抄録
The allergenic load of house dust mite allergy is largely constituted by a few proteins with a hierarchical
pattern of allergenicity. The serodominant specificities are the group 1&2 and the group 23 faecal allergens.
The collective IgE binding to the group 1&2 allergens can measure unequivocal HDM sensitisation
better than HDM extracts although discrepancies have been found in regions with complex
acarofauna suggesting a need to investigate the specificity with allergen components. The group 4, 5,
7&21 allergens that each induce responses in about 40% of subjects are mid-tier allergens accounting for
most of the remaining IgE binding. Their titres are proportional to the concomitant responses to Der
p1&2. Group 2 allergen variants have different antibody binding. Body proteins only occasionally induce
sensitisation although a higher prevalence of binding by atopic dermatitis patients provides a new
avenue of research. A broad spectrum of IgE binding has been associated with diverse symptoms but not
with the severity of asthma which is associated with low IgG antibody. Some allergens such as the group
14 large lipid binding proteins and the recently described proteins Der f 24-33, need further investigation
but with the cognoscence that other denominated allergens have been found to be minor sensitisers
by comparative quantitative analyses. Scabies is a confounder for diagnosis with extracts,
inducing cross-reactive antibodies with Der p 4&20 as is seafood allergy with cross reactivity to Der p 10
a minor HDM allergen. The HDM genome sequence can now be used to verify allelic and paralogous
variations.
