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Giannetti A, Pession A, Bettini I, Ricci G, Giannì G, Caffarelli C. IgE Mediated Shellfish Allergy in Children-A Review. Nutrients 2023; 15:3112. [PMID: 37513530 PMCID: PMC10386692 DOI: 10.3390/nu15143112] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/08/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Shellfish is a leading cause of food allergy and anaphylaxis worldwide. Recent advances in molecular characterization have led to a better understanding of the allergen profile. High sequence homology between shellfish species and between shellfish and house dust mites leads to a high serological cross-reactivity, which does not accurately correlate with clinical cross-reactions. Clinical manifestations are immediate and the predominance of perioral symptoms is a typical feature of shellfish allergy. Diagnosis, as for other food allergies, is based on SPTs and specific IgE, while the gold standard is DBPCFC. Cross-reactivity between shellfish is common and therefore, it is mandatory to avoid all shellfish. New immunotherapeutic strategies based on hypoallergens and other innovative approaches represent the new frontiers for desensitization.
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Affiliation(s)
- Arianna Giannetti
- Paediatrics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (A.G.); (A.P.)
| | - Andrea Pession
- Paediatrics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (A.G.); (A.P.)
| | - Irene Bettini
- Paediatrics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (A.G.); (A.P.)
| | - Giampaolo Ricci
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy;
| | - Giuliana Giannì
- Clinica Pediatrica, Azienda Ospedaliero-Universitaria, Medicine and Surgery Department, Università di Parma, 43126 Parma, Italy;
| | - Carlo Caffarelli
- Clinica Pediatrica, Azienda Ospedaliero-Universitaria, Medicine and Surgery Department, Università di Parma, 43126 Parma, Italy;
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Giovannini M, Beken B, Buyuktiryaki B, Barni S, Liccioli G, Sarti L, Lodi L, Pontone M, Bartha I, Mori F, Sackesen C, du Toit G, Lopata AL, Muraro A. IgE-Mediated Shellfish Allergy in Children. Nutrients 2023; 15:2714. [PMID: 37375617 DOI: 10.3390/nu15122714] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 05/27/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
Shellfish, including various species of mollusks (e.g., mussels, clams, and oysters) and crustaceans (e.g., shrimp, prawn, lobster, and crab), have been a keystone of healthy dietary recommendations due to their valuable protein content. In parallel with their consumption, allergic reactions related to shellfish may be increasing. Adverse reactions to shellfish are classified into different groups: (1) Immunological reactions, including IgE and non-IgE allergic reactions; (2) non-immunological reactions, including toxic reactions and food intolerance. The IgE-mediated reactions occur within about two hours after ingestion of the shellfish and range from urticaria, angioedema, nausea, and vomiting to respiratory signs and symptoms such as bronchospasm, laryngeal oedema, and anaphylaxis. The most common allergenic proteins involved in IgE-mediated allergic reactions to shellfish include tropomyosin, arginine kinase, myosin light chain, sarcoplasmic calcium-binding protein, troponin c, and triosephosphate isomerase. Over the past decades, the knowledge gained on the identification of the molecular features of different shellfish allergens improved the diagnosis and the potential design of allergen immunotherapy for shellfish allergy. Unfortunately, immunotherapeutic studies and some diagnostic tools are still restricted in a research context and need to be validated before being implemented into clinical practice. However, they seem promising for improving management strategies for shellfish allergy. In this review, epidemiology, pathogenesis, clinical features, diagnosis, and management of shellfish allergies in children are presented. The cross-reactivity among different forms of shellfish and immunotherapeutic approaches, including unmodified allergens, hypoallergens, peptide-based, and DNA-based vaccines, are also addressed.
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Affiliation(s)
- Mattia Giovannini
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
- Department of Health Sciences, University of Florence, 50139 Florence, Italy
| | - Burcin Beken
- Department of Pediatric Allergy & Immunology, School of Medicine, Acibadem University, 34303 Istanbul, Turkey
| | - Betul Buyuktiryaki
- Division of Pediatric Allergy, Department of Pediatrics, School of Medicine, Koc University, 34450 Istanbul, Turkey
| | - Simona Barni
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
| | - Giulia Liccioli
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
| | - Lucrezia Sarti
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
| | - Lorenzo Lodi
- Department of Health Sciences, University of Florence, 50139 Florence, Italy
- Immunology Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
| | - Matteo Pontone
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
- Department of Health Sciences, University of Florence, 50139 Florence, Italy
| | - Irene Bartha
- Pediatric Allergy Group, Department of Women and Children's Health, School of Life Course Sciences, King's College London, London SE1 9RT, UK
- Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London SE1 7EH, UK
| | - Francesca Mori
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
| | - Cansin Sackesen
- Division of Pediatric Allergy, Department of Pediatrics, School of Medicine, Koc University, 34450 Istanbul, Turkey
| | - George du Toit
- Pediatric Allergy Group, Department of Women and Children's Health, School of Life Course Sciences, King's College London, London SE1 9RT, UK
- Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London SE1 7EH, UK
- Peter Gorer Department of Immunobiology, School of Immunology & Microbial Sciences, King's College London, London SE5 9NU, UK
| | - Andreas L Lopata
- Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia
- Tropical Futures Institute, James Cook University, Singapore 387380, Singapore
| | - Antonella Muraro
- Food Allergy Referral Centre, Department of Mother and Child Health, University of Padua, 35128 Padua, Italy
