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Oscherwitz M, Godinich BM, Singh N, Rohr BR. Beyond the shell: malacology in medical dermatology. Arch Dermatol Res 2024; 316:576. [PMID: 39180552 PMCID: PMC11344720 DOI: 10.1007/s00403-024-03343-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 08/01/2024] [Accepted: 08/16/2024] [Indexed: 08/26/2024]
Affiliation(s)
- Max Oscherwitz
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, 27157-1071, USA.
| | - Brandon M Godinich
- Texas Tech Health Science Center El Paso Paul L. Foster School of Medicine, El Paso, TX, USA
| | - Nupur Singh
- University of Tennessee Health Science Center, Memphis, TN, USA
| | - Bethany R Rohr
- Department of Dermatology, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH, USA
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2
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Mederos-Luis E, Poza-Guedes P, Pineda F, Sánchez-Machín I, González-Pérez R. Gastropod Allergy: A Comprehensive Narrative Review. Curr Issues Mol Biol 2024; 46:5950-5964. [PMID: 38921026 PMCID: PMC11202862 DOI: 10.3390/cimb46060355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 06/10/2024] [Accepted: 06/10/2024] [Indexed: 06/27/2024] Open
Abstract
Food allergies have increased significantly in recent decades, with shellfish being a leading cause of food allergy and anaphylaxis worldwide, affecting both children and adults. The prevalence of shellfish allergies is estimated to be approximately 0.5-2.5% of the general population, varying significantly by geographical location, age, and consumption habits. Although mollusk consumption has risen, the prevalence of mollusk allergies remains unknown. While extensive research has focused on crustacean allergies, mollusk allergies, particularly those related to gastropods, have received comparatively less attention. Clinical manifestations of shellfish allergy range from localized symptoms to life-threatening systemic reactions, such as anaphylaxis. Notably, severe bronchospasm is a predominant clinical feature in cases involving gastropods. Several allergens have been identified in mollusks, including paramyosin, tropomyosin, and sarcoplasmic calcium-binding protein. In gastropods, documented allergens include tropomyosin, paramyosin, the heavy chain of myosin, and Der p 4 amylase. Diagnosis typically involves a thorough clinical history, skin testing, in vitro quantification of immunoglobulin (Ig) E, and confirmation through an oral challenge, although the latter is reserved for selected cases. This narrative review highlights the limited research on gastropod allergy. It provides a comprehensive list of purified and recombinant allergens and discusses the applications of component-resolved diagnosis as well as current therapeutic developments.
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Affiliation(s)
- Elena Mederos-Luis
- Allergy Department, Hospital Universitario de Canarias, 38320 Tenerife, Spain; (E.M.-L.); (P.P.-G.); (I.S.-M.)
- Food Allergy Unit, Hospital Universitario de Canarias, 38320 Tenerife, Spain
| | - Paloma Poza-Guedes
- Allergy Department, Hospital Universitario de Canarias, 38320 Tenerife, Spain; (E.M.-L.); (P.P.-G.); (I.S.-M.)
- Food Allergy Unit, Hospital Universitario de Canarias, 38320 Tenerife, Spain
- Severe Asthma Unit, Hospital Universitario de Canarias, 38320 Tenerife, Spain
- Instituto de Investigación Sanitaria de Canarias (IISC), 38200 Tenerife, Spain
| | | | - Inmaculada Sánchez-Machín
- Allergy Department, Hospital Universitario de Canarias, 38320 Tenerife, Spain; (E.M.-L.); (P.P.-G.); (I.S.-M.)
- Instituto de Investigación Sanitaria de Canarias (IISC), 38200 Tenerife, Spain
- Allergen Immunotherapy Unit, Hospital Universitario de Canarias, 38320 Tenerife, Spain
| | - Ruperto González-Pérez
- Allergy Department, Hospital Universitario de Canarias, 38320 Tenerife, Spain; (E.M.-L.); (P.P.-G.); (I.S.-M.)
- Severe Asthma Unit, Hospital Universitario de Canarias, 38320 Tenerife, Spain
- Instituto de Investigación Sanitaria de Canarias (IISC), 38200 Tenerife, Spain
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3
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Nordlee JA, Baumert JL, Taylor SL. Preparation of Blinded Food Matrixes for Clinical Oral Challenges. Methods Mol Biol 2024; 2717:143-157. [PMID: 37737982 DOI: 10.1007/978-1-0716-3453-0_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
Clinically, oral food challenges have value in the diagnosis and management of food allergy. Oral food challenges are used not only for diagnostic confirmation that ingestion of a specific food elicits an adverse reaction, but also for determining individual threshold doses, tracking the progress toward desensitization during immunotherapy, determining the effect of processing on the allergenicity of a specific food, assessing the allergenicity of an ingredient derived from an allergenic source, and tracking the progress toward development of age-related tolerance to a specific food. To eliminate bias in oral challenges, the food under investigation is masked in a matrix so that it is not sensorially detectable by the patient or the clinical observer. The preparation of oral challenge foods requires care in the selection of the allergenic components, the selection of the components of the matrix, the masking of the allergenic component, and the homogeneity of the allergen in the overall matrix.
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Affiliation(s)
- Julie A Nordlee
- Food Allergy Research & Resource Program, Department of Food Science & Technology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Joe L Baumert
- Food Allergy Research & Resource Program, Department of Food Science & Technology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Steve L Taylor
- Food Allergy Research & Resource Program, Department of Food Science & Technology, University of Nebraska-Lincoln, Lincoln, NE, USA.
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4
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Bianco M, Ventura G, Calvano CD, Losito I, Cataldi TRI. Food allergen detection by mass spectrometry: From common to novel protein ingredients. Proteomics 2023; 23:e2200427. [PMID: 37691088 DOI: 10.1002/pmic.202200427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/04/2023] [Accepted: 08/10/2023] [Indexed: 09/12/2023]
Abstract
Food allergens are molecules, mainly proteins, that trigger immune responses in susceptible individuals upon consumption even when they would otherwise be harmless. Symptoms of a food allergy can range from mild to acute; this last effect is a severe and potentially life-threatening reaction. The European Union (EU) has identified 14 common food allergens, but new allergens are likely to emerge with constantly changing food habits. Mass spectrometry (MS) is a promising alternative to traditional antibody-based assays for quantifying multiple allergenic proteins in complex matrices with high sensitivity and selectivity. Here, the main allergenic proteins and the advantages and drawbacks of some MS acquisition protocols, such as multiple reaction monitoring (MRM) and data-dependent analysis (DDA) for identifying and quantifying common allergenic proteins in processed foodstuffs are summarized. Sections dedicated to novel foods like microalgae and insects as new sources of allergenic proteins are included, emphasizing the significance of establishing stable marker peptides and validated methods using database searches. The discussion involves the in-silico digestion of allergenic proteins, providing insights into their potential impact on immunogenicity. Finally, case studies focussing on microalgae highlight the value of MS as an effective analytical tool for ensuring regulatory compliance throughout the food control chain.
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Affiliation(s)
- Mariachiara Bianco
- Dipartimento di Chimica, Università degli Studi di Bari Aldo Moro, Bari, Italy
| | - Giovanni Ventura
- Dipartimento di Chimica, Università degli Studi di Bari Aldo Moro, Bari, Italy
- Centro interdipartimentale SMART, Università degli Studi di Bari Aldo Moro, Bari, Italy
| | - Cosima D Calvano
- Dipartimento di Chimica, Università degli Studi di Bari Aldo Moro, Bari, Italy
- Centro interdipartimentale SMART, Università degli Studi di Bari Aldo Moro, Bari, Italy
| | - Ilario Losito
- Dipartimento di Chimica, Università degli Studi di Bari Aldo Moro, Bari, Italy
- Centro interdipartimentale SMART, Università degli Studi di Bari Aldo Moro, Bari, Italy
| | - Tommaso R I Cataldi
- Dipartimento di Chimica, Università degli Studi di Bari Aldo Moro, Bari, Italy
- Centro interdipartimentale SMART, Università degli Studi di Bari Aldo Moro, Bari, Italy
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5
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Chang F, Eng L, Chang C. Food Allergy Labeling Laws: International Guidelines for Residents and Travelers. Clin Rev Allergy Immunol 2023; 65:148-165. [PMID: 37160543 PMCID: PMC10169132 DOI: 10.1007/s12016-023-08960-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2023] [Indexed: 05/11/2023]
Abstract
The prevalence of food allergies varies by country, as does each country's food allergen labeling. While labeling laws may vary by country, most follow the Codex Alimentarius. Even developing countries have some degree of labeling guidelines for food allergies, but it is highly developed countries that tend to implement stricter labeling regulations to protect their citizens and tourists. Different organizations, both domestic and international, such as Food Allergy Research and Education (FARE), work to advance food allergen labeling laws around the globe. Eating out and traveling can be anxiety-provoking for people with food allergies, especially when traveling to international destinations. Furthermore, experiences that young children, teenagers, and parents have with food allergies can have psychosocial and social impacts. To evaluate food allergen labeling laws across the globe, official legal documents outlining the laws pertaining to foods and allergen food labeling were reviewed for each respective country or region. These were organized according to continent, then region or country. The majority of countries require that major food groups be listed on food labels, including milk, egg, soy, wheat, peanuts, treenuts, fish, and shellfish. There are individual variations across regions depending on staples in respective diets. With increasing rates of food allergies worldwide, legislative action is needed to ensure that people living with food allergies can more safely purchase and consume foods. Until then, the work of avoiding accidental ingestions and anaphylaxis remains primarily with the individual, who must educate themselves on labeling laws and implement other protective measures.
