The allergen that is supposed to induce the original allergic responses is named the primary sensitizer, and the others are considered cross-reactive allergens. There are several clinical and laboratory criteria to classify an allergic reaction as cross-reacting, but the condition should be first empirically demonstrated (104). The clinical relevance of IgE cross-reactivity has been described for foods, pollens, mites and other allergen sources (105), but its occurrence between mite and Ascaris allergens, although widely suspected (106), has not been thoroughly investigated. Cross-reactivity
depends on amino acid sequences JNK activity inhibition and conformational structures of the molecules, which explains why it is more frequent (but not exclusive)
among phylogenetically related species. Ascaris and mites are related invertebrates and are expected to share several allergens. Independently of which source is the primary sensitizer, among inhabitants of the tropics, allergenic stimulus find more derived from a persistent inhalation of high concentrations of mite allergens and infections with A. lumbricoides may generate a particular immune response that involves cross-reactivity in both directions. Several antigens of Ascaris have been analysed (50,107,108) and other are under scrutiny, but our knowledge about the allergenic composition of the whole extract is still very limited; in fact, the International Union of Immunology Societies only reports the ABA-1 allergen (Asc s 1) and Idelalisib the recently submitted tropomyosin (Asc l 3). Because almost all allergens from domestic mites have been identified, it is now possible to study their cross-reactivity with Ascaris.
We performed dose–response ELISA and immunoblotting inhibition studies with extracts of B. tropicalis, D. pteronyssinus and A. suum, demonstrating that there is a high degree of cross-reactivity between these sources including protein IgE epitopes (24). Although carbohydrate epitopes can be involved (109), inhibition of IgE binding was also demonstrated using deglycosylated extracts and nonglycosylated recombinant allergens. Using sera from patients with asthma, our experiments strongly suggest that mites are the primary sensitizers and that clinically relevant allergens such as tropomyosin and glutathione transferases are involved. Although, as suggested, the clinical relevance of cross-reactivity between parasites and house dust mites in tropical regions needs to be demonstrated (109,110), we postulate that the high prevalence of IgE antibodies to mites observed in tropical populations is partially the result of cross-reactivity with Ascaris allergens. Also, the high prevalence of allergy observed in urban areas of the tropics, even in places with poor hygienic conditions, may be influenced by the same phenomenon.