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Fruscione S, Barrale M, Zarcone M, Alba D, Ravazzolo B, Belluzzo M, Onida R, Cammilleri G, Costa A, Ferrantelli V, Savatteri A, De Bella DD, Pipitone S, D'Atria A, Pieri A, Tramuto F, Costantino C, Maida CM, Graziano G, Palomba M, Mattiucci S, Brusca I, Mazzucco W. Screening of Anisakis-Related Allergies and Associated Factors in a Mediterranean Community Characterized by High Seafood Consumption. Foods 2024; 13:2821. [PMID: 39272586 PMCID: PMC11395279 DOI: 10.3390/foods13172821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 08/30/2024] [Accepted: 09/03/2024] [Indexed: 09/15/2024] Open
Abstract
Dietary changes expose consumers to risks from Anisakis larvae in seafood, leading to parasitic diseases and allergies. Anisakis is recognized by EFSA as a significant hazard, with potential oncogenic implications. Diagnostic advancements, like the Basophil Activation Test (BAT), enhance sensitivity and accuracy in identifying Anisakis sensitization, complementing traditional IgE tests. We conducted a cross-sectional study on patients with allergic symptoms from April 2021 to April 2023 at two outpatient clinics in western Sicily. Our goal was to assess the prevalence of Anisakis-related allergies and to identify risk profiles using specific Anisakis IgE and the BAT, especially in regions with high raw fish consumption. The study evaluated specific Anisakis IgE as a screening tool for Anisakis sensitization, using questionnaires, blood samples, and immuno-allergology analyses. Anisakis-specific IgE values were compared with the BAT results, with statistical analyses including Fisher's exact test and logistic regression. The results showed an 18.5% seroprevalence of Anisakis IgE, while the BAT as a second-level test showed 4.63%, indicating the BAT's superior specificity and accuracy. The study highlighted the importance of the BAT in diagnosing Anisakis sensitization, especially in cases of cross-reactivity with Ascaris and tropomyosin. The findings confirm the BAT's exceptional specificity in identifying Anisakis sensitization and support using Anisakis-specific IgE for population-based risk profiling. The BAT can effectively serve as a confirmatory test.
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Affiliation(s)
- Santo Fruscione
- PROMISE Department, University of Palermo, 90127 Palermo, Italy
| | - Maria Barrale
- U.O.C. of Clinical Pathology Buccheri La Ferla Hospital FBF, 90123 Palermo, Italy
| | - Maurizio Zarcone
- U.O.C. Epidemiologia Clinica con Registro Tumori, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy
| | - Davide Alba
- PROMISE Department, University of Palermo, 90127 Palermo, Italy
| | - Barbara Ravazzolo
- U.O.C. Epidemiologia Clinica con Registro Tumori, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy
| | - Miriam Belluzzo
- PROMISE Department, University of Palermo, 90127 Palermo, Italy
| | - Rosa Onida
- U.O.C. of Clinical Pathology Buccheri La Ferla Hospital FBF, 90123 Palermo, Italy
| | | | - Antonella Costa
- Experimental Zooprophylactic Institute of Sicily, 90129 Palermo, Italy
| | | | | | | | - Salvatore Pipitone
- U.O.C. Epidemiologia Clinica con Registro Tumori, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy
| | - Alida D'Atria
- U.O.C. Epidemiologia Clinica con Registro Tumori, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy
| | - Alessia Pieri
- U.O.C. Epidemiologia Clinica con Registro Tumori, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy
| | - Fabio Tramuto
- PROMISE Department, University of Palermo, 90127 Palermo, Italy
- U.O.C. Epidemiologia Clinica con Registro Tumori, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy
| | - Claudio Costantino
- PROMISE Department, University of Palermo, 90127 Palermo, Italy
- U.O.C. Epidemiologia Clinica con Registro Tumori, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy
| | - Carmelo Massimo Maida
- PROMISE Department, University of Palermo, 90127 Palermo, Italy
- U.O.C. Epidemiologia Clinica con Registro Tumori, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy
| | - Giorgio Graziano
- U.O.C. Epidemiologia Clinica con Registro Tumori, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy
| | - Marialetizia Palomba
- Department of Ecological and Biological Sciences, Tuscia University, 01100 Viterbo, Italy
| | - Simonetta Mattiucci
- Section of Parasitology, Department of Public Health and Infectious Diseases, University Hospital "Policlinico Umberto I", Sapienza-University of Rome, 00185 Rome, Italy
| | - Ignazio Brusca
