A review of house dust mite allergy in India.

Abstract

House dust mites (HDMs) are extensively reported as potent allergens worldwide with India being in the top row. HDM sensitization is hugely reported from India and has led to the concern of implementing proper guidelines for treatment of the sufferers. Climatic conditions and a rapid shift of life style toward a more indoor and urbanised pattern are denoted as the probable causes of increased HDM exposure and sensitization. On the contrary, the varying rate of HDM allergy from similar climate and urbanised areas throughout the world suggest the influence of genetic predisposition. At present, in India, avoidance of HDM exposure is recommended as the baseline defence. Allergen immunotherapy (AIT) guidelines are proposed in India to maintain uniformity in the diagnosis techniques and management strategies throughout the country. Considering the genetic susceptibility toward allergic diseases, the concept of 'personalised medicine' is preferred over the 'mass targeted treatment'. From the Indian perspective, the present problem is Dermatophagoides pteronyssinus and D. farinae allergens are not well characterised at the molecular level. As a consequence, India is still reliant on less standardised allergen extracts. The proper identification, purification, and molecular characterization of HDM allergens can combat this problem. In this review, we aimed to portray a complete account of HDM allergy in India with respect to prevalence, probable triggers, diagnosis and therapy. We have attempted to present the current ambiguities along with the likely deciphering that would pave the way to solve HDM allergy-related queries in India.