Sema CANBAKAN, Dilşad MUNGAN, Yılmaz BAŞER, Evrim Eylem AKPINAR, Serdar AKPINAR

Astımlı hastalarda depo akarı duyarlılığı ve ilişkili faktörler

Giriş: Çalışmamızda astım ve astım ve rinit tanısı almış hastalardaki depo akarı duyarlılığı ve duyarlanmada etkili olan faktörlerin araştırılması amaçlandı.Hastalar ve Metod: Astım ve astım + rinit tanısı bulunan 149 hasta çalışmaya alındı. Standart deri testine depo akarlarından Acarus siro (A. Siro), Lepidoglyphus destructor (L. destructor), Glycophagus domesticus (G. domesticus) ve Tyrophagus putrescentiae (T. putrescentiae) eklenerek uygulandı. Hastaların yaşam koşulları, sigara içme öyküleri, allerjik hastalık öyküleri, semptomların mevsimlerle ilişkisini sorgulayan bir anket uygulandı. Solunum tarama spesifik IgE yanı sıra deri testinde depo akarlarına duyarlılığı olanlar arasından seçilen bir gruba L. destructor spesifik IgE düzeyi ölçümleri yapıldı.Bulgular: Prick test sonuçlarına göre hastaların 115 hastada en az bir allerjene karşı duyarlılık saptanırken, 34 hastada hiçbir allerjene karşı duyarlılık saptanmadı. En az bir depo akarı türüne karşı duyarlılık %61.7 olarak tespit edildi. A. siro %50.4, L. destructor %48.7, G. domesticus %47 ve T. putrescentiae %40 oranında deri testi pozitifliği mevcuttu. Ev tozu akarı duyarlılığı %58.3 olarak tespit edildi. Kırsal alanda yaşayanlarda depo akarı duyarlılığı, kentsel alanda yaşayanlarla karşılaştırıldığında, istatistiksel olarak anlamlı derecede yüksek bulundu (p< 0.05). L. destructor spesifik IgE çalışılan grupta %9.1 oranında L. destructor IgE pozitifliği vardı. Standart deri testi paneline göre duyarlılık saptanmayan olguların %22.7'si en az bir depo akarı türüne deri testi duyarlılığı göstermekteydi.Sonuç: Depo akarları kırsal alanda yaşayanlarla, ahır, samanlık, ambar ve kilerle ilişkili koşullarda yaşayanlarda önemli bir allerjendir. Kırsal alanda yaşayanlarda standart deri testi paneline depo akarlarının eklenmesi uygundur.

Storage mite sensitivity and related factors in asthmatic patients

Introduction: The aim of the study was to investigate the storage mite sensitivity and related factors in patients with asthma or asthma and rhinitis.Patients and Methods: 149 patients with asthma or asthma and rhinitis were included to the study. Prick test was performed after addition of Acarus siro (A. siro), Lepidoglyphus destructor (L. destructor), Glycophagus domesticus (G. domesticus) and Tyrophagus putrescentiae (T. putrescentiae) to the standart prick test. Living conditions, smoking history, allergic diseases status, seasonal variations in symptoms were evaluated by a questionnaire. Besides, respiratory screening spesific IgE, L. destructor spesific IgE was examined in a group of patients who were allergic to storage mites according to prick tests.Results: Prick test results showed that; 115 of the patients were sensitized while 34 of them were not. House dust mite sensitivity was detected as mite 58.3%.The storage mite sensitivity for at least one of the studied species was detected in 61.7% of patients. The sensitivity rates were 50.4%, 48.7%, 47%, %40 for A. siro, L. destructor, G. domesticus and T. putrescentiae, respectively. The storage mite sensivity was found higher in the patients from the rural areas (p< 0.05). L. destructor IgE positiveness was detected in 9.1% of the group that antibody levels were examined. Positive reaction was detected for at least one of the storage mite species in %22.7 of the patients who were considered as not sensitized according to the results of the standart prick tests.Conclusion: As a result, storage mites are important allergens in subjects who live in rural areas and close contact with barn, haymow, bin and pantry. Addition of storage mite allergens to the standart prick test panel of patients living in rural area is suitable.