- U.O.C. of Clinical Pathology Buccheri La Ferla Hospital FBF, 90123 Palermo, Italy
| | - Walter Mazzucco
- PROMISE Department, University of Palermo, 90127 Palermo, Italy
- U.O.C. Epidemiologia Clinica con Registro Tumori, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy
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Brusca I, Barrale M, Zarcone M, Fruscione S, Onida R, De Bella DD, Alba D, Belluzzo M, Uasuf CG, Cammilleri G, Costa A, Ferrantelli V, Savatteri A, Cannizzaro E, Calamusa G, Lacca G, Maida CM, Pipitone S, D’Atria A, Palomba M, Costantino C, Mattiucci S, Mazzucco W. Basophil Activation Test in the Diagnosis of Anisakis Allergy: An Observational Study from an Area of High Seafood Consumption in Italy. Pathogens 2023; 12:777. [PMID: 37375467 PMCID: PMC10305353 DOI: 10.3390/pathogens12060777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/23/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
The rising popularity of undercooked or raw seafood containing larvae of the Anisakis parasite has led to issues of public health concern due to allergic manifestations. We conducted an observational study on the use of an innovative Anisakis allergy diagnostic algorithm in a convenience sample of 53 allergic outpatients recruited in Western Sicily, between April 2021 and March 2022. We included individuals with an anamnesis suggestive of IgE sensitization to Anisakis reporting clinical manifestation in the last month due to allergic reactions after eating fresh fish, or in subjects at high exposure risk with sea products while abstaining from fish ingestion, excluding those with documented fish sensitization. Outpatients were tested via Skin Prick Test, IgE-specific dosage and Basophil Activation Test (BAT). Twenty-six outpatients were diagnosed with Anisakis, while 27 with Chronic Urticaria (CU). We found a seven-fold excess risk for Anisakis (p4) positivity in the Anisakis allergic outpatients, as compared to the CU ones. BAT showed the best diagnostic accuracy (92.45%) and specificity (100%), while specific IgE to Ascaris (p1) documented the best sensitivity (92.31%) but a very low specificity (37.04%). In conclusion, our findings may represent a potentially useful contribution to the future development of updated clinical guidelines.
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Affiliation(s)
- Ignazio Brusca
- U.O.C of Clinical Pathology Buccheri La Ferla Hospital FBF, 90123 Palermo, Italy; (I.B.); (M.B.); (R.O.)
| | - Maria Barrale
- U.O.C of Clinical Pathology Buccheri La Ferla Hospital FBF, 90123 Palermo, Italy; (I.B.); (M.B.); (R.O.)
| | - Maurizio Zarcone
- U.O.C. of Clinical Epidemiology with Cancer Registry, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy; (M.Z.); (S.P.); (A.D.); (W.M.)
| | - Santo Fruscione
- PROMISE Department, University of Palermo, 90127 Palermo, Italy; (D.D.D.B.); (D.A.); (M.B.); (A.S.); (E.C.); (G.C.); (G.L.); (C.M.M.); (C.C.)
| | - Rosa Onida
- U.O.C of Clinical Pathology Buccheri La Ferla Hospital FBF, 90123 Palermo, Italy; (I.B.); (M.B.); (R.O.)
| | - Daniele Domenico De Bella
- PROMISE Department, University of Palermo, 90127 Palermo, Italy; (D.D.D.B.); (D.A.); (M.B.); (A.S.); (E.C.); (G.C.); (G.L.); (C.M.M.); (C.C.)
| | - Davide Alba
- PROMISE Department, University of Palermo, 90127 Palermo, Italy; (D.D.D.B.); (D.A.); (M.B.); (A.S.); (E.C.); (G.C.); (G.L.); (C.M.M.); (C.C.)
| | - Miriam Belluzzo
- PROMISE Department, University of Palermo, 90127 Palermo, Italy; (D.D.D.B.); (D.A.); (M.B.); (A.S.); (E.C.); (G.C.); (G.L.); (C.M.M.); (C.C.)
| | - Carina Gabriela Uasuf
- Allergy Disease Center, Institute of Translational Pharmacology (IFT), National Research Council (CNR), 90146 Palermo, Italy;
| | - Gaetano Cammilleri
- Experimental Zooprophylactic Institute of Sicily, 90129 Palermo, Italy; (G.C.); (A.C.); (V.F.)
| | - Antonella Costa
- Experimental Zooprophylactic Institute of Sicily, 90129 Palermo, Italy; (G.C.); (A.C.); (V.F.)
| | - Vincenzo Ferrantelli
- Experimental Zooprophylactic Institute of Sicily, 90129 Palermo, Italy; (G.C.); (A.C.); (V.F.)
| | - Alessandra Savatteri
- PROMISE Department, University of Palermo, 90127 Palermo, Italy; (D.D.D.B.); (D.A.); (M.B.); (A.S.); (E.C.); (G.C.); (G.L.); (C.M.M.); (C.C.)
| | - Emanuele Cannizzaro
- PROMISE Department, University of Palermo, 90127 Palermo, Italy; (D.D.D.B.); (D.A.); (M.B.); (A.S.); (E.C.); (G.C.); (G.L.); (C.M.M.); (C.C.)
| | - Giuseppe Calamusa
- PROMISE Department, University of Palermo, 90127 Palermo, Italy; (D.D.D.B.); (D.A.); (M.B.); (A.S.); (E.C.); (G.C.); (G.L.); (C.M.M.); (C.C.)