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Wai CYY, Leung NYH, Leung ASY, Ngai SM, Pacharn P, Yau YS, Rosa Duque JSD, Kwan M, Jirapongsananuruk O, Chan WH, Chua G, Lee QU, Piboonpocanun S, Ho PK, Wong JC, Li S, Xu KJY, Wong GWK, Chu K, Leung PSC, Vichyanond P, Leung TF. Comprehending the allergen repertoire of shrimp for precision molecular diagnosis of shrimp allergy. Allergy 2022; 77:3041-3051. [PMID: 35567339 PMCID: PMC9795902 DOI: 10.1111/all.15370] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 04/06/2022] [Accepted: 04/26/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Clinical management of shrimp allergy is hampered by the lack of accurate tests. Molecular diagnosis has been shown to more accurately reflect the clinical reactivity but the full spectrum of shrimp allergens and their clinical relevance are yet to be established. We therefore sought to comprehend the allergen repertoire of shrimp, investigate and compare the sensitization pattern and diagnostic value of the allergens in allergic subjects of two distinct populations. METHODS Sera were collected from 85 subjects with challenge-proven or doctor-diagnosed shrimp allergy in Hong Kong and Thailand. The IgE-binding proteins of Penaeus monodon were probed by Western blotting and identified by mass spectrometry. Recombinant shrimp allergens were synthesized and analyzed for IgE sensitization by ELISA. RESULTS Ten IgE-binding proteins were identified, and a comprehensive panel of 11 recombinant shrimp allergens was generated. The major shrimp allergens among Hong Kong subjects were troponin C (Pen m 6) and glycogen phosphorylase (Pen m 14, 47.1%), tropomyosin (Pen m 1, 41.2%) and sarcoplasmic-calcium binding protein (Pen m 4, 35.3%), while those among Thai subjects were Pen m 1 (68.8%), Pen m 6 (50.0%) and fatty acid-binding protein (Pen m 13, 37.5%). Component-based tests yielded significantly higher area under curve values (0.77-0.96) than shrimp extract-IgE test (0.70-0.75). Yet the best component test differed between populations; Pen m 1-IgE test added diagnostic value only in the Thai cohort, whereas sensitizations to other components were better predictors of shrimp allergy in Hong Kong patients. CONCLUSION Pen m 14 was identified as a novel shrimp allergen predictive of challenge outcome. Molecular diagnosis better predicts shrimp allergy than conventional tests, but the relevant component is population dependent.
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Affiliation(s)
- Christine Y. Y. Wai
- Department of Paediatrics, Prince of Wales HospitalThe Chinese University of Hong KongHong KongChina
| | - Nicki Y. H. Leung
- Department of Paediatrics, Prince of Wales HospitalThe Chinese University of Hong KongHong KongChina
| | - Agnes S. Y. Leung
- Department of Paediatrics, Prince of Wales HospitalThe Chinese University of Hong KongHong KongChina
| | - Sai Ming Ngai
- State Key Laboratory of AgrobiotechnologyThe Chinese University of Hong KongHong KongChina,School of Life SciencesThe Chinese University of Hong KongHong KongChina
| | - Punchama Pacharn
- Division of Allergy and Immunology, Department of Pediatrics, Faculty of MedicineSiriraj Hospital, Mahidol UniversityBangkokThailand
| | - Yat Sun Yau
- Department of PaediatricsQueen Elizabeth HospitalHong KongChina
| | - Jaime Sou Da Rosa Duque
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of MedicineThe University of Hong KongHong KongChina
| | - Mike Y. W. Kwan
- Department of Paediatrics and Adolescent MedicinePrincess Margaret Hospital and Yan Chai HospitalHong KongChina
| | - Orathai Jirapongsananuruk
- Division of Allergy and Immunology, Department of Pediatrics, Faculty of MedicineSiriraj Hospital, Mahidol UniversityBangkokThailand
| | - Wai Hung Chan
- Department of PaediatricsQueen Elizabeth HospitalHong KongChina
| | - Gilbert T. Chua
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of MedicineThe University of Hong KongHong KongChina
| | - Qun Ui Lee
- Department of Paediatrics and Adolescent MedicinePrincess Margaret Hospital and Yan Chai HospitalHong KongChina
| | | | - Po Ki Ho
- Department of PaediatricsQueen Elizabeth HospitalHong KongChina
| | - Joshua S. C. Wong
- Department of Paediatrics and Adolescent MedicinePrincess Margaret Hospital and Yan Chai HospitalHong KongChina
| | - Shanshan Li
- School of Life SciencesThe Chinese University of Hong KongHong KongChina
| | - Kary J. Y. Xu
- Department of Paediatrics, Prince of Wales HospitalThe Chinese University of Hong KongHong KongChina
| | - Gary W. K. Wong
- Department of Paediatrics, Prince of Wales HospitalThe Chinese University of Hong KongHong KongChina
| | - Ka Hou Chu
- School of Life SciencesThe Chinese University of Hong KongHong KongChina
| | - Patrick S. C. Leung
- Division of Rheumatology, Allergy and Clinical ImmunologyUniversity of CaliforniaDavisCaliforniaUSA
| | - Pakit Vichyanond
- Division of Allergy and Immunology, Department of Pediatrics, Faculty of MedicineSiriraj Hospital, Mahidol UniversityBangkokThailand,Samitivej Allergy InstituteSamitivej Thonburi HospitalBangkokThailand
| | - Ting Fan Leung
- Department of Paediatrics, Prince of Wales HospitalThe Chinese University of Hong KongHong KongChina,Hong Kong Hub of Paediatric ExcellenceThe Chinese University of Hong KongHong KongChina
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Lamara Mahammed L, Belaid B, Berkani LM, Merah F, Rahali SY, Ait Kaci A, Berkane I, Sayah W, Allam I, Djidjik R. Shrimp sensitization in house dust mite algerian allergic patients: A single center experience. World Allergy Organ J 2022; 15:100642. [PMID: 35432714 PMCID: PMC8988002 DOI: 10.1016/j.waojou.2022.100642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/19/2022] [Accepted: 03/04/2022] [Indexed: 11/19/2022] Open
Abstract
