Local Crude House Dust Extracts as a Substitute for Standardized House Dust Mite Extracts in Allergy Diagnostic and Immunotherapy

Allergic diseases are a significant global health issue commonly triggered by house dust mite (HDM) allergens. Standardized HDM extracts are currently usually used in allergen immunotherapy (AIT) and diagnostic tests. However, in several tropical regions, such as Indonesia, these standardized extracts were either expensive, difficult to obtain, or did not represent local allergen exposure. Previous studies examined crude house dust extracts (CHDE) derived from locally collected dust as a possible substitute because it reflected the complex allergenic and other composition of the local environment. Therefore, this study aimed to review the potential of Local Crude House Dust Extracts (LCHDE) as a regionally relevant substitute source of allergens for both diagnostic and therapeutic applications. CHDE reflected real environmental exposure, including region-specific mite, fungi, and bacterial components, which could better represent local allergen profiles. LCHDE offered a promising, cost-effective, and contextually relevant option for allergy diagnosis in developing regions. However, its application in immunotherapy necessitated rigorous allergen profiling, and regional collaboration was crucial to establish CHDE suitable for clinical use.