2010 Non-IgE reactions from dust mites

Dangerous non-IgE inflammatory reaction from dust mites is named as a ‘New Aspirin Triad’. Scientists are piecing together the reasons why ingestion of mite contaminated wheat flour can result in severe anaphylaxis in a subset of mite allergic patients who are also hypersensitive to non-steroidal anti-inflammatory drugs such as aspirin.

Their success could explain why some episodes of oral or exercise induced anaphylaxis, previously diagnosed as ‘of unknown origin’, occur.  They designated the ‘New Aspirin Triad’ as associated with allergic rhinitis, aspirin/NSAID hypersensitivity and severe reactions to mite-contaminated foodstuff.  In this subset of atopic mite allergic patients the added non-IgE inflammatory ‘load’ plus the possibility of aspirin enhanced gut permeability (leading to greater food sensitivity) is key to their investigation.  Identification of patients ‘at risk’ and blocking of leukotriene receptors is one future solution identified by the research team.

They base their investigation on recent research that demonstrated that mite and Aspergillus fumigatus extracts stimulate the increased production of non-IgE (cysteinyl leukotriene) inflammation from bone marrow-derived dendritic cells and pulmonary CD11c+cells.

In a separate study doctors consider that Group II allergens from dust mites have properties that can survive the baking process.  They are stable from heat, to extremes of PH, and to digestion by proteases.

References

‘A novel non-IgE-medicated pathway of mite-induced inflammation’. Sanchez-Borges M, Capriles-Hulett A, Caballero-Fonseca F, J. Allergy Clin. Immunol., 2010; Vol 126, Issue 2: p 403-404

‘Dectin-2 recognotion of house dust mite triggers cysteinyl leukotriene generated by dendritic cells’ Barrett NA, Maekawa A, Rahman OM, Austen KF, Kanaoka Y, J. Immunol. 2009;182: p1119-1128

‘Anaphylaxis after ingestion of wheat flour contaminated with mites’, Blanco C. et al. J. Allergy Clin. Immunol. 1997;99:308-313