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Affiliation(s)
- Francesca Chang
- Northumbria University, Ellison Place, Newcastle Upon Tyne, NE1 8ST UK
| | - Lauren Eng
- Amherst College, Keefe Campus Center, AC# 1285, 16 Barrett Hill Drive, Amherst, MA 01002-5000 USA
| | - Christopher Chang
- Division of Immunology, Allergy and Pediatric Rheumatology, Joe DiMaggio Children’s Hospital, Memorial Healthcare System, 1131 N 35Th Avenue, Suite 220, Hollywood, FL 33021 USA
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6
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Sugimoto K, Shinagawa T, Kuroki K, Toma S, Hosomi R, Yoshida M, Fukunaga K. Dietary Bamboo Charcoal Decreased Visceral Adipose Tissue Weight by Enhancing Fecal Lipid Excretions in Mice with High-Fat Diet-Induced Obesity. Prev Nutr Food Sci 2023; 28:246-254. [PMID: 37842254 PMCID: PMC10567601 DOI: 10.3746/pnf.2023.28.3.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/31/2023] [Accepted: 07/24/2023] [Indexed: 10/17/2023] Open
Abstract
Bamboo charcoal (BC) powder is prepared from thick bamboo stems via dry distillation and is often used for food coloring. Due to the unique structure of the micropores in bamboo stems, BC powder also serves as an indigestible carrier to prevent the absorption of toxic substances and nutrients from the digestive tract. This study evaluated the health-promoting function of BC, particularly its effects in decreasing visceral adipose tissue in a mouse model with high-fat diet (HFD)-induced obesity. Four-week-old male C57BL/6J mice were divided into three groups and fed either a low-fat (LF) diet (7% fat), HF diet (25% fat), or HF diet with 0.5% BC (HF-BC). After 80 days, the HF-BC diet was found to have decreased epididymal and mesenteric white adipose tissue weights compared to HFD. The inhibition of visceral fat accumulation by BC intake was partly due to enhanced fecal fatty acid excretion induced by its bile acid-binding and pancreatic lipase inhibition. Contrarily, the gut microbiota, known to influence systemic energy metabolism, did not change significantly between the HF and HF-BC groups. These results indicate that dietary BC inhibits visceral fat accumulation, which could reduce obesity development.
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Affiliation(s)
- Koki Sugimoto
- Faculty of Chemistry, Materials, and Bioengineering, Kansai University, Osaka 564-8680, Japan
- Faculty of Food and Nutritional Sciences, Toyo University, Gunma 374-0193, Japan
| | - Taiki Shinagawa
- Faculty of Chemistry, Materials, and Bioengineering, Kansai University, Osaka 564-8680, Japan
| | - Katsuo Kuroki
- Unused Resources R&D, Kandagiko Co., Ltd., Tottori 683-0852, Japan
| | - Saki Toma
- Unused Resources R&D, Kandagiko Co., Ltd., Tottori 683-0852, Japan
| | - Ryota Hosomi
- Faculty of Chemistry, Materials, and Bioengineering, Kansai University, Osaka 564-8680, Japan
| | - Munehiro Yoshida
- Faculty of Chemistry, Materials, and Bioengineering, Kansai University, Osaka 564-8680, Japan
| | - Kenji Fukunaga
- Faculty of Chemistry, Materials, and Bioengineering, Kansai University, Osaka 564-8680, Japan
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7
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Liang Y, Zhao Y, Sun H, Dan J, Kang Y, Zhang Q, Su Z, Ni Y, Shi S, Wang J, Zhang W. Natural melanin nanoparticle-based photothermal film for edible antibacterial food packaging. Food Chem 2023; 401:134117. [DOI: 10.1016/j.foodchem.2022.134117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 08/17/2022] [Accepted: 09/01/2022] [Indexed: 10/14/2022]
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8
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Devenir des allergies alimentaires à l’âge adulte. REVUE FRANÇAISE D'ALLERGOLOGIE 2022. [DOI: 10.1016/s1877-0320(22)00485-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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9
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Blaschke VM, Tran TU, Naneh M, Zagon J, Winkel M. An improved duplex real-time PCR method for the systematic detection of commercially relevant crustaceans in food. Food Control 2022. [DOI: 10.1016/j.foodcont.2022.109517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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10
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Kamath SD, Liu T, Giacomin P, Loukas A, Navarro S, Lopata AL. Mollusk allergy: Not simply cross-reactivity with crustacean allergens. Allergy 2022; 77:3127-3130. [PMID: 35575977 PMCID: PMC9796110 DOI: 10.1111/all.15377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 04/28/2022] [Accepted: 05/11/2022] [Indexed: 01/28/2023]
Affiliation(s)
- Sandip D. Kamath
- Australian Institute of Tropical Health and MedicineJames Cook UniversityTownsvilleQLDAustralia
- Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary SciencesJames Cook UniversityTownsvilleQLDAustralia
- Centre for Molecular TherapeuticsJames Cook UniversityCairnsQLDAustralia
| | - Tiange Liu
- National University of Singapore (Suzhou) Research InstituteSuzhouChina
| | - Paul Giacomin
- Australian Institute of Tropical Health and MedicineJames Cook UniversityTownsvilleQLDAustralia
- Centre for Molecular TherapeuticsJames Cook UniversityCairnsQLDAustralia
| | - Alex Loukas
- Australian Institute of Tropical Health and MedicineJames Cook UniversityTownsvilleQLDAustralia
- Centre for Molecular TherapeuticsJames Cook UniversityCairnsQLDAustralia
| | - Severine Navarro
- QIMR Berghofer Medical Research InstituteBrisbaneQLDAustralia
- Woolworths Centre for Childhood Nutrition Research, Faculty of HealthQueensland University of TechnologyBrisbaneQLDAustralia
| | - Andreas L. Lopata
- Australian Institute of Tropical Health and MedicineJames Cook UniversityTownsvilleQLDAustralia
- Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary SciencesJames Cook UniversityTownsvilleQLDAustralia
- Tropical Futures InstituteJames Cook UniversitySingaporeSingapore
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11
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Nahrungsmittelunverträglichkeiten - eine diagnostische Herausforderung. ALLERGO JOURNAL 2022. [DOI: 10.1007/s15007-021-4932-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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12
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Effect of pressure cooking alone and in combination with other treatments on shrimp allergic protein, tropomyosin. JOURNAL OF FOOD SCIENCE AND TECHNOLOGY 2022; 59:1193-1201. [PMID: 35153330 PMCID: PMC8814115 DOI: 10.1007/s13197-021-05124-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 04/23/2021] [Accepted: 04/27/2021] [Indexed: 10/21/2022]
Abstract
Shrimp allergen, tropomyosin is a highly heat stable allergen a common causative of shrimp allergy in sensitive individuals. Effect of house hold pressure cooking on immunogenicity of shrimp allergen, topomyosin from Metapenaeus dobsoni was investigated in both shrimp extract and peeled shrimp by extending the time of pressure cooking to 5, 10 and 20 min. Soaked shrimps in salt, baking soda, papain and acetic acid along with pressure cooking was also investigated. In the case of extracts, IgE activity was significantly (p < 0.05) decreased and the tropomyosin band was absent in the immunoblott using pooled sera of shrimp sensitive individuals. While in the case of whole peeled shrimp, IgE activity was significantly (p < 0.05) increased and the tropomyosin band was retained in the immunoblott analysis which indicates the retention of allerginicity in the peeled shrimp. Although pressure cooked shrimp after soaking in acetic acid didn't show significant (p > 0.05) difference to that of without soaking, the tropomyosin band was observed to be very faint or absent in SDS PAGE and immunoblott analysis which indicated the effective reduction in allegenicity of whole peeled shrimp.
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13
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Jiang X, Zhao Y, Tang C, Appelbaum M, Rao Q. Aquatic food animals in the United States: Status quo and challenges. Compr Rev Food Sci Food Saf 2022; 21:1336-1382. [PMID: 35150203 DOI: 10.1111/1541-4337.12923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 01/03/2022] [Accepted: 01/06/2022] [Indexed: 12/29/2022]
Abstract
This review summarizes (1) the U.S. status quo for aquatic food animal production and marketing; (2) major food safety and quality issues/concerns for aquatic food animals in the United States, including fish misbranding, finfish/shellfish allergies, pathogens, toxins and harmful residues, microplastics, and genetically engineered salmon; and (3) various U.S. regulations, guidances, and detection methods for the surveillance of fishery products. Overall, fish misbranding is the biggest challenge in the United States due to the relatively low inspection rate. In addition, due to the regulatory differences among countries, illegal animal drugs and/or pesticide residues might also be identified in imported aquatic food animals. Future regulatory and research directions could focus on further strengthening international cooperation, enhancing aquatic food animal inspection, and developing reliable, sensitive, and highly efficient detection methods.
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Affiliation(s)
- Xingyi Jiang
- Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, Florida, USA
| | - Yaqi Zhao
- Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, Florida, USA
| | - Chunya Tang
- Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, Florida, USA
| | - Megan Appelbaum
- Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, Florida, USA
| | - Qinchun Rao
- Department of Nutrition and Integrative Physiology, Florida State University, Tallahassee, Florida, USA
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14
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Nugraha R, Ruethers T, Taki AC, Johnston EB, Karnaneedi S, Kamath SD, Lopata AL. Recombinant Tropomyosin from the Pacific Oyster (Crassostrea gigas) for Better Diagnosis. Foods 2022; 11:foods11030404. [PMID: 35159555 PMCID: PMC8834279 DOI: 10.3390/foods11030404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 02/01/2023] Open
Abstract
The Pacific oyster is a commercially important mollusc and, in contrast to most other shellfish species, frequently consumed without prior heat treatment. Oysters are rich in many nutrients but can also cause food allergy. Knowledge of their allergens and cross-reactivity remains very limited. These limitations make an optimal diagnosis of oyster allergy difficult, in particular to the Pacific oyster (Crassostrea gigas), the most cultivated and consumed oyster species worldwide. This study aimed to characterise IgE sensitisation profiles of 21 oyster-sensitised patients to raw and heated Pacific oyster extract using immunoblotting and advanced mass spectrometry, and to assess the relevance of recombinant oyster allergen for improved diagnosis. Tropomyosin was identified as the major allergen recognised by IgE from 18 of 21 oyster-sensitised patients and has been registered with the WHO/IUIS as the first oyster allergen (Cra g 1). The IgE-binding capacity of oyster-sensitised patients’ IgE to purified natural and recombinant tropomyosin from oyster, prawn, and dust mite was compared using enzyme-linked immunosorbent assay. The degree of IgE binding varied between patients, indicating partial cross-sensitisation and/or co-sensitisation. Amino acid sequence alignment of tropomyosin from these three species revealed five regions that contain predicted IgE-binding epitopes, which are most likely responsible for this cross-reactivity. This study fully biochemically characterises the first and major oyster allergen Cra g 1 and demonstrates that the corresponding recombinant tropomyosin should be implemented in improved component-resolved diagnostics and guide future immunotherapy.
