House Dust Mite Allergen Exposure in Adults Is Associated with Strong Specific Sensitization But Not with Clinical and Functional Respiratory Health Outcomes

Abstract

Background: Exposure to house dust has been associated with asthma in adults, and this is commonly interpreted as a direct immunological response to dust mite allergens in those who are IgE sensitised to house dust mite (HDM). Objectives: The aim of this analysis is to utilise information collected as part of a large international observational multicentre study in order to explore, in adults, associations of respiratory symptoms, including severity of symptoms with mattress house dust mite allergen levels. Methods: Mattress house dust mite concentrations were measured in a population based sample of 2890 adults aged between 27 and 56 years living in 22 centres in 10 countries. Generalized linear mixed models were employed to explore the association of respiratory symptoms with house dust mite concentrations, adjusting for individual and household confounders. Results: There was no overall association of respiratory outcomes with measured house dust mite concentrations, even in those who reported they had symptoms on exposure to dust and those who had physician diagnosed asthma. There was an association of high serum specific IgE levels to HDM (> 3.5 kUA/L) with mattress house dust mite concentrations. Conclusions: In conclusion, in a large international cross-sectional survey of adults there was evidence of an association of house dust mite concentrations with high levels of serum specific IgE to HDM, but not with clinical and functional respiratory health outcomes.