Der F1 Research Articles

Results of a Home-Based Environmental Intervention Among Urban Children With Asthma

Morgan WJ, Crain EF, Gruchalla RS, et al. N Engl J Med. 2004;351:1068‐1080To determine if environmental modification reduces asthma morbidity in inner-city, atopic children.Asthmatic children (age range: 5–11 years) from inner cities who were skin-test positive to at least 1 of 11 indoor allergens. To be eligible for the study, the children had to have had 1 hospitalization or 2 unscheduled medical visits for asthma in the previous 6 months.Nine hundred thirty-seven children with atopic asthma (age range: 5–11 years) in 7 major US cities were enrolled in a randomized, controlled trial of an environmental intervention that lasted 1 year and included education and remediation for exposure to both allergens and environmental tobacco smoke. Home environmental exposures were assessed every 6 months, and asthma-related complications were assessed every 2 months during the intervention and for 1 year after the intervention.For every 2-week period, the intervention group had fewer days with symptoms than did the control group during both the intervention year (3.39 vs 4.20 days; P < .001) and the year afterward (2.62 vs 3.21 days; P < .001). The intervention group had greater declines in the levels of allergens at home, such as Dermatophagoides farinae (Der f1) allergen in the bed (P < .001) and on the bedroom floor (P = .004), Dermatophagoides pteronyssinus in the bed (P = .007), and cockroach allergen on the bedroom floor (P < .001). Reductions in the levels of cockroach allergen and dust-mite allergen (Der f1) on the bedroom floor were significantly correlated with reduced complications of asthma (P < .001).Among inner-city children with atopic asthma, an individualized, home-based, comprehensive environmental intervention decreases exposure to indoor allergens including cockroach and dust-mite allergens, resulting in reduced asthma-associated morbidity.Inner-city children with asthma are exposed to many indoor allergens. Reducing the concentrations of these allergens can be extremely challenging, and there has been limited evidence to prove the efficacy of such measures. This study demonstrates that aggressive environmental modification targeting specific allergens can reduce the asthma-related morbidity in this population. Asthmatic children allergic to cockroach and/or dust mite allergens are most likely to benefit from diligent environmental control.

Concentrations of cat and dust-mite allergens in dust samples from 92 large US office buildings from the BASE Study

The concentrations of cat (Fel d1) and dust-mite (Der f1 and Der p1) allergens were measured in 92 large office buildings in the US Environmental Protection Agency's Building Assessment Survey and Evaluation (BASE) Study (251 dust samples; one to four samples per building). Fel d1 was detected in almost all buildings and samples (91 buildings, 99%; 235 samples, 94%; range: <0.01-19 microg/g; median: 0.3 microg/g). Cat allergen exceeded 1 microg/g (a lower symptom threshold) in 56 samples (22%) from 45 buildings, but exceeded 8 microg/g (a sensitization threshold) in only two samples (1%) from two buildings. Der f1 or Der p1 was found in approximately half of all buildings and samples (63 and 70% of buildings; 45 and 51% of samples; range: <0.01-53 microg/g and <0.01-25 microg/g; median: <0.02 and 0.03 microg/g, respectively). Mite allergen exceeded 2 microg/g (a sensitization threshold) in seven samples (3%) from five buildings and exceeded 10 microg/g (a symptom threshold) in three samples (1%) from three buildings. Fel d1 concentration was significantly higher in samples collected in summer (June to September, 48 buildings), but cat allergen was not correlated with either mite allergen. Der f1, but not Der p1, concentration tended to be higher in samples collected in winter (December to April, 44 buildings), and the two mite allergens were significantly correlated only in winter. Cat and mite allergens were detected in 78% of representative US office buildings, but the concentrations seldom exceeded levels associated with sensitization or symptom provocation. The information on the concentrations of cat and dust-mite allergens in representative large US offices has expanded the baseline data available for interpretation of measurements from other building investigations. With suggested refinements, the BASE protocol for measurement of allergen concentrations in dust samples may serve as a guide to future studies of building characteristics, bioaerosol concentrations, and occupant perceptions of the indoor environment.

