Problemi correnti
Il ruolo della profilassi ambientale nella prevenzione e nel trattamento dell’asma
ALLERGEN AVOIDANCE FOR HOUSE DUST MITE
ILARIA ROMEI, ROBERTA FABBRICI, ELISA MILANESI, BARBARA BOSEGGIA, ATTILIO L. BONER
Clinica Pediatrica, Policlinico G.B. Rossi, Università di Verona
Aprile 2004 - pagg. 235 -242
Abstract
The Author offers an overview of allergen avoidance measures for house dust mite (HD). The
main HD allergen, Der p1, is a proteolytic enzyme which has direct effects on respiratory
epithelium and on immune system. There is sufficient evidence of the efficacy of allergen
avoidance measures in preventing sensitization to HD and reducing the prevalence of wheezing.
The target population for allergen avoidance measures are subjects at genetic risks, infants
with sensitization to eggs and toddlers with sensitization to grass. The milestone of HD
allergen avoidance is the use of bedding encasement (including mattress, pillow and covers)
with effective barrier materials such as micro-fibers and elimination of carpets. Prolonged stay
at higher altitudes where the HD mites cannot survive can reduce bronchial hyper-responsiveness
more effectively than specific immunotherapy. The generous use of steam, vacuum cleaner
with water pre-filter and high efficiency final filter can be effective complements.
Classificazione MeSH
Bibliografia
1. Boner A, Pescollderungg L, Silverman M.
The role of house dust mite elimination in the
management of childhood asthma: an unresolved
issue. Allergy 2002;57(Suppl 74):23-31.
2. National Asthma Education and Prevention program. Expert panel Report: Guidelines for the Diagnosis and Management of Asthma Update on Selected Topics - 2002. J Allergy Clin Immunol 2002;110:S141-219.
3. Sears MR, Greene JM, Willam AR, et al. A longitudinal population-based, cohort study of childhood asthma followed to adulthood. N Engl J Med 2003;349:1414-22.
4. Sporik R, Holgate ST, Platts-Mills TA, Cogswell JJ. Exposure to house-dust mite allergen (Der p 1) and the development of asthma in childhood. A prospective study. N Engl J Med 1990;323:502-7.
5. Pearce N, Pekkanen J, Beasley R. How much asthma is really attributable to atopy? Thorax 1999;54:268-72.
6. Peat JK, Tovey E, Mellis CM, Leeder SR, Woolcoock AJ. Importance of house dust mite and Alternaria allergens in childhood asthma: an epidemiological study in two climatic regions of Australia. Clin Exp Allergy 1993; 23:812-5.
7. Perzanowski MS, Platts-Mills T. Relevance of allergens from cats and dogs to asthma in the northernmost province of Sweden: Schools as a major site of exposure. J Allergy Clin Immunol 1999;103:1018-24.
8. Litonjua A, Carey VJ, Burge HA, et al. Exposure to cockroach allergen in the home is associated with incident doctor-diagnosed asthma and recurrent wheezing. JACI 2001; 107:41-7.
9. Sidenius KE, Hallas TE, Brygget T, et al. House dust mites and their allergens at selected locations in the homes of house dust miteallergic patients. Clin Exp Allergy 2002; 32:1299-304.
10. Gough L, Schultz O, Sewell HF, Shakib F. The cysteine protease activity of the major dust mite allergene Der p1 selectively enhances the immunoglobulin E antibody response. J Exp Med 1999;190:1897-902.
11. Wan H, Winton HL, Soeller C, et al. Der p1 facilitates transepitelian allergen delivery by distruption of tight junctions. J Clin Invest 1999;104:123-33.
12. Miike S, Kita H. Human eosinophilis are activated by cysteine proteases and release inflammatory mediators. J Allergy Clin Immunol 2003;111:704-13.
13. Machado DC, Horton D, Harrop R, Peachell PT, Helm BA. Potential allergens stimulate the release of mediators of the allergic response from cells of mast lineage in the absence of sensitisation with antigen-specific IgE. Eur J Immunol 1996;26:2972-80.
14. Hewitt CR, Broun AP, Hart BJ, Pritchard DI. A major house dust mite allergen disrupts the immunoglobulin E network by selectively cleaving CD23: innate protection by antiproteases. J Exp Med 1995;182:1537-44.
15. Wood LJ, Sehmi R, Dorman S, et al. Allergen induced increases in bone marrow T lymphocytes and interleukin-5 expression in subjects with asthma. Am J Respir Crit Care Med 2002;166:883-9.
