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Selection of house dust mite–allergic patients by molecular diagnosis may enhance success of specific immunotherapy

Chen KW, Zieglmayer P, Zieglmayer R, Lemell P, Horak F, Bunu CP, Valenta R, Vrtala S. J Allergy Clin Immunol. 2019 Mar;143(3):1248-1252.e12. doi: 10.1016/j.jaci.2018.10.048. Epub 2018 Nov 14. PMID: 30445063


To the Editor:

House dust mites (HDMs) are one of the most potent and frequent allergen sources worldwide. More than 40% of patients with allergy are sensitized to HDM allergens and suffer from allergic symptoms such as rhinoconjunctivitis, atopic dermatitis, and allergic asthma, the most severe form of respiratory allergy. The HDM Dermatophagoides pteronyssinus contains several different allergens of which Der p 1, Der p 2, Der p 5, Der p 7, Der p 21, and Der p 23 are the clinically most relevant allergens according to the frequency of IgE sensitization and the ability to induce allergic reactions. Allergen-specific immunotherapy (AIT) is effective and safe for the treatment of HDM allergy, but it has been shown that HDM extracts vary regarding the contents of important HDM allergens and extracts used for AIT are standardized only for Der p 1 and Der p 2 according to the guidelines of the European Medicines Agency


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