Background Cross-reactivity between shrimp and house dust mite (HDM) proteins has been widely documented. However, a significant geographical variability in sensitization patterns and cross-reactive allergens has been reported which may impact the diagnosis and management of shrimp allergy among HDM-shrimp co-sensitized patients. This study aimed to investigate the prevalence of shrimp and tropomyosin sensitization among HDM-allergic patients in order to understand the local epidemiology to inform the development of targeted diagnostic and therapeutic tools. Methods Four hundred forty-six (446) HDM-allergic patients and 126 atopic controls were screened for shrimp-specific IgE using the IMMULITE 2000 XPI® System. HDM-shrimp sensitized subjected were also tested for IgE tropomyosin (nPen m 1) and thoroughly interviewed about their shellfish consumption habits. Tropomyosin sensitized patients were subjected to further analysis including measurement of IgE specific to squid and crab. Results The prevalence of shrimp sensitization in the HDM-allergic population was 20.4% vs 0% in the control group. Of them 63.7% were clinically allergic to shrimp, while 9 cases had no history of allergic reaction to this food and 24 patients reported not having consumed shrimp before. Besides, 72.5% of the HDM-shrimp sensitized subjects had tropomyosin-specific IgE with a positivity rate of 82.8% among shrimp-allergic patients. Among tropomyosin reactors, 95.5% were sensitized to crab and 89.5% to squid, none of them had previously ingested neither crab nor squid. Nevertheless, one-third of HDM-shrimp sensitized patients who never consumed shrimp before did not react to tropomyosin. Conclusions Shrimp allergy seems to be strictly dependent on HDM sensitization, at least in this geographical area. Therefore, HDM allergic patients should be systematically screened for shrimp sensitization and asked about the consumption of shellfish. Tropomyosin is a major and clinically relevant shrimp allergen that accounts for shellfish-HDM cross-reactivity. However, other components could be involved.
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Ukleja-Sokołowska N, Żbikowska-Gotz M, Lis K, Adamczak R, Bartuzi Z. Assessment of TSLP, IL 25 and IL 33 in patients with shrimp allergy. Allergy Asthma Clin Immunol 2021; 17:76. [PMID: 34301307 PMCID: PMC8299623 DOI: 10.1186/s13223-021-00576-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 07/11/2021] [Indexed: 12/02/2022] Open
Abstract
Background Shrimp allergy is a growing problem among the European population. TSLP, IL-25 and IL-33 are involved in the pathophysiology of allergic diseases, including asthma and atopic dermatitis, as they activate the Th2-dependent immune response. Methods Thirty-seven patients (18 male and 19 female) with a positive history of symptoms associated with shrimp consumption were selected. All patients had blood samples taken to assess the concentration of allergen-specific IgE (sIgE) to house dust mites (HDM) and shrimp (Singleplex, quantitative method with cut off value > 0,35 kAU/L) as well as the level of allergen components using the ImmunoCap ISAC method (Microarray test, semi-quantitative with cut off value > 0,3 ISU-E). The concentrations of TSLP, IL-25 and IL-33 in the patients’ blood serum was assessed using the ELISA method (Cusabio). Twenty patients with negative allergy history of allergic disease tests were included in the control group. Results Among the 37 shrimp-allergic patients, ImmunoCap ISAC was identified the presence of sIgE to the available shrimp allergen components in only 14 cases (37.8%). TSLP and IL25 levels were significantly higher in the study group. No statistically significant correlation was found between the concentration of analyzed alarmins and the concentration of sIgE level to shrimp or HDM between the study and control groups. No statistically significant correlation was found between poly-sensitization occurring in patients and levels of TSLP, IL-25 and IL-33 . Conclusion In shrimp-allergic patients, the concentrations of TSLP and IL-25 were significantly higher than in the control group (1.33 vs. 0.49 and 157 vs. 39.36, respectively). There was no correlation between the concentrations of TSLP, IL-25 and IL-33 and the concentration of sIgE in the patients or the number of allergen components that the patients were sensitized to. Trial registration: Bioethics Committee 147/2015, 11.03.2015. Supplementary Information The online version contains supplementary material available at 10.1186/s13223-021-00576-9.
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Affiliation(s)
- Natalia Ukleja-Sokołowska
- Department of Allergology, Clinical Immunology and Internal Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, ul. Ujejskiego 75, 85-168, Bydgoszcz, Poland.
| | - Magdalena Żbikowska-Gotz
- Department of Allergology, Clinical Immunology and Internal Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, ul. Ujejskiego 75, 85-168, Bydgoszcz, Poland
| | - Kinga Lis
- Department of Allergology, Clinical Immunology and Internal Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, ul. Ujejskiego 75, 85-168, Bydgoszcz, Poland
| | - Rafał Adamczak
- Department of Obstetrics and Gynecology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Zbigniew Bartuzi
- Department of Allergology, Clinical Immunology and Internal Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, ul. Ujejskiego 75, 85-168, Bydgoszcz, Poland
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Ukleja-Sokołowska N, Lis K, Żbikowska-Gotz M, Adamczak R, Kuźmiński A, Bartuzi Z. Clinical utility of immunological methods based on the singleplex and multiplex ImmunoCap systems for diagnosis of shrimp allergy. J Int Med Res 2021; 49:3000605211006597. [PMID: 33840250 PMCID: PMC8044572 DOI: 10.1177/03000605211006597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Levels of specific IgE (sIgE) against allergen components can be assessed using multiplex assays or with highly sensitive, quantitative methods. The aim of this study was to compare the sensitivity and specificity of different immunological methods for diagnosis of shrimp allergy. METHODS Twenty patients with positive skin prick tests for frozen tiger shrimp were selected for further examination. Blood samples were taken to assess concentrations of sIgE against the house dust mites Dermatophagoides pteronyssinus and D. farinae, shrimp allergen extract, allergen components Der p 1, Der p 2 and Pan a 1 (ImmunoCap), and the ImmunoCap ISAC 112 panel. RESULTS All patients had elevated levels of sIgE against shrimp and D pteronyssinus. Eight patients were sensitized to Pen m 1, three patients were sensitized to Pen m 2, and two patients were sensitized to Pen m 4 (ISAC). ImmunoCap ISAC detected shrimp sensitization in 50% of patients. There was a strong correlation between concentrations of sIgE against Pen m1 and Der p 10 detected by ImmunoCap. CONCLUSIONS The singleplex ImmunoCap system remains the reference diagnostic method, but in the case of shrimp allergy ImmunoCap ISAC provided better insight into patient allergen profiles.
