs as a reaction to the dust mite allergens that commonly live in household dust. It is sensitization and an allergic reaction to the droppings of the dust mites. The droppings are an indoor aeroallergen, which on inhalation triggers the allergic reaction. […] The dust mite’s gut contains peptidase 1, which is one of the potent digestive enzymes that persist in their fecal matter and is the major inducer of the allergy. Peptidase 1 exhibits cysteine protease activity. […] These allergens on inhalation cause a sensitization reaction, through epithelial leakage into the respiratory system by cleavage of the tight junctions in between the epithelial cells. This leads to increased epithelial permeability, allowing the movement of house dust mite allergens to dendritic antigen-presenting cells.

• #2 Dust Mite Allergy | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/20773

  IgE mediated sensitization is responsible for the pathogenesis of dust mite allergy. This a Type 1 hypersensitivity reaction in which the CD4 + and T helper cells stimulate the B cells to produce IgE antibodies specific to the antigen, which is the house dust mite allergen. The IgE binds onto the FceRI receptors on mast cells and blood basophil cells. The mast cells and basophil cells now get sensitized to the allergen-specific IgE antibodies. On subsequent exposure to the same allergens, there is crosslinking of the bound IgE sensitized cells, leading to their degranulation. The inflammatory mediators are released, causing the clinical manifestation of the dust mite allergy. […] When the house dust mite fecal pellets are inhaled, they contact the airway epithelium and become hydrated and discharge their allergenic contents onto a mucosal barrier. For interaction with dendritic antigen-presenting cells, potential allergens must cross this protective epithelium. The tight junctions are the route for their entry. The allergens, predominantly, Der p 1 disrupt these tight junctions by either of the following two processes:

• #2 Dust Mite Allergy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560718/

  When the house dust mite fecal pellets are inhaled, they contact the airway epithelium and become hydrated and discharge their allergenic contents onto a mucosal barrier. For interaction with dendritic antigen-presenting cells, potential allergens must cross this protective epithelium. The tight junctions are the route for their entry. The allergens, predominantly, Der p 1 disrupt these tight junctions by either of the following two processes: […] Der p 1, being the major cause of dust mite allergy, is responsible for triggering the IgE binding levels of 80 to 90 percent. It targets CD23 and CD25, which cleaves these receptors from the surface of the active B and T cells, respectively, triggering the further release of IgE. […] Dust mite allergy leads to the development of atopic asthma, which is a predisposition to the development of hypersensitivity Type 1 reactions.

• #2 Dust Mite Allergy – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560718/

  House dust mite allergy plays a role in the development or exacerbation of atopic dermatitis. The house dust mite allergens activate the pattern activation receptors that include toll-like receptor 1, toll-like receptor 6, and toll-like receptor 9 and nucleotide-binding oligomerization domain 2. This leads to a release of innate proallergic cytokines, namely interleukin-25 and interleukin-33, in epidermal keratinocytes, causing the activation of the innate immune system in the keratinocytes.

• #2 House dust mite-related respiratory allergies and probiotics: a narrative review | Clinical and Molecular Allergy | Full Text

  https://clinicalmolecularallergy.biomedcentral.com/articles/10.1186/s12948-018-0092-9

  This stage is followed by the triggering of Th2 cell-mediated immunity and consequent inflammation of the lungs epithelial linings. […] Calderon et al. further added that the efficacy of HDM allergens in eliciting a powerful allergic reaction is compounded by stimulation of the innate immune system along with the Th2 cell-mediated immune response.

• #2 Dust Mite Allergy | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/20773

  Der p 1, being the major cause of dust mite allergy, is responsible for triggering the IgE binding levels of 80 to 90 percent. It targets CD23 and CD25, which cleaves these receptors from the surface of the active B and T cells, respectively, triggering the further release of IgE. […] Dust mite allergy leads to the development of atopic asthma, which is a predisposition to the development of hypersensitivity Type 1 reactions.