TRAFFIC-RELATED AIR POLLUTION AND THE DEVELOPMENT OF ASTHMA, ALLERGY AND RESPIRATORY INFECTIONS: EXTENDED FOLLOW-UP OF A BIRTH COHORT

ISEE-134 Introduction: We have previously examined the relationship between traffic-related air pollution and the development of asthmatic/allergic symptoms and respiratory infections in the first two years of life for a birth cohort (N∼ 4,000) study in The Netherlands. Here we present findings from analysis at age four. Methods: A validated model based on measurements and geographic modeling was used to assign outdoor concentrations of traffic-related air pollutants (NO2, PM2.5 and “soot”) at the home addresses of the cohort. Questionnaire-derived data on wheeze, dry nighttime cough, ear/nose/throat infections, skin rash and physician diagnoses of asthma, bronchitis, influenza and eczema at age four were analyzed in relation to air pollutants. Multiple logistic regression models controlled for gender, maternal age, parental education, parental allergy, maternal smoking, ETS exposure, other siblings, ethnicity, breastfeeding, mattress cover, and the presence of mold, pets and unvented gas appliances at home. Total IgE and specific IgE to Der p1 (house dust mite), Der f1 (house dust mite), Fel d1 (cat), Can f1 (dog), grass pollen, birch pollen, egg, milk and Alternaria was measured in a subset (n∼ 700) of the cohort. Results: Adjusted odds ratios for wheeze (e.g., OR=1.8, 95% CI = 1.1–2.7 for “soot”), doctor-diagnosed asthma (2.2, 1.1–4.7), ear/nose/throat infections (1.7, 1.1–2.5) and flu/serious colds (1.8, 1.1–3.0) indicated positive associations with air pollutants. No consistent positive associations were observed for eczema, skin rash, cough or bronchitis. In the subset of the cohort with objective measurements of allergic sensitization (specific IgE), we also observed positive associations between air pollution and sensitization to food allergens (e.g., 5.6, 1.0–15.8 for “soot”), but no indications of associations with sensitization to indoor or outdoor aeroallergens or with elevated total IgE. As sensitization to food allergens (28%) was more prevalent than sensitization to indoor (17%) or outdoor (9%) allergens, further follow-up is necessary to determine if this sensitization shifts towards aeroallergens at later ages. Conclusion: These findings at age four confirm earlier observations made at age 2 in the same cohort and indicate associations between exposure to traffic-related air pollution and asthma, allergy and respiratory infections in a birth cohort.

Concentrations of domestic mite and pet allergens and endotoxin in Palestine.

A few studies have compared indoor allergens and endotoxin levels between urban and rural settings as important determinants for asthma and atopy in children. However, no study was done in the Middle East or investigated refugee camps. As part of a nested case-control study in Ramallah in 2001, we measured house dust mite and pet allergens, as well as endotoxin in dust collected from 110 children's mattresses and living room floors. Geometric mean (GM) concentrations of Dermatophagoides pteronyssinus (Der p1) antigen were 4.48 microg/g in mattress dust and 1.23 microg/g floor dust. The highest Der p1 levels were seen in refugee camps. Concentrations of Dermatophagoides farinae antigen (Der f1) were much lower (<0.08 microg/g dust). Concentrations of cat allergen (Fel d1) were highest in villages, and those of dog allergen (Can f1) were highest in mattresses from cities and in floor dust from refugee camps. GM of endotoxin levels were 25.7 EU/mg in mattress dust and 49 EU/mg dust in floor dust. Concentrations of Der p1 were high compared to Western European countries, but were lower compared to UK and Australia. Levels of pet allergens were lower than in Western Europe. Endotoxin levels were higher compared to developed countries. Indoor environmental factors such as dampness seemed to be important determinants for allergen and endotoxin, but living habits such as lack of mattress cover appeared unimportant.

Eliminating Dermatophagoides farinae spp. (Acari: Pyroglyphidae) and their allergens through high temperature treatment of textiles.

House dust mite allergens cause allergy and asthma in sensitized individuals. The allergens they produce are known to resist decay under natural household conditions and are thought to accumulate until removed. We sought to evaluate the effects of high temperature (96 degrees C) generated by a hard surface cleaner on live mite populations of American house dust mites, Dermatophagoides farinae Hughes and their allergens in carpet and mattresses. Statistically significant (P < 0.05) mite mortality (100%) was observed in response to treatment in both textile surfaces. Similar effects were observed on Der f1 fecal allergen. Allergen reductions in carpet with two or five pass treatment regimes were 61.4 and 100%, respectively. These results demonstrate the potential of employing a hard surface steam cleaner as a novel method to eliminate house dust mite populations and their allergens in a residential setting and appeal particularly promising as an environmental control strategy.

The determinants of dust mite allergen and its relationship to the prevalence of symptoms of asthma in the Asia-Pacific region.

