ABSTRACT
Insect inhalant allergy is a health problem worldwide due to the cosmopolitan distribution of these arthropods. Cross-reactivity of arthropod allergens can be identified among members of the taxonomic groups Crustacea, Arachnida, and Insecta, described as “pan-allergy.” In particular for cockroach, sensitization to indoor allergens is strongly associated with the development of asthma. In urban and inner-city areas, up to 80% of children with asthma may have IgE antibody to cockroach allergens. This chapter provides an overview of the current state of knowledge on insect inhalant allergens and how to address this heath problem. Insect allergy therapy should be based on three approaches: (1) environmental control (avoidance), (2) pharmacotherapy, and (3) immunotherapy with the appropriate allergens. Eradication of cockroach and other insect infestations is essential to control inhalant insect allergic diseases. Cockroach immunotherapy is currently based on the use of nonstandardized extracts with variable allergen content. In the last 20 years, molecular cloning of insect allergens revealed their function and/or structure, as well as mechanisms of disease. Combined with the capacity to express recombinant allergens, molecular structure studies have identified IgE antibody binding sites and T-cell epitopes on cockroach allergens for the design of potential recombinant allergens for immunotherapy.
