Sastre J, Ibañez M D, Lombardero M, Laso M T, Lehrer S
Servicio de Alergia, Fundación Jimenez Díaz, Universidad Autónoma de Madrid, Spain.
Allergy. 1996 Aug;51(8):582-6. doi: 10.1111/j.1398-9995.1996.tb04672.x.
Previous studies have established that cockroach allergens are important sensitizing agents in the induction of rhinitis and asthma principally in urban areas. This study was undertaken to assess skin test reactivity and specific IgE antibody reactivity to extracts of Periplaneta americana (P.a.), Blattella germanica (B.g.), B. orientalis (B.o.), and a fecal extract of B. germanica (FEB.g.) in a group of patients with rhinitis and asthma living in an urban area in Europe. We examined clinical characteristics and aerollergen sensitivities of 171 consecutive Madrid urban patients with rhinitis and asthma who met the criteria for the study. A comprehensive clinical evaluation was followed by skin prick test with common allergens and saline extracts of P.a., B.g., B.o., and FEB.g. and measurement of serum specific IgE antibody to cockroach extracts. The age of patients ranged from 7 to 68 years (mean 20.4 +/- 16). A total of 153 (90.5%) subjects were atopic and 19 (10%) were considered nonallergic. Pollen sensitivity (66.5%) was most prevalent, distantly followed by sensitivity to cockroach (25.7%), mite (20%), cat (15.5%), Alternaria alternata (14.5%), dog (14%), and food (2%). Skin test reactivity to cockroach extracts was 37 (21.6%) to B.o., 20 (11.6%) to P.a., 19 (11.1%) to B.g. and five (2.9%) to FEB.g. Twenty-one of these patients had rhinitis, 19 rhinitis and asthma, and one only asthma; 26 had perennial symptoms, while 16 had seasonal (spring) symptoms; three (1.7%) patients had only positive prick test to cockroach; all had perennial rhinitis and/or asthma. Eighteen (10.5%) patients had specific serum IgE (RAST 1 or 2) to B.o., 13 (7.6%) to P.a., and six (3.5%) to B.g. Eighty (46.7%) patients had visual evidence of cockroach infestation in their home, mostly B.o.; 31 had positive prick test to cockroach (P < 0.0003). The results indicate that sensitivity to outdoor allergens (pollen) is more prevalent than to indoor allergens. Cockroach sensitization is the most important indoor allergen in our area, and B.o. accounts for most cockroach sensitization.
以往研究表明，蟑螂过敏原是诱发鼻炎和哮喘的重要致敏原，主要存在于城市地区。本研究旨在评估欧洲某城市地区一组鼻炎和哮喘患者对美洲大蠊（P.a.）、德国小蠊（B.g.）、东方蜚蠊（B.o.）提取物以及德国小蠊粪便提取物（FEB.g.）的皮肤试验反应性和特异性IgE抗体反应性。我们对171例符合研究标准的马德里城市连续鼻炎和哮喘患者的临床特征和空气过敏原敏感性进行了检查。在进行全面临床评估后，对常见过敏原以及P.a.、B.g.、B.o.和FEB.g.的生理盐水提取物进行皮肤点刺试验，并检测血清中针对蟑螂提取物的特异性IgE抗体。患者年龄在7至68岁之间（平均20.4±16岁）。共有153例（90.5%）受试者为特应性体质，19例（10%）被认为是非过敏性体质。花粉敏感性（66.5%）最为普遍，其次是蟑螂敏感性（25.7%）、螨虫敏感性（20%）、猫敏感性（15.5%）、链格孢敏感性（14.5%）、狗敏感性（14%）和食物敏感性（2%）。对蟑螂提取物的皮肤试验反应性为：对B.o.呈阳性的有37例（21.6%），对P.a.呈阳性的有20例（11.6%），对B.g.呈阳性的有19例（11.1%），对FEB.g.呈阳性的有5例（2.9%）。这些患者中，21例患有鼻炎，19例患有鼻炎和哮喘，1例仅患有哮喘；26例有常年性症状，16例有季节性（春季）症状；3例（1.7%）患者仅对蟑螂点刺试验呈阳性；均患有常年性鼻炎和/或哮喘。18例（10.5%）患者血清特异性IgE（RAST 1或2）对B.o.呈阳性，13例（7.6%）对P.a.呈阳性，6例（3.5%）对B.g.呈阳性。80例（46.7%）患者家中有蟑螂出没的明显迹象，主要是B.o.；31例对蟑螂点刺试验呈阳性（P<0.0003）。结果表明，对室外过敏原（花粉）的敏感性比室内过敏原更为普遍。蟑螂致敏是我们地区最重要的室内过敏原，且B.o.导致了大多数蟑螂致敏情况。
