title: Identification of the main allergen sensitizers in an Iran asthmatic population by molecular diagnosis.
abstract: BACKGROUND
  There has been a significant growth in the prevalence of allergy, mainly associated to IgE-mediated disorders such as asthma and rhinitis. The identification of atopy in asthmatic patients through the measurement of specific IgE can help to identify risk factors that cause asthmatic symptoms in patients. The development and use of individualized allergen-based tests by the Component Resolved Diagnosis has been a crucial advance in the accurate diagnosis and control of allergic patients. The objective of this work was to assess the usefulness of molecular diagnosis to identify environmental allergens as possible factors influencing the development and manifestation of asthma in a group of asthmatic patients from Iran.
  
  
  METHODS
  
  
  
  METHODS
  202 adult asthmatic patients treated at the Loghman Hakim Hospital and Pasteur Institute of Teheran (Iran) from 2011 to 2012. Specific IgE determined by the ImmunoCAP system were used to both evaluate the patients' atopic condition and the molecules involved in the allergic sensitization. SDS-PAGE IgE-immunoblotting associated with mass spectrometry was carried out to study the cockroach IgE-binding sensitizing proteins.
  
  
  RESULTS
  Forty-five percent of all patients could be considered atopic individuals. Eighty-two percent of atopic patients were sensitized to pollen allergens. The Salsola kali (Sal k 1) and the Phleum pratense (rPhl p 1 and/or rPhl p 5) major allergens were the most common sensitizers among pollens (71% and 18%, respectively). Thirty-five percent of the atopic population was sensitized to cockroach. Four different allergens, including a previously unknown alpha-amylase, were identified in the cockroach extract. No significant associations could be demonstrated between the severity of asthma and the specific IgE levels in the atopic population. Statistical analysis identified the Sal k 1 as the main protein allergen influencing the development and expression of asthma in the studied population.
  
  
  CONCLUSIONS
  Pollen and cockroach were the most relevant allergen sources in the asthmatic population. The Salsola kali major allergen was the main cause for sensitization in the atopic patients suffering asthma. Using the Component Resolved Diagnosis, it was possible to identify a new Blattella germanica cockroach allergen (Blattella alpha amylase 53 kDa) that could sensitize a relevant percentage of this population.
authors.affiliation: Department of Mycology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14115-331, Iran ; Laboratory of Parasitology and Allergy, Center for Research Lascaray Ikergunea, University of the Basque Country, Pº Universidad, 7, 01006 Vitoria, Spain ; Department of Immunology, Microbiology and Parasitology, Faculty of Pharmacy, University of the Basque Country, Pº Universidad, 7, 01006 Vitoria, Spain.
authors.forename: Fardis
authors.initials: F
authors.lastname: Teifoori
authors.affiliation: Department of Mycology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14115-331, Iran.
authors.forename: Masoomeh
authors.initials: M
authors.lastname: Shams-Ghahfarokhi
authors.affiliation: Laboratory of Parasitology and Allergy, Center for Research Lascaray Ikergunea, University of the Basque Country, Pº Universidad, 7, 01006 Vitoria, Spain ; Department of Immunology, Microbiology and Parasitology, Faculty of Pharmacy, University of the Basque Country, Pº Universidad, 7, 01006 Vitoria, Spain.
authors.forename: Idoia
authors.initials: I
authors.lastname: Postigo
authors.affiliation: Department of Mycology, Pasteur Institute of Iran, Tehran 13164, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Razzaghi-Abyaneh
authors.affiliation: Clinical Research Department, Pasteur Institute of Iran, Tehran 13164, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Eslamifar
authors.affiliation: Laboratory of Parasitology and Allergy, Center for Research Lascaray Ikergunea, University of the Basque Country, Pº Universidad, 7, 01006 Vitoria, Spain ; Department of Immunology, Microbiology and Parasitology, Faculty of Pharmacy, University of the Basque Country, Pº Universidad, 7, 01006 Vitoria, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gutiérrez
authors.affiliation: Laboratory of Parasitology and Allergy, Center for Research Lascaray Ikergunea, University of the Basque Country, Pº Universidad, 7, 01006 Vitoria, Spain ; Department of Immunology, Microbiology and Parasitology, Faculty of Pharmacy, University of the Basque Country, Pº Universidad, 7, 01006 Vitoria, Spain.
authors.forename: Ester
authors.initials: E
authors.lastname: Suñén
authors.affiliation: Laboratory of Parasitology and Allergy, Center for Research Lascaray Ikergunea, University of the Basque Country, Pº Universidad, 7, 01006 Vitoria, Spain ; Department of Immunology, Microbiology and Parasitology, Faculty of Pharmacy, University of the Basque Country, Pº Universidad, 7, 01006 Vitoria, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Martínez
keywords: Allergen; Allergy; Asthma; Atopy; Cockroach; Component resolved diagnosis; Mould; Pollen; Protein; Risk factor; Specific IgE
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