Sensitization profile of patients desensitized to house dust. Guidelines for revision of immunotherapy.

The use of house dust as an allergen for diagnostic and therapeutic use is no longer recommended by the Agence du Medicament (French Drug Agency). In order to determine the sensitisation profile to the constituent respiratory allergens of house dust, the authors conducted a multicentre open prospect ive trial in 245 patients undergoing desensitization for less than 5 years by allergen extracts containing variable proportions of house dust. Skin pr ick-tests were performed under blinded conditions with the following coded allergen extracts: D. pteronyssinus, D. farinae, Tyrophagus, Lepidoglyphus, Glyciphagus storage dust mites, cat, dog, German cockroach, Cladosporium a nd Alternaria. A specific IgE assay was performed for each respiratory alle rgen tested. Two hundred and twenty patients (89.8%) had a positive skin te st (papule > 5 mm) to at least one respiratory allergen. Positive skin test frequencies were distributed as follows, in decreasing order: D. pteronyss inus (61.5%), D. farinae (54%), cat (19.4%), Tyrophagus (18.2%), cockroach (14.5%), Lepidoglyphus (13%), dog (12.1%), Alternaria (11.7%), Cladosporium (8%) and Glyciphagus (8%). Specific IgE assays were positive for D. pteron yssinus (74.2%), D. farinae (73.8%), Tyrophagus (32.2%), cat (30.2%), Lepid oglyphus (16.3%), dog (10.2%), Glyciphagus (9.8%), Alternaria (8.8%), cockr oach (7.7%) and Cladosporium (1.6%). In conclusion, this study shows that p atients are mainly sensitized to D. pteronyssinus and D. farinae and a cons iderable proportion are sensitized to Tyrophagus and cat. Current desensiti zation programmes with house dust should therefore preferably be revised to include the most frequent respiratory allergens as a function of the clini cal setting.