title: Mite component-specific IgE repertoire and phenotypes of allergic disease in childhood: the tropical perspective.
abstract: Sensitization to perennial aeroallergens correlates with the risk of persistent asthma (AS) in children. In tropical Singapore, multiple codominant species of mites abound in the indoor environment, and preferential species-specific sensitization has been associated with different phenotypes of allergic disease. We investigated the pattern of mite component-specific IgE (mcsIgE) in children with different phenotypes of clinical allergic disease in an environment with multiple mite species exposure. A prospective evaluation of newly diagnosed patients with clinical diagnosis of allergic rhinitis (AR), atopic dermatitis (AD), or AS and sensitization to one or more aeroallergens were performed. Sera were tested for specific IgE against an extensive panel of Dermatophagoides pteronyssinus and Blomia tropicalis allergens. A total of 253 children were included, mean age 7.3 yr, 79% fulfilled criteria for AR, 46% AS, 71% AD, and 31% for all three. Sensitization to one or both mites was observed in 91% of children, 89% were sensitized to D. pteronyssinus, and 70% to B. tropicalis. The most common mite allergens recognized by these atopic children were Der p 1 (64%), Der p 2 (71%), Blo t 5 (45%), Blo t 7 (44%), and Blo t 21 (56%). Specific IgE responses to an increased number of distinct mite allergens correlated with the complexity of the allergic phenotype. In multivariate analysis, an increased risk for the multi-systemic phenotype (AR + AS + AD) was associated with sensitization to an increased repertoire of mite components (three or more) (OR 4.3, 95% CI 2.1-8.8, p = 0.001) and a positive parental history of AS (OR 2.4, 95% CI 1.2-2.9, p = 0.013). A highly pleiomorphic IgE response to the prevalent indoor mites is associated with the presence of a multi-systemic allergic phenotype in childhood in a tropical environment.
authors.affiliation: Allergy and Immunology Unit, Chaim Sheba Medical Center, Tel Hashomer, Israel. drkidon@bezeqint.net
authors.forename: Mona I
authors.initials: MI
authors.lastname: Kidon
authors.forename: Wen Chin
authors.initials: WC
authors.lastname: Chiang
authors.forename: Chiang Wen
authors.initials: CW
authors.lastname: Chin
authors.forename: Woei Kang
authors.initials: WK
authors.lastname: Liew
authors.forename: Liew Woei
authors.initials: LW
authors.lastname: Kang
authors.forename: Tan Ching
authors.initials: TC
authors.lastname: Ong
authors.forename: Ong Tan
authors.initials: OT
authors.lastname: Ching
authors.forename: Yuen Seng
authors.initials: YS
authors.lastname: Tiong
authors.forename: Tiong Yuen
authors.initials: TY
authors.lastname: Seng
authors.forename: Kang Ning
authors.initials: KN
authors.lastname: Wong
authors.forename: Wong Kang
authors.initials: WK
authors.lastname: Ning
authors.forename: Aaron Chen
authors.initials: AC
authors.lastname: Angus
authors.forename: Seow Theng
authors.initials: ST
authors.lastname: Ong
authors.forename: Ong Seow
authors.initials: OS
authors.lastname: Theng
authors.forename: Yun Feng
authors.initials: YF
authors.lastname: Gao
authors.forename: Gao Yun
authors.initials: GY
authors.lastname: Feng
authors.forename: Kavita
authors.initials: K
authors.lastname: Reginald
authors.forename: Xue Zhi
authors.initials: XZ
authors.lastname: Bi
authors.forename: Bi Xue
authors.initials: BX
authors.lastname: Zhi
authors.forename: Hui Shen
authors.initials: HS
authors.lastname: Shang
authors.forename: Shang Hui
authors.initials: SH
authors.lastname: Shen
authors.forename: Fook Tim
authors.initials: FT
authors.lastname: Chew
authors.forename: Chew Fook
authors.initials: CF
authors.lastname: Tim
mesh_terms: D000293:Adolescent; D000818:Animals; D039741:Antigens, Dermatophagoides / Q000097:blood / Q000276:immunology; D060829:Arthropod Proteins; D001249:Asthma / Q000209:etiology* / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003546:Cysteine Endopeptidases; D003876:Dermatitis, Atopic / Q000209:etiology* / Q000276:immunology; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007223:Infant; D008297:Male; D008925:Mites / Q000276:immunology*; D012221:Rhinitis, Allergic, Perennial / Q000209:etiology* / Q000276:immunology; D012846:Singapore / Q000453:epidemiology; D012882:Skin Tests; D013045:Species Specificity
chemical_list: D039741:Antigens, Dermatophagoides; D060829:Arthropod Proteins; C451163:Dermatophagoides pteronyssinus antigen p 2; D007073:Immunoglobulin E; D003546:Cysteine Endopeptidases; C451162:Dermatophagoides pteronyssinus antigen p 1