Advances in the role of house dust mite allergen components in the pathogenesis of allergic diseases.

House dust mites (HDMs) represent one of the most prevalent indoor aeroallergens globally and are closely associated with type 2 immune-mediated conditions, including allergic asthma, allergic rhinitis, and atopic dermatitis. To date, over 30 HDM allergenic components have been identified and are classified into proteases, lipid-binding proteins, structural proteins, and proteins with uncharacterized functions based on their structural and biological features. Among these, allergens from group 1, 2, and 23 exhibit robust immunoglobulin E(IgE)-binding activity and play pivotal roles in allergic sensitization and inflammatory cascades. HDM allergens disrupt epithelial barrier integrity, activate cell surface receptors, and promote the maturation of dendritic cells via Toll-like receptors, thereby driving type 2 immune responses. Furthermore, recent studies indicate that HDM allergens modulate the homeostasis of the immune microenvironment by affecting metabolic pathways, such as glycolysis, lipid metabolism, and ferroptosis. Traditional diagnostics and treatments heavily rely on crude mite extracts, which are limited by their complex composition, batch-to-batch variability, and a heightened risk of adverse reactions. Conversely, component-resolved diagnosis (CRD) and allergen immunotherapy (AIT) present novel avenues for precision medicine. This review systematically delineates the classification, structural characteristics, and immunopathogenic mechanisms of HDM allergen components in allergic diseases. It further summarizes recent advances in precision diagnostics and targeted interventions, aiming to provide a theoretical foundation for the individualized clinical management of allergic diseases.