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Affiliation(s)
- Natalia Ukleja-Sokołowska
- Department of Allergology, Clinical Immunology and Internal Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Kinga Lis
- Department of Allergology, Clinical Immunology and Internal Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Magdalena Żbikowska-Gotz
- Department of Allergology, Clinical Immunology and Internal Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Rafał Adamczak
- Department of Obstetrics and Gynecology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Andrzej Kuźmiński
- Department of Allergology, Clinical Immunology and Internal Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Zbigniew Bartuzi
- Department of Allergology, Clinical Immunology and Internal Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
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8
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Ukleja-Sokołowska N, Gawrońska-Ukleja E, Lis K, Żbikowska-Gotz M, Bartuzi Z. Analysis of the allergen profile of patients sensitized to shrimp based on ImmunoCAP immune solid-phase allergen chip results. Ann Allergy Asthma Immunol 2020; 125:355-357. [PMID: 32544533 DOI: 10.1016/j.anai.2020.06.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/02/2020] [Accepted: 06/06/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Natalia Ukleja-Sokołowska
- Department of Allergology, Clinical Immunology and Internal Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland.
| | - Ewa Gawrońska-Ukleja
- Department of Allergology, Clinical Immunology and Internal Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Kinga Lis
- Department of Allergology, Clinical Immunology and Internal Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Magdalena Żbikowska-Gotz
- Department of Allergology, Clinical Immunology and Internal Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Zbigniew Bartuzi
- Department of Allergology, Clinical Immunology and Internal Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
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Li J, Li Z, Kong D, Li S, Yu Y, Li H. IgE and IgG4 responses to shrimp allergen tropomyosin and its epitopes in patients from coastal areas of northern China. Mol Med Rep 2020; 22:371-379. [PMID: 32319635 PMCID: PMC7248481 DOI: 10.3892/mmr.2020.11084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 03/17/2020] [Indexed: 11/05/2022] Open
Abstract
Sensitization to allergens and their peptides varies among patients due to geographical or ethnic differences. The present study aimed to investigate immunoglobulin (Ig)E and IgG4 responses to tropomyosin and its peptides in shrimp allergic patients from northern China. A total of 92 subjects were studied, including 35 shrimp allergic patients, 29 patients with house dust mite (HDM) and/or cockroach allergic patients and 28 healthy volunteers. Serum IgE and IgG4 antibodies to recombinant shrimp tropomyosin (rPen a 1) and its peptides were measured by means of a light-initiated chemiluminescent assay. A total of 9 major sequential epitopes of Pen a 1 reported in the literature were synthesized. Of 35 shrimp allergic patients, 25 (71.4%) had positive Pen 1-specific IgE (sIgE) antibodies and 22 (62.9%) contained measurable rPen a 1-specific IgG4 (sIgG4) antibodies. A strong IgG4 response accompanied the presence of IgE to Pen a 1. None of the patients with HDM and/or cockroach allergy demonstrated IgE reactivity to rPen a 1. The reaction frequency of IgE binding epitope was 20–48%, while that of IgG4 binding epitope was 63.6–3.9%. The IgE and IgG4 recognition patterns of the tropomyosin peptides demonstrated high interpatient heterogeneity. Diversity of IgE binding epitopes was positively correlated with Pen a 1 sIgE levels. In the study population, tropomyosin was a major allergen recognized by the majority of shrimp allergic patients, which is consistent with previous reports. However, none of the 9 epitopes are major (reaction frequency >50%) IgE-binding regions, indicating the epitopes profile may be different in other regions.
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Affiliation(s)
- Junpu Li
- The Clinical Laboratory of Tianjin Chest Hospital, Tianjin 300222, P.R. China
| | - Zhiwei Li
- Department of Clinical Laboratory, School of Medical Laboratory, Tianjin Medical University, Tianjin 300203, P.R. China
| | - Deyu Kong
- Department of Laboratory Medicine, Tianjin Port Hospital, Tianjin 300456, P.R. China
| | - Shaoshen Li
- Department of Laboratory Medicine, Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin 300120, P.R. China
| | - Yang Yu
- Department of Clinical Laboratory, School of Medical Laboratory, Tianjin Medical University, Tianjin 300203, P.R. China
| | - Huiqiang Li
- Department of Clinical Laboratory, School of Medical Laboratory, Tianjin Medical University, Tianjin 300203, P.R. China
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Abstract
PURPOSE OF REVIEW Focusing on the strict relationship between house dust mites and crustaceans from the allergenic point of view. RECENT FINDINGS The well-known tropomyosin was considered for years as the cross-reacting allergen between shrimp and house dust mites. In the last few years, several allergens not only in shrimps but also in house dust mite have been identified and other molecules other than tropomyosin have been shown to cross-react between crustaceans and mites. The present review investigates the very complex allergen sources in shrimp and mites, giving a satisfactorily complete picture of the interrelationships between common allergens. Several minor HDM allergens are homologous to major and minor shrimp allergens; tropomyosin is not the only cross-reactive allergen between shrimp and mites.