| | - Guido Lacca
- PROMISE Department, University of Palermo, 90127 Palermo, Italy; (D.D.D.B.); (D.A.); (M.B.); (A.S.); (E.C.); (G.C.); (G.L.); (C.M.M.); (C.C.)
| | - Carmelo Massimo Maida
- PROMISE Department, University of Palermo, 90127 Palermo, Italy; (D.D.D.B.); (D.A.); (M.B.); (A.S.); (E.C.); (G.C.); (G.L.); (C.M.M.); (C.C.)
| | - Salvatore Pipitone
- U.O.C. of Clinical Epidemiology with Cancer Registry, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy; (M.Z.); (S.P.); (A.D.); (W.M.)
| | - Alida D’Atria
- U.O.C. of Clinical Epidemiology with Cancer Registry, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy; (M.Z.); (S.P.); (A.D.); (W.M.)
| | - Marialetizia Palomba
- Department of Ecological and Biological Sciences, Tuscia University, 01100 Viterbo, Italy;
| | - Claudio Costantino
- PROMISE Department, University of Palermo, 90127 Palermo, Italy; (D.D.D.B.); (D.A.); (M.B.); (A.S.); (E.C.); (G.C.); (G.L.); (C.M.M.); (C.C.)
| | - Simonetta Mattiucci
- Department of Public Health and Infectious Diseases, Section of Parasitology, Sapienza-University of Rome, University Hospital “Policlinico Umberto I”, 00185 Rome, Italy;
| | - Walter Mazzucco
- U.O.C. of Clinical Epidemiology with Cancer Registry, Azienda Ospedaliera Universitaria Policlinico di Palermo, 90127 Palermo, Italy; (M.Z.); (S.P.); (A.D.); (W.M.)
- PROMISE Department, University of Palermo, 90127 Palermo, Italy; (D.D.D.B.); (D.A.); (M.B.); (A.S.); (E.C.); (G.C.); (G.L.); (C.M.M.); (C.C.)
- College of Medicine, University of Cincinnati, Cincinnati, OH 45267, USA
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Podder I, Jaiswal S, Das A. Dietary strategies for chronic spontaneous urticaria: an evidence-based review. Int J Dermatol 2023; 62:143-153. [PMID: 34826140 DOI: 10.1111/ijd.15988] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/01/2021] [Accepted: 11/06/2021] [Indexed: 01/20/2023]
Abstract
Although the relationship between diet and chronic spontaneous urticaria (CSU) remains elusive, several patients seek dietary modifications as they are easy and cost-effective. Adequate patient education and counseling are crucial as modified diets may be beneficial for a subset of antihistamine refractory CSU patients, and no modality currently exists to identify these patients. Elimination of food items based exclusively on patient history may lead to unnecessary restrictions in most cases resulting in nutritional deficiencies and impaired quality of life. Several dietary strategies have been tried till date with varying rates of success and evidence. This review highlights the various dietary strategies along with their levels of evidence, which may help the treating dermatologists and physicians to counsel CSU patients and make evidence-based treatment decisions. There is grade A recommendation for the elimination of food additives (artificial pseudoallergens), personalized diets, vitamin D supplementation, Diamine oxidase supplementation and probiotics (in children), grade B recommendation for dietary elimination of red meat, fish and their products, natural pseudoallergens (fruits, vegetables, and spices), and low-histamine diet, while dietary elimination of gluten (with concomitant celiac disease) has grade C recommendation. Notably, elimination diets should be continued for at least 3 consecutive weeks to assess their effectiveness.
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Affiliation(s)
- Indrashis Podder
- Department of Dermatology, Venereology and Leprosy, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India
| | - Saurabh Jaiswal
- Department of Dermatology, Indira Gandhi Government Medical College, Nagpur, Maharastra, India
| | - Anupam Das
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
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IgE-mediated Anisakis allergy in children. Allergol Immunopathol (Madr) 2023; 51:98-109. [PMID: 36617828 DOI: 10.15586/aei.v51i1.692] [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: 06/04/2022] [Accepted: 08/09/2022] [Indexed: 01/03/2023]
Abstract
Anisakids are nematodes responsible for different clinical patterns in humans. The well-known human-infecting Anisakis species include members of the Anisakis simplex (AS) complex. Humans usually contract anisakiasis through ingestion of raw or undercooked seafood containing Anisakis larvae. Once Anisakis has been ingested, patients may develop disease driven directly by Anisakis larvae and/or by allergic reaction due to this nematode. The capability of inducing allergic reactions depends on the expression of specific antigens by nematodes and host factors. This study aims to resume actual knowledge about AS and Anisakiasis with regard to epidemiology, pathophysiology, clinical presentation, diagnosis, and treatment. Particular attention is paid to Anisakis allergens and their cross-reactivity on available diagnostic methods, and defining a diagnostic pathway for Anisakis allergy. Because only a few data are available in the literature about pediatric population, we focus on this group of patients specifically.
