What is the best allergy medicine for dust mites

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Control techniques

This section is transcluded from Dust.

(edit | history)

House dust mites are present indoors wherever humans live. Positive tests for dust mite allergies are extremely common among people with asthma. Dust mites are microscopic arachnids whose primary food is dead human skin cells, but they do not live on living people. They and their feces and other allergens which they produce are major constituents of home dust, but because they are so heavy they are not suspended for endless in the air. They are generally found on the floor and other surfaces until disturbed (by walking, for example). It could take somewhere between twenty minutes and two hours for dust mites to settle back below out of the air.

Dust mites are a nesting species that prefers a dark, warm, and humid climate. They flourish in mattresses, bedding, upholstered furniture, and carpets. Their feces include enzymes that are released upon contact with a moist surface, which can happen when a person inhales, and these enzymes can kill cells within the human body.[19] Home dust mites did not become a problem until humans began to use textiles, such as western style blankets and clothing.[20]

Bed linen

Hot tumble drying a bed linen for 1 hour will kill 99% of mites therein.[22]

Weekly changing the bed linen reduces the risk of exposure to dust mites.[16]

Cotton covers not covered with finish mattress covers are extremely likely to become colonised by bacteria and molds; they must be cleaned periodically (at least every second to third month).[23]

Dust mite eggs are freeze tolerant (−70 °C for 30 minutes); hatching can normally be prevented by exposure of fabrics to:[24]

  1. Direct sunlight for 3 hours or
  2. Dry or wet heat of at least 60 °C (140 °F) for a minimum of 30 minutes.

Dust mites drown in water.[25]

Good properties of anti-mite fabrics own been identified as being:[26]

  1. Dust leakage of less than 4%.
  2. Allergen impenetrability >99%.
  3. Thread count greater than 246.
  4. Pore size of between 2 and 10 microns.
  5. Breathability between 2 and 6 cm3/second/cm2.

Furniture

Furniture with wooden or leather surfaces reduce the dust mite population.[21]

Indoor climate

Allergy patients are advised to hold the relative humidity under 50%, if possible.

Extremely few mites can survive if the humidity is less than 45% (at 22 °C (72 °F)). However, they can survive if the humidity is high just for an hour and a half per day, for example due to cooking.[25]


External links

House dust mites (Dermatophagoides pteronyssinus) aggregateA scanning electron micrograph of a female dust mite

Mites and ticks are included in the subclass Acari, which forms one of the most abundant and diverse biological groups within the arachnids (Arthropods) (Fig.

1). Its name derives from the Latin expression acarus, which in turn derives from the Greek name Akari, whose first known mention is attributed to Aristotle (, Historia Animalium, Book 5, Chapter 32). He most likely used this name to mention the mite species Carpoglyphis lactis. Mites are characterized by having four pairs of legs, such as spiders and scorpions (insects own three pairs of legs; crustaceans five pairs of legs) which are relatively smaller than their bodies.

Most of the mite species own a size of less than 1 mm (most home dust mite species are under half a millimeter). Mites can be considered as one of the oldest terrestrial animals. One of the first known mite fossils (identified as Protoacarus crani, Raford) originates from the Devonian period, almost 400 Ma ago. Approximately 30,000 species of mites, placed in more than 1,700 genera, own been described. However, it is considered that the number of undescribed species could be more than 100,000. Mites are distributed worldwide and own competed with insects for aquatic and terrestrial habitats.

They can be found in the soil of forests and grasslands, or on any organic waste. Numerous species spend part of their life cycle in trees and shrubs, while others live in caves or own adapted to live in boiling springs. Depending on the species, they feed on plants, fungi, algae, organic matter, animal waste, other arthropod, nematode, or infest the exterior and interior of every kinds of animals (insects, reptiles, birds and mammals) [2].

Most domestic mites belong to the order Astigmata. They do not own external respiratory openings or stigmata (Astigmata means “no stigma”).

Their little size makes the ratio between the body surface and its interior sufficient to permit efficient gas exchange through the skin. In other orders, breathing could also take put through body openings (1–4 stigmas), which are located in the front half of the body, or through a trachea [3].

Mites own developed a digestive tract, including a mouth and mouth parts, salivary glands, and an intestine, consisting of esophagus, little intestine, along with a large intestine and an anal opening.

Their digestive system produces spherical fecal particles (diameter of about 20 μm) wrapped in a peritrophic membrane, which are the main vector of mite allergens. Mites most commonly found inside the houses worldwide include D. pteronyssinus, D. farinae, E. maynei and B. tropicalis [4, 5]. They feed mainly on human scales and other micronutrients. The quantity of human flakes released daily by an adult is of 0.5 to 1 g, and therefore, it is a extremely abundant food source. In addition to human skin scales the diet may also include: fungi and other constituents of the skin microbiota, body fragments of insects (beetles, cockroaches, moths), etc.

