The journal of allergy and clinical immunology. Global · 2026
Regional diversity of major house dust mite allergens in Spain: Molecular profiles and clinical correlates.
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Rial Manuel J, El-Qutob David, Alcover Javier, Villamayor Laura, Martínez-Gomariz Montserrat, González-Pérez Ruperto
Аннотация
BACKGROUND: House dust mites (HDMs) are a major cause of respiratory allergies worldwide. Molecular diagnosis has allowed a more precise characterization of sensitization patterns, which may have clinical and therapeutic relevance. However, large-scale data on molecular HDM sensitization profiles in real-world settings remain limited in Spain.
OBJECTIVE: We aimed to determine the seroprevalence and major allergens of HDM molecular components across different Spanish regions and to explore their association with allergic phenotypes, including allergic rhinitis (AR) and asthma.
METHODS: A multicenter cross-sectional study was conducted in 5 Spanish regions. A total of 458 serum samples from patients with suspected HDM allergy were analyzed using a multiplex molecular diagnostic platform. Sensitization was defined as specific IgE ≥ 0.3 kUA/L. Allergens with a prevalence ≥50% were considered major allergens. Associations with AR and asthma were evaluated by prevalence odds ratios (PORs) and chi-square tests.
RESULTS: The most prevalent HDM allergens were Der p 23 (85.2%), Der f 2 (82.3%), Der p 2 (81.0%), Der p 1 (77.5%), and Der f 1 (71.0%). Regional differences were observed, with Galicia showing high sensitization to Gly d 2 and Lep d 2 (both 57%). In the Canary Islands, >50% of patients were sensitized to Gly d 2, Lep d 2, Der p 21, Der p 5, Der p 7, and Blot 5. Sensitization to Blot 5 showed a moderate association with asthma (POR, 3.64), whereas Tyr p 2 was linked to persistent AR (POR, 2.33). Sensitization to Lep d 2 had variable associations with AR severity across regions.
CONCLUSIONS: Der p 23, Der f 2, Der p 2, Der p 1, and Der f 1 are the major HDM allergens in Spain, with regional variability suggesting environmental or genetic modifiers. Certain molecular allergens are associated with more severe or persistent allergic phenotypes, highlighting the value of component-resolved diagnosis for risk stratification and immunotherapy planning.
OBJECTIVE: We aimed to determine the seroprevalence and major allergens of HDM molecular components across different Spanish regions and to explore their association with allergic phenotypes, including allergic rhinitis (AR) and asthma.
METHODS: A multicenter cross-sectional study was conducted in 5 Spanish regions. A total of 458 serum samples from patients with suspected HDM allergy were analyzed using a multiplex molecular diagnostic platform. Sensitization was defined as specific IgE ≥ 0.3 kUA/L. Allergens with a prevalence ≥50% were considered major allergens. Associations with AR and asthma were evaluated by prevalence odds ratios (PORs) and chi-square tests.
RESULTS: The most prevalent HDM allergens were Der p 23 (85.2%), Der f 2 (82.3%), Der p 2 (81.0%), Der p 1 (77.5%), and Der f 1 (71.0%). Regional differences were observed, with Galicia showing high sensitization to Gly d 2 and Lep d 2 (both 57%). In the Canary Islands, >50% of patients were sensitized to Gly d 2, Lep d 2, Der p 21, Der p 5, Der p 7, and Blot 5. Sensitization to Blot 5 showed a moderate association with asthma (POR, 3.64), whereas Tyr p 2 was linked to persistent AR (POR, 2.33). Sensitization to Lep d 2 had variable associations with AR severity across regions.
CONCLUSIONS: Der p 23, Der f 2, Der p 2, Der p 1, and Der f 1 are the major HDM allergens in Spain, with regional variability suggesting environmental or genetic modifiers. Certain molecular allergens are associated with more severe or persistent allergic phenotypes, highlighting the value of component-resolved diagnosis for risk stratification and immunotherapy planning.