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A Prospective Validation of the NUT CRACKER Diagnostic Algorithm for Walnut and Pecan Allergy with Prediction of Severity. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:265-274.e6. [DOI: 10.1016/j.jaip.2020.09.041] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/01/2020] [Accepted: 09/20/2020] [Indexed: 01/19/2023]
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Kolkhir P, Maurer M. Chronic Spontaneous Urticaria and Comorbidities. URTICARIA AND ANGIOEDEMA 2021:77-107. [DOI: 10.1007/978-3-030-84574-2_7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2025]
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Bax HJ, Chauhan J, Stavraka C, Khiabany A, Nakamura M, Pellizzari G, Ilieva KM, Lombardi S, Gould HJ, Corrigan CJ, Till SJ, Katugampola S, Jones PS, Barton C, Winship A, Ghosh S, Montes A, Josephs DH, Spicer JF, Karagiannis SN. Basophils from Cancer Patients Respond to Immune Stimuli and Predict Clinical Outcome. Cells 2020; 9:E1631. [PMID: 32645919 PMCID: PMC7408103 DOI: 10.3390/cells9071631] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/01/2020] [Accepted: 07/03/2020] [Indexed: 02/07/2023] Open
Abstract
Basophils are involved in manifestations of hypersensitivity, however, the current understanding of their propensity for activation and their prognostic value in cancer patients remains unclear. As in healthy and atopic individuals, basophil populations were identified in blood from ovarian cancer patients (n = 53) with diverse tumor histologies and treatment histories. Ex vivo basophil activation was measured by CD63 expression using the basophil activation test (BAT). Irrespective of prior treatment, basophils could be activated by stimulation with IgE- (anti-FcεRI and anti-IgE) and non-IgE (fMLP) mediated triggers. Basophil activation was detected by ex vivo exposure to paclitaxel, but not to other anti-cancer therapies, in agreement with a clinical history of systemic hypersensitivity reactions to paclitaxel. Protein and gene expression analyses support the presence of basophils (CCR3, CD123, FcεRI) and activated basophils (CD63, CD203c, tryptase) in ovarian tumors. Greater numbers of circulating basophils, cells with greater capacity for ex vivo stimulation (n = 35), and gene signatures indicating the presence of activated basophils in tumors (n = 439) were each associated with improved survival in ovarian cancer. Circulating basophils in cancer patients respond to IgE- and non-IgE-mediated signals and could help identify hypersensitivity to therapeutic agents. Activated circulating and tumor-infiltrating basophils may be potential biomarkers in oncology.
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Affiliation(s)
- Heather J. Bax
- St. John’s Institute of Dermatology, School of Basic & Medical Biosciences, King’s College London, London SE1 9RT, UK; (H.J.B.); (J.C.); (C.S.); (A.K.); (M.N.); (G.P.); (K.M.I.); (D.H.J.)
- School of Cancer & Pharmaceutical Sciences, King’s College London, Guy’s Hospital, London SE1 9RT, UK;
| | - Jitesh Chauhan
- St. John’s Institute of Dermatology, School of Basic & Medical Biosciences, King’s College London, London SE1 9RT, UK; (H.J.B.); (J.C.); (C.S.); (A.K.); (M.N.); (G.P.); (K.M.I.); (D.H.J.)
- School of Cancer & Pharmaceutical Sciences, King’s College London, Guy’s Hospital, London SE1 9RT, UK;
| | - Chara Stavraka
- St. John’s Institute of Dermatology, School of Basic & Medical Biosciences, King’s College London, London SE1 9RT, UK; (H.J.B.); (J.C.); (C.S.); (A.K.); (M.N.); (G.P.); (K.M.I.); (D.H.J.)
- School of Cancer & Pharmaceutical Sciences, King’s College London, Guy’s Hospital, London SE1 9RT, UK;
- Departments of Medical Oncology and Clinical Oncology, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK; (A.W.); (S.G.); (A.M.)
| | - Atousa Khiabany
- St. John’s Institute of Dermatology, School of Basic & Medical Biosciences, King’s College London, London SE1 9RT, UK; (H.J.B.); (J.C.); (C.S.); (A.K.); (M.N.); (G.P.); (K.M.I.); (D.H.J.)
- School of Cancer & Pharmaceutical Sciences, King’s College London, Guy’s Hospital, London SE1 9RT, UK;
| | - Mano Nakamura
- St. John’s Institute of Dermatology, School of Basic & Medical Biosciences, King’s College London, London SE1 9RT, UK; (H.J.B.); (J.C.); (C.S.); (A.K.); (M.N.); (G.P.); (K.M.I.); (D.H.J.)
| | - Giulia Pellizzari
- St. John’s Institute of Dermatology, School of Basic & Medical Biosciences, King’s College London, London SE1 9RT, UK; (H.J.B.); (J.C.); (C.S.); (A.K.); (M.N.); (G.P.); (K.M.I.); (D.H.J.)
| | - Kristina M. Ilieva
- St. John’s Institute of Dermatology, School of Basic & Medical Biosciences, King’s College London, London SE1 9RT, UK; (H.J.B.); (J.C.); (C.S.); (A.K.); (M.N.); (G.P.); (K.M.I.); (D.H.J.)
