Component-Resolved Diagnosis of American Cockroach () Allergy in Patients From Different Geographical Areas.

Manifestation of respiratory allergy to American cockroach () is prominent in the subtropical and tropical areas. However, co-existing perennial indoor inhalant allergies frequently compromise clinical diagnosis of cockroach allergy, and the analysis of sensitization pattern is limited by the lack of allergens widely available for component-resolved diagnostics (CRD). To evaluate a collection of previously described recombinant allergens for CRD in cockroach allergy. A panel of nine recombinant a allergens (Per a 1-5, 7-10) was generated, purified, and subjected to physicochemical characterization by applying circular dichroism (CD) spectroscopy, dynamic light scattering (DLS), amino acid (AA) analysis, and mass spectrometry (MS). Patients ( = 117) from India, Korea, Venezuela, and Iran, reporting perennial respiratory indoor allergies with IgE sensitization to cockroach (), were included. The sensitization profile was monitored by the experimental ImmunoCAP testing. ImmunoCAP testing confirmed IgE sensitization to and/or extract in 98 of 117 patients ( = 0.95). Five out of 117 patients were sensitized to only one of the two cockroach species. Within the whole study group, the prevalence of sensitization to individual allergens varied from 4% (Per a 2) to 50% (Per a 9), with the highest IgE values to Per a 9. Patients from four countries displayed different sensitization profiles at which Per a 3 and Per a 9 were identified as major allergens in India and Korea. -derived lipocalin and myosin light chain were characterized as new minor allergens, designated as Per a 4 and Per a 8. extract showed higher diagnostic sensitivity than all individual components combined, suggesting the existence of allergens yet to be discovered. Utilization of a panel of purified allergens revealed highly heterogeneous sensitization patterns and allowed the classification of lipocalin and myosin light chain from as new minor allergens.