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Affiliation(s)
- Roni Nugraha
- Department of Aquatic Product Technology, Faculty of Fisheries and Marine Science, IPB University, Bogor 16680, Indonesia;
- Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, James Cook University, Douglas 4811, Australia; (T.R.); (A.C.T.); (E.B.J.); (S.K.); (S.D.K.)
- Australian Institute of Tropical Health and Medicine, James Cook University, Douglas 4811, Australia
- Centre for Sustainable Tropical Fisheries and Aquaculture, Faculty of Science and Engineering, James Cook University, Douglas 4811, Australia
| | - Thimo Ruethers
- Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, James Cook University, Douglas 4811, Australia; (T.R.); (A.C.T.); (E.B.J.); (S.K.); (S.D.K.)
- Australian Institute of Tropical Health and Medicine, James Cook University, Douglas 4811, Australia
- Centre for Sustainable Tropical Fisheries and Aquaculture, Faculty of Science and Engineering, James Cook University, Douglas 4811, Australia
- Centre for Food and Allergy Research, Murdoch Children’s Research Institute, Parkville 3052, Australia
- Tropical Futures Institute, James Cook University Singapore, Singapore 387380, Singapore
| | - Aya C. Taki
- Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, James Cook University, Douglas 4811, Australia; (T.R.); (A.C.T.); (E.B.J.); (S.K.); (S.D.K.)
- Department of Veterinary Biosciences, Melbourne Veterinary School, The University of Melbourne, Melbourne 3010, Australia
| | - Elecia B. Johnston
- Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, James Cook University, Douglas 4811, Australia; (T.R.); (A.C.T.); (E.B.J.); (S.K.); (S.D.K.)
- Australian Institute of Tropical Health and Medicine, James Cook University, Douglas 4811, Australia
- Centre for Sustainable Tropical Fisheries and Aquaculture, Faculty of Science and Engineering, James Cook University, Douglas 4811, Australia
| | - Shaymaviswanathan Karnaneedi
- Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, James Cook University, Douglas 4811, Australia; (T.R.); (A.C.T.); (E.B.J.); (S.K.); (S.D.K.)
- Australian Institute of Tropical Health and Medicine, James Cook University, Douglas 4811, Australia
- Centre for Sustainable Tropical Fisheries and Aquaculture, Faculty of Science and Engineering, James Cook University, Douglas 4811, Australia
- Centre for Food and Allergy Research, Murdoch Children’s Research Institute, Parkville 3052, Australia
| | - Sandip D. Kamath
- Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, James Cook University, Douglas 4811, Australia; (T.R.); (A.C.T.); (E.B.J.); (S.K.); (S.D.K.)
- Australian Institute of Tropical Health and Medicine, James Cook University, Douglas 4811, Australia
- Centre for Sustainable Tropical Fisheries and Aquaculture, Faculty of Science and Engineering, James Cook University, Douglas 4811, Australia
- Centre for Food and Allergy Research, Murdoch Children’s Research Institute, Parkville 3052, Australia
| | - Andreas L. Lopata
- Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, James Cook University, Douglas 4811, Australia; (T.R.); (A.C.T.); (E.B.J.); (S.K.); (S.D.K.)
- Australian Institute of Tropical Health and Medicine, James Cook University, Douglas 4811, Australia
- Centre for Sustainable Tropical Fisheries and Aquaculture, Faculty of Science and Engineering, James Cook University, Douglas 4811, Australia
- Centre for Food and Allergy Research, Murdoch Children’s Research Institute, Parkville 3052, Australia
- Tropical Futures Institute, James Cook University Singapore, Singapore 387380, Singapore
- Correspondence: ; Tel.: +61-747814563
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15
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Yu C, Ding X, Gao X, Lin H, Ullah Khan M, Lin H, Dang X, Li Z. Immunological Cross-Reactivity Involving Mollusc Species and Mite-Mollusc and Cross-Reactive Allergen PM Are Risk Factors of Mollusc Allergy. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2022; 70:360-372. [PMID: 34978452 DOI: 10.1021/acs.jafc.1c05421] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Marine molluscs are seafood consumed worldwide and could cause food allergies, while investigation on their sensitizing components and cross-reactivity seems to be rare. Furthermore, allergy to mites may result in anaphylaxis in mollusc-allergic individuals owing to their cross-reactivity. The aim of the study was to identify cross-reactive allergens and investigate the cross-reactivity between different mollusc groups and mite-mollusc. The extracted mollusc and dust mite proteins were separated by SDS-PAGE, and IgE-binding components were recognized by immunoblotting with sera from patients sensitized to mollusc and mite. Cross-reactivity of different mollusc groups and mite-mollusc was assessed using ELISA and inhibition ELISA. The results of the immune detection, ELISA, and inhibition ELISA indicated that different mollusc groups and mite-mollusc showed varying degrees of cross-reactivity. The most frequently recognized cross-reactive protein was paramyosin from different mollusc groups and dust mite, while cross-reactive allergen paramyosin in the mite extract was identified and evaluated by MS and Allermatch, respectively. Inhibition ELISA studies also revealed that paramyosin played an important role in molluscan and mite-molluscan cross-reactivity. These findings contribute to a better understanding of the cross-reactivity involving mollusc species and mite-mollusc, which can be used to assist in the diagnosis and treatment of mite- and mollusc-allergic disorders.
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Affiliation(s)
- Chuang Yu
- College of Food Science and Engineering, Ocean University of China, No. 5, Yushan Road, Qingdao, Shandong Province 266003, P. R. China
| | - Xue Ding
- College of Food Science and Engineering, Ocean University of China, No. 5, Yushan Road, Qingdao, Shandong Province 266003, P. R. China
| | - Xiang Gao
- Department of Allergy, The Affiliated Hospital of Qingdao University, No. 16, Jiangsu Road, Qingdao, Shandong Province 266003, P. R. China
| | - Hong Lin
- College of Food Science and Engineering, Ocean University of China, No. 5, Yushan Road, Qingdao, Shandong Province 266003, P. R. China
| | - Mati Ullah Khan
- College of Food Science and Engineering, Ocean University of China, No. 5, Yushan Road, Qingdao, Shandong Province 266003, P. R. China
| | - Hang Lin
- Department of Allergy, The Affiliated Hospital of Qingdao University, No. 16, Jiangsu Road, Qingdao, Shandong Province 266003, P. R. China
| | - Xuewen Dang
- College of Food Science and Engineering, Ocean University of China, No. 5, Yushan Road, Qingdao, Shandong Province 266003, P. R. China
| | - Zhenxing Li
- College of Food Science and Engineering, Ocean University of China, No. 5, Yushan Road, Qingdao, Shandong Province 266003, P. R. China
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Zhao L, Zhang Y, Zhang S, Zhang L, Lan F. The effect of immunotherapy on cross-reactivity between house dust mite and other allergens in house dust mite -sensitized patients with allergic rhinitis. Expert Rev Clin Immunol 2021; 17:969-975. [PMID: 34388949 DOI: 10.1080/1744666x.2021.1968834] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION House dust mite (HDM) is a main perennial allergen causing allergic rhinitis (AR). It has been shown that HDM cross-reacts with a variety of other allergens. Presently, allergen-specific immunotherapy (AIT) is an effective way for management of mono-sensitized HDM+ AR patients. However, management approaches to polysensitized HDM-sensitized AR patients are not standardized yet. AREA COVERED This article reviews the data available in the literature for cross-reactivity between HDM and inhalant or food allergens, the diagnosis of cross-reactivity in HDM-sensitized AR patients, and the effect of immunotherapy on cross-reactivity in HDM-sensitized AR patients; which may help to develop effective therapeutic strategies for management of polysensitized HDM-sensitized AR patients in the future. EXPERT OPINION Pan-allergen proteins such as tropomyosin, arginine kinase (AK), glutathione S-transferase (GST), and hemocyanin are responsible for cross-reactivity between HDM and other allergens. To distinguish genuine or cross-reactive sensitization, molecular- or component-resolved diagnosis is suggested to apply in HDM-sensitized AR patients. The effect of HDM immunotherapy to treat the associated cross-reactivity in HDM-sensitized AR patients is still contradictory, and might be dependent on the degree of homology between two allergens. Furthermore, targeting tropomyosin might be a promising way to treat HDM patients with allergen cross-reactivity. ABBREVIATIONS AIT: allergen-specific immunotherapy; AK: arginine kinase; AR: allergic rhinitis; CRD: component-resolved diagnostics; Der f: Dermatophagoides farina; Der p: Dermatophagoides pteronyssinus; EAACI: European Academy of Allergy and Clinical Immunology; GST: glutathione S-transferase; GWAS: genome-wide association study; HDM: house dust mite; IgE: immunoglobulin E; RAST: radioallergosorbent test; sIgE: specific IgE; SIT: specific immunotherapy; SCIT: subcutaneous immunotherapy; SLIT: sublingual immunotherapy; SPT: skin prick test.
