Acarex Test Research Articles

Activité du conseil médical en environnement intérieur (CMEI) en Bourgogne : évaluation auprès des médecins et des patients

Since December 2009, chest physicians and allergologists in Burgundy have been able to call upon a medical indoor environment counsellor (MIEC). The consultations are free for the patient and are undertaken following a medical referal after systematic cutaneous prick tests. To describe the indications, the distribution of prescriptions and to measure the impact of the counsellor's visits on the first 100patients at 6months and on the physicians at 18months. Telephone interviews with the 67physicians (whether prescribers or not) concerning their motivation and/or expectations, and with the first 100patients concerning follow up of the recommendations. Seventy percent of the physicians replied (n=47). The satisfaction of prescribers (n=22) was 8.42/10. The indications were rhinitis and a poorly controlled asthma. The requests concerned the search for dust mite (50%) and moulds (46%). Eighty-four percent of the physicians discussed the MIEC's report with the patients. The patients' symptoms were rhinitis (79%), asthma (57%) and conjunctivitis (33%). The Acarex test(®), performed in cases of positive prick tests to house dust mites (n=72), was strongly positive for 67patients. Sixteen mould samples out of 21were above the standard concentrations. Sixty-nine patients had followed the recommendations of the MIEC. The impact of the MIEC visits was perceived as positive by the physicians and the patients. The medico-economic impact warrants further evaluation.

Le Conseil Habitat-Santé dans la prise en charge des maladies allergiques respiratoires

Input from Housing and health counselling services is advisable when a patient's health seems to be impaired by their housing conditions. 650 home visits have been performed by our organisation since 2002. Each visit includes a questionnaire to assess respiratory as well as non-respiratory indoor risk factors, Acarex test to assess mite-allergen content in mattress dust, mould sampling and, when appropriate, air sampling for measurement of volatile organic compounds and aldehydes. The dwellings studied were mostly flats located in the downtown and occupied by a tenant. In most instances, several health hazards were identified. These hazards, in decreasing occurrence included: mold (74.4%), mite infestation in mattress dust (56.3%), cleaning products accessible to children's'hands (47.8%), dangerous electrical circuits (21.1%), exposure to chemical air pollutants (9.0%), exposure to an electromagnetic field (2.8%). Numerous fungal species were identified often occurring in association. This service allowed the identification of numerous and various health hazards. Its efficacy and effectiveness remains to be evaluated.

Comparative study of simple semiquantitative dust mite allergen tests

Two simple, commercially available and semiquantitative dust mite allergen tests, namely, the Acarex test(®) and Mitey Checker(®), were compared using 2 and 10 μg of Der 1 allergen per gram of dust, as evaluated by enzyme-linked immunosorbent assay (ELISA), to clarify which method is better suited for practical use. Mite allergen exposure levels of 106 floor, bed and sofa surfaces were evaluated by the Acarex test(®), Mitey Checker(®), and ELISA. A template of 100 cm×100cm was placed on the same surfaces to identify the examined areas. A dust collection filter was attached to a vacuum cleaner, and the area in the template (1 m(2)) was vacuumed. Then, to evaluate the other two tests, samples from the two other areas in the template (1 m(2)) that neighbored each other and did not overlap were vacuumed. To predict Der 1 levels of 2 μg/g dust or higher, the sensitivity and specificity of the Acarex test(®) were 100% and 13.3%, and those, of Mitey Checker(®) were 91.8% and 71.1%, respectively. To predict Der 1 levels of 10 μg/g dust or higher, the sensitivity and specificity of the Acarex test(®) were 50.0% and 96.2%, and those of Mitey Checker(®) were 85.7% and 79.5%, respectively. Compared with Der 1<2.0, 2.0-9.9.≥10.0 (μg/g dust), the percent agreement and kappa of the Acarex test(®) were 47.2% and 0.234, and those of Mitey Checker(®) were 70.0% and 0.505, respectively. To evaluate mite allergen exposure level for practical use in Japanese living environments, Mitey Checker(®) is better than the Acarex test(®) because of its higher sensitivity and specificity.

