Cross-reactivity and sensitization profiles of cockroach and moth allergens provide new insights in cockroach-allergic patients

Abstract

Background: Inhalant insect allergens are widely implicated as common triggers of respiratory allergies, but little is known about cross-reactivity between cockroaches and other insect allergens. This study mainly investigates sensitization profiles and cross-reactivity between cockroach allergens and moth allergens to provide insights into the clinical management of cockroach-allergic patients.

Methods: A total of 386 suspected cockroach-sensitized patients were enrolled. Sensitization rates were determined using IgE testing for common airborne allergens. Cross-reactivity was evaluated using IgE inhibition assays, immunoblotting, and basophil activation tests. Age-related sensitization patterns were analyzed to assess variability in immune response across different demographics.

Results: A high frequency of silk moth was observed in cockroach-sensitized patients, with sensitization rates to German cockroach and silk moth allergens at 81.09% and 81.61%, respectively, and a high co-sensitization rate (54.66%). Age analysis revealed similar peak sensitization of German cockroach and silk moth in school-age children and young adults, with a lower prevalence in the elderly. Additionally, cockroach crude extract can inhibit the IgE-binding of cockroach-sensitized patients' sera and silk moth crude extract, while various moths can activate basophils as well.

Conclusions: This study highlights the similar age-related sensitization patterns between German cockroach and silk moth, differing from those observed with house dust mites. Besides, cross-reactivity between different cockroach and moth allergens was confirmed through significant IgE inhibition, multiple sequences alignment of shared epitopes and basophil activation tests. These findings highlight the need to consider cross-reactivity between cockroach and moth allergens in clinical evaluations.

Keywords: Blattella germanica (German cockroach); Cockroach allergy; Cross-reactivity; Insect allergen; Silk moth.

Fig. 1

Graphical abstract. The study identifies significant cross-reactivity between cockroach and moth allergens in cockroach-allergic patients, demonstrating shared sensitization patterns, age-related differences, and strong IgE inhibition. These findings emphasize the importance of addressing co-exposure to insect allergens in clinical management and suggest targeted strategies for improved allergy diagnosis and treatment. Abbreviation: d1 (Dermatophagoides pteronyssinus), d2 (Dermatophagoides farinae), d201 (Blomia tropicalis), e1 (Felis domesticus), e5 (Canis familiaris), m3 (Aspergillus fumigatus), w6 (Artemisia vulgaris), i6 (Blattella germanica), i8 (Bombyx mori) and i206 (Periplaneta americana)

Fig. 2

Analysis of age-related sensitization patterns of insect allergens. Sankey diagrams show the flow of sensitization and distribution from age-related trends to the IgE level of 3 insect allergens, including German cockroach (A), silk moth (B) and Dermatophagoides pteronyssinus (C). The width of the arrows corresponds to the proportion of sensitized patients, with thicker arrows indicating stronger associations

Fig. 3

Evaluation of cross-reactivity between cockroaches and moths by sera cross-inhibition assay and immunoblotting. The graph shows the percentage of IgE inhibition in the serum of cockroach-sensitized patients when exposed to German cockroach (A) and American cockroach (B) insect allergens. Higher inhibition rates indicate stronger cross-reactivity. (C) M: marker, Lane 1: without inhibitor (control lane), Lane 2: Preincubated with Chinese oak silkmoth crude extract, Lane 3: Preincubated with American cockroach crude extract, Lane 4: Preincubated with German cockroach crude extract, Lane 5: Preincubated with termite crude extract

Fig. 4

Basophils activation test. (A) Flow cytometry gating strategy for basophil subsets; (B) The x-axis represents CCR3, while the y-axis represents CD63. Activated basophils are in the Q2 quadrant. Anti-FcƐRI antibodies (PC1) and PBS serve as the positive and negative controls, respectively