From Big Medical Encyclopedia

DUST ALLERGY (grech, alios another + ergon action) — allergic reactions to house (household) and production dust; it is characterized by preferential defeat of a respiratory organs.

For the first time attempts to find out a role of house dust as etiol, a factor in a sensitization of an organism were made in the 20th 20 century when the Core (R. A. Kern, 1921) and R. Cook (1922) was described by cases of the bronchial asthma {see) caused by a sensitization to house dust. In 40 — the 50th 20 century the first works devoted to definition of specific active components of house dust were published. In 1960 R. Voorhorst one of the first suggested about biol, as allergen and established to a basis of specific components of house dust a role of mites of the sort Dermatophagoides in development of a sensitization (see). In the USSR (see), including and allergens of dust, the works of groups of researchers directed by A. D. Ado, A are devoted to studying of allergens. E. Vermel, A. A. Polner, etc.

Exact data on the incidence caused by P. and., in the USSR and other countries is not present. According to different researchers, the sensitization to house dust occurs approximately at 15% of the population, apprx. 21% of cases of diseases of allergic diseases (see) are caused by an allergy to house dust. Apprx. 50% of all patients having allergic diseases of a respiratory organs, sensibilizirovana to house dust. Allergic diseases of a respiratory organs at contact with production pylyam (see. Pneumoconiosis ), according to B. I. Zertsalova and I. S. Ivanova (1967), average 1,6%.

Dust allergens belong to ekzoallergena of a noninfectious origin and have complex structure: debris of an animal, plant, microbic origin, remains of synthetic fabrics, plastic and other products of organic synthesis, and also inorganic matters. The composition of dust of premises depends on the things which are there, however along with individual components house dust contains the general antigenic components. Library and peryevy dust can be components of house dust and independent individual allergens.

The most active effective agent of house dust are microscopic mites (Acarina), and 70 — 80% of a house akarofauna make mites of Dermatophagoides pteronyssinus, Dermatophagoides farinae and other types meet less often. There are data that in house dust it is possible to find more than 50 species of mites, and in 1 g of dust the number of mites sometimes reaches several thousand.

At house dust extracts there can be bacterial endotoxins therefore at statement provocative (see. Provocative tests ) or skin tests (see) with dust allergens in certain cases register temperature increase. Bando (T. Bando, 1974), estimating house dust from the point of view of microbiology, established that they from 67% of samples of house dust were sowed nonpathogenic staphylococcus, from 20,4% — gram-negative bacteria and cocci, from 9,9% — mold and other fungi, from 2,7% — gram-negative mycobacteria. From one sample of house dust the streptococcus, golden staphylococcus and fungi of the sort Candida were not sowed.

For diagnosis and P.'s treatment and. from house dust prepare drug of dust allergen. For this purpose house dust is collected by the vacuum cleaner from upholstered furniture, feather-beds, pillows, carpets, etc., degreased ether, for 3 — 4 days Cooks fill in with liquid (fiziol, the solution stabilized by the phosphatic buffer, pH 7,0 — 7,2 with addition of phenol) at the rate of 3 g of the fat-free material on 100 ml of liquid, extract is dialyzed against liquid by Cooks within 1 — 2 days, filter via Zeytts's filter, check for sterility and harmlessness, standardize on number of units of protein nitrogen (PNU), part to concentration from 100 to 20 000 PNU in test and will see off biol, standardization on sick and healthy people by statement of skin tests with a series of cultivations of allergen.

It is established that dust allergen represents mix of carbohydrates, including and aminosugars, with polypeptides, whose maintenance apprx. 10 — 15%. Allergen keeps the specific activity after processing by trypsin and chymotrypsin, but loses it after processing by pepsin. Berens suggested that allergenic activity to dust allergen is given by the connections of aldiminny type which are formed as a result of so-called reaction of browning (Meyard's reaction) between amino groups of peptides and reducing sugars of a carbohydrate part of allergen.

Dust (see), consisting of organic matters of a plant origin (dust of textile productions, grain dust, etc.), gains allergenicity at the expense of bacterial and especially fungal infection, and also impurity of pesticides, herbicides, mineral substances, pollen, particles of insects, etc. The dust consisting of organic matters of animal origin (a part of wool and dandruff of animals on production of fur products and woolen fabrics), contains so-called epidermal allergens, and also allergens of dyes, etc.