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Affiliation(s)
- Limin Zhao
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Nasal Disease, Beijing Institute of Otolaryngology, Beijing, China
| | - Yuling Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Nasal Disease, Beijing Institute of Otolaryngology, Beijing, China
| | - Shujian Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Nasal Disease, Beijing Institute of Otolaryngology, Beijing, China
| | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Nasal Disease, Beijing Institute of Otolaryngology, Beijing, China
| | - Feng Lan
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Nasal Disease, Beijing Institute of Otolaryngology, Beijing, China
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17
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Han TJ, Huan F, Liu M, Li MS, Yang Y, Chen GX, Lai D, Cao MJ, Liu GM. IgE epitope analysis of sarcoplasmic-calcium-binding protein, a heat-resistant allergen in Crassostrea angulata. Food Funct 2021; 12:8570-8582. [PMID: 34338271 DOI: 10.1039/d1fo01058a] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Sarcoplasmic-calcium-binding protein (SCP) has been investigated as a novel allergen in Crassostrea angulata. Nevertheless, knowledge of its effector-cell-based allergic relevance and epitopes is limited. In this study, the heat-resistant allergen SCP was able to induce significant upregulation of CD63 and CD203c (p < 0.05), which showed obvious allergenicity in a basophil activation test. Furthermore, immunoinformatic tools, a one-bead-one-compound peptide library, and phage display technology were combined to analyze the allergenic epitopes of SCP. Five linear epitopes named L-SCP-1 (AA22-33), L-SCP-2 (AA64-75), L-SCP-3 (AA80-90), L-SCP-4 (AA107-116), and L-SCP-5 (AA144-159) were verified using serological tests. Additionally, two conformational epitopes (C-SCP-1 and C-SCP-2) were determined, and C-SCP-1 was located at one of the calcium-binding sites (AA106-117). Moreover, SCP showed weaker typical α-helical features and higher hydrophobicity after Ca2+ depletion, which reduced its IgE-binding capacity. Overall, these epitope data could enhance our understanding of oyster allergens, which could be used to develop hypoallergenic shellfish products.
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Affiliation(s)
- Tian-Jiao Han
- College of Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Jimei University, Xiamen, Fujian 361021, China.
| | - Fei Huan
- College of Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Jimei University, Xiamen, Fujian 361021, China.
| | - Meng Liu
- College of Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Jimei University, Xiamen, Fujian 361021, China.
| | - Meng-Si Li
- College of Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Jimei University, Xiamen, Fujian 361021, China.
| | - Yang Yang
- College of Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Jimei University, Xiamen, Fujian 361021, China.
| | - Gui-Xia Chen
- Women and Children's Hospital Affiliated to Xiamen University, Xiamen, Fujian 361003, China
| | - Dong Lai
- The Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian 361021, China
| | - Min-Jie Cao
- College of Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Jimei University, Xiamen, Fujian 361021, China.
| | - Guang-Ming Liu
- College of Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Jimei University, Xiamen, Fujian 361021, China.
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18
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Tambuzzi S, Gentile G, Boracchi M, Di Candia D, Bianchi R, Zoja R. Postmortem diagnostics of assumed suicidal food anaphylaxis in prison: a unique case of anaphylactic death due to peach ingestion. Forensic Sci Med Pathol 2021; 17:449-455. [PMID: 33939114 PMCID: PMC8413180 DOI: 10.1007/s12024-021-00373-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2021] [Indexed: 02/02/2023]
Abstract
Suicidal ingestion of food which the victim is aware they are allergic to is an exceptional occurrence in the forensic field. To the best of our knowledge, no cases of suicidal food anaphylaxis have been reported to date. Therefore we present the first case described in the literature. A 30-year-old prisoner was found dead inside his cell with the remains of a peach remains next to his body, and a handwritten farewell note in his pocket. The autopsy revealed only non-specific findings, while laboratory investigations (serological, toxicological, histological, and immunohistochemical) played a pivotal role in determing the cause and manner of death. In particular, a high titer of both total and specific IgE antibodies was detected, as well as an increase of the tryptase level in cadaveric blood. Moreover, a massive concentration of salicylates was measured in the gastric contents. Microscopically, cellular residues characterized by a vegetal structure were observed in the gastric contents and elements suggestive of mast cells were detected in the glottis, lungs, and myocardium. The immunohistochemical investigation with anti-CD117 and anti-tryptase antibodies showed positivity for mast cells, some of which appeared degranulated. Such findings were entirely consistent with an acute systemic anaphylactic reaction triggered by allergy. Therefore, the prisoner’s death was attributed to self-induced food anaphylaxis caused by the ingestion of peaches. This conclusion was achieved based only on circumstantial data, anamnestic information, autopsy findings, and multiple laboratory results. This integrated approach should be used to pursue a post-mortem diagnosis of anaphylaxis.
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Affiliation(s)
- Stefano Tambuzzi
- Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Via Luigi Mangiagalli, 37 - 20133, Milano, Italy
| | - Guendalina Gentile
- Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Via Luigi Mangiagalli, 37 - 20133, Milano, Italy
| | - Michele Boracchi
- Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Via Luigi Mangiagalli, 37 - 20133, Milano, Italy
| | - Domenico Di Candia
- Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Via Luigi Mangiagalli, 37 - 20133, Milano, Italy
| | - Rachele Bianchi
- Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Via Luigi Mangiagalli, 37 - 20133, Milano, Italy
| | - Riccardo Zoja
- Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Via Luigi Mangiagalli, 37 - 20133, Milano, Italy.
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19
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Development of a Sandwich Enzyme-Linked Immunosorbent Assay for Detection and Quantification of Clam Residues in Food Products. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6685575. [PMID: 33791376 PMCID: PMC7997747 DOI: 10.1155/2021/6685575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 02/19/2021] [Accepted: 03/04/2021] [Indexed: 11/17/2022]
Abstract
Seafood is a frequent cause of allergic reactions to food globally. The presence of undeclared trace amounts of clam can cause allergic reactions in sensitive individuals. Limited tools are available to test food products for the presence of traces of clam. We report on the development of a sandwich ELISA that can detect and quantify clam protein in food. Antisera against a mix of two commercially important clam species, Atlantic Surf (Spisula solidissima) and ocean quahog (Arctica islandica), were raised in rabbit and sheep. A sandwich ELISA was constructed with this antisera, and sensitivity and specificity were evaluated. Also, model food products spiked with clam protein were analyzed to assess the performance of the ELISA. Comparison was made with a commercially available ELISA for crustacea. The lower limit of quantification of the sandwich ELISA is 2.5 ppm clam protein in food samples, allowing the detection of low amounts of clam that may trigger a reaction in clam allergic patients. The sandwich ELISA was highly specific with cross-reactivity only noted for other molluscan shellfish (mussel and scallop). Clam protein in tomato juice and potato cream soup was detected well with recoveries ranging from 65 to 74% and from 74 to 113%, respectively. However when potato cream soup was retorted, the recover fell to 20%, imposing the risk of underestimating the clam content of a food product. A commercially available crustacean ELISA test was not suitable to detect clam protein. The sandwich ELISA described here is suitable for detection and quantification of clam protein in food products. Care should be taken with food products that have been retorted as the results may be underestimated.
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Occupational allergic contact urticaria to tropomyosin from squid. Allergol Select 2020; 4:129-134. [PMID: 33326506 PMCID: PMC7734873 DOI: 10.5414/alx02121e] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 11/12/2019] [Indexed: 12/16/2022] Open
Abstract
A cook’s mate working in an Austrian restaurant reported acutely occurring urticarial skin lesions after processing and cooking squid. The prick-to-prick test with squid showed a ++ positive urticarial reaction. Elevated specific IgE antibody levels to squid, shrimp, and house dust mites as well as to tropomyosin from shrimp and house dust mite could be detected in the ImmunoCAP. By means of immunoblot and ELISA, a reaction to squid extract as well as increased IgE antibody levels to squid and tropomyosin from squid could be detected. The patient was diagnosed with a clinically and occupationally relevant type I allergy to squid with cross-reaction to tropomyosin of other invertebrates and therefore recognized as an occupational disease.
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21
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Garino C, Mielke H, Knüppel S, Selhorst T, Broll H, Braeuning A. Quantitative allergenicity risk assessment of food products containing yellow mealworm (Tenebrio molitor). Food Chem Toxicol 2020; 142:111460. [PMID: 32505700 DOI: 10.1016/j.fct.2020.111460] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 05/25/2020] [Accepted: 05/25/2020] [Indexed: 12/21/2022]
Abstract
Insect-based foods are starting to enter the EU market, raising concerns about their safety. Allergic consumers might be exposed to even a greater risk, since insects have proven to trigger allergic symptoms, particularly in patients sensitised to crustaceans. Current legislation does not enforce producers to include insects in the list of allergenic ingredients. Food allergenicity risk assessment (FARA) is still at its infancy, and the debate on the need to define allergen thresholds is open. In this paper, we aimed at applying the concepts of stochastic quantitative FARA to describe present and future scenarios of exposure to foods containing Tenebrio molitor, the yellow mealworm. According to our risk characterisation, mealworm-based food products represent a major risk for individuals allergic to crustaceans to develop symptoms after the consumption of a dose lower than a serving size. Moreover, other allergic consumers might be at risk. A correct labelling of insect containing foods would help safeguarding the health of EU allergic consumers. Quantitatively assessing the risk of allergenicity provides a clear description of the problem, facilitating the decisional process of the risk manager, supporting the implementation of effective allergen management procedures and limiting the phenomenon of uninformative precautionary labelling.
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Affiliation(s)
- Cristiano Garino
- German Federal Institute for Risk Assessment (BfR), P.O. Box 33 00 13, D-14191, Berlin, Germany.
| | - Hans Mielke
- German Federal Institute for Risk Assessment (BfR), P.O. Box 33 00 13, D-14191, Berlin, Germany
| | - Sven Knüppel
- German Federal Institute for Risk Assessment (BfR), P.O. Box 33 00 13, D-14191, Berlin, Germany
| | - Thomas Selhorst
- German Federal Institute for Risk Assessment (BfR), P.O. Box 33 00 13, D-14191, Berlin, Germany
| | - Hermann Broll
- German Federal Institute for Risk Assessment (BfR), P.O. Box 33 00 13, D-14191, Berlin, Germany
| | - Albert Braeuning
- German Federal Institute for Risk Assessment (BfR), P.O. Box 33 00 13, D-14191, Berlin, Germany
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22
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Yi MH, Kim JY, Jeong KY, Ree HI, Yong TS. Survey of IgE Reactivity to Nonbiting Midges in Korea and Identification of IgE-Binding Protein. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2019; 11:644-654. [PMID: 31332976 PMCID: PMC6658401 DOI: 10.4168/aair.2019.11.5.644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 04/06/2019] [Accepted: 05/01/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE Chironomids (nonbiting midges) are widely and abundantly distributed near ponds, rivers, and artificially dammed pools used for irrigation. Chironomids contain allergens and cause airway allergy in humans. In this study, we aimed to examine the allergic potential of chironomids in inhabitants living near artificially dammed pools. METHODS We examined immunoglobulin E (IgE) reactivity to chironomid extracts in the sera of residents living around installed dams and assessed the correlations of IgE responses between chironomids (Chironomus flaviplumus, Chironomus kiiensis, Cricotopus bicinctus) and house dust mites (Dermatophagoides farinae). In addition, we identified potential IgE binding proteins specific for adult C. bicinctus, a popular species in Korea. Specific IgE antibodies in sera collected from the participants against the extracts were tested using enzyme-linked immunosorbent assay (ELISA). RESULTS The average IgE-positive rates were 10.4%, 8.1%, and 8.2% in C. bicinctus, C. flaviplumus, and C. kiiensis, respectively. The IgE-positive rate and IgE titer of C. bicinctus antigen were higher in residents living around installed dams than in those who lived other places (P = 0.013). Western blotting using sera having high IgE titers to C. bicinctus in ELISA showed the presence of a protein of approximately 42 kDa that was homologous to the actin protein isoform in C. bicinctus extracts as demonstrated using mass spectrometry. CONCLUSIONS Our results showed that people living near installed dams were more sensitized to C. bicinctus and that the 42 kDa IgE-binding protein could be useful for further studies on chironomid allergic disease and clinical applications.
