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Tong WS, Li S, Leung NYH, Wong WT, Leung TF, Leung PSC, Chu KH, Wai CYY. Shrimp Extract Exacerbates Allergic Immune Responses in Mice: Implications on Clinical Diagnosis of Shellfish Allergy. Clin Rev Allergy Immunol 2024; 66:250-259. [PMID: 38775874 PMCID: PMC11193834 DOI: 10.1007/s12016-024-08994-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2024] [Indexed: 06/23/2024]
Abstract
Tropomyosin has been identified as the major cross-reactive shellfish allergen, but recent studies showed the presence of other clinically relevant allergens. This study aims at determining the allergic immune responses of mice sensitized with raw and boiled shrimp extracts in comparison to recombinant tropomyosin (rTM). Female Balb/c mice were intragastrically sensitized and challenged with raw, boiled shrimp or rTM. Systemic, cellular and humoral allergic responses were compared, while allergenicity of the extracts was also compared by skin prick test (SPT) and immunoblot on shrimp allergic subjects. We showed that rTM and shrimp extracts induced IgE- and Th2-mediated allergic responses in mice, distinguished by remarkable intestinal inflammation in small intestine across all regimens. Notably, boiled shrimp extract exhibited the highest sensitization rate (73.7% of mice developed positive TM-specific IgE response) when compared with raw extract (47.8%) and rTM (34.8%). Mice sensitized with boiled extract manifested the highest allergen-specific IgE and Th2 cytokine responses than the others. Immunoblot results indicated that tropomyosin remained the major allergen in extract-based sensitization and had stronger allergenicity in a heat-treated form comparing to untreated TM, which was in line with the SPT results that boiled extract induced larger wheal size in patients. Hemocyanin and glycogen phosphorylase were also identified as minor allergens associated with manifestation of shrimp allergy. This study shows that boiled extract enhanced sensitization and Th2 responses in agreement with the higher allergenicity of heat-treated TM. This study thus presents three shrimp allergy murine models suitable for mechanistic and intervention studies, and in vivo evidence implies higher effectiveness of boiled extract for the clinical diagnosis of shellfish allergy.
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Affiliation(s)
- Wai Sze Tong
- School of Life Sciences, The Chinese University of Hong Kong, HKSAR, China
| | - Shanshan Li
- School of Life Sciences, The Chinese University of Hong Kong, HKSAR, China
| | - Nicki Y H Leung
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, HKSAR, China
| | - Wing Tak Wong
- School of Life Sciences, The Chinese University of Hong Kong, HKSAR, China
| | - Ting Fan Leung
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, HKSAR, China
| | - Patrick S C Leung
- Division of Rheumatology, Allergy and Clinical Immunology, University of California, