Recurring allergy symptoms after waking up? It could be due to dust mites
Allergens that are part of the feces and exoskeleton of dust mites, invisible members of human households, can cause milder symptoms like mucosal swelling, itching of the nose or throat, but also a stronger immune reaction, asthma, or severe allergic rhinitis. It is stated that 1−2% of the global population suffers from dust mite allergy, which corresponds to 65−130 million people. Why does it arise and what can be done in its prevention and treatment?
Deep roots of dust allergy
So-called dust allergy was first described in 1920, and its causative agent, the dust mite (Dermatophagoides pteronyssinus), was identified in 1967. Along with this species, Dermatophagoides farinae and Euroglyphus maynei are also mentioned as the main causes of dust allergy in humans. These mites reach adulthood in 3−4 weeks. Although their life in adulthood lasts only a few weeks, the female lays 40−80 eggs. Therefore, it is not surprising that under favorable conditions in human dwellings, they can rapidly multiply and literally flood the area. It is stated that a double bed mattress contains up to 2 million mites, which produce a total of 40 million feces.
Critical microenvironment factors
Moisture primarily creates pleasant conditions for mites. Therefore, their occurrence, besides carpets and upholstered furniture, is mainly tied to a regularly used bed. Relative humidity increases in the presence of a person, and food sources in the form of keratin, which is part of the exfoliated skin flakes, are literally abundant.
Although mites themselves would not present a significant problem for humans, they leave feces the size of pollen grains in mattresses, which are easily inhaled. These feces and the mites' shed skins contain strong allergens (24 described) capable of activating both the innate and acquired immune responses of humans, leading to the production of specific IgE antibodies, which result in the degranulation of basophils and mast cells and the release of inflammatory mediators like histamine or leukotrienes into the body.
Mite allergy in asthmatics
Mite allergy is closely related to the development of atopic eczema or bronchial asthma. The European Academy of Allergy and Clinical Immunology (EAACI) in its current guidelines recommends detailed diagnostics in asthmatics suspected of mite allergy to distinguish allergic asthma caused by mite exposure from asthma with sensitivity to mites.
Basic methods include provocative skin prick tests and the detection of specific IgE antibodies in the blood serum. It is also necessary to thoroughly assess the impact of allergic sensitivity on asthma symptoms and disease control. This can be done through a detailed patient history, and, if necessary, a bronchoprovocation test using the allergen. If the asthma with exacerbations is proven to be triggered by mite exposure, besides standard pharmacological therapy to ensure disease control, it is also worth considering the start of allergen immunotherapy.
Regimen measures
Clear prevention of dust allergy onset is the reduction of mites in the household. The focus should be on relative humidity, aiming to lower it below 50%, and on temperature; it is advisable to sleep in a well-ventilated, cooler room. Special anti-mite mattress treatments, frequent washing of covers at higher temperatures, and vacuuming with high-efficiency vacuum cleaners also help.
New on the market are natural plant extracts that mimic mite pheromones. These products can be applied to a cotton fabric, thus 'calling' mites inhabiting the bed to it, and then it can be washed at a minimum of 60°C. An example is a product whose main components are extracts of lemon balm and lemongrass (ExAller).
Conclusion
Mite allergens play a key role in the development of allergic rhinitis and asthma, but the processes leading from hypersensitivity to symptomatic disease are not yet fully understood. More knowledge about mites, their allergens, and their microhabitat will enable us to develop more effective interventions for patients with mite allergies.
(leš)
Sources:
1. Aggarwal P., Senthilkumaran S. Dust mite allergy. StatPearls Publishing, Treasure Island, 2021.
2. Calderón M. A., Linneberg A., Kleine-Tebbe J. et al. Respiratory allergy caused by house dust mites: What do we really know? J Allergy Clin Immunol 2015; 136 (1): 38–48, doi: 10.1016/j.jaci.2014.10.012.
3. Agache I., Lau S., Akdis C. A. et al. EAACI guidelines on allergen immunotherapy: House dust mite-driven allergic asthma. Allergy 2019; 74 (5): 855–873, doi: 10.1111/all.13749.
4. Get rid of the symptoms of house dust mite allergy. Regain your health and well-being. ExAller, 2022. Available at: www.exaller.com/cs/skoncujte-s-alergií-na-roztoče-exaller
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