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Affiliation(s)
- Myung Hee Yi
- Department of Environmental Medical Biology, Arthropods of Medical Importance Resource Bank, Institute of Tropical Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Ju Yeong Kim
- Department of Environmental Medical Biology, Arthropods of Medical Importance Resource Bank, Institute of Tropical Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Kyoung Yong Jeong
- Department of Internal Medicine, Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Han Il Ree
- Department of Environmental Medical Biology, Arthropods of Medical Importance Resource Bank, Institute of Tropical Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Tai Soon Yong
- Department of Environmental Medical Biology, Arthropods of Medical Importance Resource Bank, Institute of Tropical Medicine, Yonsei University College of Medicine, Seoul, Korea.
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23
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Huang J, Liu C, Wang Y, Wang C, Xie M, Qian Y, Fu L. Application of in vitro and in vivo models in the study of food allergy. FOOD SCIENCE AND HUMAN WELLNESS 2018. [DOI: 10.1016/j.fshw.2018.10.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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24
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Local bivalve allergens — a Malaysian perspective. ALLERGO JOURNAL 2018. [DOI: 10.1007/s15007-018-1721-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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25
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Burkhardt S, Genet P, Sabatasso S, La Harpe R. Death by anaphylactic shock in an institution: an accident or negligence? Int J Legal Med 2018; 133:561-564. [PMID: 30187123 DOI: 10.1007/s00414-018-1929-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 08/29/2018] [Indexed: 01/01/2023]
Abstract
This is a description of a man, institutionalised for learning difficulties, known to have an allergy to seafood. After eating a pie, the patient quickly developed dyspnoea and vomiting. The staff at the institution administered epinephrine and called the emergency services. Despite cardiopulmonary resuscitation, the patient died shortly after being admitted to the emergency department of the University Hospitals of Geneva. In the light of the circumstances of the death and of a discrepancy between the information given to the police by the staff at the institution looking after the patient on the one hand, and the preliminary elements of the investigation on the other hand, it was suspected that there was failure in care of the patient and our institute was asked to carry out an autopsy. Basing on all the investigations carried out, the cause of death was anaphylactic reaction following the ingestion of seafood, contrary to what had been alleged by the staff at the home.
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Affiliation(s)
- Sandra Burkhardt
- University Center of Legal Medicine, Lausanne-Geneva, 1, rue Michel Servet, 1211, Geneva 4, Switzerland.
| | - Pia Genet
- University Center of Legal Medicine, Lausanne-Geneva, 1, rue Michel Servet, 1211, Geneva 4, Switzerland
| | - Sara Sabatasso
- University Center of Legal Medicine, Lausanne-Geneva, 1, rue Michel Servet, 1211, Geneva 4, Switzerland
| | - Romano La Harpe
- University Center of Legal Medicine, Lausanne-Geneva, 1, rue Michel Servet, 1211, Geneva 4, Switzerland
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26
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Faisal M, Vasiljevic T, Donkor ON. Effects of selected processing treatments on antigenicity of banana prawn (Fenneropenaeus merguiensis
) tropomyosin. Int J Food Sci Technol 2018. [DOI: 10.1111/ijfs.13922] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Md Faisal
- Advanced Food Systems Research Unit; Institute of Sustainable Industries & Liveable Cities and College of Health and Biomedicine; Victoria University; Werribee Campus, PO Box 14428 Melbourne Vic. 8001 Australia
| | - Todor Vasiljevic
- Advanced Food Systems Research Unit; Institute of Sustainable Industries & Liveable Cities and College of Health and Biomedicine; Victoria University; Werribee Campus, PO Box 14428 Melbourne Vic. 8001 Australia
| | - Osaana N. Donkor
- Advanced Food Systems Research Unit; Institute of Sustainable Industries & Liveable Cities and College of Health and Biomedicine; Victoria University; Werribee Campus, PO Box 14428 Melbourne Vic. 8001 Australia
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27
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Rolland JM, Varese NP, Abramovitch JB, Anania J, Nugraha R, Kamath S, Hazard A, Lopata AL, O'Hehir RE. Effect of Heat Processing on IgE Reactivity and Cross-Reactivity of Tropomyosin and Other Allergens of Asia-Pacific Mollusc Species: Identification of Novel Sydney Rock Oyster Tropomyosin Sac g 1. Mol Nutr Food Res 2018; 62:e1800148. [PMID: 29756679 PMCID: PMC6099307 DOI: 10.1002/mnfr.201800148] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 04/17/2018] [Indexed: 01/24/2023]
Abstract
SCOPE Shellfish allergy is an increasing global health priority, frequently affecting adults. Molluscs are an important shellfish group causing food allergy but knowledge of their allergens and cross-reactivity is limited. Optimal diagnosis of mollusc allergy enabling accurate advice on food avoidance is difficult. Allergens of four frequently ingested Asia-Pacific molluscs are characterized: Sydney rock oyster (Saccostrea glomerata), blue mussel (Mytilus edulis), saucer scallop (Amusium balloti), and southern calamari (Sepioteuthis australis), examining cross-reactivity between species and with blue swimmer crab tropomyosin, Por p 1. METHODS AND RESULTS IgE ELISA showed that cooking increased IgE reactivity of mollusc extracts and basophil activation confirmed biologically relevant IgE reactivity. Immunoblotting demonstrated strong IgE reactivity of several proteins including one corresponding to heat-stable tropomyosin in all species (37-40 kDa). IgE-reactive Sydney rock oyster proteins were identified by mass spectrometry, and the novel major oyster tropomyosin allergen was cloned, sequenced, and designated Sac g 1 by the IUIS. Oyster extracts showed highest IgE cross-reactivity with other molluscs, while mussel cross-reactivity was weakest. Inhibition immunoblotting demonstrated high cross-reactivity between tropomyosins of mollusc and crustacean species. CONCLUSION These findings inform novel approaches for reliable diagnosis and improved management of mollusc allergy.
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Affiliation(s)
- Jennifer M. Rolland
- Department of Immunology and PathologyMonash UniversityMelbourneVictoriaAustralia,Department of AllergyClinical Immunology and Respiratory MedicineCentral Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
| | - Nirupama P. Varese
- Department of Immunology and PathologyMonash UniversityMelbourneVictoriaAustralia,Department of AllergyClinical Immunology and Respiratory MedicineCentral Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
| | - Jodie B. Abramovitch
- Department of Immunology and PathologyMonash UniversityMelbourneVictoriaAustralia,Department of AllergyClinical Immunology and Respiratory MedicineCentral Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
| | - Jessica Anania
- Department of Immunology and PathologyMonash UniversityMelbourneVictoriaAustralia,Department of AllergyClinical Immunology and Respiratory MedicineCentral Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
| | - Roni Nugraha
- Centre for Biodiscovery and Molecular Development of TherapeuticsMolecular Allergy Research LaboratoryJames Cook UniversityTownsvilleAustralia,Department of Aquatic Product TechnologyBogor Agricultural UniversityBogorIndonesia
| | - Sandip Kamath
- Centre for Biodiscovery and Molecular Development of TherapeuticsMolecular Allergy Research LaboratoryJames Cook UniversityTownsvilleAustralia
| | - Anita Hazard
- Department of AllergyClinical Immunology and Respiratory MedicineCentral Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
| | - Andreas L. Lopata
- Centre for Biodiscovery and Molecular Development of TherapeuticsMolecular Allergy Research LaboratoryJames Cook UniversityTownsvilleAustralia
| | - Robyn E. O'Hehir
- Department of Immunology and PathologyMonash UniversityMelbourneVictoriaAustralia,Department of AllergyClinical Immunology and Respiratory MedicineCentral Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
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Abstract
Food allergies can newly arise in adulthood or persist following a food allergy occurring in childhood. The prevalence of primary food allergy is basically higher in children than in adults; however, in the routine practice food allergies in adulthood appear to be increasing and after all a prevalence in Germany of 3.7 % has been published. The clinical spectrum of manifestations of food allergies in adulthood is broad. Allergy symptoms of the immediate type can be observed as well as symptoms occurring after a delay, such as indigestion, triggering of hematogenous contact eczema or flares of atopic dermatitis. The same principles for diagnostics apply in this group as in childhood. In addition to the anamnesis, skin tests and in vitro tests, as a rule elimination diets and in particular provocation tests are employed. Molecular allergy diagnostics represent a major step forward, which allow a better assessment of the risk of systemic reactions to certain foodstuffs (e.g. peanuts) and detection of cross-reactions in cases of apparently multiple sensitivities. Current German and European guidelines from 2015 are available for the practical approach to clarification of food allergies. The most frequent food allergies in adults are nuts, fruit and vegetables, which can cross-react with pollen as well as wheat, shellfish and crustaceans. The therapy of allergies involves a consistent avoidance of the allogen. Detailed dietary plans are available with avoidance strategies and instructions for suitable food substitutes. A detailed counseling of affected patients by specially trained personnel is necessary especially in order to avoid nutritional deficiencies and to enable patients to enjoy a good quality of life.
