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Over the past decades, incidence rates of immune-mediated inflammatory diseases including asthma and IBDs have been rising steadily in both Western and low/middle-income countries.1 The cause of this increase has been a topic of intense investigation, and a variety of factors such as diet, hygiene and pollution have been implicated. One of the most clear correlations between disease and environment is that between exposure to house dust mite (HDM) and asthma exacerbations.2 HDM contains several antigens, including Der p1, a cysteine protease that damages the airway epithelium thus allowing antigens to pass into the pulmonary tissue.3 In atopic individuals, this results in a potent IgE-mediated specific anti-Der …
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.
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