- Breast Cancer Now Research Unit, School of Cancer & Pharmaceutical Sciences, King’s College London, Guy’s Cancer Centre, London SE1 9RT, UK
| | - Sara Lombardi
- Guy’s and St Thomas’ Oncology & Haematology Clinical Trials (OHCT), Guy’s Cancer Centre, London SE1 9RT, UK;
| | - Hannah J. Gould
- Randall Centre for Cell and Molecular Biophysics, School of Basic and Medical Biosciences, King’s College London, London SE1 9RT, UK;
- Asthma UK Centre, Allergic Mechanisms in Asthma, King’s College London, London SE1 9RT, UK; (C.J.C.); (S.J.T.)
| | - Christopher J. Corrigan
- Asthma UK Centre, Allergic Mechanisms in Asthma, King’s College London, London SE1 9RT, UK; (C.J.C.); (S.J.T.)
- Department of Respiratory Medicine and Allergy and School of Immunology and Microbial Sciences, King’s College London, London SE1 9RT, UK
| | - Stephen J. Till
- Asthma UK Centre, Allergic Mechanisms in Asthma, King’s College London, London SE1 9RT, UK; (C.J.C.); (S.J.T.)
- Department of Respiratory Medicine and Allergy and School of Immunology and Microbial Sciences, King’s College London, London SE1 9RT, UK
| | - Sidath Katugampola
- Centre for Drug Development, Cancer Research UK, 2 Redman Place, London E20 1JQ, UK; (S.K.); (P.S.J.); (C.B.)
| | - Paul S. Jones
- Centre for Drug Development, Cancer Research UK, 2 Redman Place, London E20 1JQ, UK; (S.K.); (P.S.J.); (C.B.)
| | - Claire Barton
- Centre for Drug Development, Cancer Research UK, 2 Redman Place, London E20 1JQ, UK; (S.K.); (P.S.J.); (C.B.)
- Barton Oncology Ltd., 8 Elm Avenue, Eastcote, Middlesex HA4 8PD, UK
| | - Anna Winship
- Departments of Medical Oncology and Clinical Oncology, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK; (A.W.); (S.G.); (A.M.)
| | - Sharmistha Ghosh
- Departments of Medical Oncology and Clinical Oncology, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK; (A.W.); (S.G.); (A.M.)
| | - Ana Montes
- Departments of Medical Oncology and Clinical Oncology, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK; (A.W.); (S.G.); (A.M.)
| | - Debra H. Josephs
- St. John’s Institute of Dermatology, School of Basic & Medical Biosciences, King’s College London, London SE1 9RT, UK; (H.J.B.); (J.C.); (C.S.); (A.K.); (M.N.); (G.P.); (K.M.I.); (D.H.J.)
- School of Cancer & Pharmaceutical Sciences, King’s College London, Guy’s Hospital, London SE1 9RT, UK;
- Departments of Medical Oncology and Clinical Oncology, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK; (A.W.); (S.G.); (A.M.)
| | - James F. Spicer
- School of Cancer & Pharmaceutical Sciences, King’s College London, Guy’s Hospital, London SE1 9RT, UK;
- Departments of Medical Oncology and Clinical Oncology, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK; (A.W.); (S.G.); (A.M.)
| | - Sophia N. Karagiannis
- St. John’s Institute of Dermatology, School of Basic & Medical Biosciences, King’s College London, London SE1 9RT, UK; (H.J.B.); (J.C.); (C.S.); (A.K.); (M.N.); (G.P.); (K.M.I.); (D.H.J.)