An important role in P.'s development and. plays pollution of the air basin. City dust, edges represents an aerosol from particles of industrial wastes, the particles which are contained in exhaust gases, smoke of boiler rooms, etc. consists of organic and inorganic components, including metals (iron, manganese, molybdenum, etc.), and causes a polyvalent sensitization, is frequent against the background of a bacterial allergy (see. Infectious allergy ). Penetration of dust allergens through protective barriers is promoted by meteoconditions.

At a dust allergy at 75 — 90% of patients observe the immediate (himergichesky) V-dependent reactions caused by IgE. Very seldom, in 3% of cases of P. and., observe T-dependent reactions of the slowed-down type (on A. D. Ado's classification, 1978). In the latter case at contact of T lymphocytes (see Immunekompetentny cells) from a pylyama, containing bacterial substances or haptens (see), the so-called lymphokines, the activating macrophages and possessing cytolytic action are released. Some researchers do not exclude participation in P.'s development and. an autoimmune component (see. Immunopathology ). In allergen of house dust the general antigenic determinants with albumine and gamma-globulins of blood serum of the person are found, communication between an allergy to house dust and to an epithelium of mucous membranes of the person is revealed.

Except allergic reactions, at P. and. so-called pseudo-allergic reactions — the bystander phenomenons caused by the water-soluble and thermostable agents-gistaminoliberatorami who are contained in dust and not having allergenic properties can be observed.

At P.'s modeling and. on a lab. animals in their respiratory tracts are marked out by the changes characteristic of allergic reactions of immediate type (plasmatic treatment, Mucoid swelling and fibrinoid transformation of fabrics up to a fibrinoid necrosis, emergence in a zone of an immune inflammation of coarse-dispersion proteins, fibrin, polymorphonuclear leukocytes, preferential eosinophils, and erythrocytes). Regarding cases note patomorfol. the changes characteristic of allergic reactions of the slowed-down type.

The dust allergy at 80% of patients is shown in the form of an atopic (noninfectious and allergic) form of bronchial asthma, approximately at 10% — in the form of allergic rhinitis (see), tracheitis (see), allergic conjunctivitis (see), at 7 — 10% — in the form of a small tortoiseshell (see), a Quincke's edema (see. Quincke hypostasis ), eczemas (see), atopic dermatitis are more rare (see. Neurodermatitis ). Allergic defeats of respiratory bodies at inhalation pyly, containing organic components, including disputes of mushrooms, can proceed in the form of alveolites (see. Exogenous allergic alveolites ). System manifestations of P. of ampere-second involvement in process of blood cells are possible (see. Purpura of a trombotsitopenichesk cc), development in a beyt (see), various nefropatiya.

At children allergic reaction to house dust is shown usually in 3 — 5 years, its intensity increases with age. Item and. more often boys suffer. By data A. D. Ado and N. V. Adrianova, the predisposition hereditarily caused at the patients addressing in to lay down. institutions of Moscow concerning an allergy to dust, about one or several lines are burdened.

Item and. differs in a year-round current, sometimes note the improvement connected with the minimum concentration of allergen in air in the summer. The aggravation is possible in September — October in connection with a breeding season of the main allergizuyushchy beginning of house dust — mites. A recurrence is possible in the winter since concentration of allergen of house dust in air of dwellings is maximum at this time. Item and. it is characterized by accurate remissions at the termination of contact with allergen (so-called eliminative effect). Accession hron, respiratory diseases and a bacterial allergy mark out seldom, by data A. D. Ado (1976), only at 8 — 9% of the patients suffering from P. and.

Complications at P. and. generally the same, as at atopic forms of bronchial asthma — almost main manifestation of P. and. They consist in development of emphysema of lungs (see), a pulmonary heart (see) p are shown usually on 3 — the 5th year of a disease at the medium-weight course of a disease.

Diagnosis Item and. establish by means of specific diagnostic methods (see. Allergy diagnostic tests ). Skin tests, direct and indirect concern to them, first of all, (see P rausnittsa-Kyustner reaction ), and provocative tests (see). As auxiliary specific diagnostic tests use a radioallergosorbent method (see), the basphilic test (see), etc.

