To analyze the allergenicity spectrum characteristics of house dust mite (HDM) components (Der p 1, Der p 2, Der p 10, Der p 23) in HDM-allergic children from the Beijing area, and explore the associations between sensitization to these components and allergic rhinitis (AR) with comorbid allergic asthma (AA) or atopic dermatitis (AD). Using a cross-sectional study design, 221 children (140 males and 81 females) aged 4-16 years with positive serum HDM-specific immunoglobulin E (sIgE) who attended Beijing Civil Aviation General Hospital from March 2024 to May 2025 were included. AR, AA and AD were diagnosed and grouped according to established guidelines. Serum total IgE and component-specific sIgE levels(Der p 1, Der p 2, Der p 10, Der p 23) were measured using chemiluminescence. The results showed that Der p 2 and Der p 1 were the predominant sensitizing components, with sensitization rates of 62.0% (137/221) and 58.8% (130/221) respectively, followed by Der p 23 (17.2%, 38/221), and Der p 10 (9.0%, 20/221), among the 221 children. The median concentration of Der p 2-sIgE (1.41 kUA/L) was significantly higher than that of Der p 1 (0.27 kUA/L). Co-sensitization to Der p 1 and Der p 2 was the most common pattern (29.0%, 64/221). The sensitization rates to Der p 1 were significantly higher in the AR with AA group compared to the AR without AA group (χ2=5.157,P<0.05). After adjusting for age, sex, total IgE, and the number of sensitized inhalant allergens in multivariate logistic regression and using a more stringent sIgE positivity threshold (≥0.70 kUA/L), Der p 1 sensitization remained independently associated with an increased risk of asthma co-morbidity (aOR=2.22, 95%CI: 1.137-4.316, P<0.05). In the subgroup analysis of children with asthma co-morbidity, Der p 1-sIgE concentration showed a significant positive correlation with asthma severity (aOR=1.16, 95%CI: 1.020-1.310, P<0.05). No significant associations were found between component sensitizations and AD comorbidity(χ2=1.534, 0.299, 1.243, 0.316, P>0.05). In conclusion,among the children with dust mite allergy in Beijing area studied Der p 1 sensitization demonstrates a robust and independent association with asthma comorbidity and correlates with asthma severity, whereas the highly immunogenic component Der p 2 does not have an independent association with asthma. These provides a reference for component-resolved diagnosis, individualized risk assessment, and precision immunotherapy for pediatric HDM-allergic diseases in the Beijing area. 本研究分析北京地区屋尘螨过敏儿童组分致敏谱特征，并探讨主要组分（Der p 1、Der p 2、Der p 10、Der p 23）致敏与过敏性鼻炎（AR）共患过敏性哮喘（AA）和特应性皮炎（AD）的相关性。本研究采用横断面研究设计，纳入2024年3月至2025年5月于民航总医院就诊的4~16岁、血清屋尘螨特异性免疫球蛋白E抗体（sIgE）阳性的儿童221例（男性140例，女性81例）。依据指南标准诊断AR、AA和AD并进行分组。采用磁微粒化学发光法检测血清总IgE（tIgE）及组分sIgE水平（Der p 1、Der p 2、Der p 10、Der p 23）。结果显示，221例患儿中，Der p 2与Der p 1为主要致敏组分，致敏率分别为62.0%（137/221）与58.8%（130/221），Der p 23为17.2%（38/221），Der p 10最低（9.0%，20/221）。Der p 2-sIgE浓度中位数（1.41 kUA/L）显著高于Der p 1（0.27 kUA/L）。Der p 1与Der p 2共致敏最常见（29.0%，64/221）。AR伴AA组Der p 1致敏率高于AR不伴AA组（χ2=5.157，P<0.05）。调整年龄、性别、tIgE及吸入物致敏种类，sIgE采用≥0.70 kUA/L阳性阈值后，多因素logistic回归模型分析结果显示，Der p 1致敏仍与哮喘共病风险独立相关（aOR=2.22，95%CI：1.137~4.316，P<0.05）。在哮喘共病亚组分析中Der p 1-sIgE浓度与哮喘严重程度呈正向关联（aOR=1.16，95%CI：1.020~1.310，P<0.05）。各组分致敏与AD共病无显著关联（χ2=1.534、0.299、1.243、0.316，P>0.05）。综上，本研究的屋尘螨过敏儿童中，Der p 1致敏与哮喘共病存在稳健的显著独立关联。而高免疫原性组分（Der p 2）与哮喘无独立关联。这为北京地区儿童尘螨过敏性疾病的组分解析诊断、个体化风险评估及精准免疫治疗提供了参考依据。.
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arXiv · 2022-05-17
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