- Breast Cancer Now Research Unit, School of Cancer & Pharmaceutical Sciences, King’s College London, Guy’s Cancer Centre, London SE1 9RT, UK
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Viñas M, Postigo I, Suñén E, Martínez J. Urticaria and silent parasitism by Ascaridoidea: Component-resolved diagnosis reinforces the significance of this association. PLoS Negl Trop Dis 2020; 14:e0008177. [PMID: 32243436 PMCID: PMC7170265 DOI: 10.1371/journal.pntd.0008177] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 04/20/2020] [Accepted: 02/27/2020] [Indexed: 12/11/2022] Open
Abstract
Urticaria remains a major problem in terms of aetiology, investigation, and management, and although parasitic diseases are considered potential causes, the absence of a consistent link between parasitic infections and skin allergy symptoms leads to the need for a deeper study of parameters that support this association. The objectives of this study were to analyse a possible relationship between parasitism by Ascarididae (Toxocara canis and Anisakis simplex) and the clinical expression of urticaria and to identify possible parasitic molecular markers for improving the diagnosis of unknown urticaria aetiology. The prevalence of Toxocara and Anisakis infestations was evaluated by measuring the levels of specific IgG (sIgG) and IgE (sIgE) antibodies against crude extracts and isolated components from whole larvae of Anisakis simplex (Ani s 1, Ani s 3 and Ani s 7) and Toxocara canis (TES-120, TES-70, TES-32 and TES-26) using immunologic and molecular diagnostic methods. A cross-sectional study was performed in a group of 400 individuals. The study group consisted of 95 patients diagnosed with urticaria (55 with chronic urticaria and 40 with acute urticaria). A control group consisted of 305 subjects without urticaria (182 diagnosed with respiratory allergy and 123 without allergy). Statistically significant differences were demonstrated in the seroprevalence of specific IgG and IgE antibodies between the urticaria patients and the healthy general population when isolated ascarid antigens were evaluated. The prevalence of IgG antibodies against Ani s 1, IgE antibodies against TES-120 and IgE antibodies against TES-70 were significantly different between the control individuals (healthy general population) and patients with urticaria. Moreover, the urticaria patient group demonstrated a higher seroprevalence of antibodies (sIgE and sIgG) against Anisakis simplex larva whole extract than the control group but just with statistically diferences when sIgE was evaluated. The presence of IgE and/or IgG antibodies against Ani s 3 (tropomyosin) can help to discriminate between patients with and without urticaria. Both ascarids seem to be associated with urticaria, although in our region, Anisakis seems to have greater involvement than Toxocara in this relationship. Molecular diagnostics can be used to associate urticaria with parasite infestations. Tropomyosin and Ani s 1 were the most relevant markers to demonstrate the association between urticaria and the most relevant Ascarididae parasites in our region.
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Affiliation(s)
- Marta Viñas
- Allergy Service, Hospital de Terrassa, Consorci Sanitari de Terrassa, Carretera de Torrebonica, Barcelona, Spain
| | - Idoia Postigo
- Laboratory of Parasitology and Allergy, Research Center Lascaray, Department of Immunology, Microbiology and Parasitology, University of the Basque Country, Faculty of Pharmacy, Paseo de la Universidad, Vitoria, Spain
| | - Ester Suñén
- Laboratory of Parasitology and Allergy, Research Center Lascaray, Department of Immunology, Microbiology and Parasitology, University of the Basque Country, Faculty of Pharmacy, Paseo de la Universidad, Vitoria, Spain
| | - Jorge Martínez
- Laboratory of Parasitology and Allergy, Research Center Lascaray, Department of Immunology, Microbiology and Parasitology, University of the Basque Country, Faculty of Pharmacy, Paseo de la Universidad, Vitoria, Spain
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Anisakis sensitization in different population groups and public health impact: A systematic review. PLoS One 2018; 13:e0203671. [PMID: 30235242 PMCID: PMC6147426 DOI: 10.1371/journal.pone.0203671] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 08/25/2018] [Indexed: 11/19/2022] Open
Abstract
Anisakis simplex spp. sensitization rates have increased worldwide, with a significant impact on health-care systems. To date, no clear-cut diagnostic criteria and laboratory algorithm have been established, so anisakiasis still represents an under-reported health problem whose clinical manifestations, when present, mimic the much more common allergic and digestive disorders. Aim of the study was to systematically review the available literature on the prevalence of sensitization against Anisakis in the general population and in specific population groups, taking into account the impact of the different available diagnostic techniques on the epidemiological data. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, relevant papers reporting Anisakis sensitization epidemiological data were found covering a period ranging from 1996 to February 2017. Overall, 41 studies comprising 31,701 participants from eleven countries were included in the qualitative synthesis. General asymptomatic population resulted sensitized to Anisakis in 0.4 to 27.4% of cases detected by means of indirect ELISA or ImmunoCAP specific IgE detection, and between 6.6% and 19.6% of the samples by Skin prick test (SPT). Occupationally exposed workers (fishermen, fishmongers and workers of fish-processing industries) documented specific IgE between 11.7% and 50% of cases, whereas SPT positivity ranged between 8% and 46.4%. Symptomatic allergic patients to any kind of allergen were found to be positive to Anisakis specific IgE detection between 0.0% (in children with mastocytosis) to 81.3% (among adults with shellfish allergy). Results highlighted that hypersensitivity prevalence estimates varied widely according to geographical area, characteristics of the population studied, diagnostic criteria and laboratory assays. Further studies are needed to overcome the documented misdiagnosis by improving the diagnostic approach and, consequently, providing more affordable estimates in order to address public health interventions on populations at high risk of exposure to Anisakis and to tailor health services related to specific groups.