16. Wan H,Winton Hl, Soeller C, et al. Quantitative structural and biochemical analyses of tight junction dynamics following exposure of epithelial cells to house dust mite allergen Der p1. Clin Exp Allergy 2000; 30:685-98.
17. Sun G, Stacey MA, Schmidt M, et al. Interaction of mite allergens Der p3 and Der p9 with protease-activated receptor-2 expressed by lung epithelial cells. J Immunol 2001; 167:1014-21.
18. Akaike T, Maruo H, Sakata Y, Sato K. Potentation of infectivity and pathogenesis of influenza A virus by a house dust mite protease. J Infect Dis 1999;170:1023-6.
19. Brown T, Farmer K, MacDonald L, et al. House dust mite Der p1 down-regulates defences of the lung by inhactivating elastase inhibitors. Am J Respir Cell Mol Biol 2003;29: 381-9.
20. Lowe L, Murray CS, Custovic A, et al. Specific airway resistance in 3-year-old children: a prospective cohort study. Lancet 2002;359: 1904-8.
21. Langley JM, Goldthorpe S, Craven M, et al. Exposure and sensitisation to indoor allergens: association with lung function, bronchial reactivity, and exhalated nitric oxide measures in asthma. J Allergy Clin Immunol 2003;112:362-8.
22. Green RM, Custovic A, Sanderson G, Hunter J, Johnston SL, Woodcok A. Synergism between allergens and viruses and risk of hospital admission with asthma: case-control study. BMJ 2002 30; 324:763. Erratum in BMJ 2002;324:1131.
23. Song P, Milanese M, Crimi E, Reheder K, Brusasco V. Allergen challenge of passively sensitized human bronchi alters M2 and beta 2 receptor function. Am J Resp Crit Care Med 1997;155:1230-4.
24. Nimmagadda SR, Szefler SJ, Spahn JD, Surs W, Leung DY. Allergen exposure decreases glucocorticoid receptor binding affinity and steroid responsivness in atopic asthmatic. Am J Respir Crit Care Med 1997;155: 87-93.
25. Regoly-Merei G. The life and scientific activity of Girolamo Cardano. Orv Hetil 1971; 112:2291-3.
26. Schei MA, Hessen JO, Lund E. House-dust mites and mattresses. Allergy 2002;57:538-42.
27. Gotzsche PC, Hammarquist C, Burr M. House dust mite control measures in the management of asthma: meta-analysis. BMJ 1998; 317:1105-10.
28. Rijssenbeek-Nouwens AJ, Oosting MS, de Bruin-Weller I, et al. Clinical evaluation of the effect of the anti-allergic mattress covers in patients with moderate to severe asthma and house dust mite allergy: a randomised double blind placebo controlled study. Thorax 2002; 57:784-90.
29. Woodcock A, Forster L, Matthews E, et al. Control of exposure to mite allergen and allergen-impermeable bed covers for adults with asthma. N Engl J Med 2003;349:225-36.
30. Owen S, Morganstern M, Hepworth J, Woodcock A. Control of house dust mite antigen in bedding. Lancet 1990; 335:396-7.
31. Tanaka H, Masuda T, Tokuoka S, et al. Time course study on the development of allergen- induced airway remodelling in mice: ther effect of allergen avoidance on established airway remodelling. Inflamm Res 2002;51: 307-16.
32. Paggiaro PL, Vagaggini B, Bacci E, et al. Prognosis of occupational asthma. Eur Respir J 1994;7(4):761-7.
33. Park HS, Nahm DH. Prognostic factors for toluene disocyanate-induced occupational asthma after removal from exposure. Clin Exp Allergy 1997;27:1145-50.
34. Peroni DG, Piacentini GL, Vicentini L, et al. Effective allergen avoidance reduces residual volume and sputum eosinophilis in children with asthma. J Allergy Clin Immunol 2001; 108:308.
35. Shapiro G, Mendelson LM, Pearlman DS. Once-daily budesonide inhalation powder maintains pulmonary function and symptoms of asthmatic children previously receiving inhaled corticosteroids. Ann Allergy Asthma Immunol 2001;86:633-40.
36. Carswell F, Birmingham K, Oliver J, Crewers A, Weeks J. The respiratory effects of reduction of mite allergen in the bedrooms of asthmatic children - a double-blind controlled trial. Clin Exp Allergy 1996;26:386-96.
