IgE and IgG anti-house dust mite specificities in allergic disease

Background: There are few studies that quantitatively compare IgE and IgG antibody binding to the major and minor house dust mite allergens. Objective: To measure the IgE and IgG antibody specificities produced by adults and children, including children admitted to an emergency department for asthma. Methods: Antibodies were measured by solid-phase microliter assays. Results: Children recruited from the emergency department had similar titers and patterns of IgE antibody binding compared with children without acute disease. Der p 1 and 2 bound 50 % to 65 % of the IgE antibody, and most of the remaining binding was to Der p 4, 5, and 7. Der p 3, 8, 10, and 20 induced low titers. The pattern was similar across a wide range of antibouse.dust mite titers. IgG(1) and IgG(4) antibodies predominantly bound the major and midrange allergens and were mainly found in children with allergy. Children recruited in the emergency department had lower titers. Conclusion: The same IgE antibody-binding pattern and predominant contribution of Der p 1 and 2 was found across a wide range of total IgE antibody titers and for children admitted to an emergency department. IgG, and IgG(4) antibodies bound to the more allergenic specificities and were largely found in children with allergy. The IgG antibody titers were lower in sera from children admitted to the emergency department for asthma exacerbations. Clinical implications: Der p 1 and 2 and possibly Der p 4, 5, and 7 provide a formulation suitable for immunotherapy and diagnosis. Low IgG antibodies were a feature of acute disease.