House dust mite allergy: The importance of house dust mite allergens for diagnosis and immunotherapy

House dust mite (HDM) allergy belongs to the most important allergies and affects approximately 65–130 million people worldwide. Additionally, untreated HDM allergy may lead to the development of severe disease manifestations such as atopic dermatitis or asthma. Diagnosis and immunotherapy of HDM allergic patients are well established but are often hampered by the use of mite extracts that are of bad quality and lack important allergens. The use of individual allergens seems to be a promising alternative to natural allergen extracts, since they represent well-defined components that can easily be produced and quantified. However, a thorough characterization of the individual allergens is required to determine their clinical relevance and to identify those allergens that are required for correct diagnosis of HDM allergy and for successful immunotherapy. This review gives an update on the individual HDM allergens and their benefits for diagnosis and immunotherapy of HDM allergic patients. •HDM allergy represents one of the most important allergies worldwide and is associated with severe disease manifestations.•Diagnosis and immunotherapy of HDM allergic patients could be improved by the use of recombinant HDM allergens.•Der p 1, Der p 2 and Der p 23 represent the major HDM allergens, Der p 5, Der p 7 and Der p 21 the mid-tier allergens. A combination of these six allergens seems to be sufficient for diagnosis and immunotherapy of HDM allergic patients.