37. Pichler CE, Marquardsen A, Sparholt Lowenstein H, et al. Specific immunotherapy with Dermatophagoides pteronyssinus and D. farinae results in decreased bronchial hyperreactivity. Allergy 1997;52:274-83.
38. Peroni DG, Boner AL, Vallone G, Antolini I, Warner JO. Effective allergen avoidance at high altitude reduces allergen-induced bronchial hyperresponsiveness. Am J Respir Crit Care Med 1994;149:1442-6.
39. Mahakittikun V, Komoltri C, Nochot H, Angus AC, Chew FT. Laboratory assessment of the efficiency of encasing materials against house dust mites and their allergens. Allergy 2003;58:981-5.
40. Peroni DG, Ress M, Pigozzi M, et al. Efficacy in allergen control and air permeability of different materials used for bed encasement. 2004 in press.
41. Simpson A, Custovic A, Simpson B, Woodcock A. Effect of mite Allergen Avoidance Measures on Levels of Can f 1 in Homes Without Dogs. J Allergy Clin Immunol 2002;109:77Ab.
42. Colloff MJ, Taylor C, Merrett TG. The use of domestic steam cleaning for the control of house dust mites. Clin Exp Allergy 1995; 25:1061-6.
43. Hide DW, Matthews S, Matthews L, et al. Effect of allergen avoidance in infancy on allergic manifestations at age two years. J Allergy Clin Immunol 1994;93:842-6.
44. Arshad SH, Matthews S, Gant G, Hide DW. Effect of allergen avoidance on development of allergic disorders in infancy. Lancet 1992;20;339:1493-7.
45. Matthews SM, Bateman BJ, Arshad H. The David Hide Asthma and Allergy Researche Centre; Isle of Wight, UK. Effect of Allergen Avoidance in Infancy on Allergic Manifestations at Age Eight Years. JACI 2001;107: S300.
46. Custovic A, Simpson BM, Simpson A, Kissen P, Woodcock A. NAC Manchester Asthma and Allergy Study Group. Effect of environmental manipulation in pregnancy and early life respiratory symptoms and atopy during first year of life: a randomised trial. Lancet 2001;358:188-93.
47. Arshad SH, Bateman B, Matthews SM. Primary prevention of asthma and atopy during childhood by allergen avoidance in infancy: a randomised controlled study. Thorax 2003; 58:489-93.
48. Illi S, von Mutius E, Lai S, et al. The pattern of atopic sensitization is associated with development of asthma in childhood. J Allergy Clin Immunol 2001;108:709-14.
49. Peat JK, Salome C.M, Woolcock AJ. Longitudinal changes in atopy during a 4-year period: Relation to bronchial hyperresponsiveness and respiratory symptoms in a population sample of Australian children. J Allergy Clin Immunol 1990;85:65-74.
50. Nickel R, Kulig M, Forster J, Bergmann R, Bauer CP, et al. Sensitization to hen’s egg at the age of twelve months is predictive for allergic sensitisation to common indoor and outdoor allergens at the age of three years. J Allergy Clin Immunol 1997;99:613-7.
51. Nishioka K, Yasueda H, Saito H. Preventive effect of bedding encasement with microfine fibers on mite sensitisation. J Allergy Clin Immunol 1998;101:28-32.
52. Silvestri M, Rossi GA, Cozzani S, Pulvirenti G, Fasce L. Age dipendent tendency to become sensitized to other classes of aeroallergens in atopic asthmatic children. Ann All Asthma Immunol 1999;83:335-40.
53. Arshad SH, Bojarskas J, Tsitoura S, et al. Prevention of sensitisation to house dust mite by allergen avoidance in school age children: a randomised controlled study. Clin Exp Allergy 2002;32:843-9.
54. Tsitoura S, Nestoridou K, Botis P, et al. SPACE study group: prevention of sensitisation to house dust mite by allergen avoidance in school age children: a randomised controlled study. Clin Exp Allergy 2002;32:843-9.
55. Xuan W, Marks GB, Toelle BG, et al. Risck factors for onset and remission of atopy, wheeze, and airway hyperresponsivenes. Thorax 2002;57:104-9.
56. Squillace SP, Sporik RB, Rakes G, et al. Sensitization to dust mites as a dominant risk factor for asthma among adolescents living in central Virginia. Multiple regression analysis of a population-based study. Am J Respir Crit Care Med 1997;156:1760-4.
57. Murray AB, Ferguson AX. Dust-free bedrooms in the treatment of asthmatic children with house dust or house dust mite allergy: a controlled trial. Pediatrics 1983; 71:418-22.