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Leung ASY, Leung NYH, Wai CYY, Leung TF, Wong GWK. Allergen immunotherapy for food allergy from the Asian perspective: key challenges and opportunities. Expert Rev Clin Immunol 2018; 15:153-164. [PMID: 30488732 DOI: 10.1080/1744666x.2019.1554432] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Introduction: Prevalence of food allergy is rising in different regions of the world. Asia has not been spared from this epidemic, but epidemiological data have revealed a different pattern of food allergens in this continent. Allergen-specific immunotherapy (AIT) for food allergy, which has been revolutionary as the main focus of research in recent years, needs to be adapted for the different populations in Asia. Areas covered: Recent evidence shows increasing popularity and superiority of AIT over strict food avoidance as the cornerstone of food allergy management. Asia is a distinctive continent with specific food allergy triggers, in particular, seafood, and wheat. Peanut, on the contrary, is not a common food allergen in most parts of Asia. The common Asian food allergens, as well as the rapidly developing food-specific AIT in this region will be covered in this article. Expert commentary: Evidence on oral immunotherapy for wheat allergy and preclinical data on shellfish AIT are promising. Further work should be done on resolving cross-sensitization between environmental allergens with wheat and shellfish allergens, and a modified AIT approach to enhance the safety and effectiveness of food-specific immunotherapy.
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Affiliation(s)
- Agnes Sze Yin Leung
- a Department of Paediatrics , The Chinese University of Hong Kong, Prince of Wales Hospital Shatin , New Territories , Hong Kong
| | - Nicki Yat Hin Leung
- a Department of Paediatrics , The Chinese University of Hong Kong, Prince of Wales Hospital Shatin , New Territories , Hong Kong
| | - Christine Yee Yan Wai
- a Department of Paediatrics , The Chinese University of Hong Kong, Prince of Wales Hospital Shatin , New Territories , Hong Kong
| | - Ting Fan Leung
- a Department of Paediatrics , The Chinese University of Hong Kong, Prince of Wales Hospital Shatin , New Territories , Hong Kong
| | - Gary Wing Kin Wong
- a Department of Paediatrics , The Chinese University of Hong Kong, Prince of Wales Hospital Shatin , New Territories , Hong Kong
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Taha AAER, Etewa SE, Abdel-Rahman SA, Al Ghandour AMF, Atta AH, Darwish AM. House dust mites among allergic patients at the Allergy and Immunology Unit, Zagazig University: an immunologic and serologic study. J Parasit Dis 2018; 42:405-415. [PMID: 30166788 DOI: 10.1007/s12639-018-1016-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Accepted: 06/04/2018] [Indexed: 12/27/2022] Open
Abstract
In the twenty-first century, the occurrence of allergic diseases has increased. Prevention and control of house dust mites (HDMs) are required as they play a major role in allergic conditions. The present work aimed to detect HDM allergy (Dermatophagoides pteronyssinus and Dermatophagoides farinae) among allergic patients attending the Allergy and Immunology Unit, Zagazig University. Ninety-six patients with a history of allergic diseases were included in this study. They were examined for allergy to D. pteronyssinus and D. farinae using different diagnostic tools: the skin prick test (SPT) and measurement of specific IgE antibodies to HDM allergen extracts. Ninety-six allergic patients were recruited in this study [60 females (62.5%) and 36 males (37.5%) aged between 5-60 years]. SPT (81.2 and 79.2%) and IgE (70.9 and 75%) gave positive results for both D. pteronyssinus and D. pteronyssinus, respectively. The common risk factors were use of cotton bedding > 10 years old, older homes > 20 years, crowded homes, family history, home dampness and homes at the ground floor. It was concluded that allergies to D. pteronyssinus and D. farinae contribute to allergic diseases in Zagazig City. Use of the SPT and IgE level is a promising diagnostic tool in the diagnosis of D. pteronyssinus and D. farinae.
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Affiliation(s)
- Afaf Abd El-Raouf Taha
- 1Department of Medical Parasitology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Samia E Etewa
- 1Department of Medical Parasitology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Sara A Abdel-Rahman
- 1Department of Medical Parasitology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | - Amal H Atta
- 2Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Asmaa M Darwish
- 1Department of Medical Parasitology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Tsedendorj O, Chinuki Y, Ueda K, Kohno K, Adachi A, Morita E. Tropomyosin is a minor but distinct allergen in patients with shrimp allergies in Japan. J Cutan Immunol Allergy 2018. [DOI: 10.1002/cia2.12019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Onon Tsedendorj
- Department of Dermatology; Shimane University Faculty of Medicine; Izumo Japan
| | - Yuko Chinuki
- Department of Dermatology; Shimane University Faculty of Medicine; Izumo Japan
| | - Kiyoe Ueda
- Department of Dermatology; Shimane University Faculty of Medicine; Izumo Japan
| | | | - Atsuko Adachi
- Department of Dermatology; Hyogo Prefectural Kakogawa Medical Centre; Kakogawa Japan
| | - Eishin Morita
- Department of Dermatology; Shimane University Faculty of Medicine; Izumo Japan
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Yang Z, Zhao J, Wei N, Feng M, Xian M, Shi X, Zheng Z, Su Q, Wong GWK, Li J. Cockroach is a major cross-reactive allergen source in shrimp-sensitized rural children in southern China. Allergy 2018; 73:585-592. [PMID: 29072879 DOI: 10.1111/all.13341] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND Little is known about the prevalence of food allergy (FA) in China. The aim of this study was to investigate the disparity of FA between urban and rural areas in southern China. METHODS EuroPrevall questionnaire responses were obtained from 5542 school-age children in urban Guangzhou and 5319 in rural Shaoguan. A case-control study enrolled 190 children with adverse reactions (ARs) after food intake as cases and 212 controls in Guangzhou, whereas 116 cases and 233 controls in Shaoguan. These subjects underwent skin prick test (SPT) and serum IgE measurements to food and inhalant allergens. Allergen extracts from shrimp, house dust mite (HDM), and cockroach were prepared for IgE cross-reactivity testing in 23 Guangzhou and 20 Shaoguan shrimp-sensitized subjects. RESULTS The prevalence of ARs to shrimp was higher in Guangzhou than in Shaoguan children (3.5% vs 1.4%, P < .001). However, sensitization rate to shrimp (SPT: 3.7% vs 11.2%, P = .015; IgE: 12.6% vs 36.2%, P < .001) and cockroach (SPT: 5.3% vs 33.5%; IgE: 2.6% vs 27.6%, P < .001) was lower in Guangzhou. A significant correlation between shrimp and HDM/cockroach IgE was found in Shaoguan children. The proportions of positive IgE to tropomyosin (Pen a 1, Der p 10) were lower than 7.4% in both areas. Cockroach allergen has a significantly higher inhibition rate of binding to IgE to house dust mite allergens in Shaoguan sera. CONCLUSION Shrimp is a common allergic food in southern China. Higher proportion of shrimp sensitization in rural subjects could be explained by cross-reactivity to cockroach. Tropomyosin was not a major allergen responding to the cross-reactivity.
