House dust mite rDer p 1 IgE, d202
There is a new direction in the diagnosis of allergic reactions: molecular or component allergodiagnostics.
The molecular diagnosis of allergy is based on the detection of sensitization to allergens at the molecular level using natural highly purified and recombinant allergen molecules, that is, their individual components, not extracts.
In the late 1980s, when the introduction of DNA technologies began, it was possible to characterize and clone allergen molecules, which helped to identify antigenic determinants in various allergic diseases. All this played an important role in the emergence of a new direction in allergology – molecular diagnostics, which, in turn, contributed to the development of more effective allergy treatment. Determination of antibodies to recombinant allergens of allergology components. This allows you to differentiate between true and cross-allergy. The use of recombinant allergens is a new tool in the diagnosis of type I allergic reactions, which allows you to obtain detailed information about the sensitization of the patient, cross-reactivity with other allergens, to justify the feasibility and predict the effectiveness of allergen-specific immunotherapy (ASIT).
This direction has changed the views on the examination and treatment of patients and bring them in line with those in World medicine.
There are 3 main analysis of doing this research:
Molecular allergodiagnostics makes it possible to differentiate true sensitization from sensitization due to cross-reactivity. These data will help to identify the sources of allergies: a single one, several closely related ones, or many different ones.
Molecular allergodiagnostics will eliminate the need for provocative tests and allow for clearer recommendations regarding the elimination of contact with allergens.
Molecular allergodiagnostics is necessary in the selection of ASIT, in persons with polyvalent sensitization, the most accurate way to determine the most important allergen for which therapy will be performed. It is shown that the use of molecular diagnostic methods makes it necessary to change the ASIT, selected according to the results of skin tests.
In order to begin utilizing allergen components and correctly interpreting analysis results, it is necessary to know basic information about allergen components and their clinical use:
Allergen molecules are given a name, at the beginning the first three letters of the Latin genus name, then the first letter of the species and an Arabic numeral, the allergen number (the number depends on the order of isolation and/or clinical importance). For example: Birch – Bet v 1, Bet v 2, etc.
The allergenic substance contains not one but several protein components that can act as allergens: "major" - main allergens, others "minor" - secondary allergens.
Major allergen components are allergenic molecules, antibodies to which are found in more than half – 50% of patients in the population responding to this source. They are resistant to heat and more immunogenic. They are large in size and are contained in this allergen in larger quantities.
Minor ones are smaller in size and less immunogenic allergenic molecules that are usually contained in smaller amounts in the allergen, but are present in many different allergens, sometimes not closely related, providing cross-allergy. That is, allergens with a prevalence of more than 50% are called major allergens and less than 10% are called minor allergens.
The names of recombinant allergens come from the Latin name and the serial number of the allergen.
Allergy to house dust mites is a common cause of allergic asthma, allergic rhinitis and conjunctivitis, and atopic dermatitis.
65-130 million people are affected worldwide. The most important house dust mites are Dermatophagoides pteronyssinus, they can be found in mattresses, carpets, blankets, pillows, etc. As a rule, they feed on dead skin epithelium, which a person loses daily. The products of mites are digestive enzymes: the proteins Der p1 and Der p2, which contribute to the destruction of human skin cells that the mites feed on.
These substances enter the body by inhalation, with an increased concentration of dust in the air or in contact with products that may contain an allergen (clothing, pillows, blankets, etc.). The following allergy symptoms are likely: redness, skin rashes, itching, bullation and swelling of the skin, redness and burning of the mucous membrane of the eyes, watery eyes, swelling of the eyelids, sneezing, coughing, shortness of breath.
There are 23 allergens associated with D. pteronyssinus, but the most important are Der p 1 IgE and Der p 2 IgE, it is the cause of allergy to the house dust mite in 80% of cases. Different people may show one or more symptoms of allergy to Dermatophagoides pteronyssinus:
- runny nose or stuffy nose;
- sneezing;
- manifestations similar to asthma symptoms
- cough, wheezing, shortness of breath;