The life cycle of dust mites and some of the storage mites consists of five stages (egg, larva, protonymph, tritonymph and adults).

In each stage, there is an athletic period followed by another, shorter, quiescent stage, before a new stadium emerges from the ancient exoskeleton. The quiescent period protonymph in dust mites can be endless lasting as it is resistant to drying and allows mites to survive endless dry periods (several months).

What is the best allergy medicine for dust mites

This stage remains attached to the substrate and cannot be removed by vacuuming. Some storage mites (L. destructor, A. siro) own an additional stage (deutonymph or hipopus) which allows them to resist unfavorable weather or nutritional conditions.

The life cycle of the mites is directly dependent on the temperature. Microhabitats where mites are found in homes are not uniform in temperature and relative humidity and the temperature fluctuates within a microhabitat.

Thus, their development at low-temperature (on the floor) is lower as compared to their development in warmer conditions (mattresses, or sofas). For D. pteronyssinus, a cycle from egg to adult takes about 122 days at 16 °C (75% RH) while it only takes 15 days at 35 °C [6, 7].

An allergenic role has been attributed to home dust since the early years of the past century. This allergenicity was responsible for a large number of respiratory allergic diseases worldwide. The importance of these allergic manifestations induced by the inhalation of home dust present in soil, mattresses, carpets, rugs, sofas, and comforters was thoroughly studied by diverse researchers in an attempt to identify the main components responsible for this allergenic effect.

In 1921, Kern refers for the first time to the importance of home dust in allergic manifestations [8]. In 1922, Cooke speculates about the existence of allergens of unknown origin and nature in home dust allergen and extracts were prepared for desensitization studies [9]. In 1924, Storm Van Leeuwen associated the dust allergy phenomenon with certain climatic circumstances, as spectacular clinical improvements were observed when patients were moved to high mountain climates with low relative humidities [10].

The occasional discovery of mites in home dust was pointed out by diverse investigators on several occasions. The presence in home dust of mites of the genus Dermatophagoides farinae was indicated for the first time in 1964 by Oshima [11]. However, Voorhorst and Spieksma in 1964, showed that home dust contains mite species with a high allergenic power, which could be responsible for the allergenicity of home dust [12]. Fain identified in 1966 the mite D. pteronyssinus as the main allergen source responsible for numerous respiratory allergies induced by the inhalation of home dust [13].

Mites found worldwide in human premises can generally be grouped into home dust mites and storage mites.

They are found in carpets, fabrics, upholstery, pillows and mattresses. Blomia tropicalis, was formerly known as a storage dust mite, but is now also accepted as a home dust mite as it is found extensively in dust from homes in tropical and subtropical countries. Storage mites include Glycyphagus domesticus, Lepidoglyphus destructor, Blomia kulagini, Tyrophagus putrescentiae, Acarus siro, Suidasia pontifica, Glycycometus malaysiensis, Aleuroglyphus ovatus and Thyreophagus entomophagus. Storage mites are commonly found worldwide in storage facilities for grains such as wheat, corn, oats, barley and hay.

They may contaminate or invade and thrive in processed foods made from the grains (e.g., flour, cereals and baking mixes) when these products become moist or are stored in humid environments. In recent years, the new term domestic mites has been coined to include every mite species present in the indoor environment that can sensitize humans. It includes every the above mentioned species which can be regularly found in the indoor environment, including bedding, sofas, kitchen floors, etc.

Mite identification studies worldwide own confirmed that most mite species are present in most sites where these studies own been conducted, including the Northern and Southern hemispheres.

Mites are almost absent in the artic regions, or in highly freezing and dry climates, such as in high altitude areas in the Alps. There is ample evidence that numerous mite species can sensitize exposed individuals and produce allergic diseases. It has been suggested that any mite species which is in contact with a genetically prone individual, can induce sensitization. Mite allergens can be detected in numerous areas of the home, including beds, carpets, upholstered furniture and clothing.

Leather-covered couches, wood furniture, and bare floors contain fewer mites. Beds are the perfect habitat for mites, since they provide the ideal temperature, food and moisture for their proliferation, and allergens they produce accumulate deep inside mattresses and pillows, especially when they are ancient. Information on the distribution of home dust mites provides valuable data to design environmental control strategies.

Allergy to mites is a global health problem recognized by the World Health Organization, which affects millions of people around the world. The discovery of the cause-effect relationship between sensitization to mites and asthma is relatively recent, approximately 50 years.

In these years there own been significant advances in the identification and characterization of mite allergens and numerous own been purified and sequenced. Similarly, there has been grand progress in the standardization of allergenic extracts of several mite species for diagnosis and treatment, and the clinical efficacy of immunotherapy using extracts of several species of mites has been demonstrated.

Treatment Overview

When you get immunotherapy in the form of allergy shots, your allergist or doctor injects little doses of substances that you are allergic to (allergens) under your skin.

