Abstract
IgE sensitization to cockroach allergens is associated with development of allergic diseases, such as asthma. To understand the relevance of different cockroach allergens for diagnosis and immunotherapy, a comprehensive analysis of IgE antibody levels and T cell reactivity to an expanded set of cockroach allergens and their relationship to disease was performed in a cohort of USA cockroach sensitized patients. IgE antibody levels to recombinant chitinase and hemocyanin were measured for 23 subjects by custom-made ImmunoCAPs and compared with IgE levels to eight cockroach allergens we previously reported for the same cohort. Ex vivo T cell activation (Ox40/PDL-1 expression) of PBMCs stimulated with peptide pools derived from 11 German cockroach proteins, including nine official cockroach allergens, plus chitinase and vitellogenin, was determined by flow cytometry. IgE prevalences to chitinase (17%) and hemocyanin (44%) were comparable to values for the other eight allergens that we previously reported (21–57%). Hemocyanin (Bla g 3), was a major allergen (one to which more than 50% of patients with an allergy to its source react) for a sub-group of 15 highly cockroach-sensitized subjects (IgE > 3.5 kUA/L: 53%). Chitinase was officially named as new allergen Bla g 12. Cockroach-specific IgE levels in plasma showed excellent correlation with the sum of 10 allergen-specific IgE (r = 0.94, p < 0.001). T cell reactivity to 11 proteins was highly variable among subjects, the highest being for vitellogenin, followed by Bla g 3. The main finding was that cockroach allergen-specific IgE and T cell reactivity patterns were unique per subject, and lacked immunodominant allergens and correlation with clinical phenotype/disease severity in the studied cohort. Knowing the subject-specific B/T cell reactivity profiles to a comprehensive panel of cockroach allergens will contribute to diagnosis of cockroach allergy and will be important for planning and assessing allergen immunotherapy outcomes, according to the allergen content in therapeutic cockroach extracts.
Highlights
Cockroach allergy is an important health problem associated with the development of asthma, especially in inner-cities where cockroach infestations frequently occur [1, 2]
There was overall a correlation of the number of allergens recognized per subject and their titer with the IgE antibody binding to the cockroach extract
The goal was to expand our knowledge about the relative importance of cockroach allergens at the IgE and T cell level in relation to disease for diagnosis and therapy
Summary
Cockroach allergy is an important health problem associated with the development of asthma, especially in inner-cities where cockroach infestations frequently occur [1, 2]. Each cockroach-sensitized patient has an individual profile of B and T cell reactivity to different molecules in cockroach extracts [3, 4, 7]. This observation is of relevance, since it is currently unknown whether the immunotherapeutic potency of cockroach extracts resides in the modulation of T cells, antibody/B cells, or both. In another study, focusing on B cell reactivity, we showed that in a cohort of 10 year-old children allergen-specific IgE levels were higher and recognized a broader range of allergens among cockroach allergic subjects with asthma and rhinitis than among cockroach allergic subjects without those diseases [8]
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