• #2 Overview of Allergic and Atopic Disorders – Immunology; Allergic Disorders – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/immunology-allergic-disorders/allergic-autoimmune-and-other-hypersensitivity-disorders/overview-of-allergic-and-atopic-disorders

  By definition, an allergen induces type I IgE-mediated or type IV T-cell-mediated immune responses. […] Sources of allergens that most commonly cause acute and chronic allergic reactions (type I and type IV) include house dust mite feces. […] When allergen binds to IgE-sensitized mast cells and basophils, histamine is released from their intracellular granules. […] Histamine facilitates inflammation and is the primary mediator of clinical atopy.

• #2 Overview of Allergic and Atopic Disorders – Immunology; Allergic Disorders – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/immunology-allergic-disorders/allergic-autoimmune-and-other-hypersensitivity-disorders/overview-of-allergic-and-atopic-disorders

  Allergic (including atopic) and other hypersensitivity disorders are inappropriate or exaggerated immune reactions to foreign antigens. […] Type I reactions (immediate hypersensitivity) are IgE-mediated. Antigen binds to IgE that is bound to tissue mast cells and blood basophils, triggering release of preformed mediators (eg, histamine, proteases, chemotactic factors) and synthesis of other mediators (eg, prostaglandins, leukotrienes, platelet-activating factor, cytokines). These mediators cause vasodilation, increased capillary permeability, mucus hypersecretion, smooth muscle spasm, and tissue infiltration with eosinophils, type 2 helper T (TH2) cells, and other inflammatory cells. […] Type I hypersensitivity reactions develop. […] Type I reactions underlie all atopic disorders (eg, atopic dermatitis, allergic asthma, rhinitis, conjunctivitis) and many allergic disorders (eg, anaphylaxis, some cases of angioedema, urticaria, latex and some food allergies).

• #2 New Insights Reveal How House Dust Mites Trigger Allergic Asthma by Activating the Immune System | School of Medicine | University of Pittsburgh

  https://www.medschool.pitt.edu/news/new-insights-reveal-how-house-dust-mites-trigger-allergic-asthma-activating-immune-system

  Using new tools that allowed them to track Th2 cells and see exactly when they get activated and where they went, the researchers found that in response to inhaled house dust mite, a specific molecular pathway involving a protein called BLIMP1 was needed to generate Th2 cells in the lymph node. These cells then move to the lung and drive disease. […] They also found that two signaling molecules, or cytokines, called IL2 and IL10 were required for expression of BLIMP1. […] This finding opens that door to therapeutic options targeting IL10, which hadnt previously been considered, particularly for newly diagnosed patients. […] According to Poholek, most patients with allergic asthma receive steroids, which treat the symptoms but not the root of the disease. There is a huge need for new treatments that allow early intervention before allergic asthma causes long-term damage to the airways. […] Now, we have a lot more work to figure out how these regions form and whether disrupting these regions could disrupt the formation of Th2 cells, halting allergic asthma.

• #2 AAIR :: Allergy, Asthma & Immunology Research

  https://e-aair.org/DOIx.php?id=10.4168/aair.2019.11.4.450

  Regarding allergic diseases, helminth infections have a dual effect: during severe infections they induce immunosuppression of the Th2 response and diminish allergic symptoms. In contrast, when they are light, with low parasitic load, they increase allergic responses. […] The reduction of the immunomodulatory effects of parasitic infections (especially those by soil transmitted helminths) might boost IgE reactivity to HDMs. […] The environment is the great modifier of genome and epigenome, and most of the adaptation to environmental changes involves these cellular components. […] The current human genome is the result of a long evolutionary process, where environment-induced mutations have led to highly polymorphic DNA sequences.

• #2 Dust Mite Allergy | Learn About Common Household Allergies

  https://www.nationaljewish.org/conditions/allergy/overview/allergens/dust-mite

  Dust mite allergy can cause symptoms of the nose, the eyes and particularly of the lungs in somebody who has allergic asthma. […] If droppings of dust mites are inhaled or come in contact with the skin, they may cause allergic symptoms and aggravate asthma and/or eczema. […] Treatment for dust mite allergy generally involves limiting exposure to dust mites. […] Dust mites live on human skin scales. […] Dust mites thrive in humidity, and the humidity in your home should be below 40%. […] Use special allergen-impermeable casings for mattresses and pillows to keep allergens from reaching you.

• #2 What is a Dust Mite Allergy? | ZYRTEC®

  https://www.zyrtec.com/allergy-guide/understanding-allergies/types/dust-mites

  Why do some people get dust mite allergies but others do not? Allergies may have a genetic component as they often run in families. Exposure to air pollution, cigarette smoke, and other environmental toxins may also increase their likelihood. Usually, dust mite allergies begin in childhood or during adolescence. While you can treat the symptoms, the allergy never goes away.

• #2

  https://link.springer.com/article/10.1007/s40629-022-00232-7

  House dust mite allergens are common triggers for allergic rhinoconjunctivitis and allergic asthma; they can aggravate atopic dermatitis and rarely lead to anaphylactic reactions due to dust mite allergens in food. […] The risk of developing allergic asthma is higher for patients suffering from house dust mite-related allergic rhinitis than for patients with allergic rhinitis due to pollen allergy; asthma patients with house dust mite-related allergic rhinitis statistically have worse lung function and are more likely to experience asthma exacerbations than asthmatics without house dust mite-related allergic rhinitis. […] The triggering or at least worsening of atopic dermatitis due to exposure with house dust mite allergens can be proven by patch tests with house dust mite extracts. […] Sensitization to Der p 23 is also important because it correlates with a significant risk of asthma symptoms.

• #2

  https://us.klarify.me/pages/dust-mite-allergy-rash

  House dust mite allergens can trigger atopic dermatitis (eczema) or make eczema symptoms worse. […] So how do house dust mites cause atopic dermatitis or dust mite allergy rash? Well dust mites can be a trigger factor in some people. Allergens can damage the outer layer of the skin by reducing skin barrier function. They can also penetrate at a deeper level, potentially causing inflammation and chronic itching. In both instances, this could leave the skin vulnerable and delay healing and recovery. […] Dust mite allergies are an IgE-mediated Type I allergic reaction. This means your immune system incorrectly interprets dust mites as a threat. And it creates specific Immunoglobulin E (IgE) antibodies as a defense. The next time you encounter dust mites your antibodies alert cells to release chemicals, including histamine. This is what causes dust mite allergy symptoms, such as a rash. An allergic reaction to dust mites usually shows itself within 24 hours.

• #2 New approaches to immunotherapy in house dust mite allergy

  https://www.e-cep.org/journal/view.php?number=20125555563

  Allergen immunotherapy (AIT) has developed over the last few decades and has emerged as a promising treatment. House dust mite (HDM) is a target allergen in AIT, and various modified HDM allergens have been improved for their efficacy. […] This article review focuses on HDM allergens developed for AIT efficacy, and determines that their action mechanisms are strongly based on immune tolerance. […] The effective mechanisms subsequent to AIT include the suppressive actions of interleukin-10 and transforming growth factor- secreted by regulatory cells, including regulatory T cells and regulatory B cells, and isotype switching from immunoglobulin E to immunoglobulin G4. […] Immune tolerance is a complex and antiallergic mechanism after artificial exposure to a modified allergen. […] The downregulated Th2 cytokines (such as IL-4, IL-5, and IL-13) block the degranulation of basophils and mast cells diminishing the release of histamine and lipid metabolites such as prostaglandin and leukotriene, and decreased tissue injury.

• #2 Clinical and Experimental Pediatrics

  https://www.e-cep.org/m/journal/view.php?number=20125555563

  Increased levels of IgG4 or IgA prevent the actions of the IgE-mediated allergic cascade accompanied with low IgE levels. […] The altered isotype switching, i.e., transition of IgE to IgG4, is a pivotal biomarker of AIT outcome. […] Dendritic cells (DCs) are double-edgeds words, depending on their surroundings. […] However, some DCs are able to suppress T-cell activation in a specific situation. […] During allergen uptake, DCs function as initiators of allergic inflammation, in which they trigger an immune reaction against bacteria. […] Regulatory cells are derived from T cells, B cells, and natural killer (NK) cells, and are key inducers of immune tolerance or suppressors of allergic responses. […] IL-10 or/and TGF- released by regulatory cells inhibits IgE production and increases IgG4 production.

• #2 Dust Mite Allergy | AAFA.org

  https://aafa.org/allergies/types-of-allergies/insect-allergy/dust-mite-allergy/

  Dust mites may be the most common trigger of year-round allergies and allergic asthma. […] Both the body parts and the waste of dust mites are allergens for many people. […] In a warm, humid house, dust mites can survive all year. […] The most important step is to avoid dust mites as much as possible. Limiting your exposure to dust mites will reduce your symptoms. […] Many people with a dust mite allergy do not get complete relief from medicines. This means they may consider immunotherapy (allergy shots). […] Immunotherapy is a long-term treatment that can help prevent or reduce the severity of allergic reactions. […] SCIT is a series of shots that have progressively larger amounts of allergen. […] SCIT can provide long-lasting symptom relief. […] SLIT is a way to treat dust mite allergies without injections. […] This exposure improves tolerance to the dust mites and reduces symptoms.

• #2 Dust mite allergy – Wikipedia

  https://en.wikipedia.org/wiki/Dust_mite_allergy

  Dust mite allergy, also known as house dust allergy, is a sensitization and allergic reaction to the droppings of house dust mites. The mite’s gut contains potent digestive enzymes (notably peptidase 1) that persist in their feces and are major inducers of allergic reactions such as wheezing. The mite’s exoskeleton can also contribute to allergic reactions. […] Allergen immunotherapy is the only treatment that alters the disease mechanism. […] Dust mites are a nesting species that prefer a dark, warm, and humid climate. They flourish in mattresses, bedding, upholstered furniture, and carpets. Their feces include enzymes that are released upon contact with a moist surface, which can happen when a person inhales, and these enzymes can kill cells within the human body. […] Allergen immunotherapy (AIT, also known as desensitization or hypo-sensitization) is a treatment involved in administering the doses of allergens to accustom the body to substances that are generally harmless (pollen, house dust mites), thereby inducing specific long-term tolerance.

• #3

  https://link.springer.com/article/10.1007/s40629-022-00232-7

  House dust mite allergens are common triggers for allergic rhinoconjunctivitis and allergic asthma; they can aggravate atopic dermatitis and rarely lead to anaphylactic reactions due to dust mite allergens in food. […] The risk of developing allergic asthma is higher for patients suffering from house dust mite-related allergic rhinitis than for patients with allergic rhinitis due to pollen allergy; asthma patients with house dust mite-related allergic rhinitis statistically have worse lung function and are more likely to experience asthma exacerbations than asthmatics without house dust mite-related allergic rhinitis. […] The triggering or at least worsening of atopic dermatitis due to exposure with house dust mite allergens can be proven by patch tests with house dust mite extracts. […] Sensitization to Der p 23 is also important because it correlates with a significant risk of asthma symptoms.

• #3 A review on emerging frontiers of house dust mite and cockroach allergy research | Allergologia et Immunopathologia

  https://www.elsevier.es/en-revista-allergologia-et-immunopathologia-105-articulo-a-review-on-emerging-frontiers-S0301054616000045