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Affiliation(s)
- Thomas Werfel
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
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Zhang Y, Deng Y, Zhao Y. Structure-based modelling of hemocyanin allergenicity in squid and its response to high hydrostatic pressure. Sci Rep 2017; 7:40021. [PMID: 28112159 PMCID: PMC5256278 DOI: 10.1038/srep40021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Accepted: 12/01/2016] [Indexed: 11/09/2022] Open
Abstract
The secondary, tertiary, and quaternary structures of squid hemocyanin (Hc) were characterised, and the relationship between Hc structure and allergenicity responses to high hydrostatic pressure (HHP) was modelled. The Hc allergenicity varied with its protein structure. Electrophoresis analysis revealed that HHP treatment significantly decreased the band intensity of Hc when increasing pressure from 200 and 400 MPa to 600 MPa. The protein structure analysis of squid Hc showed that while HHP treatment decreased the α-helix content, free sulfhydryl content, and Rg, it increased the random coil content, surface hydrophobicity index (Ho), Guinier aggregation number (〈Nagg〉G) and average aggregation number (〈Nagg〉Q). The α-helix and random coil contents of the 600 MPa treated samples were 23.67% and 37.54%, respectively, compared to 32.37% and 32.02% in the control, respectively. HHP treatment decreased the IgE and IgG-binding capacities, indicating a significant decrease in the allergenicity (P< 0.05) of squid Hc. This study provided meaningful information of applying HHP to reduce allergenicity, and explained the responses of Hc protein structure to HHP for lowering the allergenicity of squid.
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Affiliation(s)
- Yifeng Zhang
- Key Laboratory of Urban Agriculture (South), Ministry of Agriculture, SJTU-Bor S. Luh Food Safety Center, Department of Food Science and Technology, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
| | - Yun Deng
- Key Laboratory of Urban Agriculture (South), Ministry of Agriculture, SJTU-Bor S. Luh Food Safety Center, Department of Food Science and Technology, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
| | - Yanyun Zhao
- Key Laboratory of Urban Agriculture (South), Ministry of Agriculture, SJTU-Bor S. Luh Food Safety Center, Department of Food Science and Technology, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China.,Department of Food Science &Technology, Oregon State University, 100 Wiegand Hall, Corvallis, OR 97331, USA
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Transforming insect biomass into consumer wellness foods: A review. Food Res Int 2016; 89:129-151. [DOI: 10.1016/j.foodres.2016.10.001] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 09/28/2016] [Accepted: 10/02/2016] [Indexed: 02/01/2023]
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Pedrosa M, Boyano-Martínez T, García-Ara C, Quirce S. Shellfish Allergy: a Comprehensive Review. Clin Rev Allergy Immunol 2016; 49:203-16. [PMID: 24870065 DOI: 10.1007/s12016-014-8429-8] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Shellfish allergy is of increasing concern, as its prevalence has risen in recent years. Many advances have been made in allergen characterization. B cell epitopes in the major allergen tropomyosin have been characterized. In addition to tropomyosin, arginine kinase, sarcoplasmic calcium-binding protein, and myosin light chain have recently been reported in shellfish. All are proteins that play a role in muscular contraction. Additional allergens such as hemocyanin have also been described. The effect of processing methods on these allergens has been studied, revealing thermal stability and resistance to peptic digestion in some cases. Modifications after Maillard reactions have also been addressed, although in some cases with conflicting results. In recent years, new hypoallergenic molecules have been developed, which constitute a new therapeutic approach to allergic disorders. A recombinant hypoallergenic tropomyosin has been developed, which opens a new avenue in the treatment of shellfish allergy. Cross-reactivity with species that are not closely related is common in shellfish-allergic patients, as many of shellfish allergens are widely distributed panallergens in invertebrates. Cross-reactivity with house dust mites is well known, but other species can also be involved in this phenomenon.
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Affiliation(s)
- María Pedrosa
- Allergy Department, Hospital La Paz Institute for Health Research (IdiPAZ), Paseo de la Castellana 261, 28046, Madrid, Spain.
| | - Teresa Boyano-Martínez
- Allergy Department, Hospital La Paz Institute for Health Research (IdiPAZ), Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Carmen García-Ara
- Allergy Department, Hospital La Paz Institute for Health Research (IdiPAZ), Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Santiago Quirce
- Allergy Department, Hospital La Paz Institute for Health Research (IdiPAZ), Paseo de la Castellana 261, 28046, Madrid, Spain
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Abstract
Shellfish are diverse, serve as main constituents of seafood, and are extensively consumed globally because of their nutritional values. Consequently, increase in reports of IgE-mediated seafood allergy is particularly food associated to shellfish. Seafood-associated shellfish consists of crustaceans (decapods, stomatopods, barnacles, and euphausiids) and molluskans (gastropods, bivalves, and cephalopods) and its products can start from mild local symptoms and lead to severe systemic anaphylactic reactions through ingestion, inhalation, or contact like most other food allergens. Globally, the most commonly causative shellfish are shrimps, crabs, lobsters, clams, oysters, and mussels. The prevalence of shellfish allergy is estimated to be 0.5-2.5% of the general population but higher in coastal Asian countries where shellfish constitute a large proportion of the diet. Diversity in allergens such as tropomyosin, arginine kinase, myosin light chain, and sarcoplasmic binding protein are from crustaceans whereas tropomyosin, paramyosin, troponin, actine, amylase, and hemoyanin are reported from molluskans shellfish. Tropomyosin is the major allergen and is responsible for cross-reactivity between shellfish and other invertebrates, within crustaceans, within molluskans, between crustaceans vs. molluskans as well as between shellfish and fish. Allergenicity diagnosis requires clinical history, in vivo skin prick testing, in vitro quantification of IgE, immunoCAP, and confirmation by oral challenge testing unless the reactions borne by it are life-threatening. This comprehensive review provides the update and new findings in the area of shellfish allergy including demographic, diversity of allergens, allergenicity, their cross-reactivity, and innovative molecular genetics approaches in diagnosing and managing this life-threatening as well as life-long disease.
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Affiliation(s)
- Samanta S Khora
- a Medical Biotechnology Lab, Department of Medical Biotechnology , School of Biosciences and Technology, VIT University , Vellore , India
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Ljubojević Hadžavdić S, Marinović Kulisić S, Jurakić Tončić R, Jerković Gulin S, Bradamante M. Occupational contact urticaria caused by squid. Contact Dermatitis 2016; 74:304-5. [DOI: 10.1111/cod.12526] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Revised: 11/23/2015] [Accepted: 11/24/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Suzana Ljubojević Hadžavdić
- Department of Dermatology and Venereology, School of Medicine University of Zagreb; University Hospital Centre Zagreb; Zagreb 10000 Croatia
| | - Sandra Marinović Kulisić
- Department of Dermatology and Venereology, School of Medicine University of Zagreb; University Hospital Centre Zagreb; Zagreb 10000 Croatia
| | - Ružica Jurakić Tončić
- Department of Dermatology and Venereology, School of Medicine University of Zagreb; University Hospital Centre Zagreb; Zagreb 10000 Croatia
| | - Sandra Jerković Gulin
- Department of Dermatology and Venereology; General Hospital Šibenik; 22000 Šibenik Croatia
| | - Mirna Bradamante
- Department of Dermatology and Venereology, School of Medicine University of Zagreb; University Hospital Centre Zagreb; Zagreb 10000 Croatia
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Chokshi NY, Sicherer SH. Interpreting IgE sensitization tests in food allergy. Expert Rev Clin Immunol 2015; 12:389-403. [DOI: 10.1586/1744666x.2016.1124761] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Lin H, Li Z, Lin H, Song Y, Lv L, Hao Z. Effect of pH shifts on IgE-binding capacity and conformational structure of tropomyosin from short-neck clam (Ruditapes philippinarum). Food Chem 2015; 188:248-55. [DOI: 10.1016/j.foodchem.2015.05.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Revised: 04/27/2015] [Accepted: 05/01/2015] [Indexed: 11/28/2022]
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Vidal C, Bartolomé B, Rodríguez V, Armisén M, Linneberg A, González-Quintela A. Sensitization pattern of crustacean-allergic individuals can indicate allergy to molluscs. Allergy 2015; 70:1493-6. [PMID: 26186699 DOI: 10.1111/all.12693] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2015] [Indexed: 11/29/2022]
Abstract
This study investigated the sensitization pattern of crustacean-allergic patients according to tolerance to molluscs. Thirty-one patients with anaphylaxis to crustaceans (14 with mollusc allergy and 17 with mollusc tolerance) were studied using skin prick tests (SPTs), specific IgEs (sIgEs) and SDS-PAGE immunoblotting. IgE-reactive shrimp proteins were identified by proteomic analyses. Patients with mollusc allergy presented more frequently SPTs positive to molluscs and higher sIgE titres in response to both molluscs and crustaceans. Shrimp-sIgE and rPen a1-sIgE values of 1.57 kUA /l and 4.38 kUA /l, respectively, showed positive likelihood ratios of 4.3 and 10.9 for the identification of mollusc allergy. Patients with mollusc allergy reacted more frequently to tropomyosin in immunoblots than did patients without it (93% vs 35%, respectively, P = 0.004). Reactivity to proteins other than tropomyosin (n = 14) was not different between the two groups. Among patients with crustacean anaphylaxis, patients with mollusc allergy and mollusc tolerance show a different pattern of sensitization, something that may help identify them.
