House Dust Mite Exposure: Can It Be A Severe COVID-19 Prevention?


  • Reqgi First Trasia Universitas Sultan Ageng Tirtayasa



House dust mite, covid-19, eosinophil, prevention, corona virus


Background: In the midst of the ongoing COVID-19 pandemic, many studies are looking for treatment  to suppress viral replication and prevention through vaccination. However, to this day the number of incidences and deaths due to COVID-19 is still increasing.

Objective: The purpose of this article is to review theoretically the alleged increase in eosinophils in house dust mite exposure can prevent the severity of COVID-19 symptoms.

Methods: This article was compiled through a literature search in reputable international journals by the time 2020-2021.

Result: The severity of symptoms that arise due to COVID-19 infection is one of them caused by eosinophenia. On the other hand, the host immune response to house dust mite exposure can increase the number of eosinophils through stimulation of IL-6, IL-8, GM-CSF, IL-5 and IL-33. These eosinophils will then express TLR-7 on the cell surface which makes them able to recognize SARS-CoV-2. Stimulation of this eosinophil receptor triggers the production of cytokines, degranulation, superoxide, and nitric oxide (NO) through NO synthase which has a direct antiviral effect. EDN and ECP of human eosinophils can decrease viral infectivity through a ribonuclease-dependent mechanism. Eosinophils are capable of producing extracellular traps composed of eosinophilic granule proteins bound to mitochondrial DNA in response to viral infection in vitro, especially in an oxidative lung tissue environment. Eosinophils also rapidly mobilize granules of Th1 cytokines, including IL-12 and IFN-g which are important for antiviral immune responses.

Conclusion: Although available data are still limited, there are indications that eosinophils have a protective effect during SARS-CoV-2 infection. Therefore, biological agents such as exposure to house dust mites targeting eosinophils may be useful to help clarify the role of eosinophils in their antiviral response.


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Seyed E, Riahi N, Nikzad H. The novel coronavirus disease-2019 (COVID-19): Mechanisms of action, detection, and recent therapeutic strategies. Virology. 2020;551(January):1–9. DOI:

Jee Y. WHO International Health Regulations Emergency Committee for the COVID- 19 outbreak. Epidemiol Health. 2020;42:e2020013. doi:10.4178/epih.e2020013 DOI:

Van Empel G, Mulyanto J, Wiratama BS. Undertesting of COVID-19 in Indonesia: what has gone wrong?. J Glob Health. 2020;10(2):020306. doi:10.7189/jogh.10.020306 DOI:

Gallo Marin B, Aghagoli G, Lavine K, et al. Predictors of COVID-19 severity: A literature review. Rev Med Virol. 2021;31(1):1-10. doi:10.1002/rmv.2146 DOI:

Lindsley AW, Schwartz JT, Rothenberg ME. Eosinophil responses during COVID-19 infections and coronavirus vaccination.2020;1(July):1-7 DOI:

Flores-Torres AS, Salinas-Carmona MC, Salinas E, Rosas-Taraco AG. Eosinophils and respiratory viruses. Viral Immunol 2019;32:198-207. DOI:

Zhang JJ, Dong X, Cao YY, Yuan YD, Yang YB, Yan YQ, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China [published online ahead of print February 19, 2020]. Allergy. DOI:

Abu Khweek A, Kim E, Joldrichsen MR, Amer AO, Boyaka PN. Insights Into Mucosal Innate Immune Responses in House Dust Mite-Mediated Allergic Asthma. Front Immunol. 2020;11(December):1–14. DOI:

Proud D, Leigh R. Epithelial cells and airway diseases. Immunol Rev. (2011) 242:186– 204. doi: 10.1111/j.1600-065X.2011.01033.x DOI:

Spits H, Cupedo T. Innate lymphoid cells: emerging insights in development, lineage relationships, and function. Ann Rev Immunol. (2012) 30:647– 75. doi: 10.1146/annurev-immunol-020711-075053 DOI:

Cunningham PT, Elliot CE, Lenzo JC, Jarnicki AG, Larcombe AN, Zosky GR, et al. Sensitizing and Th2 adjuvant activity of cysteine protease allergens. Int Arch Allergy Imm. (2012) 158:347–58. doi: 10.1159/000334280 DOI:

Kauffman HF, Tamm M, Timmerman JA, Borger P. House dust mite major allergens Der p 1 and Der p 5 activate human airway-derived epithelial cells by protease-dependent and protease-independent mechanisms. Clin Mol Allergy. (2006) 4:5. doi: 10.1186/1476-7961-4-5 DOI:

Eisenbarth SC, Piggott DA, Huleatt JW, Visintin I, Herrick CA, Bottomly K. Lipopolysaccharide-enhanced, toll-like receptor 4-dependent T helper cell type 2 responses to inhaled antigen. J Exp Med. (2002) 196:1645– 51. doi: 10.1084/jem.20021340 DOI:

Trompette A, Divanovic S, Visintin A, Blanchard C, Hegde RS, Madan R, et al. Allergenicity resulting from functional mimicry of a Toll-like receptor complex protein. Nature. (2009) 457:585–8. doi: 10.1038/nature07548 DOI:

Madouri F, Guillou N, Fauconnier L, Marchiol T, Rouxel N, Chenuet P, et al. Caspase-1 activation by NLRP3 inflammasome dampens IL-33-dependent house dust mite-induced allergic lung inflammation. J Mol Cell Biol. (2015) 7:351–65. doi: 10.1093/jmcb/mjv012 DOI:

Zaslona Z, Flis E, Wilk MM, Carroll RG, Palsson-McDermott EM, Hughes MM, et al. Caspase-11 promotes allergic airway inflammation. Nat Commun. (2020) 11:1055. doi: 10.1038/s41467-020-14945-2 DOI:

Barrett NA, Rahman OM, Fernandez JM, Parsons MW, Xing W, Austen KF, et al. Dectin-2 mediates Th2 immunity through the generation of cysteinyl leukotrienes. J Exp Med. (2011) 208:593–604. doi: 10.1084/jem.20100793 DOI:

Lee CG, Da Silva CA, Dela Cruz CS, Ahangari F, Ma B, Kang MJ, et al. Role of chitin and chitinase/chitinase-like proteins in inflammation, tissue remodeling, and injury. Ann Rev Physiol. (2011) 73:479–501. doi: 10.1146/annurev-physiol-012110- 142250 DOI:

Mansson A, Fransson M, Adner M, Benson M, Uddman R, Bjornsson S, et al. TLR3 in human eosinophils: functional effects and decreased expression during allergic rhinitis. Int Arch Allergy Immunol 2010;151:118-28. DOI:

Nagase H, Okugawa S, Ota Y, Yamaguchi M, Tomizawa H, Matsushima K, et al. Expression and function of Toll-like receptors in eosinophils: activation by Toll- like receptor 7 ligand. J Immunol 2003;171:3977-82. DOI:

Domachowske JB, Dyer KD, Bonville CA, Rosenberg HF. Recombinant human eosinophil-derived neurotoxin/RNase 2 functions as an effective antiviral agent against respiratory syncytial virus. J Infect Dis 1998; 177:1458-64. DOI:

Drake MG, Bivins-Smith ER, Proskocil BJ, Nie Z, Scott GD, Lee JJ, et al. Human and mouse eosinophils have antiviral activity against parainfluenza virus. Am J Re- spir Cell Mol Biol 2016;55:387-94. DOI:

Silveira JS, Antunes GL, Gassen RB, Breda RV, Stein RT, Pitrez PM, et al. Respi- ratory syncytial virus increases eosinophil extracellular traps in a murine model of asthma. Asia Pac Allergy 2019;9:e32. DOI:

Yousefi S, Sharma SK, Stojkov D, Germic N, Aeschlimann S, Ge MQ, et al. Oxida- tive damage of SP-D abolishes control of eosinophil extracellular DNA trap forma- tion. J Leukoc Biol 2018;104:205-14. DOI:

Davoine F, Lacy P. Eosinophil cytokines, chemokines, and growth factors: emerging roles in immunity. Front Immunol 2014;5:570. DOI:

Samarasinghe AE, Melo RC, Duan S, LeMessurier KS, Liedmann S, Surman SL, et al. Eosinophils promote antiviral immunity in mice infected with influenza A virus. J Immunol 2017;198:3214-26. DOI:

Del Pozo V, De Andres B, Martin E, Cardaba B, Fernandez JC, Gallardo S, et al. Eosinophil as antigen-presenting cell: activation of T cell clones and T cell hybridoma by eosinophils after antigen processing. Eur J Immunol 1992; 22:1919-25. DOI:

Phipps S, Lam CE, Mahalingam S, Newhouse M, Ramirez R, Rosenberg HF, et al. Eosinophils contribute to innate antiviral immunity and promote clearance of res- piratory syncytial virus. Blood 2007;110:1578-86. DOI:

Sabogal Pineros YS, Bal SM, van de Pol MA, Dierdorp BS, Dekker T, Dijkhuis A, et al. Anti-IL-5 in mild asthma alters rhinovirus-induced macrophage, B-cell, and neutrophil responses (MATERIAL): a placebo-controlled, double-blind study. Am J Respir Crit Care Med 2019;199:508-17. DOI:

Edwards MR, Strong K, Cameron A, Walton RP, Jackson DJ, Johnston SL. Viral infections in allergy and immunology: how allergic inflammation influences viral infections and illness. J Allergy Clin Immunol 2017;140:909-20. DOI:

Yin Y, Wunderink RG. MERS, SARS and other coronaviruses as causes of pneu- monia. Respirology 2018;23:130-7. DOI:

Li X, Xu S, Yu M, Wang K, Tao Y, Zhou Y, et al. Risk factors for severity and mor- tality in adult COVID-19 inpatients in Wuhan [published online ahead of print April 12, 2020]. J Allergy Clin Immunol. 006.

Du Y, Tu L, Zhu P, Mu M, Wang R, Yang P, et al. Clinical features of 85 fatal cases of COVID-19 from Wuhan: a retrospective observational study. Am J Respir Crit Care Med 2020;201:1372-9. DOI:

Liu F, Xu A, Zhang Y, Xuan W, Yan T, Pan K, et al. Patients of COVID-19 may benefit from sustained lopinavir-combined regimen and the increase of eosinophil may predict the outcome of COVID-19 progression. Int J Infect Dis 2020;95:183-91. DOI:

Hassani M, Leijte G, Bruse N, Kox M, Pickkers P, Vrisekoop N, et al. Differenti- ation and activation of eosinophils in the human bone marrow during experimental human endotoxemia [published online ahead of print January 10, 2020]. J Leukoc Biol. doi: 10.1002/JLB.1AB1219-493R. DOI:

Butterfield JH. Treatment of hypereosinophilic syndromes with prednisone, hy- droxyurea, and interferon. Immunol Allergy Clin North Am 2007;27:493-518. DOI:

Tian S, Hu W, Niu L, Liu H, Xu H, Xiao SY. Pulmonary pathology of early-phase 2019 novel coronavirus (COVID-19) pneumonia in two patients with lung cancer. J Thorac Oncol 2020;15:700-4. DOI:

Barton LM, Duval EJ, Stroberg E, Ghosh S, Mukhopadhyay S. COVID-19 autopsies, Oklahoma, USA [published online ahead of print April 10, 2020]. Am J Clin Pathol. DOI:




How to Cite

Trasia, R. F. (2023). House Dust Mite Exposure: Can It Be A Severe COVID-19 Prevention?. International Islamic Medical Journal, 4(1), 12–18.