FC‐30 Presence of dust mites in the environment of dust mite‐sensitized atopic dogs

Dust mites (DM) are the most common offending aeroallergens in atopic dogs. The aim of this study was to compare the DM load of households with atopic dogs (Group A, n = 8) that had positive intradermal test reactions to Dermatophagoides farinae, D. pteronyssinus, Acarus siro, Lepidoglyphus destructor and/or Tyrophagus putrescentiae to the DM load of households with nonatopic dogs (Group B, n = 4) and of nonpet households (Group C, n = 8). Group A dogs presented with perennial pruritus, were free of pathogenic mites and fleas, did not respond to an elimination diet, and fulfilled the diagnostic criteria of atopic dermatitis. All Group B dogs tested intradermally negative and had no dermatological problems. Dust samples were vacuum collected in a standardized fashion from the human (all groups) and dog mattresses (Groups A and B) or from the couch (Group C) four times, once for each season of the year. The presence of DM was assessed with a commercial test (Acarex test) and stereoscopically. At least one DM was found in all Group A houses. The DM load was not significantly different between the seasons or the three animal groups. The sensitivity of the Acarex test was significantly lower than that of stereoscopic examination (P &lt; 0.001). In conclusion, the environmental DM load was similar between atopic and nonatopic dogs, the presence of dogs in a household didn't increase DM numbers, and stereoscopy was more sensitive than the Acarex test for the detection of DM. Funding: Self‐funded.

Avoidance of allergens and air pollutants in respiratory allergy

Avoidance of allergens and air pollutants in respiratory allergy

Controlling Indoor Mite Exposure: The Relevance of the Acarex Test

The Acarex test is an easy, rapid and cost-effective means of assessing exposure to house dust mites. The present study was designed to evaluate the correlation between the Acarex test using a 4-point and a 7-point scale and the major allergens content (Der p1 + Der f1) of house dust samples measured by an ELISA technique and also to assess the validity of the test with regard to both sampling and reading of the colour scale. Some 719 house dust samples from patients’ homes were evaluated using the supplied 4-point scale (classes 0, 1, 2, 3) and again with interpolation of 3 intermediate scale points (classes 0.5, 1.5, 2.5) and Der p1 + Der f1 content using ELISA. Reliability of sampling was studied in 39 dwellings comparing results obtained by householders and technicians. Reproducibility of reading the colorimetric scale was evaluated in 3 trained technicians and 15 untrained people. The correlation between the Acarex and the ELISA results was 0.68 (p < 0.0001) with class 0 reliable for assessing low allergen levels, class 1 unable to discriminate, and classes 2 and 3 reflecting high allergen levels (class 3 identified 94.2% of samples with an allergen content greater than 10 µg·g^–1). Discrepancies between Acarex scores for samples collected by patients and those collected by technicians did not exceed half a scale point. Reproducibility of reading by trained technicians gave intraindividual and interindividual coefficients of variation of 0% for classes 0 and 3 and about 20% or more for the other classes. On average readings by untrained participants had 42% discrepancies, mostly in classes 1 and 2. We conclude that the Acarex test is a useful home test whether used by patients or technicians; misclassifications of colour readings were less frequent at the scale extremes.

Controlling Indoor Mite Exposure: The Relevance of the Acarex Test

The Acarex test is an easy, rapid and cost-effective means of assessing exposure to house dust mites. The present study was designed to evaluate the correlation between the Acarex test using a 4-point and a 7-point scale and the major allergens content (Der p1 + Der f1 ) of house dust samples measured by an ELISA technique and also to assess the validity of the test with regard to both sampling and reading of the colour scale. Some 719 house dust samples from patients' homes were evaluat ed using the supplied 4-point scale (classes 0, 1, 2, 3) and again with interpolation of 3 intermediate scale points (classes 0.5, 1.5, 2.5) and Der p1 + Der f1 content using ELISA. Reliability of sampling was studied in 39 dwell ings comparing results obtained by householders and technicians. Reproducibility of reading the colorimetric scale was evaluated in 3 trained technicians and 15 untrained people. The correlation between the Acarex and the ELISA results was 0.68 (p &lt; 0.0001) with class 0 reliable for assessing low allergen levels, class 1 unable to discriminate, and classes 2 and 3 reflecting high aller gen levels (class 3 identified 94.2% of samples with an allergen content greater than 10 μg.g-1). Discrepancies between Acarex scores for samples collected by patients and those collected by technicians did not exceed half a scale point. Reproducibility of reading by trained techni cians gave intraindividual and interindividual coeffi cients of variation of 0% for classes 0 and 3 and about 20% or more for the other classes. On average readings by untrained participants had 42% discrepancies, mostly in classes 1 and 2. We conclude that the Acarex test is a useful home test whether used by patients or techni cians ; misclassifications of colour readings were less fre quent at the scale extremes. Copyright©2001 S. KargerAG, Basel

Mite allergen content in mattress dust of Dermatophagoides‐allergic asthmatics/rhinitics and matched controls