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Affiliation(s)
- C. Vidal
- Department of Medicine; Complejo Hospitalario Universitario de Santiago; Santiago de Compostela Spain
| | | | - V. Rodríguez
- Department of Medicine; Complejo Hospitalario Universitario de Santiago; Santiago de Compostela Spain
| | - M. Armisén
- Department of Medicine; Complejo Hospitalario Universitario de Santiago; Santiago de Compostela Spain
| | - A. Linneberg
- Research Centre for Prevention and Health; Glostrup University Hospital; Copenhagen Denmark
| | - A. González-Quintela
- Department of Medicine; Complejo Hospitalario Universitario de Santiago; Santiago de Compostela Spain
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Yadzir ZHM, Misnan R, Bakhtiar F, Abdullah N, Murad S. Tropomyosin, the major tropical oyster Crassostrea belcheri allergen and effect of cooking on its allergenicity. Allergy Asthma Clin Immunol 2015; 11:30. [PMID: 26504467 PMCID: PMC4620636 DOI: 10.1186/s13223-015-0099-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 10/15/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many types of shellfish including oysters are sometime cooked before ingestion and it has been demonstrated that cooking may affect the allergenicity of food. Therefore, the aim of our present study is to identify major and minor allergens of tropical oyster (Crassostrea belcheri) and to investigate the effect of different cooking processing on the allergenicity of this oyster. METHODS Raw, boiled, fried and roasted extracts of oyster were prepared. Protein profiles were analysed using sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE). Major and minor allergens and allergenicity patterns of all extracts were then determined by immunoblotting with sera from patients with positive skin prick tests (SPT) to the raw oyster extract. Mass-spectrometry was used to identify the major allergenic proteins of this oyster. RESULTS SDS-PAGE of the raw extract showed 15 protein bands (20-180 kDa). In contrast, smaller numbers of protein bands were demonstrated in the boiled extract, those ranging between 40-42 and 55-150 kDa were denatured, whereas the protein profiles were altered to a similar degree by frying or roasting. The 37 kDa proteins had the highest frequency of IgE-binding (95 %), thus identified as the major allergen of this tropical oyster. Other minor IgE-binding proteins were observed at various molecular weights. Immunoblot of raw extract yielded 11 IgE-binding proteins. The cooked extracts showed only a single IgE-binding protein at 37 kDa. Mass spectrometry analysis of the 37 kDa major allergen identified this spot as tropomyosin. CONCLUSIONS Cooked extracts produce lower IgE-binding than raw extract, which suggest that thermal treatment can be used as a tool in attempting to reduce oyster allergenicity by reducing the number of IgE-reactive bands. The degree of allergenicity of this oyster was demonstrated in the order raw > boiled > fried ≈ roasted. A heat-resistent 37 kDa protein, corresponding to tropomyosin, was identified as the major allergen of this tropical oyster.
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Affiliation(s)
- Zailatul Hani Mohamad Yadzir
- Allergy and Immunology Research Centre, Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia ; Department of Biology, Faculty of Science and Mathematics, Universiti Pendidikan Sultan Idris, 35900 Tanjong Malim, Perak Malaysia
| | - Rosmilah Misnan
- Department of Biology, Faculty of Science and Mathematics, Universiti Pendidikan Sultan Idris, 35900 Tanjong Malim, Perak Malaysia
| | - Faizal Bakhtiar
- Allergy and Immunology Research Centre, Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - Noormalin Abdullah
- Allergy and Immunology Research Centre, Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - Shahnaz Murad
- Allergy and Immunology Research Centre, Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
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Werfel T, Asero R, Ballmer-Weber BK, Beyer K, Enrique E, Knulst AC, Mari A, Muraro A, Ollert M, Poulsen LK, Vieths S, Worm M, Hoffmann-Sommergruber K. Position paper of the EAACI: food allergy due to immunological cross-reactions with common inhalant allergens. Allergy 2015; 70:1079-90. [PMID: 26095197 DOI: 10.1111/all.12666] [Citation(s) in RCA: 129] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2015] [Indexed: 01/22/2023]
Abstract
In older children, adolescents, and adults, a substantial part of all IgE-mediated food allergies is caused by cross-reacting allergenic structures shared by inhalants and foods. IgE stimulated by a cross-reactive inhalant allergen can result in diverse patterns of allergic reactions to various foods. Local, mild, or severe systemic reactions may occur already after the first consumption of a food containing a cross-reactive allergen. In clinical practice, clinically relevant sensitizations are elucidated by skin prick testing or by the determination of specific IgE in vitro. Component-resolved diagnosis may help to reach a diagnosis and may predict the risk of a systemic reaction. Allergy needs to be confirmed in cases of unclear history by oral challenge tests. The therapeutic potential of allergen immunotherapy with inhalant allergens in pollen-related food allergy is not clear, and more placebo-controlled studies are needed. As we are facing an increasing incidence of pollen allergies, a shift in sensitization patterns and changes in nutritional habits, and the occurrence of new, so far unknown allergies due to cross-reactions are expected.
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Affiliation(s)
- T. Werfel
- Department of Dermatology and Allergy; Hannover Medical University; Hannover Germany
| | - R. Asero
- Ambulatorio di Allergologia; Clinica San Carlo; Paderno Dugnano; Milan Italy
| | - B. K. Ballmer-Weber
- Allergy Unit; Department of Dermatology; University Hospital Zürich; Zürich Switzerland
| | - K. Beyer
- Division of Paediatric Pneumology and Immunology; Charité University Hospital; Berlin Germany
| | - E. Enrique
- Allergy Division; Hospital General de Castellón; Castellón Spain
| | - A. C. Knulst
- Department of Dermatology/Allergology; University Medical Center Utrecht; Utrecht The Netherlands
| | - A. Mari
- Associated Center for Molecular Allergology (CAAM); Latina Italy
| | - A. Muraro
- The Referral Centre for Food Allergy Diagnosis and Treatment Veneto Region; Department of Mother and Child Health; University of Padua; Padua Italy
| | - M. Ollert
- Department of Infection and Immunity; Luxembourg Institute of Health; Esch-sur-Alzette; Luxembourg and Department of Dermatology and Allergy; Biederstein; Technische Universität München (TUM); Munich Germany
| | - L. K. Poulsen
- Allergy Clinic Copenhagen University Hospital at Gentofte; Copenhagen Denmark
| | - S. Vieths
- Division of Allergology; Paul-Ehrlich Institute; Langen Germany
| | - M. Worm
- Department of Dermatology and Allergy; of Charité - Universitätsmedizin Berlin; Berlin Germany
| | - K. Hoffmann-Sommergruber
- Department of Pathophysiology and Allergy Research; Medical University of Vienna; Vienna Austria
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Tropomyosin and Actin Identified as Major Allergens of the Carpet Clam (Paphia textile) and the Effect of Cooking on Their Allergenicity. BIOMED RESEARCH INTERNATIONAL 2015; 2015:254152. [PMID: 26413512 PMCID: PMC4564582 DOI: 10.1155/2015/254152] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 08/19/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To identify the major allergenic proteins of clam (Paphia textile) and to investigate the effect of different cooking methods on the allergenicity of these identified proteins. METHODS Clam protein extracts were separated by denaturing polyacrylamide gel electrophoresis. IgE reactive proteins were then analyzed by immunoblotting with sera from patients with positive skin prick tests (SPT) to the raw clam extract. Mass spectrometry was used to identify the major allergenic proteins of this clam. RESULTS Raw extract showed 12 protein bands (18-150 kDa). In contrast, fewer protein bands were seen in the boiled extract; those ranging from 40 to 150 kDa were denatured. The protein profiles were similarly altered by frying or roasting. The immunoblots of raw and boiled extracts yielded 10 and 2 IgE-binding proteins, respectively. The fried and roasted extracts showed only a single IgE-binding protein at 37 kDa. Mass spectrometry analysis of the 37 and 42 kDa major allergens indicated that these spots were tropomyosin and actin, respectively. CONCLUSION The two major allergens of Paphia textile were identified as the thermostable tropomyosin and a new thermolabile allergen actin.
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Popescu FD. Cross-reactivity between aeroallergens and food allergens. World J Methodol 2015; 5:31-50. [PMID: 26140270 PMCID: PMC4482820 DOI: 10.5662/wjm.v5.i2.31] [Citation(s) in RCA: 123] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 03/25/2015] [Accepted: 04/16/2015] [Indexed: 02/07/2023] Open
Abstract
In patients with respiratory allergy, cross-reactivity between aeroallergens and foods may induce food allergy, symptoms ranging from oral allergy syndrome to severe anaphylaxis. Clinical entities due to IgE sensitization to cross-reactive aeroallergen and food allergen components are described for many sources of plant origin (pollen-food syndromes and associations, such as birch-apple, cypress-peach and celery-mugwort-spice syndromes, and mugwort-peach, mugwort-chamomile, mugwort-mustard, ragweed-melon-banana, goosefoot-melon associations), fungal origin (Alternaria-spinach syndrome), and invertebrate, mammalian or avian origin (mite-shrimp, cat-pork, and bird-egg syndromes). Clinical cases of allergic reactions to ingestion of food products containing pollen grains of specific plants, in patients with respiratory allergy to Asteraceae pollen, especially mugwort and ragweed, are also mentioned, for honey, royal jelly and bee polen dietary supplements, along with allergic reactions to foods contaminated with mites or fungi in patients with respiratory allergy to these aeroallergens. Medical history and diagnosis approach may be guided by the knowledge about the diverse cross-reacting allergens involved, and by the understanding of these clinical entities which may vary significantly or may be overlapping. The association between primary IgE sensitization with respiratory symptoms to inhaled allergens and food allergy due to cross-reactive allergen components is important to assess in allergy practice. The use of molecular-based diagnosis improves the understanding of clinically relevant IgE sensitization to cross-reactive allergen components from aeroallergen sources and foods.
