Cockroach allergens and asthma in Brazil: Identification of tropomyosin as a major allergen with potential cross-reactivity with mite and shrimp allergens,☆☆,

Presented in part at the American Academy of Allergy, Asthma and Immunology Annual Meeting, March 1999.
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Abstract

Background: Cockroaches produce several proteins that induce IgE antibody responses. Although cockroaches are abundant in warm and humid areas, sensitization to cockroach allergens has not been investigated in Brazil. Objective: The aims of this study were to investigate the frequency of cockroach allergy among patients with asthma, rhinitis, or both in Brazil and to identify American cockroach allergens. Methods: Skin tests using cockroach extracts were performed on children and young adults with asthma, rhinitis, or both. A Periplaneta americana complementary (c)DNA library was screened by using IgE antibodies from Brazilian patients allergic to cockroaches. Reactivity of an mAb directed to Dermatophagoides pteronyssinus tropomyosin against cockroach tissue was examined by immunofluorescence. Results: Cockroach allergy was present in 55% and 79% of the patients, as determined by using skin prick tests alone or combined prick and intradermal tests, respectively. Five cDNA clones reacted with IgE antibody and contained the same sequence. A representative clone (1300 bp), pa 12, coded for a protein that reacted with 50% of the sera from patients allergic to cockroaches on plaque immunoassay and showed a high degree of homology to tropomyosins, particularly those from invertebrates. P americana tropomyosin showed 80%, 81%, and 82% sequence identity to tropomyosins from D pteronyssinus, D farinae, and shrimp, respectively, which have been previously defined as important allergens. An mAb directed against D pteronyssinus tropomyosin, which also recognizes shrimp tropomyosin, showed binding to cockroach striated muscle. Conclusion: Our results support the recommendation that cockroach extracts should be routinely used for the evaluation of patients with asthma, rhinitis, or both in Brazil. The identification of P americana tropomyosin as an important allergen will make it possible to investigate cross-reactivity among cockroaches, mites, and food derived from invertebrates. (J Allergy Clin Immunol 1999;104:329-37.)

Section snippets

Subjects and skin testing

A total of 134 patients participated in the study. Ninety-five were 4 to 18 years old with moderate-to-severe asthma and rhinitis (78 patients) or with rhinitis alone (17 patients), and all were seen at the Pediatric Allergy Clinic at the School of Medicine of Ribeirão Preto, University of São Paulo, Brazil. Thirty-nine were children and young adults 2 to 25 years old with asthma and rhinitis (24 patients) or with rhinitis alone (15 patients), who attended the Pediatric Allergy Clinic at

Prevalence of cockroach allergy among asthmatic subjects in Brazil

Children and young adults with asthma, rhinitis, or both living in 2 cities in Southeast Brazil (Ribeirão Preto and São Paulo) had positive immediate skin test responses to cockroach. By using skin prick tests to determine the diagnosis of cockroach allergy, 73 of 134 patients (55%) had a positive skin test response to B germanica or P americana (Fig 1, A and B ).

. Skin test reactivity to inhalant allergens among patients with asthma, rhinitis, or both living in Ribeirão Preto (A ) and São Paulo

DISCUSSION

Our results of skin testing revealed that a proportion of children and young adults with asthma, rhinitis, or both who live in Brazil are allergic to cockroaches. The prevalence of 55% positive skin prick test responses to B germanica or P americana among our patients is comparable with the prevalence previously found among low-income patients living in large US cities, including New York35 and Chicago,36 and it is higher than the prevalence in other areas.5 Combined results from prick and

Acknowledgements

We thank Ms Kátia Tobias and Ms Andreia Kuramoto for technical assistance; Mrs Vani Alves, Department of Morphology, School of Medicine of Ribeirão Preto-USP, Ribeirão Preto, SP, for preparing the frozen sections; and Dr William Swaim, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Md, for his assistance with microscopy. We also thank Dr Susheela Sridhara for helping with sequence analysis, and Jolanda van Leewen for producing the anti-D

References (41)

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Supported by Fundaçad de Ampara à Pesquisa de Estado de São Paulo (FAPESP), São Paulo, Brazil; by the Netherlands Asthma Foundation grant no. 88.28; and by National Institutes of Health grants AI 32557 and AI 34607. L. Karla Arruda is recipient of a Young Investigator Award from FAPESP, São Paulo, Brazil.

☆☆

Reprint requests: L. Karla Arruda, MD, Department of Immunology, Faculdade de Medicina de Ribeirão Preto–USP, Av. Bandeirantes 3900, Ribeirão Preto, SP 14049-900, Brazil.

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