The role that house dust mites play in the primary causation of asthma is controversial. Approximately thirty-six 10-yr-old children in each of 10 centres in the Asia-Pacific region participated. Researchers collected dust from mattresses and living room floors using standardized procedures. Der p1 and Der f1 were analysed using a double monoclonal antibody enzyme-linked immunosorbent assay. Geometric mean allergen levels were calculated for each centre. An ecological analysis was conducted to show the regression of the geometric mean allergen level, using the highest household level, against asthma symptom and severity prevalence data from the International Study of Asthma and Allergies in Childhood, Phase I. Among children aged 13-14 yr, the change in asthma symptom prevalence was associated with per unit change in Der p1 microg/g (1.08, 95% CI 0.10-2.06) and Der 1 microg/g (Der p1 + Der f1) (0.64, 95% CI 0.02-1.26). The change in having four or more attacks of asthma in the last 12 months was associated with per unit change in Der p 1 microg/g (0.29, 95% CI -0.02 to 0.60) and Der 1 microg/g (0.20, 95% CI 0.01-0.38). There was no effect for total Der p1 or Der f1 (total or microg/g). Among children aged 6-7 yr, neither allergen was related to symptoms or severity prevalence. While our findings suggest that Dermatophagoides pteronyssinus may have a role in the primary causation of asthma, the complexity of this association reinforces the need for prospective studies.

A new and safer method for preserving allergen stability in human vaccines

Rationale Specific allergen immunotherapy is the only treatment that reverses the immunologic imbalance responsible for causing IgE-medicated symptoms. Each allergen vaccine, however, is a mixture of glycoproteins that have varying stabilities in solutions. Currently, human serum albumin (HSA) is widely used as a stabilizing agent in FDA licensed vaccines, which creates a potential risk for the transmission of prion-induced illnesses. We have, therefore, developed a new and safer method of preserving allergen vaccines to eliminate the need for HSA in allergen vaccines. Methods Over a period of 40 weeks, we studied the stability of commercially available vaccines using three methods of preservation: HSA, phosphate buffered saline (PBS), and trehalose. Allergen vaccines were diluted and stored similar to our allergy clinic's routine, and samples studied for specific allergen concentrations using monoclonal reagents. Freezing and thawing effects were also analyzed. The major allergens included in this study were cat (Fel d1), cockroach (Bla g1), and Der f1 from D. farinae. Results Trehalose was comparable to HSA in preserving the antigenicity of both cat and cockroach allergens. Trehalose was superior to both HSA and PBS in stabilizing the mite allergen Der f1. Conclusions These initial studies support the use of trehalose in the stabilization of allergen vaccines intended for human use. The potential transmission of prion proteins to patients who are given allergy injections that contain human serum albumin can thus be totally avoided. Future studies will determine if this patent pending trehalose method proves to be as effective in other commonly used allergen vaccines.

The effect of corona discharge on dust mite and cat allergens

Corona discharge has previously been reported to destroy the house dust mite allergen Der p1. This present paper describes the efficacy of corona discharge to destroy three more clinically important allergens and investigates the factors that affect this process. Using Der p1, Der p2, Der f1 and Fel d1 the allergen reducing efficacies of both negative and positive corona, of varying magnitudes, were assessed. The effect of the duration of exposure, initial allergen concentration and ozone, a by-product of corona discharge, was also investigated. The time course of allergen reduction in situ was also followed using an experimental and a commercially available, ionizer. Negative corona was found to be the most efficacious polarity in the majority of cases. Fel d1 reacted the least with positive corona products, which may be due to the primary structure of this allergen. The in situ tests showed that it was possible to destroy surface allergen up to 4 m away from the corona source, but this reduction was not found to be time-dependent over the three week exposure period. Further research directed at improving existing ionizer designs and the development of protocols for the safe use of ionizers to destroy domestic allergen reservoirs would be extremely beneficial.

アレルギー性鼻炎と住環境ダニ抗原量

Several reports indicate that the severity of perennial allergic rhinitis is related to levels of dust-mite allergens. In this study, the levels of dust-mite allergens measured in the homes of 13 people with allergic rhinitis and 10 healthy volunteers. Dust specimens were collected with a vacuum cleaner and analyzed for the presence of major mite allergens (Der 1=Der p1+Der f1, Der 2=Der p2+Der f2) by using ELISA. Levels of Der 1 were higher in bedclothes, in bedrooms, and on family room floors. There were no differences between the homes of the 13 people with allergic rhinitis and the 10 healthy volunteers. No association was found between levels of dust-mite allergens and the severity of nasal symptoms. Although the levels of mite allergens increased in most of homes 2 months after cleaning, there was an insignificant tendency for improvement in nasal symptoms in homes with decreased levels 2 months after cleaning.

