[Evaluation of sensitization to Der p 1 and Der p 2 in a pediatric population of the North of Portugal]

Abstract

Introduction: In Portugal, data on the role of Der p 1 and Der p 2 in patients with house dust mite (HDM) allergy are scarce. Allergen-specific immunotherapy (sIT) is the only treatment that improves symptoms, reduces the need for pharmacological therapy and modifies the natural history of the disease. With this study, the authors aim to understand the local epidemiology and to clarify if the molecular assay of major allergens is advantageous in deciding and/or modifying the decision to initiate sIT in children with clinical indication which are sensitized to Dermatophagoides pteronyssinus.

Methods: Retrospective study with analysis of patients with asthma and/or rhinitis.

Study period: January/2013-December/2016.

Inclusion criteria: 1) positive prick-test to Dermatophagoides pteronyssinus; and 2) clinically relevant disease under treatment. Assay Der p 1 and Der p 2 values ≥0.35 kUA/L were considered positive. Statistical significance was set at P<.05.

Results: The clinical files of 279 patients. Mean ages 9.55 years (min.4-max.17). Asthma was present in 199 children (71.3%) and rhinitis in 245 (87.8%). Der p 1 and Der p 2 was <0.35kUA/L in 29 (10,4%) patients. The value of Der p 1/Der p 2 correlated with the size of the prick-test papule, the value of the eosinophils and the total IgE.

Conclusions: Der p 1 and Der p 2 are dominant allergens in our population and there may be benefits in determining these molecular allergen levels in patients with a positive prick-test and a clinical indication for sIT prior to a decision of initiating sIT or not.

Keywords: Allergens; Alérgenos; Dermatophagoides antigens; Dermatophagoides antígenos; Dermatophagoides pteronyssinus antigen p 1; Dermatophagoides pteronyssinus antigen p 2; Dermatophagoides pteronyssinus antígeno p 1; Dermatophagoides pteronyssinus antígeno p 2; Desensibilización; Desensitization; Hipersensibilidad; Hypersensitivity; Immunologic; Inmunología; Mites; Ácaros.