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Sabogal-Cuadro P, Zakzuk J. Prueba de activación de basófilos: aspectos técnicos, metodológicos y su utilidad clínica. REVISTA DE LA FACULTAD DE MEDICINA 2018. [DOI: 10.15446/revfacmed.v66n3.61820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción. La prueba de activación de basófilos (PAB) se considera una técnica confiable y segura para el diagnóstico de problemas alérgicos.Objetivo. Profundizar en el estado del arte de la PAB y su utilidad clínica.Materiales y métodos. Se realizó una revisión narrativa de la literatura mediante la búsqueda electrónica en las bases de datos y metabuscadores Ovid Medline, Google Scholar y PubMed, sin limitar la búsqueda por fecha, idioma o tipo de artículo. Se buscaron artículos sobre los detalles técnicos de la PAB y su utilidad clínica en el manejo de las enfermedades alérgicas.Resultados. De los marcadores de activación, CD63 ha sido el más estudiado y es el que mejor representa un evento de degranulación anafiláctica, mientras que CD203c es representativo de varias formas de degranulación. La superioridad de uno sobre otro como prueba diagnóstica depende del problema alérgico estudiado. En cuanto a los métodos de detección de basófilos, su selección con un único marcador, CCR3, se propone como una opción con buena relación de costo-efectividad.Conclusiones. La PAB es una herramienta prometedora para evaluar en clínica las reacciones alérgicas de forma segura. Es necesario una mayor estandarización de protocolos para obtener resultados más reproducibles.
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Abstract
PURPOSE OF REVIEW To compare the prevalence of sensitization in different countries based on specific IgE values and to evaluate the use of isolated native or recombinant allergens for diagnosis. RECENT FINDINGS Isolated allergens help in the diagnosis of truly sensitized patients avoiding false positives due to cross-reactions. Their use is therefore highly recommended, especially when used as a combination of several relevant allergens. The use of purified allergens allows an accurate diagnosis and this has led to three important findings: (1) in addition to the digestive route of sensitization, occupational and non-digestive exposure seems to be clinically relevant. (2) The parasite appears as an important agent for chronic urticaria. And (3) in endemic countries, the amount of highly sensitized subjects in the general population could be as high as 7%. Adequate information to asymptomatic patients on fish consumption habits would avoid new contacts with parasite allergens and decrease their specific IgE levels and consequently the appearance of acute or chronic episodes induced by the parasite.
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Panaszek B, Pawłowicz R, Grzegrzółka J, Obojski A. Autoreactive IgE in Chronic Spontaneous/Idiopathic Urticaria and Basophil/Mastocyte Priming Phenomenon, as a Feature of Autoimmune Nature of the Syndrome. Arch Immunol Ther Exp (Warsz) 2016; 65:137-143. [PMID: 27582030 DOI: 10.1007/s00005-016-0417-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 06/20/2016] [Indexed: 01/27/2023]
Abstract
Recent years of research have shed a new light on the role of IgE in immune reactions. It seems to be more than just a contribution to immediate type of allergic response. It appears that monomeric IgE may enhance mast cell activity without cross-linking of FcεRI by IgE specific allergen or autoreactive IgG anti-IgE antibodies. Monomeric IgE molecules are heterogeneous concerning their ability to induce survival and activation of mast cells only by binding the IgE to FcεRI, but not affecting degranulation of cells. It also turned out that IgE may react to autoantigens occurring in the blood not only in chronic spontaneous urticaria (CSU) but also in other autoimmune diseases. The aforementioned phenomena may promote the activity of mast cells/basophils in CSU that easily degranulate when influenced by various inner (autoreactive IgG against IgE and FcεRI, autoreactive IgE for self-antigens) and outer factors (cold, heat, pressure) or allergens. These findings forced the new approach to the role of autoimmunity, self-antigens and IgE autoantibodies in the pathology of CSU. CSU put in the scheme of autoreactive IgG and autoreactive IgE seems to be either a kind of an autoimmune disease or a clinical manifestation of some other defined autoimmune diseases or both.
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Affiliation(s)
- Bernard Panaszek
- Department of Internal Medicine and Allergy, Wroclaw Medical University, Curie-Skłodowskiej 66, 50-367, Wrocław, Poland.
