Therapeutic measures include limiting contact with allergens, the use of barrier drugs, antiallergic drugs, ASIT.
Reduced dust contact. Conducting regular wet cleaning of the premises (floors and walls, furniture and household appliances) with cleaning of carpets, mattresses, timely replacement of bed linen. It is advisable to replace feather pillows and duvets with synthetic ones. It is necessary to air the rooms daily, humidifying the air in the rooms.
Barrier means. In the initial stage of allergic rhinitis, caused by allergies to dust, it is possible to use special sprays applied to the nasal mucosa and create a barrier, protective layer there that prevents the penetration of the allergen.
Antiallergic drugs. Antihistamines of the first and second generation, membrane stabilizers are used, in severe cases – glucocorticosteroids are topical, oral or parenteral.
ASIT. The use of allergen-specific immunotherapy is most effective in allergic rhinitis and bronchial asthma (if an immunological study revealed allergens of domestic animals and dust mites). Treatment should be carried out according to strict indications, taking into account possible side effects from therapy. The total duration of ASIT is from 2 to 5 years.
Dust allergy – a hypersensitivity reaction that develops when it enters the respiratory tract or on the skin of foreign protein components contained in the dust. Clinical symptoms are manifested by the development of a runny nose, cough and sneezing, difficulty breathing and suffocation, itching of the skin. According to the WHO, approximately 40% of all cases of year-round allergic reactions on Earth are associated with increased body sensitivity to dust components. The most common allergen present in house dust is mite microparticles and their metabolic products. On average, one gram of dust from a mattress can contain from 200 to 15,000 ticks.
Causes of dust allergies
The complex of organic and inorganic components contained in the dust includes all sorts of chemicals entering the apartment from the street, fragments of animal activity, insects, arachnids and other potential allergens:
- Street dust. Contains particles of soil, gravel, bitumen, cement, soot, plant pollen and spores of fungi, various microorganisms.
- Animal waste products. These are wool, dandruff, saliva, production of sebaceous glands, pet excrement (cats, dogs, rabbits, guinea pigs, etc.). The main allergenic properties are foreign proteins of saliva and the top layer of animal skin attached to their coat.
- House dust mites. Microscopic fragments of bodies and feces of pyroglyphic dust mites are localized in mattresses, blankets, pillows, carpeting and upholstery of upholstered furniture. Mites feed on constantly exfoliating cells of the human epidermis, isolating special enzymes for their cleavage, which are strong allergens. The optimal environment for the life of pyroglyph mites is humidity above 50-60% and temperature in the range of 20-26 degrees Celsius.
- Other allergens. Includes cellulose particles from paper pages of books and various microorganisms contained in library dust, mold fungi, body fragments, and insect secretions (flies, ants, cockroaches).
The above allergens are microscopic in size, volatile, water-soluble, so they can easily penetrate into the human body along with dust through direct contact with interior objects and bedding (during sleep and rest, when cleaning the premises), and by inhalation.
Pathogenesis of dust allergy
During the initial contact with dust allergens, sensitization develops, accompanied by increased production of specific immunoglobulin IgE by immune cells. Repeated penetration of the foreign protein into the body (on the mucous membranes of the nasopharynx, bronchi, skin) and its interaction with antibodies causes the activation of mast cells with the release of inflammatory mediators and the development of clinical manifestations of an allergic reaction in one of the target organs.
Corresponding symptoms may appear in the first minutes after interacting with the allergen (in the early phase) or after 3-6 hours (the delayed phase).
In the pathogenesis is present and the mechanism of nonspecific tissue hyperreactivity to substances that are not true allergens. In this case, the symptoms appear in response to the non-specific irritant effect of non-protein components of dust in the absence of an immunological stage and the development of the inflammatory process by the mechanism of a pseudo-allergic reaction.
Symptoms of dust allergies
The clinical picture of an allergic reaction to dust depends on the route of entry of foreign proteins into the body (mucosa of the nasopharynx, larynx and bronchi, skin), hereditary predisposition, age, associated diseases and other factors. At the same time, there are signs of conjunctivitis, rhinitis, bronchial asthma, atopic dermatitis. Symptoms of dust allergies can occur throughout the year, including during the autumn-winter period.
