Endotyping Cellular and Humoral Cross-Reactivity between Blomia tropicalis and Farfantepenaeus brasiliensis in Patients with Allergic Multimorbidity

Abstract

Background: Panallergens, such as tropomyosin, produce cross-reactivity between indoor allergens and food allergens, including the house dust mite Blomia tropicalis and the Brazilian pink shrimp Farfantepenaeus brasiliensis, and are responsible for the clinical symptoms present in patients with allergic multimorbidity phenotypes. Aim: To evaluate the potential of the Tube Titration of Precipitins (TTP) and the Leukocyte Adherence Inhibition Test (LAIT) to discriminate and correlate cellular and humoral immunoreactivity against protein extracts of B. tropicalis and F. brasiliensis in patients with non–IgE-mediated allergic multimorbidity phenotypes. Study Design: We examined retrospectively the medical charts of two cohorts of patients clinically diagnosed with non–IgE-mediated allergic multimorbidity phenotypes related to inhalation or contact with house dust and/or consumption of shrimps, who were concomitantly investigated for these allergens with the help of TTP or LAIT. Methodology: The registered results of the TTP and LAIT against protein extracts of B. tropicalis and F. brasiliensis were distributed in ranges through cascade distribution charts. The correlation between the paired assays was calculated using Pearson's methodology and demonstrated by dispersion graphs. Results: The TTP for the B. tropicalis extract showed a distribution concentrated on the higher dilutions. The mean was 1:353; the median was 1:256; the standard deviation was 1:163; the mode was 1:512 (appeared 49 times). The TTP for the F. brasiliensis extract showed a distribution concentrated on the higher dilutions. The mean was 1:380; the median was 1:512; the standard deviation was 1:157; the mode was 1:512 (which appeared 57 times). The LAIT for the B. tropicalis extract showed a wide distribution range of results. The LAI ranged from 0% to 100%. The mean was 49.8%; the median was 51.5%; the standard deviation was 30.0%; the mode was 0% (appeared eleven times). The LAIT for the F. brasiliensis extract showed a wide distribution range of results. The LAI ranged from 0% to 100%. The mean was 55%; the median was 56%; the standard deviation was 28.8%; the mode was 0% (appeared five times). There was no significant correlation between B. tropicalis and F. brasiliensis when analyzed by TTP or LAIT results. Conclusion: Our preliminary results suggest that the TTP and LAIT may reveal humoral and cellular immunoreactivity in patients with allergic multimorbidity phenotypes using protein extracts of B. tropicalis and F. brasiliensis.