  Mites are microscopic arachnids causing allergy worldwide, the major culprits being house dust mite Dermatophagoides pteronyssinus and Dermatophagoides farinae. The two species vary in their allergenic diversity, yet show cross-reactivity. Almost all body parts of the mites, including the gut (oesophagus, proventriculus and other digestive parts), faeces, cuticles and eggs are allergens, triggering allergy in 85% of asthmatics. More than 20 house dust mite allergens have been characterised so far, classified into many groups. Most of them are proteins, either cysteine proteases belonging to group 1 (papain-like family), or serine proteases belonging to group 2, 3, 6, and 9 (trypsin, chymotrypsin, and collagenase). Evidence suggests that allergenicity can arise from mite-associated bacterial and fungal products as well, although they have not been well-explored. Even though explicit allergy elicitation pathways are obscure, the proteases are suspected to be recognised by susceptible individuals cell pattern recognition receptors (PRR) such as Toll-like receptors (TLRs), C-type lectin receptors (CLRs), retinoic acid-inducible gene 1-like receptors (RLR), NOD-like receptors (NLR) and AIM2-like receptors (ALR), among many other likely players. Allergen recognition by these receptors, followed by the loss of epithelial integrity and cytokine-driven inflammation cascade manifests as asthma, atopic dermatitis, urticaria, rhinitis, conjunctivitis and other hypersensitivity reactions. Recent times have unveiled a wealth of information on the pathogenesis of mite allergy, some crucial of which have been analysed below. Epithelial cells are the first line of defence, which undergo perturbation during allergy, especially the cells lining the nasal, airway, pulmonary, mucosal and skin. Much investigation has dealt with the permeability upset by allergens and revealed the adverse effects on the tight junctions. Exposure to Der p 1 disintegrates cell-cell adhesion complexes and impairs the expression of transmembrane proteins (occluding, claudin-1 and junction adhesion molecule-A (JAM-A)). The breakdown of tight junction permits Der p 1 to traverse the epithelial barrier, setting the stage for downstream inflammation. The critical role of tight junctions has been confirmed in that epithelial cells resisted allergens by de novo synthesis of occludins. Der p 1 induced inflammatory cytokines (IL-6, IL-8), monocyte chemoattractant protein-1 (MCP-1) and tumour necrosis factor- (TNF-) from human monocytic THP-1 cell line. Sensitization of this cell line was mediated by -catenin (a vital protein for intracellular contact and transcription), regulated in turn by Der p 1-phosphorylated glycogen synthase kinase 3. Other studies have also reported that allergic response can be blocked by preventing -catenin degradation. In vitro as well as in vivo studies have revealed that dust mite extract imposes stress on endoplasmic reticulum (ER), mediated via activation of transcription factor 6 (ATF6) and protein disulphide isomerase, ERp57. Dectin-2, a CLR cluster signalling protein has been found to play a profound role in allergy. This protein located on phagocytic cells senses mite allergen and elicits cytokines, arbitrating airway inflammation. To lend further support to this finding, Dectin-2 have been detected in bronchial biopsies of asthma patients and dendritic cells. The protein on encounter with mite allergen, induced Th2 and Th17 cell differentiation, leading to airway inflammation.

• #3 Dust Mite Allergy | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/20773

  IgE mediated sensitization is responsible for the pathogenesis of dust mite allergy. This a Type 1 hypersensitivity reaction in which the CD4 + and T helper cells stimulate the B cells to produce IgE antibodies specific to the antigen, which is the house dust mite allergen. The IgE binds onto the FceRI receptors on mast cells and blood basophil cells. The mast cells and basophil cells now get sensitized to the allergen-specific IgE antibodies. On subsequent exposure to the same allergens, there is crosslinking of the bound IgE sensitized cells, leading to their degranulation. The inflammatory mediators are released, causing the clinical manifestation of the dust mite allergy. […] When the house dust mite fecal pellets are inhaled, they contact the airway epithelium and become hydrated and discharge their allergenic contents onto a mucosal barrier. For interaction with dendritic antigen-presenting cells, potential allergens must cross this protective epithelium. The tight junctions are the route for their entry. The allergens, predominantly, Der p 1 disrupt these tight junctions by either of the following two processes:

• #3 Clinical and Experimental Pediatrics

  https://www.e-cep.org/m/journal/view.php?number=20125555563

  Allergen immunotherapy (AIT) has developed over the last few decades and has emerged as a promising treatment. House dust mite (HDM) is a target allergen in AIT, and various modified HDM allergens have been improved for their efficacy. […] This article review focuses on HDM allergens developed for AIT efficacy, and determines that their action mechanisms are strongly based on immune tolerance. […] The effective mechanisms subsequent to AIT include the suppressive actions of interleukin-10 and transforming growth factor- secreted by regulatory cells, including regulatory T cells and regulatory B cells, and isotype switching from immunoglobulin E to immunoglobulin G4. […] Immune tolerance is a complex and antiallergic mechanism after artificial exposure to a modified allergen. […] The downregulated Th2 cytokines (such as IL-4, IL-5, and IL-13) block the degranulation of basophils and mast cells diminishing the release of histamine and lipid metabolites such as prostaglandin and leukotriene, and decreased tissue injury.

• #3 House Dust Mite Immunotherapy: Allergy Uses, Side Effects

  https://www.medicinenet.com/house_dust_mite_immunotherapy/article.htm

  House dust mite (HDM) immunotherapy is a treatment approved for house dust mite-induced allergic rhinitis, with or without conjunctivitis, in patients 12 to 65 years of age. HDM immunotherapy is used in patients who test positive to skin testing with HDM allergen extracts or for IgE antibodies to Dermatophagoides farinae or Dermatophagoides pteronyssinus. […] Allergic reactions are caused by the presence of allergen-specific immunoglobulin E (IgE) antibodies bound to immune cells, basophils and mast cells. IgE antibodies sensitize these immune cells, which release histamine and other inflammatory substances when exposed to these allergens, producing allergic reactions. HDM immunotherapy works by modulating the immune response to house dust mite allergens. […] The complete mechanism of how HDM immunotherapy improves allergic symptoms is not clear. HDM immunotherapy may work by inducing a switch from T helper 2 cell response (Th2) to T helper 1 cell (Th1) response. Th2 response promotes inflammation while Th1 response produces anti-inflammatory activity. Switching of Th2 response to Th1 response results in several anti-inflammatory processes including:

• #3 Allergens with Protease Activity from House Dust Mites

  https://www.mdpi.com/1422-0067/18/7/1368

  IgE-mediated allergy to HDM allergens represents a considerable health burden, as it is one of the major causes for asthma in industrialized countries. HDM allergens include several proteases with strong proteolytic activity, which can contribute to the allergic sensitization process as well as to the progression of the disease.

• #3 New approaches to immunotherapy in house dust mite allergy

  https://www.e-cep.org/journal/view.php?number=20125555563

  Allergen immunotherapy (AIT) has developed over the last few decades and has emerged as a promising treatment. House dust mite (HDM) is a target allergen in AIT, and various modified HDM allergens have been improved for their efficacy. […] This article review focuses on HDM allergens developed for AIT efficacy, and determines that their action mechanisms are strongly based on immune tolerance. […] The effective mechanisms subsequent to AIT include the suppressive actions of interleukin-10 and transforming growth factor- secreted by regulatory cells, including regulatory T cells and regulatory B cells, and isotype switching from immunoglobulin E to immunoglobulin G4. […] Immune tolerance is a complex and antiallergic mechanism after artificial exposure to a modified allergen. […] The downregulated Th2 cytokines (such as IL-4, IL-5, and IL-13) block the degranulation of basophils and mast cells diminishing the release of histamine and lipid metabolites such as prostaglandin and leukotriene, and decreased tissue injury.

• #4 House Dust Mite Immunotherapy: Allergy Uses, Side Effects

  https://www.medicinenet.com/house_dust_mite_immunotherapy/article.htm

  Decreased secretion of pro-inflammatory proteins (cytokines) interleukin-4 (IL-4) and interleukin-5 (IL-5) […] Increase in secretion of anti-inflammatory cytokine IL-10 […] Production of IgG blocking antibodies that bind to the allergen, preventing IgE antibodies from allergen binding and producing an allergic reaction […] Proliferation of regulatory T-cells and cytokines that suppress inflammation […] Decrease in mast cells and eosinophils, which produce an allergic response.

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