Cross-reactive IgE responses to cockroach, house dust mite, and seafood allergens in patients with allergic rhinitis

Cockroach allergens remain underrecognized in allergic diseases, despite growing evidence of their clinical impact. This study investigated cockroach sensitization prevalence in allergic rhinitis (AR) patients and its cross-reactivity with house dust mite (HDM) and seafood allergens. 110 AR patients sensitized to at least one of eight allergens: Periplaneta americana (PA), Blattella germanica (BG), Dermatophagoides pteronyssinus (DP), Dermatophagoides farinae (DF), Blomia tropicalis (BT), shrimp, crab and squid were enrolled. Sensitization was assessed using skin prick testing (SPT) and sIgE assays and cross-reactivity by direct and inhibition enzyme-linked immunosorbent assays (ELISA). HDM allergens were the most sensitized (BT: 90%, DP: 50.9%, DF: 49.1%), followed by cockroach allergens (PA/BG: 39.1%) and seafood allergens (shrimp: 30.9%, crab: 25.5%, squid: 24.5%). sIgE testing yielded comparable results. BT demonstrated the highest prevalence. Cross-reactivity was pronounced between cockroach and HDM allergens, followed by intra-cockroach species. DP had the highest frequency of cross-reactivity among HDM allergens, while BG had a higher cross-reactivity with HDM (44.5%) than PA (40.9%). Cockroach allergens exhibited minimal cross-reactivity with seafood allergens. SPT and direct ELISA performed equally, demonstrating their usefulness for assessing sensitization. Cockroach allergens interact strongly with HDM but have limited cross-reactivity with seafood.