title: Effective allergen avoidance for reducing exposure to house dust mite allergens and improving disease management in adult atopic asthmatics.
abstract: We investigated the best strategy for adult asthmatics to avoid exposure to Dermatophagoides group (Der-1) allergens.
  
  
  
  Adult atopic asthmatics (n = 111) followed a 32-item checklist for avoiding Der-1 allergen exposure. Twenty-five patients were excluded through incomplete sampling; 50 remaining patients encased their pillows/futons/mattresses in microfine-fiber covers, 13 used vacuum cleaners with dust-mite-collection nozzles, and 23 acted as non-intervention controls. During August-October 2010 and August-October 2011, dust samples were collected in Petri dishes placed in bedrooms for 2 weeks and from mattresses/futons by using adhesive tape on one morning. A Der-1 level decrease was defined as a mean 2011 Der-1 level of <1 as a ratio of the 2010 level on tape or Petri dish samples. We analyzed the associations between Der-1 level change (by ELISA) and % weekly variability in peak expiratory flow (PEF) or fraction of exhaled nitric oxide (FeNO) after intervention.
  
  
  
  Der-1 levels decreased significantly in the covers group but not the vacuuming group. FeNO levels and PEF variability were unchanged in both groups. In patients whose Petri dish or tape samples showed decreased Der-1 levels, the % PEF variability was lower in 2011 than in 2010, but FeNO levels were unchanged. Three interventions (vacuuming all family members' mattress/futon surfaces at least weekly or after exposure of the futons to sunlight, and floor wiping before vacuuming), plus using covers, were the most effective management strategy in reducing Der-1 levels.
  
  
  
  This environmental and bedding maintenance program may help manage adult atopic asthma.
authors.affiliation: a Department of Allergy and Respirology , National Hospital Organization Sagamihara National Hospital , Kanagawa , Japan.|c Department of Respirology , National Hospital Organization Saitama Hospital , Saitama , Japan.
authors.forename: Naomi
authors.initials: N
authors.lastname: Tsurikisawa
authors.affiliation: b Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital , Kanagawa , Japan.
authors.forename: Akemi
authors.initials: A
authors.lastname: Saito
authors.affiliation: a Department of Allergy and Respirology , National Hospital Organization Sagamihara National Hospital , Kanagawa , Japan.|c Department of Respirology , National Hospital Organization Saitama Hospital , Saitama , Japan.
authors.forename: Chiyako
authors.initials: C
authors.lastname: Oshikata
authors.affiliation: b Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital , Kanagawa , Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yasueda
authors.affiliation: a Department of Allergy and Respirology , National Hospital Organization Sagamihara National Hospital , Kanagawa , Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Akiyama
mesh_terms: D000328:Adult; D000368:Aged; D016902:Air Pollution, Indoor / Q000032:analysis / Q000517:prevention & control; D000485:Allergens / Q000032:analysis*; D039741:Antigens, Dermatophagoides / Q000032:analysis*; D060829:Arthropod Proteins / Q000032:analysis*; D001249:Asthma / Q000378:metabolism / Q000503:physiopathology / Q000517:prevention & control*; D001512:Bedding and Linens; D003546:Cysteine Endopeptidases / Q000032:analysis*; D019468:Disease Management; D004391:Dust / Q000032:analysis / Q000517:prevention & control; D004781:Environmental Exposure / Q000032:analysis* / Q000517:prevention & control; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000378:metabolism / Q000503:physiopathology / Q000517:prevention & control*; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000378:metabolism; D010366:Peak Expiratory Flow Rate
chemical_list: D000485:Allergens; D039741:Antigens, Dermatophagoides; D060829:Arthropod Proteins; D004391:Dust; D009569:Nitric Oxide; D007073:Immunoglobulin E; D003546:Cysteine Endopeptidases; C451159:Dermatophagoides farinae antigen f 1; C451162:Dermatophagoides pteronyssinus antigen p 1
keywords: Allergen avoidance; Dermatophagoides; adult asthma; asthma management; atopic asthma; group 1 mite antigen