It has been suggested that the mites Dermatophagoides pteronyssinus and D. farinae are important indoor environmental factors facilitating both the sensitization of atopic subjects and asthmatic attacks of house dust-sensitive patients. Contradictory results have been reported about the current exposure to mites or their allergens among patients and control groups of atopic or non-atopic subjects. In order to determine whether there is a difference in mite exposure levels between D. pteronyssinus-sensitized asthmatics and/or rhinitis and control subjects we considered a case-control study of 70 patients with asthma and/or rhinitis and positive skin test reactions to D. pteronyssinus and twice as many control subjects who were matched as to age and sex. The first control subject for each patient was an immediate neighbour of the patient and the second was patient arbitrarily chosen among hospitalized patients. Mite allergen exposure was measured in mattress dust collected under standardized conditions, by measuring Der p I+Der fI content and by performing a semiquantitative guanine determination (Acarex-test). The content of Der p I and Der fI was very high both in the homes of patients and those of healthy individuals: 69% of the total samples contained more than 10 micrograms Der pI+Der fI/g of dust. There was no significant difference between cases and controls with respect to Der p I, Der fI, Der p I+Der fI content and Acare class distributions. The calculated odds-ratios associated with the Acarex test and the mite allergens did not differ significantly from the level 1.0.(ABSTRACT TRUNCATED AT 250 WORDS)

ACAROSAN AND THE ACAREX TEST IN THE CONTROL OF HOUSE DUST MITE ALLERGENS IN THE HOME

SUMMARYHouse dust mites are believed to be major triggers for allergic disease in atopic individuals. As part of a programme controlling dietary and aero‐allergen exposure in high‐risk infants, an acaricidal foam and powder (Acarosan) was applied to bedroom and main living room carpets, as well as upholstered furniture, on four occasions in the first year of life. Dust was assayed for mite antigen (Der p1) and these results compared with the semi‐quantitative assay of guanine content (Acarex Test). After nine months mean Der p1 levels had decreased by 70% in the treatment group. Proportionally, the greatest fall occurred in those items that had the highest initial mite antigen content. The Acarex score does show a correlation with Der p1 levels, but cannot replace antigen assay when accurate data is required. A chemical acaricide may help reduce house dust mite antigen levels, but is not by itself sufficient to reduce levels below that considered critical for sensitisation.

Results in dust samples with a new quantitative guanine assessment and evaluating of risk groups

Abstract Guanine is an important substance produced in the metabolism of house dust mites (domestic mites). It is suitable as a marker for the allergen content of dust samples obtained in the interior of houses. Methods for the guanine detection are based on the complete extraction of guanine out of the dust samples and the following guanine assessment. For this the colorimetric determination of a guanine azo dye is an approved method. A new possibility represents the direct assessment via HPLC. We describe results obtained from 170 dust samples, using the HPLC method and compare these results with the formerly defined risk classes corresponding to guanine azo dye determinations (ACAREX test). Furtheron the evaluation of risk groups based on ACAREX test steps is compared with the risk definition (WHO) based directly on the guanine content. It is to be seen that the two different ways provide similar evaluations of the risk for allergic patients related with the sources of dust in indoor environments.

Acarex test correlates with monoclonal antibody test for dust mites

Forty-two dust samples from the homes of patients having positive mite skin tests were tested by both monoclonal antibody and Acarex techniques. A Spearman's correlation coefficient of 0.85 ( p = 0.0001) was found. The Acarex test is simple to use and is much less expensive than the monoclonal antibody method. The use of either method may enhance patient compliance with mite-control instructions and may prove crucial to the effective use of miticides in infested homes.

Comparison of the ACAREX test with monoclonal antibodies for the quantification of mite allergens

Comparaison d'un test colorimetrique semiquantitatif qui estime la quantite de guanine presente et d'une technique ELISA pour la quantification des allergenes de mites

Sources of pollution of indoor air by mite-allergen-containing house dust

House dust mites have adapted well to man's environment. Their excrement represents a remarkable portion of house dust and the allergens in it. In the present study, mite excreta in dust are assessed using an azo dye formation with the mite-metabolism product guanine. Field studies show that every house has different sources of pollution, but the greatest sources are mattresses and upholstery. Different assessment methods and statistical evaluations have shown a correlation between guanine content and major allergens but not with mite counts. Although mite quantities change with ecological conditions, mite allergens in dust remain almost unchanged over years. The guanine detection method is evaluated at high altitudes and in houses with patients with and without symptoms. Studies with different samples and color readings using dust of the same textile objects show the reliability of the ACAREX test. The effect of acaricides has been observed as a decrease of ACAREX levels during the month following treatment. Except in the case of mattresses with a heavy dust contamination, the sources of pollution disappear.

Investigations of allergen-containing dust samples from the interior of the house.

Using ACAREX test, it is straightforward to determine the allergen-containing excreta of housedust mites in dust samples and to detect the source of a contamination. Investigation of the antigen content by RAST inhibition shows that there is correlation between guanine and allergen content in a dust sample. There is no direct relation with the number of live (or dead) housedust mites, nor is this to be expected.