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Platt-Mills TAE. The role of allergens in airway disease. J Allergy Clin Immunol 1998;101:364-66.
Bush RK. Indoor allergens, environmental avoidance, and allergic respiratory disease. Allergy Asthma Proc 2008;29:575-9.
Olsson S, Van Hage-Hamsten M. Allergens from house dust and storage mites; similarities and differences, with empha- sis on the storage mite Lepidoglyphus destructor. Clin and Exp Allergy 2000;30:912-19.
Solomon WR, Platts-Mills TAE. Aerobiology and inhalant allergens. In: Middleton E, Reeds CE, Ellis EF, Adkinson NF, Yunginger JW, Busse WW (eds). Allegy, Vol 2. 5th ed. St Louis, Missouri: Mosby-Year Book Inc, 1998:81-99.
Gregory LG, Lloyd CM. Orchestrating house dust mite- associated allergy in the lung. Trends Immunol 2011;32:402- 11.
Gaffin JM, Phipatanakul W. The role of indoor allergens in the development of asthma. Curr Opin Allergy Clin Immunol 2009;9:128-35.
Kromquist M, Johansson E, Pershagen G, Johansson SG, van Hage-Hamsten M. Increasing prevalence of asthma over 12 years among dairy farmers on Gotland, Sweden: storage mites remain dominant allergens. Clin and Exp Allergy 1999;29:35-41.
Türk Toraks Derneği Astım tanı ve tedavi rehberi 2014 güncellemesi. Turkish Thoracic Journal 2014;15:13-9.
Fernandez- Caldas E, Iraola Calvo V. Mite allergens. Curr Allergy Asthma Rep 2005;5:402-10.
Bavbek S, Çelik G, Ediger D, Mungan D, Sin B, Demirel YS, et al. Severity and associated risk factors in adults asthma patients in Turkey. Ann Allergy Asthma Immunol 2000;85:134-9.
Magnan A, Fourre-Jullian C, Jullian H, Badier M, Lanteume A, Vervloet D, et al. Rhinitis alone or rhinitis plus asthma: What makes the difference? Eur Respir J 1998;12:1073-8.
Gates EH, Platts-Mills TAE. What the pulmonologist needs to know about allergy. Clin in Chest Med 1995;16(Suppl 4):S603-S702.
Van Hage-Hamsten M, Johansson SG. Storage mites. Review. Exp Appl Acarol 1992;16:117-28.
Iversen M, Korsgaard J, Hallas T, Dahl R. Mite allergy and exposure to storage mites and house dust mites in farmers. Clin Exp Allegy 1990;20:211-9.
Franz J-Th, Masuuch G, Müsken H, Bergman K-Ch. Mite fauna of German farms. Allergy 1997;52:1233-7.
Marx JJ Jr, Twiggs JT, Ault BJ, Merchant JA, Fernandez-Caldas E. İnhaled aeroallergen and storage mite reactivity in a Wisconsin farmer nested case-control study. Am Rev Respir Dis 1993;147:354-8.
Peden D, Reed CE. Environmental and occupational aller- gies. J Allergy Clin Immunol 2010;125:150-60.
Van Hage-hamsten M, Laggin E, Harfast B, Johansson SGO. Occurens of IgE antibodies against the 39 kDa allergen component of the mite Lepidoglyphus destructor in urban and rural subjects. Allergy 1993;48:209-11.
Celebioglu E, Ozturk AB, Comert S, Karakaya G, Kalyoncu AF. Storage mite sensitisation is associated with early life village residence in Turkey. Allergol Immunopathol 2013;41:402-6.
Vidal C, Boquete O, Gude F, Rey J, Meijide LM, Fernandes- Merino MC, et al. High prevelance of storage mite sensitiza- tion in a general adult population. Allergy 2004;59:401-5.
Ferraroni NR, Oliveira S, Ferraroni JJ. Prevelance of senziti- tation to the storage mite Acarus siro in middle-east of Brazil. J Allergy Clin Immunol 2013;131.
Kronqvist M, Johansson E, Magnusson CG, Olsson S, Eriksson TL, Gafvelin G, et al. Skin prick test and serological analysis with recombinant group 2 allergens of the dust mites L. destructor and T. putrescentiae. Clin Exp Allergy 2000;30:670-6.
Arlian LG, Morgan MS, Vyszenski-Moher DL, Sharra D. Cross- reactivity between storage and dust mites and between mites and shrimp. Exp Appl Acarol 2009;47:159-72.
Munhbayarlah S, Park JW, Ko SH, Ree HI, Hong CS. Identification of Tyrophagus putrescentiae allergens and evaluation of cross-reactivity with Dermatophagoides pter- onyssinus. Yonsei Med J 1998;39:109-15.
Zhang C, Li J, Lai X, Zheng Y, Gjesing B, Michael D, et al. House dust mite and storage mite Ig E reactivity in allergic patients from Guangzhou, China. Asian Pac J Allergy Immunol 2012;30:294-300.
Hubert J, Pekar S, Aucliky R, Nesvorna M, Stejskal V. The effect of stored barley cultivars, temperatures and humu- dity on population increase of Acarus siro, Lepidoglyphus destructor, Tyrophagus putrescentiae. Exp Appl Acarol 2013; 60:241-52.
Bessot JC, Pauli G. House dust mites and their allergens. Revue des maladies respiratoires 2011;28:227-39.
Kroidl RF, Schwichtenberg U, Frank E. Bronchial asthma due to storage mite allergy. Pneumologie 2007;61:525-30.
Akdemir C, Soyucen E. Sensitization of children to storage mites in Kutahya, Turkey. Korean J Parasitol 2009;47:387- 91.
Acıcan T. Türk ev tozu mite faunasının saptanması, üretil- mesi, antijen elde edilmesi ve antijen hasta ilişkisinin kurul- ması (tez). Ankara: Ankara Üniversitesi Tıp Fakültesi; 1992.
Tee RD, Gordon DJ, Atkinson S, et al. Immunological cross- reactivity to flor and grain mites mites in a UK bakery workface. Thorax 1988;43:803-7.
Armentia A, Tapias J, Barber D, Martin J, De la Fuente R, Sanchez P, et al. Sensitization to the storage mite lepidogly- phus destructor in wheat flour respiratory allergy. Annals Allergy 1992;68:398-403.