Arruda L K, Vailes L D, Ferriani V P, Santos A B, Pomés A, Chapman M D
Departments of Pediatrics and Cell and Molecular Biology, University of São Paulo School of Medicine of Ribeirão Preto, Brazil.
J Allergy Clin Immunol. 2001 Mar;107(3):419-28. doi: 10.1067/mai.2001.112854.
Asthma and allergy are the most common diseases associated with cockroach infestation of houses in the United States and other parts of the world. Sensitization and exposure to cockroach allergens is associated with increased asthma morbidity in the United States, especially among lower socioeconomic groups, including African American and Hispanic populations. Exposure to cockroach allergens in the first 3 months of life has been associated with repeated wheezing and asthma. The principal domestic cockroach species are Blattella germanica and Periplaneta americana. Both species produce several potent allergens, including Bla g 2 (inactive aspartic proteinase), Bla g 4 (calycin), Bla g 5 (glutathione-S-transferase), the group 1 cross-reactive allergens Bla g 1 and Per a 1, and tropomyosin. Structural homology between tropomyosins from cockroaches, mites, and shrimp may explain clinical cases of the oral allergy syndrome. The 3-dimensional structures of several cockroach allergens are known, and biologically active recombinant allergens have been produced in high-level expression vectors. The use of recombinant cockroach allergens should allow mechanisms of cockroach-induced asthma to be investigated and may lead to the development of new approaches to asthma treatment. Environmental allergen measurements of Bla g 1 and Bla g 2 have allowed exposure levels that cause allergic sensitization to be established. Abatement studies have shown that a sustained decrease in cockroach allergen levels is difficult but can be accomplished by professional application of insecticides, together with rigorous household cleaning. Cockroach asthma is an important public health problem that affects patients who are the least likely to be compliant with treatment with asthma medications or environmental control. Patient education, improvements in the housing stock, and improvements in environmental and immunologic treatment strategies are likely to be the most successful approaches to reduce the prevalence of cockroach-induced asthma.
在美国和世界其他地区，哮喘和过敏是与房屋蟑螂滋生相关的最常见疾病。在美国，对蟑螂过敏原的致敏和接触与哮喘发病率增加有关，尤其是在社会经济地位较低的群体中，包括非裔美国人和西班牙裔人群。出生后头3个月接触蟑螂过敏原与反复喘息和哮喘有关。主要的家居蟑螂种类是德国小蠊和美洲大蠊。这两种蟑螂都产生几种强效过敏原，包括Bla g 2（无活性天冬氨酸蛋白酶）、Bla g 4（钙结合蛋白）、Bla g 5（谷胱甘肽-S-转移酶）、第1组交叉反应性过敏原Bla g 1和Per a 1以及原肌球蛋白。蟑螂、螨虫和虾的原肌球蛋白之间的结构同源性可能解释了口腔过敏综合征的临床病例。几种蟑螂过敏原的三维结构已为人所知，并且已在高水平表达载体中产生了具有生物活性的重组过敏原。使用重组蟑螂过敏原应有助于研究蟑螂诱发哮喘的机制，并可能导致开发新的哮喘治疗方法。对Bla g 1和Bla g 2的环境过敏原测量已确定了引起过敏致敏的接触水平。减少蟑螂滋生的研究表明，持续降低蟑螂过敏原水平很困难，但可以通过专业施用杀虫剂以及严格的家庭清洁来实现。蟑螂诱发的哮喘是一个重要的公共卫生问题，影响那些最不可能遵守哮喘药物治疗或环境控制的患者。患者教育、住房条件改善以及环境和免疫治疗策略的改进可能是降低蟑螂诱发哮喘患病率最成功的方法。
