Supplementary Material for: Efficacy of Recombinant Allergens for Diagnosis of Cockroach Allergy in Patients with Asthma and/or Rhinitis

<b><i>Background:</i></b> Immunoglobulin E (IgE) reactivity to individual allergens among cockroach-allergic patients has revealed wide variability. The aim of this study was to assess the effectiveness of recombinant cockroach allergens for skin testing, and to determine sensitization profiles among cockroach-allergic patients living in Brazil. <b><i>Methods:</i></b> Fifty-seven cockroach-allergic patients with asthma and/or rhinitis were recruited. Skin testing with recombinant (r) allergens from <i>Periplaneta americana</i> (rPer a 1 and rPer a 7) and <i>Blattella germanica </i>(rBla g 2, rBla g 4 and rBla g 5) were performed at 10 μg/ml and 5 μg/ml (rPer a 1). IgE antibodies to rPer a 7 and rPer a 1 were quantitated by ELISA. <b><i>Results:</i></b> Of 57 patients tested, 3 (5.3%), 24 (42.1%), 4 (7%), 3 (5.3%) and 4 (7%) showed positive reactions to rPer a 1, rPer a 7, rBla g 2, rBla g 4 and rBla g 5, respectively. Twenty-eight patients (49.1%) had positive tests to at least one allergen. In keeping with skin test results, 31/57 patients (54.4%) and 5/55 patients (9%) had detectable IgE to rPer a 7 and rPer a 1, respectively. Levels of IgE to rPer a 7 were higher in patients with positive tests to rPer a 7 than those with negative tests (geometric mean 13.2 and 1.8 IU/ml, p &lt; 0.05). There was good concordance of results of skin tests and measurements of serum IgE to rPer a 7. <b><i>Conclusion:</i></b> IgE reactivity to rPer a 7 (<i>P. americana</i> tropomyosin) was dominant among patients in Brazil. However, 50% of the patients did not present reactivity to any of the recombinant allergens tested.

**背景：** 免疫球蛋白E（Immunoglobulin E，IgE）对蟑螂过敏患者体内单一变应原的反应性存在显著异质性。本研究旨在评估重组蟑螂变应原用于皮肤试验的有效性，并明确巴西境内蟑螂过敏患者的致敏谱特征。**方法：** 本研究共纳入57例合并哮喘和/或鼻炎的蟑螂过敏患者。分别以10 μg/ml浓度（rPer a 1采用5 μg/ml浓度）开展美洲大蠊（*Periplaneta americana*）重组变应原（rPer a 1、rPer a 7）及德国小蠊（*Blattella germanica*）重组变应原（rBla g 2、rBla g 4、rBla g 5）的皮肤试验。采用酶联免疫吸附试验（Enzyme-Linked Immunosorbent Assay，ELISA）定量检测患者血清中针对rPer a 7与rPer a 1的IgE抗体水平。**结果：** 57例接受检测的患者中，分别有3例（5.3%）、24例（42.1%）、4例（7.0%）、3例（5.3%）及4例（7.0%）对rPer a 1、rPer a 7、rBla g 2、rBla g 4及rBla g 5呈皮肤试验阳性反应。共计28例患者（49.1%）对至少一种重组变应原呈阳性反应。与皮肤试验结果相符，57例患者中有31例（54.4%）、55例患者中有5例（9%）可检测到针对rPer a 7与rPer a 1的IgE抗体。针对rPer a 7呈皮肤试验阳性的患者，其血清抗rPer a 7 IgE水平显著高于阴性患者（几何均数分别为13.2 IU/ml与1.8 IU/ml，*P* < 0.05）。皮肤试验结果与血清抗rPer a 7 IgE水平检测结果具有良好一致性。**结论：** 巴西境内蟑螂过敏患者中，针对rPer a 7（美洲大蠊原肌球蛋白，*P. americana* tropomyosin）的IgE反应性占主导地位。但仍有50%的患者未对本次检测的任一重组变应原呈现反应性。