What is the best allergy medicine for dust mites

This helps your body «get used to» the allergen, which can result in fewer or less severe symptoms of allergic rhinitis.

Your allergist will use an extract of grass, weed, or tree pollen; dust mites; molds; or animal dander for allergy shots. You must first own skin testing to discover out which allergen you are allergic to.

Your allergist injects under your skin a solution of salt water (saline) that contains a extremely little quantity of the allergen(s). At first, you get the shot once or twice a week.

You gradually get more of the allergen in the shots.

After about 4 to 6 months of weekly shots, you are generally getting the best quantity of allergen in the shot. This is called the maintenance dose. When you reach the maintenance dose, you get the same dose in shots every 2 to 4 weeks for the next 4 to 6 months.

The period between shots is gradually increased to about a month. And the dose generally stays the same each month. After 1 year of maintenance, your allergist will check to see if you own fewer or less severe symptoms. If your allergy symptoms own not changed, you will no longer get the shots.

If your symptoms own improved, you may continue to get monthly shots for up to 3 to 5 years.footnote 1

Other ways to get this treatment are called cluster or rush immunotherapy, in which you reach the maintenance dose more quickly.


Why It Is Done

Allergy shots can reduce your reaction to allergens, which can result in fewer or less severe symptoms. They may also prevent children who own allergic rhinitis from getting asthma.footnote 1 Recommendations on when to get allergy shots vary, but in general you and your doctor may consider them when:

  1. You own another condition that is being affected by allergic rhinitis, such as asthma.
  2. Side effects of medicines are a problem.
  3. You are allergic to only a few substances, and they are hard to avoid.
  4. Allergy symptoms are severe enough that the benefit from the shots outweighs the expense and the time spent getting the shots.
  5. You desire a treatment for the cause of your allergy, rather than treatment for just the symptoms.
  6. Avoiding allergens and using medicine do not control symptoms, or you own to take medicine every the time to control symptoms.
  7. You desire to lower the chance that you will develop asthma.


Health issues

Allergies

See also: List of mites associated with cutaneous reactions and List of allergens

The mite’s gut contains potent digestive enzymes (notably Peptidase 1) that persist in their feces and are major inducers of allergic reactions such as wheezing.

The mite’s exoskeleton can also contribute to allergic reactions. Unlike scabies mites or skin follicle mites, home dust mites do not burrow under the skin and are not parasitic.[11]

Severe dust mite infestation in the home has been linked to atopic dermatitis and epidermal barrier damage has been documented.[12]

House dust mites are associated with allergic rhinitis and asthma,[13] as well as allergic conjunctivitis.[14] Efforts to remove these mites from the environment own not been found to be effective.[13]Immunotherapy may be useful in those affected.[13] Subcutaneous injections own better evidence than under the tongue dosing.[15] Topical steroids as nasal spray or inhalation may be used.[16]

Oral mite anaphylaxis

Dermatophagoides spp. can cause oral mite anaphylaxis (AKA pancake syndrome) when found in flour.[17][18]


What To Expect

You get allergy shots in your allergist’s office.

You will stay in the office for 30 minutes after you get the shots, in case you own a severe reaction (anaphylaxis) to the injected allergens.

Redness and warmth at the shot site are common. But these go away after a short period of time.


Biology

Reproduction

The average life cycle for a home dust mite is 65–100 days.[6] A mated female home dust mite can live up to 70 days, laying 60 to 100 eggs in the final five weeks of her life. In a 10-week life span, a home dust mite will produce approximately 2,000 fecal particles and an even larger number of partially digested enzyme-covered dust particles.

Predators

The predators of dust mites are other allergenic mites (Cheyletiella), silverfish and pseudoscorpions.[5]

Characteristics

House dust mites, due to their extremely little size and translucent bodies, are barely visible to the unaided eye.[2] A typical home dust mite measures 0.2–0.3 mm (0.008–0.012 in) in length.[3] For precise identification, one needs at least 10× magnification.[citation needed] The body of the home dust mite has a striated cuticle.

Taxonomy

The dust mites are cosmopolitan members of the mite family Pyroglyphidae.

Diet

They feed on skin flakes from animals, including humans, and on some mold. Dermatophagoides farinae fungal food choices in 16 tested species commonly found in homes was observed in vitro to be Alternaria alternata, Cladosporium sphaerospermum, and Wallemia sebi, and they disliked Penicillium chrysogenum, Aspergillus versicolor, and Stachybotrys chartarum.[4]

Distribution

Dust mites are found worldwide, but are found more commonly in humid regions.[7] The species Blomia tropicalis is typically found only in tropical or subtropical regions.[8] Detectable dust mite allergen was found in the beds of about 84% of surveyed United States homes.[9] In Europe, detectable Der p 1 or Der f 1 allergen was found in 68% of surveyed homes.[10]


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