| | - Robert Pawłowicz
- Department of Internal Medicine and Allergy, Wroclaw Medical University, Curie-Skłodowskiej 66, 50-367, Wrocław, Poland
| | - Jędrzej Grzegrzółka
- Department of Histology and Embryology, Wroclaw Medical University, Wrocław, Poland
| | - Andrzej Obojski
- Department of Internal Medicine and Allergy, Wroclaw Medical University, Curie-Skłodowskiej 66, 50-367, Wrocław, Poland
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Kolkhir P, Balakirski G, Merk HF, Olisova O, Maurer M. Chronic spontaneous urticaria and internal parasites--a systematic review. Allergy 2016; 71:308-22. [PMID: 26648083 DOI: 10.1111/all.12818] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2015] [Indexed: 01/09/2023]
Abstract
Chronic spontaneous urticaria (CSU) is defined as persistent wheals, angioedema, or both lasting for >6 weeks due to known or unknown causes. Some epidemiological studies and case reports suggest that internal parasite infections (PI) can cause CSU. Here, we provide a systematic overview of published findings on the prevalence and relevance of PI in CSU and we discuss possible pathomechanisms. The prevalence of PI in CSU was investigated by 39 independent studies and comorbidity reportedly ranged from 0 to 75.4% (two-thirds of these studies reported infection rates of 10% or less). The prevalence of PI in adult and pediatric CSU patients ranged from 0% to 75.4% and from 0% to 37.8%, respectively. CSU patients were more often diagnosed with protozoa and had a significantly higher risk of toxocariasis seropositivity and Anisakis simplex sensitization when compared to healthy controls. Patients with chronic urticaria more frequently had seropositivity of fasciolosis, Anisakis simplex sensitization, and the presence of Blastocystis hominis allele 34 (ST3) as compared with control subjects. In 21 studies, efficacy of treatment with antiparasitic drugs ranged from 0 to 100% (35.7% of 269 CSU patients benefitted). In 9 (42.8%) of 21 studies, more than 50% of efficacy was observed. The reported rate of urticaria comorbidity in PI patients in 18 independent studies is 1-66.7%. Urticaria including CSU might be a quite common symptom of strongyloidiasis and blastocystosis. Pathogenic mechanisms in CSU due to PI may include specific IgE, Th2 cytokine skewing, eosinophils, activation of the complement, and the coagulation systems.
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Affiliation(s)
- P. Kolkhir
- Department of Dermatology and Venereology; Sechenov First Moscow State Medical University; Moscow Russia
| | - G. Balakirski
- Department of Dermatology and Allergology; University Hospital of Aachen; Aachen Germany
| | - H. F. Merk
- Department of Dermatology and Allergology; University Hospital of Aachen; Aachen Germany
| | - O. Olisova
- Department of Dermatology and Venereology; Sechenov First Moscow State Medical University; Moscow Russia
| | - M. Maurer
- Department of Dermatology and Allergy; Charité-Universitätsmedizin Berlin; Berlin Germany
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14
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Chirumbolo S. Major pitfalls in BAT performance may be caused by gating protocols and CD63% cut off evaluation. Cytometry A 2014; 85:382-5. [DOI: 10.1002/cyto.a.22466] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 02/27/2014] [Accepted: 03/12/2014] [Indexed: 01/30/2023]
Affiliation(s)
- Salvatore Chirumbolo
- Department of Medicine; University of Verona, University Laboratory of Medical Research-LURM est; Verona 37134 Italy
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15
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He SH, Zhang HY, Zeng XN, Chen D, Yang PC. Mast cells and basophils are essential for allergies: mechanisms of allergic inflammation and a proposed procedure for diagnosis. Acta Pharmacol Sin 2013; 34:1270-83. [PMID: 23974516 DOI: 10.1038/aps.2013.88] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Accepted: 06/12/2013] [Indexed: 02/06/2023] Open
Abstract
The current definition of allergy is a group of IgE-mediated diseases. However, a large portion of patients with clinical manifestations of allergies do not exhibit elevated serum levels of IgE (sIgEs). In this article, three key factors, ie soluble allergens, sIgEs and mast cells or basophils, representing the causative factors, messengers and primary effector cells in allergic inflammation, respectively, were discussed. Based on current knowledge on allergic diseases, we propose that allergic diseases are a group of diseases mediated through activated mast cells and/or basophils in sensitive individuals, and allergic diseases include four subgroups: (1) IgE dependent; (2) other immunoglobulin dependent; (3) non-immunoglobulin mediated; (4) mixture of the first three subgroups. According to our proposed definition, pseudo-allergic-reactions, in which mast cell or basophil activation is not mediated via IgE, or to a lesser extent via IgG or IgM, should be non-IgE-mediated allergic diseases. Specific allergen challenge tests (SACTs) are gold standard tests for diagnosing allergies in vivo, but risky. The identification of surface membrane activation markers of mast cells and basophils (CD203c, CCR3, CD63, etc) has led to development of the basophil activation test (BAT), an in vitro specific allergen challenge test (SACT). Based on currently available laboratory allergy tests, we here propose a laboratory examination procedure for allergy.
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Abstract
The basophil activation test (BAT) is a flow-cytometry-based functional assay that assesses the degree of cell activation after exposure to a stimuli. Though no standardized technique currently exists, recent advances have improved the performance of this assay, including identification of new basophil-specific markers and comparisons of the expression of CD63 to CD203c during activation. The basophil activation test has also been validated for many IgE-mediated disease conditions, which have been extensively reviewed elsewhere. This review focuses on the most recent applications of this test to the diagnosis of allergy to drugs, foods, venoms, and pollens, and the evolving role of the BAT in monitoring immunotherapy.
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Current world literature. Curr Opin Allergy Clin Immunol 2011; 11:497-502. [PMID: 21878753 DOI: 10.1097/aci.0b013e32834bbdcd] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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