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Reducing House Dust Mite Allergen Load Ineffective in Atopic Dermatitis

Reductions in allergen load through use of house dust mite-impermeable encasings for bedding does not lead to significant changes in clinical parameters for patients with atopic dermatitis (AD).

Use of the casings for mattresses, pillows and duvets does, however, result in significant decreases in Der p 1 and Der p 1 plus Der f 1 allergen concentrations, Dutch researchers report.

They suggest reduction in allergens in other patient environments could be equally important in improving patient AD symptoms. This includes work, school and outdoor environments.

Investigators from Utrecht, Rotterdam, Groningen and Amsterdam tested effectiveness of the bedding encasings for 12 months by randomising 45 atopic dermatitis patients to their use. Another 41 patients in a placebo group were assigned to use of cotton encasings.

Participants ranged in age from eight to 50 years. All had a Leicester dermatitis sign score of at least 1 percent extent and a severity score of six points or greater.

After 12 months, house dust mite-impermeable encasings reduced the Der p 1 allergen concentration in mattresses with a factor of 2.1 and the Der p 1 plus Der f 1 allergen concentration with a factor of 2.5.

"Although the decrease in allergen load was significant, no differences in treatment-induced changes were seen between the placebo and active groups," the researchers concluded.
Journal of Allergy and Clinical Immunology, 2002; 110: 500-506. "Effect of mattress encasings on atopic dermatitis outcome measures in a double-blind, placebo-controlled study: The Dutch mite avoidance study"

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