Molecular profiling of IgE sensitization to dermatophagoides allergen components: clinical correlates in a high-exposure region

Introduction Respiratory allergies, mediated by IgE reactions to house dust mites (HDM), constitute a significant disease burden in Mediterranean climates. We investigated molecular sensitization profiles to Dermatophagoides allergens and their clinical correlations in a high-exposure region. Material and methods This prospective multicentre study enrolled patients (5–65 years) with HDM-allergic rhinitis/asthma from the Valencian Community, Spain. Sensitization to Dermatophagoides components (Der p and Der f) was analysed using ALEX 2 microarray (positivity boundary IgE ≥0.30 kUA/L). Statistical analyses included descriptive statistics, correlation tests, and multivariate regression. Results Der p 2 (92.7%), Der f 2 (92.7%), Der p 1 (87%), Der p 23 (83.7%), Der f 1 (82.9%), and Der p 7 (51.2%) were the most prevalent sensitization types among 118 participants (median age 29; 53% female). Overall, 36 sensitization profiles emerged, half of which were grouped into 4 dominant profiles: profile 1 (14.4%), profile 5 (13.6%), profile 11 (6.8%), and profile 2 (95.1%), all characterized by core allergens Der p 1, Der f 1, Der p 2, and Der f 2, with varying additional components (e.g., Der p 5, 7, 21, 23). Younger age predicted higher Der p 23 reactivity ( p < 0.05), while females showed lower Der p 7/23 sensitization. Poorly controlled rhinitis (93% of cases) and asthma correlated with Der p 1/Der f 1 responses. Conclusion The study reveals diverse HDM sensitization profiles in a Mediterranean population, highlighting the clinical relevance of both major and minor allergens. Component-resolved diagnostics may support a better understanding of the heterogeneity of HDM sensitization profiles in high-exposure regions.