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Affiliation(s)
- Z. Yang
- Department of Allergy and Clinical Immunology; Guangzhou Institute of Respiratory Disease; State Key Laboratory of Respiratory Disease; The First Affiliated Hospital of Guangzhou Medical University; Guangzhou China
| | - J. Zhao
- Department of Allergy and Clinical Immunology; Guangzhou Institute of Respiratory Disease; State Key Laboratory of Respiratory Disease; The First Affiliated Hospital of Guangzhou Medical University; Guangzhou China
| | - N. Wei
- Department of Allergy and Clinical Immunology; Guangzhou Institute of Respiratory Disease; State Key Laboratory of Respiratory Disease; The First Affiliated Hospital of Guangzhou Medical University; Guangzhou China
| | - M. Feng
- Department of Allergy and Clinical Immunology; Guangzhou Institute of Respiratory Disease; State Key Laboratory of Respiratory Disease; The First Affiliated Hospital of Guangzhou Medical University; Guangzhou China
| | - M. Xian
- Department of Allergy and Clinical Immunology; Guangzhou Institute of Respiratory Disease; State Key Laboratory of Respiratory Disease; The First Affiliated Hospital of Guangzhou Medical University; Guangzhou China
| | - X. Shi
- Department of Allergy and Clinical Immunology; Guangzhou Institute of Respiratory Disease; State Key Laboratory of Respiratory Disease; The First Affiliated Hospital of Guangzhou Medical University; Guangzhou China
| | - Z. Zheng
- Department of Allergy and Clinical Immunology; Guangzhou Institute of Respiratory Disease; State Key Laboratory of Respiratory Disease; The First Affiliated Hospital of Guangzhou Medical University; Guangzhou China
| | - Q. Su
- Department of Allergy and Clinical Immunology; Guangzhou Institute of Respiratory Disease; State Key Laboratory of Respiratory Disease; The First Affiliated Hospital of Guangzhou Medical University; Guangzhou China
| | - G. W. K. Wong
- Department of Paediatrics; Prince of Wales Hospital; The Chinese University of Hong Kong; Hong Kong China
| | - J. Li
- Department of Allergy and Clinical Immunology; Guangzhou Institute of Respiratory Disease; State Key Laboratory of Respiratory Disease; The First Affiliated Hospital of Guangzhou Medical University; Guangzhou China
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Rosenfield L, Tsoulis MW, Milio K, Schnittke M, Kim H. High rate of house dust mite sensitization in a shrimp allergic southern Ontario population. Allergy Asthma Clin Immunol 2017; 13:5. [PMID: 28115965 PMCID: PMC5244585 DOI: 10.1186/s13223-017-0177-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 01/02/2017] [Indexed: 11/18/2022] Open
Abstract
Background Shrimp and house dust mite (HDM) allergies are common in Canadians. Often, both of these allergies occur in the same patient. This may be due to homology of tropomyosin or other potentially shared proteins. The aim of our study was to assess the frequency of house dust mite sensitization in a shrimp allergic Canadian population. Methods We undertook a retrospective chart review of shrimp allergic patients at an outpatient allergy clinic in Kitchener, Ontario, Canada. Our primary endpoint was to assess for presence of HDM sensitization in this population. Patients were categorized into approximate quartiles. We assessed the severity of the shrimp reactions, correlated shrimp skin test size to HDM skin test size, and measured the proportion of patients with atopic symptoms. Results We identified 95 shrimp allergic patients who were tested for house dust mite. 86 (90.5%) of these patients had a positive skin test to HDM. Patients with a shrimp skin test ≥5 mm were 5.31 times (95% CI, 1.55–18.14; p = 0.008) more likely to exhibit a dust mite skin test ≥5 mm than patients with a shrimp skin test <5 mm. The odds of a patient with a shrimp skin test between 10 and 18 mm having a larger HDM skin test were 3.93 times (95% CI 1.03–14.98, p = 0.045) the odds for a patient with a shrimp skin test size between 3 and 4 mm. We did not find a correlation between shrimp skin test size and shrimp reaction symptom grade (p = 0.301). Conclusion In our Canadian patients, we found a large majority of shrimp allergic patients to be sensitized to HDM. We found that patients with a large skin test to shrimp were more likely to have a large skin test to HDM compared to those patients with a small skin test to shrimp. We did not find a correlation between shrimp skin test size and shrimp reaction symptom severity. Most of these patients had symptoms of rhinitis and/or asthma that may have been caused by house dust mite allergy.