58. Halken S, Host A, Niklassen U, et al. Effect of mattress and pillow encasing on children with asthma and house dust mite allergy. J Allergy Clin Immunol 2003;111:169-76.
59. Wickman M, Korsgaard J. Transient sensitization to house-dust mites: a study on the influence of mite exposure and sex. Allergy 1996;51:511-3.
60. Huss K, Squire EN, Carpenter GB, et al. Effective education of adults with asthma who are allergic to dust mites. J Allergy Clin Immunol 1992;89:836-43.
61. Wickman M, Melen E, Berglind N, et al. Strategies for preventing wheezing and asthma in small children. Allergy 2003;58:742-7.
62. Carlsen KH. Can asthma and allergy be prevented in real life? Allergy 2003;58:730-2.
2. National Asthma Education and Prevention program. Expert panel Report: Guidelines for the Diagnosis and Management of Asthma Update on Selected Topics - 2002. J Allergy Clin Immunol 2002;110:S141-219.
3. Sears MR, Greene JM, Willam AR, et al. A longitudinal population-based, cohort study of childhood asthma followed to adulthood. N Engl J Med 2003;349:1414-22.
4. Sporik R, Holgate ST, Platts-Mills TA, Cogswell JJ. Exposure to house-dust mite allergen (Der p 1) and the development of asthma in childhood. A prospective study. N Engl J Med 1990;323:502-7.
5. Pearce N, Pekkanen J, Beasley R. How much asthma is really attributable to atopy? Thorax 1999;54:268-72.
6. Peat JK, Tovey E, Mellis CM, Leeder SR, Woolcoock AJ. Importance of house dust mite and Alternaria allergens in childhood asthma: an epidemiological study in two climatic regions of Australia. Clin Exp Allergy 1993; 23:812-5.
7. Perzanowski MS, Platts-Mills T. Relevance of allergens from cats and dogs to asthma in the northernmost province of Sweden: Schools as a major site of exposure. J Allergy Clin Immunol 1999;103:1018-24.
8. Litonjua A, Carey VJ, Burge HA, et al. Exposure to cockroach allergen in the home is associated with incident doctor-diagnosed asthma and recurrent wheezing. JACI 2001; 107:41-7.
9. Sidenius KE, Hallas TE, Brygget T, et al. House dust mites and their allergens at selected locations in the homes of house dust miteallergic patients. Clin Exp Allergy 2002; 32:1299-304.
10. Gough L, Schultz O, Sewell HF, Shakib F. The cysteine protease activity of the major dust mite allergene Der p1 selectively enhances the immunoglobulin E antibody response. J Exp Med 1999;190:1897-902.
11. Wan H, Winton HL, Soeller C, et al. Der p1 facilitates transepitelian allergen delivery by distruption of tight junctions. J Clin Invest 1999;104:123-33.
12. Miike S, Kita H. Human eosinophilis are activated by cysteine proteases and release inflammatory mediators. J Allergy Clin Immunol 2003;111:704-13.
13. Machado DC, Horton D, Harrop R, Peachell PT, Helm BA. Potential allergens stimulate the release of mediators of the allergic response from cells of mast lineage in the absence of sensitisation with antigen-specific IgE. Eur J Immunol 1996;26:2972-80.
14. Hewitt CR, Broun AP, Hart BJ, Pritchard DI. A major house dust mite allergen disrupts the immunoglobulin E network by selectively cleaving CD23: innate protection by antiproteases. J Exp Med 1995;182:1537-44.
15. Wood LJ, Sehmi R, Dorman S, et al. Allergen induced increases in bone marrow T lymphocytes and interleukin-5 expression in subjects with asthma. Am J Respir Crit Care Med 2002;166:883-9.
16. Wan H,Winton Hl, Soeller C, et al. Quantitative structural and biochemical analyses of tight junction dynamics following exposure of epithelial cells to house dust mite allergen Der p1. Clin Exp Allergy 2000; 30:685-98.
17. Sun G, Stacey MA, Schmidt M, et al. Interaction of mite allergens Der p3 and Der p9 with protease-activated receptor-2 expressed by lung epithelial cells. J Immunol 2001; 167:1014-21.
18. Akaike T, Maruo H, Sakata Y, Sato K. Potentation of infectivity and pathogenesis of influenza A virus by a house dust mite protease. J Infect Dis 1999;170:1023-6.