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Scientific Opinion on the evaluation of allergenic foods and food ingredients for labelling purposes. EFSA J 2014. [DOI: 10.2903/j.efsa.2014.3894] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Sampson HA, Aceves S, Bock SA, James J, Jones S, Lang D, Nadeau K, Nowak-Wegrzyn A, Oppenheimer J, Perry TT, Randolph C, Sicherer SH, Simon RA, Vickery BP, Wood R, Bernstein D, Blessing-Moore J, Khan D, Lang D, Nicklas R, Oppenheimer J, Portnoy J, Randolph C, Schuller D, Spector S, Tilles SA, Wallace D, Sampson HA, Aceves S, Bock SA, James J, Jones S, Lang D, Nadeau K, Nowak-Wegrzyn A, Oppenheimer J, Perry TT, Randolph C, Sicherer SH, Simon RA, Vickery BP, Wood R. Food allergy: a practice parameter update-2014. J Allergy Clin Immunol 2014; 134:1016-25.e43. [PMID: 25174862 DOI: 10.1016/j.jaci.2014.05.013] [Citation(s) in RCA: 520] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 05/02/2014] [Accepted: 05/06/2014] [Indexed: 02/06/2023]
Abstract
This parameter was developed by the Joint Task Force on Practice Parameters, representing the American Academy of Allergy, Asthma & Immunology (AAAAI); the American College of Allergy, Asthma & Immunology (ACAAI); and the Joint Council of Allergy, Asthma & Immunology (JCAAI). The AAAAI and the ACAAI have jointly accepted responsibility for establishing "Food Allergy: A practice parameter update-2014." This is a complete and comprehensive document at the current time. The medical environment is a changing one, and not all recommendations will be appropriate for all patients. Because this document incorporated the efforts of many participants, no single individual, including those who served on the Joint Task Force, is authorized to provide an official AAAAI or ACAAI interpretation of these practice parameters. Any request for information about or an interpretation of these practice parameters by the AAAAI or ACAAI should be directed to the Executive Offices of the AAAAI, ACAAI, and JCAAI. These parameters are not designed for use by pharmaceutical companies in drug promotion.
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González-Fernández J, Rodero M, Daschner A, Cuéllar C. New insights into the allergenicity of tropomyosin: a bioinformatics approach. Mol Biol Rep 2014; 41:6509-17. [PMID: 24985979 DOI: 10.1007/s11033-014-3534-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 06/19/2014] [Indexed: 12/16/2022]
Abstract
The invertebrate panallergen tropomyosin is a protein with an extremely simple folding. This makes it a perfect target for investigating structural differences between invertebrate and vertebrate tropomyosins, which are not considered allergenic. Phylogenetic and sequence analyses were conducted in order to explore the differences in primary structure between several tropomyosins and to promote an experimental development in the field of food allergy, based on the study of tropomyosin. The phylogenetic analyses showed that tropomyosin is a useful evolutionary marker. The phylogenetic trees obtained with tropomyosin were not always phylogenetically correct, but they might be useful for allergen avoidance by tropomyosin allergic individuals. Sequence analyses revealed that the probability of alpha helix folding in invertebrate tropomyosins was lower than in all the studied vertebrate ones, except for the Atlantic bluefin tuna Thunnus thynnus tropomyosin. This suggested that the lack of alpha helix folding may be involved in the immunogenicity of tropomyosins. More specifically, the regions adjacent to the positions 133-135 and 201 of the invertebrate tropomyosins, presented lower probability of alpha helix folding than those of vertebrates and are candidates to be responsible for their allergenicity.
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Affiliation(s)
- Juan González-Fernández
- Departamento de Parasitología, Facultad de Farmacia, Universidad Complutense, 28040, Madrid, Spain,
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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] [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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Simultaneous detection of allergenic fish, cephalopods and shellfish in food by multiplex ligation-dependent probe amplification. Eur Food Res Technol 2014. [DOI: 10.1007/s00217-014-2251-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Worm M, Jappe U, Kleine-Tebbe J, Schäfer C, Reese I, Saloga J, Treudler R, Zuberbier T, Waßmann A, Fuchs T, Dölle S, Raithel M, Ballmer-Weber B, Niggemann B, Werfel T. Food allergies resulting from immunological cross-reactivity with inhalant allergens: Guidelines from the German Society for Allergology and Clinical Immunology (DGAKI), the German Dermatology Society (DDG), the Association of German Allergologists (AeDA) and the Society for Pediatric Allergology and Environmental Medicine (GPA). ACTA ACUST UNITED AC 2014; 23:1-16. [PMID: 26120513 PMCID: PMC4479449 DOI: 10.1007/s40629-014-0004-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
A large proportion of immunoglobulin E (IgE)-mediated food allergies in older children, adolescents and adults are caused by cross-reactive allergenic structures. Primary sensitization is most commonly to inhalant allergens (e.g. Bet v 1, the major birch pollen allergen). IgE can be activated by various cross-reactive allergens and lead to a variety of clinical manifestations. In general, local and mild — in rare cases also severe and systemic — reactions occur directly after consumption of the food containing the cross-reactive allergen (e. g. plant-derived foods containing proteins of the Bet v 1 family). In clinical practice, sensitization to the primary responsible inhalant and/or food allergen can be detected by skin prick tests and/or in vitro detection of specific IgE. Component-based diagnostic methods can support clinical diagnosis. For individual allergens, these methods may be helpful to estimate the risk of systemic reactions. Confirmation of sensitization by oral provocation testing is important particulary in the case of unclear case history. New, as yet unrecognized allergens can also cause cross-reactions. The therapeutic potential of specific immunotherapy (SIT) with inhalant allergens and their effect on pollen-associated food allergies is currently unclear: results vary and placebo-controlled trials will be necessary in the future. Pollen allergies are very common. Altogether allergic sensitization to pollen and cross-reactive food allergens are very common in our latitudes. The actual relevance has to be assessed on an individual basis using the clinical information. Cite this as Worm M, Jappe U, Kleine-Tebbe J, Schäfer C, Reese I, Saloga J, Treudler R, Zuberbier T, Wassmann A, Fuchs T, Dölle S, Raithel M, Ballmer-Weber B, Niggemann B, Werfel T. Food allergies resulting from immunological cross-reactivity with inhalant allergens. Allergo J Int 2014; 23: 1–16 DOI 10.1007/s40629-014-0004-6
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Affiliation(s)
- Margitta Worm
- />Allergie-Centrum-Charité Klinik für Dermatologie, Allergologie und Venerologie Charité — Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Uta Jappe
- />Klinik für Dermatologie, Allergologie und Venerologie, Universität Lübeck, Germany
- />Forschungsgruppe Klinische und Molekulare Allergologie, Forschungszentrum Borstel, Germany
| | | | - Christiane Schäfer
- />Ernährungstherapie, Allergologische Schwerpunktpraxis, Hamburg, Germany
| | - Imke Reese
- />Ernährungsberatung und -therapie, Schwerpunkt Allergologie, München, Germany
| | - Joachim Saloga
- />Hautklinik, Universitätsmedizin der Johannes Gutenberg-Universität, Mainz, Germany
| | - Regina Treudler
- />Klinik für Dermatologie, Venerologie und Allergologie Universität Leipzig, Germany
| | - Torsten Zuberbier
- />Allergie-Centrum-Charité Klinik für Dermatologie, Allergologie und Venerologie Charité — Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Anja Waßmann
- />Dermatologisches Ambulatorium Hamburg-Alstertal, Germany
| | - Thomas Fuchs
- />Hautklinik, Georg-August-Universität, Göttingen, Germany
| | - Sabine Dölle
- />Allergie-Centrum-Charité Klinik für Dermatologie, Allergologie und Venerologie Charité — Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Martin Raithel
- />Medizinische Klinik für Gastroenterologie, Pneumologie, Endokrinologie, Universitätsklinikum Erlangen, Germany
| | | | - Bodo Niggemann
- />Klinik für Pädiatrie, Charité — Universitätsmedizin Berlin, Germany
| | - Thomas Werfel
- />Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Germany
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Nahrungsmittelallergie infolge immunologischer Kreuzreaktivitäten mit Inhalationsallergenen. ALLERGO JOURNAL 2014. [DOI: 10.1007/s15007-014-0483-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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48
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Mercier V. Allergie alimentaire aux produits de la mer en pratique quotidienne. REVUE FRANÇAISE D'ALLERGOLOGIE 2013. [DOI: 10.1016/s1877-0320(13)70045-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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49
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Jeebhay MF, Lopata AL. Occupational allergies in seafood-processing workers. ADVANCES IN FOOD AND NUTRITION RESEARCH 2012; 66:47-73. [PMID: 22909978 DOI: 10.1016/b978-0-12-394597-6.00002-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Global increased demand for seafood and its products has been associated with a concomitant rise in fishing, aquaculture, and processing activities. This increased harvesting of seafood is associated with more frequent reporting of allergic health problems among seafood processors. This review outlines the high-risk working populations, work processes, as well as host and environmental exposure risk factors for occupational respiratory and skin allergies. It also provides insights into the major and minor allergens as well as the pathophysiological mechanisms implicated. Diagnostic and preventive approaches are outlined in managing work-related allergy associated with seafood processing.
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Affiliation(s)
- Mohamed F Jeebhay
- Centre for Occupational and Environmental Health Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
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50
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Khan F, Orson F, Ogawa Y, Parker C, Davis CM. Adult seafood allergy in the Texas Medical Center: A 13-year experience. ALLERGY & RHINOLOGY 2012; 2:e71-7. [PMID: 22852122 PMCID: PMC3390121 DOI: 10.2500/ar.2011.2.0019] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
There is a paucity of data regarding prevalence and characteristics of adult seafood allergy in United States cohorts. This study was designed to determine the characteristics of patient-reported seafood allergy in a large allergy referral adult population. Retrospective analysis was performed of laboratory and clinical characteristics of seafood-allergic patients in three allergy clinics in the Texas Medical Center between January 1, 1997 and January 30, 2010. Of 5162 patients seen in this adult allergy referral population, 159 had physician-diagnosed seafood allergy with an average age of diagnosis of 50.2 (18–81 years) years. Shellfish allergy (59.1%) was more frequent than fish allergy (13.8%). Crustacean allergy (82.6%) was more frequent than mollusk allergy (7.2%). Shrimp (72.5%), crab (34.8%), and lobster (17.4%) were the most common shellfish allergies and tuna (28.6%), catfish (23.8%), and salmon (23.8%) were the most common fish allergies. One-third of seafood-allergic patients reported reactions to more than one seafood. Shellfish-allergic adults were more likely to experience respiratory symptoms than fish-allergic adults (p < 0.05). The likelihood of having anaphylaxis (32%) was not statistically different between shellfish- and fish-allergic subjects. Severe reactions were 12.9 times more likely to occur within the 1st hour of ingestion compared with nonsevere reactions (p < 0.005). The percentage of seafood allergy in this adult allergy referral population was 3.08%.
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Affiliation(s)
- Faria Khan
- Department of Pediatrics, Baylor College of Medicine, Texas Medical Center, Houston, Texas
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