IgE reactivity patterns in Asian and central European cockroach-sensitized patients reveal differences in primary sensitizing allergen sources

Irene Mittermann; Christian Lupinek; Sandra Wieser; Martina Aumayr; Wolfgang W Kuchler; Alson W M Chan; Tak Hong Lee; Petra Zieglmayer

doi:10.1016/j.jacig.2022.04.003

IgE reactivity patterns in Asian and central European cockroach-sensitized patients reveal differences in primary sensitizing allergen sources

J Allergy Clin Immunol Glob. 2022 Apr 22;1(3):145-153. doi: 10.1016/j.jacig.2022.04.003. eCollection 2022 Aug.

Authors

Irene Mittermann¹, Christian Lupinek¹, Sandra Wieser¹, Martina Aumayr¹, Wolfgang W Kuchler², Alson W M Chan³, Tak Hong Lee³, Petra Zieglmayer^{4

5}

Affiliations

¹ MacroArray Diagnostics, Vienna, Austria.
² ENT practice, Graz, Austria.
³ Allergy Centre, Hong Kong Sanatorium and Hospital, Hong Kong, China.
⁴ Vienna Challenge Chamber, Vienna, Austria.
⁵ Karl Landsteiner University, Krems, Austria.

Abstract

Background: The prevalence of cockroach (CR) sensitization and its relevance as a trigger of allergy symptoms differs greatly in different geographic areas.

Objective: This study aimed to compare molecular IgE reactivity profiles in CR-sensitized patients with perennial allergy symptoms from Hong Kong (HK) and Austria and identify the main primary sensitizers.

Methods: IgE sensitization was assessed by skin prick test and/or IgE reactivity with CR extract. Molecular IgE reactivity profiles were analyzed via multiplex assay for sensitization to allergens and extracts from CR, house dust mite (HDM), shellfish, and 3 additional insect species.

Results: HDM was the main primary sensitizer in both cohorts. In the HK group, genuine sensitization to CR was found in 45%, but none of the patients in the Austrian cohort was truly sensitized to that allergen source. Most patients from HK were cross-sensitized to other insects and/or shellfish, presumably by broad reactivity to tropomyosin and arginine kinase. About half of Austrian subjects lacked IgE to these pan-allergens, indicating co- but not cross-sensitization to insects and/or shellfish. Regarding IgE recognition frequencies, arginine kinases (64% HK, 10% Austria) and tropomyosins (42% HK, 15% Austria) were most frequently recognized; Bla g 4 (lipocalin) was detected in HK patients only (42%). Tropomyosin (Per a 7) was significantly more frequently recognized in patients with asthma. Sera from HDM-sensitized subjects from HK showed a higher proportion of sensitization to minor mite allergens.

Conclusion: Molecular profiling identified differences between CR-sensitized allergic patients from HK and Austria in terms of primary sensitizers and molecular IgE reactivity patterns. Tropomyosin from American cockroach (Per a 7) was shown to be significantly associated with asthma symptoms and might be suitable as biomarker for more severe respiratory allergy symptoms.

Keywords: Component-resolved diagnosis; arginine kinase; cockroach sensitization; cross-reactivity; edible insect sensitization; microarray; multiplex testing; primary sensitizer; tropomyosin.