19. Brown T, Farmer K, MacDonald L, et al. House dust mite Der p1 down-regulates defences of the lung by inhactivating elastase inhibitors. Am J Respir Cell Mol Biol 2003;29: 381-9.
20. Lowe L, Murray CS, Custovic A, et al. Specific airway resistance in 3-year-old children: a prospective cohort study. Lancet 2002;359: 1904-8.
21. Langley JM, Goldthorpe S, Craven M, et al. Exposure and sensitisation to indoor allergens: association with lung function, bronchial reactivity, and exhalated nitric oxide measures in asthma. J Allergy Clin Immunol 2003;112:362-8.
22. Green RM, Custovic A, Sanderson G, Hunter J, Johnston SL, Woodcok A. Synergism between allergens and viruses and risk of hospital admission with asthma: case-control study. BMJ 2002 30; 324:763. Erratum in BMJ 2002;324:1131.
23. Song P, Milanese M, Crimi E, Reheder K, Brusasco V. Allergen challenge of passively sensitized human bronchi alters M2 and beta 2 receptor function. Am J Resp Crit Care Med 1997;155:1230-4.
24. Nimmagadda SR, Szefler SJ, Spahn JD, Surs W, Leung DY. Allergen exposure decreases glucocorticoid receptor binding affinity and steroid responsivness in atopic asthmatic. Am J Respir Crit Care Med 1997;155: 87-93.
25. Regoly-Merei G. The life and scientific activity of Girolamo Cardano. Orv Hetil 1971; 112:2291-3.
26. Schei MA, Hessen JO, Lund E. House-dust mites and mattresses. Allergy 2002;57:538-42.
27. Gotzsche PC, Hammarquist C, Burr M. House dust mite control measures in the management of asthma: meta-analysis. BMJ 1998; 317:1105-10.
28. Rijssenbeek-Nouwens AJ, Oosting MS, de Bruin-Weller I, et al. Clinical evaluation of the effect of the anti-allergic mattress covers in patients with moderate to severe asthma and house dust mite allergy: a randomised double blind placebo controlled study. Thorax 2002; 57:784-90.
29. Woodcock A, Forster L, Matthews E, et al. Control of exposure to mite allergen and allergen-impermeable bed covers for adults with asthma. N Engl J Med 2003;349:225-36.
30. Owen S, Morganstern M, Hepworth J, Woodcock A. Control of house dust mite antigen in bedding. Lancet 1990; 335:396-7.
31. Tanaka H, Masuda T, Tokuoka S, et al. Time course study on the development of allergen- induced airway remodelling in mice: ther effect of allergen avoidance on established airway remodelling. Inflamm Res 2002;51: 307-16.
32. Paggiaro PL, Vagaggini B, Bacci E, et al. Prognosis of occupational asthma. Eur Respir J 1994;7(4):761-7.
33. Park HS, Nahm DH. Prognostic factors for toluene disocyanate-induced occupational asthma after removal from exposure. Clin Exp Allergy 1997;27:1145-50.
34. Peroni DG, Piacentini GL, Vicentini L, et al. Effective allergen avoidance reduces residual volume and sputum eosinophilis in children with asthma. J Allergy Clin Immunol 2001; 108:308.
35. Shapiro G, Mendelson LM, Pearlman DS. Once-daily budesonide inhalation powder maintains pulmonary function and symptoms of asthmatic children previously receiving inhaled corticosteroids. Ann Allergy Asthma Immunol 2001;86:633-40.
36. Carswell F, Birmingham K, Oliver J, Crewers A, Weeks J. The respiratory effects of reduction of mite allergen in the bedrooms of asthmatic children - a double-blind controlled trial. Clin Exp Allergy 1996;26:386-96.
37. Pichler CE, Marquardsen A, Sparholt Lowenstein H, et al. Specific immunotherapy with Dermatophagoides pteronyssinus and D. farinae results in decreased bronchial hyperreactivity. Allergy 1997;52:274-83.
38. Peroni DG, Boner AL, Vallone G, Antolini I, Warner JO. Effective allergen avoidance at high altitude reduces allergen-induced bronchial hyperresponsiveness. Am J Respir Crit Care Med 1994;149:1442-6.
39. Mahakittikun V, Komoltri C, Nochot H, Angus AC, Chew FT. Laboratory assessment of the efficiency of encasing materials against house dust mites and their allergens. Allergy 2003;58:981-5.
40. Peroni DG, Ress M, Pigozzi M, et al. Efficacy in allergen control and air permeability of different materials used for bed encasement. 2004 in press.