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Affiliation(s)
- Lana Rosenfield
- Division of Clinical Immunology and Allergy, Department of Medicine Michael D. DeGroote School of Medicine, McMaster University, Hamilton, ON Canada
| | | | - Kirolos Milio
- Faculty of Science, University of Waterloo, Waterloo, ON Canada
| | | | - Harold Kim
- Division of Clinical Immunology and Allergy, Department of Medicine Michael D. DeGroote School of Medicine, McMaster University, Hamilton, ON Canada.,Grandriver Allergy, Kitchener, ON Canada.,Schulich School of Medicine & Dentistry, Western University, London, ON Canada
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Heffler E, Sberna ME, Sichili S, Intravaia R, Nicolosi G, Porto M, Liuzzo MT, Picardi G, Fichera S, Crimi N. High prevalence of Anisakis simplex hypersensitivity and allergy in Sicily, Italy. Ann Allergy Asthma Immunol 2016; 116:146-50. [PMID: 26815707 DOI: 10.1016/j.anai.2015.12.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 11/22/2015] [Accepted: 12/14/2015] [Indexed: 11/21/2022]
Abstract
BACKGROUND Anisakis simplex can elicit allergic reactions when ingested in raw or marinated fish. The prevalence of A simplex hypersensitivity and allergy in Sicily (Italy), an area where the consumption of raw or marinated fish is very common, has not been investigated thus far. OBJECTIVE To investigate the prevalence of A simplex sensitization and its clinical relevance in a large group of unselected patients. METHODS All consecutive patients referred to the authors' allergy clinic during a 22 month-period were included in the study, evaluated for sensitization to A simplex and other allergens depending on their clinical history, and investigated for allergic symptoms after the ingestion of raw or marinated fish. RESULTS Of 3,419 patients screened, 527 (15.4%) were sensitized to A simplex and 29 of these (5.5% of sensitized patients) had a history of A simplex allergy. Approximately 30% of patients had mono-sensitization to A simplex. Co-sensitization to house dust mites or molds yielded an odds ratio of 1.98 or 3.18, respectively, for allergy to A simplex. CONCLUSION A high prevalence of A simplex sensitization in a large proportion of patients with mono-sensitization was found, confirming that eating habits influence sensitization to this nematode. Allergic symptoms from A simplex ingestion in raw or marinated fish were quite frequent, with symptoms ranging from oral allergy syndrome to anaphylaxis. Patients sensitized to A simplex were more prone to have allergic symptoms when they had co-sensitization to house dust mites or molds, suggesting possible cross-reactive but clinically relevant allergens between these allergenic sources.
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López-Matas MA, de Larramendi CH, Moya R, Sánchez-Guerrero I, Ferrer A, Huertas AJ, Flores I, Navarro LA, García-Abujeta JL, Vicario S, Andreu C, Peña M, Carnés J. In vivo diagnosis with purified tropomyosin in mite and shellfish allergic patients. Ann Allergy Asthma Immunol 2016; 116:538-43. [PMID: 27132158 DOI: 10.1016/j.anai.2016.03.034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 02/25/2016] [Accepted: 03/31/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Tropomyosin is the most studied shellfish allergen and has been involved in cross-reactivity among different invertebrates (crustacean, mollusks, mites, insects, and nematodes). OBJECTIVE To determine the relevance of tropomyosin in mite- and shellfish-sensitized patients using tropomyosin skin testing. METHODS Patients were divided into 3 groups: group M included mite allergic patients (ie, individuals with respiratory symptoms and a positive result on skin prick testing [SPT] to house dust mites), group S included shellfish allergic patients (ie, individuals who reported symptoms with shellfish), and group MS included mite- and shellfish allergic patients (ie, individuals who simultaneously fulfilled the inclusion criteria for groups M and S). Tropomyosin was purified from shrimp, characterized, and used in SPT for diagnosis in the patient population. RESULTS Eight hundred fifty patients were included in the study: 790 (92.9%) in group M, 21 (2.5%) in group S, and 39 (4.6%) in group MS. Tropomyosin was purified from shrimp with a purity higher than 95%. Forty-two individuals tested positive to tropomyosin: the prevalence was 2.7% in group M, 28.6% in group S, and 38.5% in patients of group MS. Twenty-one (50%) of the tropomyosin-positive individuals had symptoms with shellfish, and 3 (14.3%) reported anaphylaxis. CONCLUSION The prevalence of tropomyosin was low in mite-sensitized patients (2.7 %) and high in shellfish allergic patients (28.6%). The higher prevalence of tropomyosin was found in patients sensitized to both mite and shellfish (38.5%). The selection of tropomyosin-sensitized patients by SPT might help in the choice of appropriate treatments or management for these patients.
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Affiliation(s)
| | - Carlos H de Larramendi
- Allergy Section, Hospital Marina Baixa, Villajoyosa and Centro de Especialidades Foietes, Benidorm, Alicante, Spain
| | - Raquel Moya
- R&D Department, Laboratorios LETI S.L., Tres Cantos, Madrid, Spain
| | | | - Angel Ferrer
- Allergy Unit, Hospital General Universitario de Elche, Elche, Alicante, Spain
| | - Angel Julio Huertas
- Allergy Section, Complejo Hospitalario Universitario de Cartagena, Cartagena, Murcia, Spain
| | - Isabel Flores
- Allergy Unit, Hospital de la Vega Baja, Orihuela, Alicante, Spain
| | - Luis Angel Navarro
- Allergy Unit, Centro de Especialidades El Españoleto, Játiva, Valencia, Spain
| | - José Luis García-Abujeta
- Allergy Section, Hospital Marina Baixa, Villajoyosa and Centro de Especialidades Foietes, Benidorm, Alicante, Spain
| | - Sandra Vicario
- Allergy Section, Hospital Marina Baixa, Villajoyosa and Centro de Especialidades Foietes, Benidorm, Alicante, Spain
| | - Carmen Andreu
- Allergy Unit, Hospital de la Vega Baja, Orihuela, Alicante, Spain
| | - Maribel Peña
- Allergy Unit, Hospital de la Vega Baja, Orihuela, Alicante, Spain
| | - Jerónimo Carnés
- R&D Department, Laboratorios LETI S.L., Tres Cantos, Madrid, Spain.
