Introduction

IgE-mediated sensitization and molecular cross-reactivity are central to allergic disease pathogenesis. Tropomyosin, a conserved panallergen shared by house dust mites (HDM), crustaceans, and cockroaches, represents a key molecular link between inhalant and food allergens, with variable clinical relevance across geographic regions.

Aim

To investigate the prevalence and pattern of tropomyosin sensitization among allergic patients in Georgia and to determine whether cross-reactivity between HDM, shrimp, and cockroach influences allergic disease manifestations.

Material and methods

A total of 201 allergic patients sensitized to HDM, shrimp, and/or cockroach components – either individually or in combination – were analysed using the ImmunoCAP ISAC microarray. Sensitization profiles, serum specific IgE levels to tropomyosin components (Der p 10, Pen m 1, Bla g 7), and associations with clinical phenotypes were evaluated in paediatric and adult subgroups using non-parametric and regression analyses.

Results

HDM monosensitization was predominant (76.6%), whereas monosensitization to shrimp or cockroach was rare. Tropomyosin sensitization was identified in 11.4% of patients, mainly within the HDM–shrimp–cockroach polysensitized group. IgE responses to Der p 10, Pen m 1, and Bla g 7 were strongly correlated (r_s ≈ 0.9), consistent with known cross-reactivity between these components. Tropomyosin sensitization was associated with complex allergic phenotypes, particularly atopic dermatitis and rhinitis/asthma, with some age-related variation.

Conclusions

In this population, tropomyosin is a minor allergen in monosensitized individuals but a key cross-reactive component in polysensitized patients, predominantly driven by inhalant HDM exposure. These findings underline the clinical value of molecular diagnostics for identifying cross-reactivity and guiding personalised allergy management.