41. Simpson A, Custovic A, Simpson B, Woodcock A. Effect of mite Allergen Avoidance Measures on Levels of Can f 1 in Homes Without Dogs. J Allergy Clin Immunol 2002;109:77Ab.
42. Colloff MJ, Taylor C, Merrett TG. The use of domestic steam cleaning for the control of house dust mites. Clin Exp Allergy 1995; 25:1061-6.
43. Hide DW, Matthews S, Matthews L, et al. Effect of allergen avoidance in infancy on allergic manifestations at age two years. J Allergy Clin Immunol 1994;93:842-6.
44. Arshad SH, Matthews S, Gant G, Hide DW. Effect of allergen avoidance on development of allergic disorders in infancy. Lancet 1992;20;339:1493-7.
45. Matthews SM, Bateman BJ, Arshad H. The David Hide Asthma and Allergy Researche Centre; Isle of Wight, UK. Effect of Allergen Avoidance in Infancy on Allergic Manifestations at Age Eight Years. JACI 2001;107: S300.
46. Custovic A, Simpson BM, Simpson A, Kissen P, Woodcock A. NAC Manchester Asthma and Allergy Study Group. Effect of environmental manipulation in pregnancy and early life respiratory symptoms and atopy during first year of life: a randomised trial. Lancet 2001;358:188-93.
47. Arshad SH, Bateman B, Matthews SM. Primary prevention of asthma and atopy during childhood by allergen avoidance in infancy: a randomised controlled study. Thorax 2003; 58:489-93.
48. Illi S, von Mutius E, Lai S, et al. The pattern of atopic sensitization is associated with development of asthma in childhood. J Allergy Clin Immunol 2001;108:709-14.
49. Peat JK, Salome C.M, Woolcock AJ. Longitudinal changes in atopy during a 4-year period: Relation to bronchial hyperresponsiveness and respiratory symptoms in a population sample of Australian children. J Allergy Clin Immunol 1990;85:65-74.
50. Nickel R, Kulig M, Forster J, Bergmann R, Bauer CP, et al. Sensitization to hen’s egg at the age of twelve months is predictive for allergic sensitisation to common indoor and outdoor allergens at the age of three years. J Allergy Clin Immunol 1997;99:613-7.
51. Nishioka K, Yasueda H, Saito H. Preventive effect of bedding encasement with microfine fibers on mite sensitisation. J Allergy Clin Immunol 1998;101:28-32.
52. Silvestri M, Rossi GA, Cozzani S, Pulvirenti G, Fasce L. Age dipendent tendency to become sensitized to other classes of aeroallergens in atopic asthmatic children. Ann All Asthma Immunol 1999;83:335-40.
53. Arshad SH, Bojarskas J, Tsitoura S, et al. Prevention of sensitisation to house dust mite by allergen avoidance in school age children: a randomised controlled study. Clin Exp Allergy 2002;32:843-9.
54. Tsitoura S, Nestoridou K, Botis P, et al. SPACE study group: prevention of sensitisation to house dust mite by allergen avoidance in school age children: a randomised controlled study. Clin Exp Allergy 2002;32:843-9.
55. Xuan W, Marks GB, Toelle BG, et al. Risck factors for onset and remission of atopy, wheeze, and airway hyperresponsivenes. Thorax 2002;57:104-9.
56. Squillace SP, Sporik RB, Rakes G, et al. Sensitization to dust mites as a dominant risk factor for asthma among adolescents living in central Virginia. Multiple regression analysis of a population-based study. Am J Respir Crit Care Med 1997;156:1760-4.
57. Murray AB, Ferguson AX. Dust-free bedrooms in the treatment of asthmatic children with house dust or house dust mite allergy: a controlled trial. Pediatrics 1983; 71:418-22.
58. Halken S, Host A, Niklassen U, et al. Effect of mattress and pillow encasing on children with asthma and house dust mite allergy. J Allergy Clin Immunol 2003;111:169-76.
59. Wickman M, Korsgaard J. Transient sensitization to house-dust mites: a study on the influence of mite exposure and sex. Allergy 1996;51:511-3.
60. Huss K, Squire EN, Carpenter GB, et al. Effective education of adults with asthma who are allergic to dust mites. J Allergy Clin Immunol 1992;89:836-43.
61. Wickman M, Melen E, Berglind N, et al. Strategies for preventing wheezing and asthma in small children. Allergy 2003;58:742-7.
62. Carlsen KH. Can asthma and allergy be prevented in real life? Allergy 2003;58:730-2.