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Pascal M, Grishina G, Yang AC, Sánchez-García S, Lin J, Towle D, Ibañez MD, Sastre J, Sampson HA, Ayuso R. Molecular Diagnosis of Shrimp Allergy: Efficiency of Several Allergens to Predict Clinical Reactivity. J Allergy Clin Immunol Pract 2015; 3:521-9.e10. [PMID: 25769902 DOI: 10.1016/j.jaip.2015.02.001] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 01/30/2015] [Accepted: 02/03/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND The diagnosis of shellfish allergy remains a challenge for clinicians. Several shellfish allergens have been characterized and their IgE epitopes identified. However, the clinical relevance of this sensitization is still not clear. OBJECTIVE The objective of this study was to identify allergens and epitopes associated with clinical reactivity to shrimp. METHODS Shrimp-sensitized subjects were recruited and grouped based on the history of shrimp-allergic reactions and challenge outcome. IgE reactivity to recombinant crustacean allergens, and IgE and IgG4 reactivity to peptides were determined. Subjects sensitized to dust mites and/or cockroach without shrimp sensitization or reported allergic reactions, as well as nonatopic individuals, were used as controls. RESULTS A total of 86 subjects were recruited with a skin prick test to shrimp; 74 reported shrimp-allergic reactions, 58 were allergic (38 positive double-blind placebo-controlled food challenge and 20 recent anaphylaxis), and 16 were tolerant. All subjects without a history of reactions had negative challenges. The individuals with a positive challenge more frequently recognized tropomyosin and sarcoplasmic calcium-binding proteins than those found tolerant by the challenge. Especially a sarcoplasmic-calcium-binding-protein positive test is very likely to result in a positive challenge, though the frequency of recognition is low. Subjects with dust mite and/or cockroach allergy not sensitized to shrimp recognized arginine kinase and hemocyanin. Several epitopes of these allergens may be important in predicting clinical reactivity. CONCLUSION Tropomyosin and sarcoplasmic-calcium-binding-protein sensitization is associated with clinical reactivity to shrimp. Myosin light chain testing may help in the diagnosis of clinical reactivity. Arginine kinase and hemocyanin appear to be cross-reacting allergens between shrimp and arthropods. Detection of IgE to these allergens and some of their epitopes may be better diagnostic tools in the routine workup of shrimp allergy.
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Affiliation(s)
- Mariona Pascal
- Division of Allergy & Immunology and the Jaffe Food Allergy Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY; Servei d'Immunologia, Centre de Diagnòstic Biomèdic (CDB), Hospital Clínic, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Galina Grishina
- Division of Allergy & Immunology and the Jaffe Food Allergy Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Ariana C Yang
- Division of Clinical Immunology and Allergy, University of Saõ Paulo School of Medicine, Saõ Paulo, Brazil
| | - Silvia Sánchez-García
- Allergy Department, Hospital Infantil Universitario del Niño Jesús, Madrid, Spain; Section of Allergy, Fundación Jimenez Díaz, Madrid, Spain
| | - Jing Lin
- Division of Allergy & Immunology and the Jaffe Food Allergy Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - David Towle
- Mount Desert Island Biological Laboratory (MDIBL), Salsbury Cove, Me
| | - Maria Dolores Ibañez
- Allergy Department, Hospital Infantil Universitario del Niño Jesús, Madrid, Spain
| | - Joaquín Sastre
- Section of Allergy, Fundación Jimenez Díaz, Madrid, Spain
| | - Hugh A Sampson
- Division of Allergy & Immunology and the Jaffe Food Allergy Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Rosalia Ayuso
- Division of Allergy & Immunology and the Jaffe Food Allergy Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY; Ear, Nose and Throat Associates of New York, P.C., NY.
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Gámez C, Zafra MP, Boquete M, Sanz V, Mazzeo C, Ibáñez MD, Sánchez-García S, Sastre J, del Pozo V. New shrimp IgE-binding proteins involved in mite-seafood cross-reactivity. Mol Nutr Food Res 2014; 58:1915-25. [PMID: 24978201 DOI: 10.1002/mnfr.201400122] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 04/25/2014] [Accepted: 05/08/2014] [Indexed: 12/16/2022]
Abstract
SCOPE Shrimp is a seafood consumed worldwide and the main cause of severe allergenic reactions to crustaceans. Seafood allergy has been related to mite sensitization, mainly mediated by tropomyosin, but other proteins could be involved. The aim of the study was to identify new shrimp allergens implicated in mite-seafood cross-reactivity (CR) in two different climate populations: dry and humid climates. METHODS AND RESULTS Shrimp and mite IgE-binding profiles of patients from continental dry and humid climates were analyzed by immunoblotting, and the most frequently recognized Solenocera melantho shrimp proteins were identified by MS as α-actinin, β-actin, fructose biphosphate aldolase, arginine kinase, sarcoplasmic calcium-binding protein, and ubiquitin. Using inhibition immunoblot assays, we demonstrate that tropomyosin and ubiquitin were responsible for mite-seafood CR from both climates; but also α-actinin and arginine kinase are implicated in dry- and humid-climate populations, respectively. Reciprocal inhibition assays demonstrated that mites are the primary sensitizer in humid-climate, as shrimp is in continental dry-climate population. CONCLUSION Several new shrimp allergens have been identified and should be considered in the diagnosis and treatment of shrimp allergy and mite-seafood CR. Differences in mite-seafood CR were founded to be based on the climate.
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Affiliation(s)
- Cristina Gámez
- Department of Immunology, IIS-Fundación Jiménez Díaz, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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