Treatment at P. and. consists first of all in elimination of dust allergen. The termination of contact with house or production dust at a sensitization to it (including hospitalization) promotes subsiding and disappearance of symptoms of a disease. If elimination is impossible, carry out year-round specific desensitization (see) «guilty» allergens according to the classical scheme or allergens with the prolonged action (tsintanat house dust, alpirat, etc.). At impossibility of specific therapy or its inefficiency recommend treatment by glucocorticoid hormones (see) which are effective at both types of allergic reactions at P. and. Efficiency of intal (dinatrium of a hromoglikat) at P.'s treatment is proved and. At allergic reactions of immediate type to dust allergen apply antihistaminic substances (see). For stopping of the heavy attacks of bronchial asthma caused by a sensitization to house or any other dust use administration of adrenaline, the pharmaceuticals which are ksantinovy derivatives, etc. (see. Bronchial asthma, treatment).

Dignity. - hens. it is reasonable to carry out treatment in climatic zones with an arid climate, in moderate highlands. The speleoterapiya is effective (stay in the special sanatoria located in mountain caves, the developed salt mines, etc.).

Forecast at P. and. it is favorable. Specific therapy of P. and. leads to recovery and almost full preservation of working capacity.

In quality preventive measures at emergence of symptoms of an allergy to house dust it is necessary to remove the carpets, feather-beds, objects of a house situation littering the apartment and promoting accumulation of dust house conditions, replacement of feather pillows on wadded, etc. is necessary. It is impossible to hold domestic animals. Regular wet cleaning of the room is obligatory. Perhaps fuller mechanization of works, sealing of the equipment and a techno of l is under production conditions necessary. processes, improvement of conditions of warehousing of hay, grain and other pages - x. the products which are sources of dust use of protective masks, respirators and protective creams for working in the dusty environment.

Bibliography: Ado A. D. General allergology, page 101, M., 1978; Vermelya. E. Professional bronchial asthma, M., 1966; Dubinina E. V. and Pletnev B. D. Methods of detection and definition of allergenic mites of house dust, L., 1977, bibliogr.; A pathogeny of allergic processes in clinic and an experiment, under the editorship of. A. M. Chernukh and V. I. Pytsky, page 225, 235, M., 1979; e t r at N about in B., Todorov of and D about N of the h e in the Item. Studying of a sensitization to micromites in house dust at the people having bronchial asthma, Zhurn. mikr., epid. and immun., No. 6, page 104, 1977, bibliogr.; Fradkin V. A. Allergens, page 139, M., 1978; Private allergology, under the editorship of. And. D. Ado, page 67, M., 1976; Berrens L. The chemistry of atopic allergens, Basel, 1971, bibliogr.'; Berrens L. Van Dijk A. G. Physicochemical and immunochemical quantitation of house dust allergens, Develop. Biol. Stand., v. 29, p. 54, 1975; Berrens L. Young E. Purification and properties of house dust allergen, Int. Arch. Allergy, v. 19, p. 341, 1961; Blands J. o. Flour allergy in bakers, ibid., v. 52, p. 392, 1976; Cooke R. A. Allergy in theory and practice, Philadelphia, 1947; J h a V. K. a. o. Clinical studies with some air-borne pollens and dusts as respiratory allergens around Varanasi, Indian J. Chest Dis., v. 17, p. 107,1975; Lichtenstein L. M. Allergic responses to airborne allergens and insect venoms, Fed. Proc., v. 36, p. 1727, 1977; Munro-Ashman D. FranklandA. W. Treatment of allergy to house dust with pyridine-extracted alum-precipitated extracts of the house dust mite, Ann. Allergy, v. 36, p. 95, 1976; PepysJ., Chan M. Hargreave F. E. Mites and house-dust allergy, Lancet, v. 1, p. 1270, 1968; Spieksma F. T. Hausstaub-milben als Asthmaursache, Allerg. u. Immunol., Bd 22, S. 389, 1976; Sutherland C. Preparation of house-dust extracts, Brit. med. J., v. 2, p. 280, 1942; Voorhorst R. Allergie gegen Haus-staub und Schimmelpilze, in book: Aktuelle Allergiefragen, hrsg.

v. D. G. R. Findel u. K. Hansen, S. 237, Lpz., 1961.

V. A. Ado, H. G. Astafyeva, L. A. Goryachkin, A. X. Kanchurin.