Study of the possible interference of disodium octaborate tetrahydrate (DOT), carpet shampoo, and boric acid on the measurement of Der f1 and Der p1 in dust samples by ELISA using monoclonal antibodies

Study of the possible interference of disodium octaborate tetrahydrate (DOT), carpet shampoo, and boric acid on the measurement of Der f1 and Der p1 in dust samples by ELISA using monoclonal antibodies

Allergenic materials in the house dust of allergy clinic patients.

Environmental agents including animal, fungal, tree, and weed antigens are known to cause allergic rhinitis and asthma. The following study was performed to measure the antigen concentration of several of these in house dust of children seen in an allergy clinic. Comparisons are made between household allergen levels of children seen for asthma and children seen for other reasons. Dust samples were solicited from patients in a pediatric allergy specialty clinic and other individuals associated with the clinic. Persons submitting dust were asked to complete a questionnaire describing their house. Samples were extracted, centrifuged, and filtered for sterility. Samples were stored in 50% glycerol at -20 degrees C. Specific antigens for Alternaria, Cladosporium, Aspergillus, Candida, Dermatophagoides farinae, cat, dog, oak, fescue, ragweed, plantain, and cockroach were measured using inhibition assays developed with whole antigen extract. Allergens Der p1, Der f 1, Alt a 1, and Alt a 70 kD were measured using double monoclonal antibody assays. Significant concentrations of whole antigen from cat, dog, oak, Alternaria, and Cladosporium were detected. Between 0.1 and 18 microg of Der f1 and Der p1 per gram of dust were also measured. Alt a 1 and Alt a 70 kD levels varied between 3.0 and 1000 U/g of dust. Significant positive correlations were observed in levels of dust mite and Alternaria allergen for patients with an evaluation of asthma. We found measurable levels of fungal antigens (Alternaria, Cladosporium), mite antigens, and animal antigens (dog and cat) in the majority of dust samples in this self-selected set of allergy clinic patients. Specific allergens Alt a 1, Alt a 70kD, and Der p 1 were significantly higher in the homes of asthmatic patients when compared with patients seen for reasons other than asthma. These studies support the hypothesis that fungal allergen exposure is an important component in the pathogenesis of the clinical condition known as asthma.

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

HLA class II association with Type I allergy to house dust mite and Japanese cedar pollen in Japanese subjects

ABSTRACT We evaluated the incidence of the association of HLA class II phenotype and specific IgE responsiveness against house dust mite (HDM) and/or Japanese cedar pollen (Jc) in 176 patients with allergic rhinitis, with or without bronchial asthma, and 107 nonallergic subjects. Specific IgE antibody titration against the purified allergens Der f1 and Der f2 from HDM, and against Cry J1 and Cry J2 from Jc, was performed by using enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay (RIA) in sera from all subjects. HLA class II oligotyping was performed by the polymerase chain reaction sequence specific oligonucleotide (PCR-SSO) method on the DRB1*, DQA1*, DQB1* and DPB1* alleles using peripheral blood cells. The high IgE responders ≥ class 4 to the purified allergens were identified by using the IgE antibody reference concentration obtained by ELISA, RIA and routine IgE CAP RAST. Compared to the controls, the patients with both rhinitis and asthma showed significantly higher frequencies of DRB1* 0901, DQB1* 0303, and DPB1* 0401 alleles. High IgE responsiveness to HDM was associated with DRB1* 1101, 0901, DQB1* 0303, and DPB1*0401 alleles. The patients with anti-Der f1 IgE antibody concentration exceeding 72.2 ng/mL showed significantly elevated frequencies for DQB1*0401 and DPB1*0401 alleles, and those with anti Der f2 IgE antibody concentration exceeding 46.2 ng/mL showed significantly elevated frequencies for DPB1*0401 and 0901 alleles. High IgE responsiveness to Jc with Cry j1 and Cryj2 was associated with the DRB1* 1201 alleles.

Concentrations of cat (Fel d1), dog (Can f1) and mite (Der f1 and Der p1) allergens in the clothing and school environment of Swedish schoolchildren with and without pets at home.