Clinical manifestations of allergic conjunctivitis are characterized by damage to the conjunctiva with its reddening and dilated capillaries, the appearance of hyperemia and swelling of the eyelid edges, lacrimation. In the acute period, symptoms develop in the first minutes and hours after the allergen has been exposed to the conjunctiva and is accompanied by intense itching, burning sensation under the eyelids, photophobia. When dust allergy is more common chronic course of conjunctivitis with scanty manifestations: the periodic appearance of itching and burning in the eyes, a small tearing.
Irritation of the mucous membrane of the nose during allergic rhinitis is manifested by sneezing attacks, which become more pronounced in the evening after coming to the dusty room, as well as after a night’s sleep. Sneezing is accompanied by profuse rhinorrhea and itching. In chronic sensitization, there is a periodic feeling of itching, tickling in the nasal cavity, full nasal breathing is difficult. At night, worried throat and dry cough caused by irritation of the nasopharynx flowing down the mucous contents of the nasal cavity.
Allergic inflammation of the mucous membrane of the bronchial tree leads to dyspnea, a sense of lack of air, dry cough with difficult to expel sputum, sudden attacks of obstruction with suffocation. Exacerbation of atopic bronchial asthma, caused by allergies to dust, is more often observed in the fall and winter due to an increase in the amount of dust in the rooms and a decrease in humidity during the heating season. At the same time, the patient’s well-being significantly improves after the morning care from dusty rooms, and worsens in the evening after returning to the apartment.
Damage to the skin when allergic to dust is characterized by the presence of itchy skin rash on the type of urticaria, signs of atopic dermatitis with persistent erythema and peeling, cracks, eroded areas with soak and subsequent formation of crusts, frequent infection of damaged surfaces. Pruritus becomes one of the main symptoms of atopic dermatitis, aggravated during room cleaning and at night. The general condition of patients is often disturbed, which is manifested by frequent headache, sleep disturbance, irritability and mood swings, social maladjustment.
Complications of dust allergies
Complicated course develops with frequent exacerbations of respiratory and skin allergies, the accession of a bacterial infection, the combination of dust allergies with chronic diseases of the respiratory tract. After 3-5 years of moderate atopic asthma, pulmonary emphysema and pulmonary heart may develop. Systematic contact with industrial dust is fraught with the onset of pneumoconiosis.
Occasionally, dust allergies can cause systemic disorders: thrombocytopenic purpura, exogenous allergic alveolitis, nephropathy.
Dust Allergy Diagnosis
In order to properly diagnose dust allergies, it is necessary to carefully collect an allergic history (the presence of a hereditary predisposition, previous allergic reactions, deterioration of well-being in closed rooms with an abundance of upholstered furniture and carpets, during room cleaning).
A clinical examination of the skin and visible mucous membranes, palpation of the internal organs is carried out at the reception of an allergist-immunologist, palpation of the internal organs, general clinical and biochemical analyzes, spirometry are prescribed. In the presence of allergic inflammation of the nasopharynx, skin, an ENT doctor, a dermatologist, and an ophthalmologist are consulted.
To identify the disease, skin scarification and prick tests are performed with standard epidermal allergens of animals (cats, dogs, sheep, rabbit) and house dust mites, specific IgE immunoglobulins are determined. According to the testimony can be performed provocative tests. Differential diagnosis of dust allergy is carried out with other allergic diseases, pathology of upper respiratory tract (rhinitis, sinusitis of viral and bacterial etiology), acute and chronic bronchitis, skin diseases.
Prediction and prevention of dust allergies
Timely detection of allergens that cause a hypersensitivity reaction when in contact with dust and the appointment of adequate treatment (including immunotherapy), allows to achieve stable remission of the disease. Severe and complicated forms with disabilities develop under the systematic influence of dust irritants (home, library, industrial dust).
Prevention of exacerbations is based on constant measures to reduce contact with dust: daily wet cleaning of the apartment, hygienic processing of domestic animals, automation of technological processes, use of personal protective equipment (respirators, masks).
