Thank you for your recent inquiry.
The letter to the editor that you cite, to my knowledge, is one of only two reports in the literature that have noted wheezing to the inhalation of the mite-contaminated food in question. In both instances, it was the inhalation of particles of food itself and not mite as an isolated antigen (see Blanco C, et al., below).
Since the publication of the letter to the editor that you cite, there have been at least two other reports of anaphylaxis due to mite-ingested food (see Sanchez-Machin and Iglesias-Souto, et al., below). In one of these (Iglesias-Souto), a positive nasal provocation test to the mite extract alone produced a positive response.
Based on a review of these studies, it is clear that food contaminated mite allergen, in sufficient quantities, exposed to the respiratory tract, can produce reactions. However, to my knowledge, there has been no clinically significant asthma reported due to the inhalation of the mite itself (versus the inhalation of contaminated food), and therefore I would think, although reactions could be possible, they would be extremely rare. It is probably therefore very unusual for asthma due to isolated mite exposure to be a significant problem in these patients.
Thank you again for your inquiry and we hope this response is helpful to you.
Blanco C, Castillo R, Ortega N, Alvarez M, Arteaga C, Barber D, Carrillo T. Allergy Section, Hospital Universitario Ntra. Sra. del Pino, Las Palmas de Gran Canaria, Canary Islands. Oral mite anaphylaxis.
Sánchez-Machín I, Glez-Paloma Poza R, Iglesias-Souto J, Iraola V, Matheu V. Allergy. 2010 Mar 10. [Epub ahead of print] No abstract available. PMID: 20337609 [PubMed - as supplied by publisher] Oral mite anaphylaxis by Thyreophagus entomophagus in a child: a case report.
Iglesias-Souto J, Sánchez-Machín I, Iraola V, Poza P, González R, Matheu V. Clin Mol Allergy. 2009 Nov 25;7:10 J Investig Allergol Clin Immunol. 1997 Sep-Oct;7(5):323-4. Asthma due to the ingestion of contaminated flour.
Phil Lieberman, M.D.