To investigate whether our hypothesis that cat and dog owners bring allergens to public areas in their clothes was true or not, we studied the levels of Fel d1, Can f1, Der p1 and Der f1 in dust from the clothes and classrooms of children in a Swedish school. We also investigated the levels of allergen in different areas in the four classrooms used by the children. Thirty-one children were selected in four classes, forming three groups: cat owners, dog owners and children without a cat or dog at home. Furthermore, a group of children with asthma was included. Cat and dog allergens were detected in all 57 samples from clothes and classrooms. Mite allergen Der f1 was detected in low concentrations in 6 out of 48 and Der p1 in 5 out of 46 samples investigated. The concentrations of Can f1 were higher than those of Fel d1 in samples from clothes (geometric mean: 2676 ng/g fine dust and 444 ng/g) and classrooms (Can f1: 1092 ng/g, Fel d1: 240 ng/g). The dog owners had significantly higher concentrations of Can f1 (8434 ng/g fine dust) in their clothes than cat owners (1629 ng/g, p < 0.01), children without cat or dog (2742 ng/g, p < 0.05) and children with asthma (1518 ng/g, p < 0001). The cat owners did not have significantly higher levels of Fel d1 (1105 ng/g) in their clothes compared to the other three groups. (D: 247 ng/g, nCnD: 418 ng/g) but the levels were significantly higher than for all children without a cat at home (345 ng/g, p < 0.05). No concentrations of mite allergen and low concentrations of Fel d1 and Can f1 were found in the children's hair. There were significantly higher concentrations of Fel d1 and Can f1 in dust from curtains than in samples from floors and bookshelves (p < 0.05). There was no significant difference between the allergen concentrations in samples from curtains and from desks and chairs, including the teachers' chairs, the only upholstered furniture in the rooms. Our results support the hypothesis that cat and dog owners bring allergens to public areas in their clothes and support other studies showing that textiles and upholstered furniture function as reservoirs of cat and dog allergens. Thus, children with asthma and other allergic diseases will be exposed to cat and dog allergens at school and by contact with pet owners, even if they avoid animal allergens at home.

Long-term house dust immunotherapy improves pulmonary functions in children adolescents with bronchial asthma

This study involved long-term analysis of children and adolescents with house dust mite sensitive allergic asthma to investigate the effect of immunotherapy (IT) with a house dust extract containing certain amounts of Dermatophagoides farinae ( Der f1 ), and Dermatophagoides pteronyssinus (Der p1, Der p2) . The medication requirements, peak expiratory flow (PEF) circadian variations, forced expiratory flow between 25 and 75% of the vital capacity (FEF 25-75 ), maximal expiratory flow at 50 and 25% vital capacity (V 50 and V 25 ), and specific airway resistance (SRaw) were evaluated over a 3-year period in patients treated with IT. When compared with the results for control asthmatic patients who had not been treated with IT, statistically significant amelioration regarding the PEF circadian variations, %FEF 25-75 , %V 50 and %V 25 was observed in IT-treated patients during the study. Although the improvement for medication requirement during the study was not different statistically between the two groups, we concluded that long-term house dust IT may result in amelioration of pulmonary functions, which may account for its clinical effectiveness in the treatment of asthmatic patients.

HLA class II association with Type I allergy to house dust mite and Japanese cedar pollen in Japanese subjects

We evaluated the incidence of the association of HLA class II phenotype and specific IgE responsiveness against house dust mite (HDM) and/or Japanese cedar pollen (Jc) in 176 patients with allergic rhinitis, with or without bronchial asthma, and 107 nonallergic subjects. Specific IgE antibody titration against the purified allergens Der f1 and Der f2 from HDM, and against Cry J1 and Cry J2 from Jc, was performed by using enzyme-linked immunosorbent assay (ELISA) and radio-immunoassay (RIA) in sera from all subjects. HLA class II oligotyping was performed by the polymerase chain reaction sequence specific oligonucleotide (PCR-SSO) method on the DRB1*, DQA1*, DQB1* and DPB1* alleles using peripheral blood cells. The high IgE responders ≥ class 4 to the purified allergens were identified by using the IgE antibody reference concentration obtained by ELISA, RIA and routine IgE CAP RAST. Compared to the controls, the patients with both rhinitis and asthma showed significantly higher frequencies of DRB1* 0901, DQB1* 0303, and DPB1* 0401 alleles. High IgE responsiveness to HDM was associated with DRB1* 1101, 0901, DQB1* 0303, and DPB1*0401 alleles. The patients with anti-Der f1 IgE antibody concentration exceeding 72.2 ng/mL showed significantly elevated frequencies for DQB1*0401 and DPB1*0401 alleles, and those with anti Der f2 IgE antibody concentration exceeding 46.2 ng/mL showed significantly elevated frequencies for DPB1*0401 and 0901 alleles. High IgE responsiveness to Jc with Cry j1 and Cry j2 was associated with the DRB1* 1201 alleles.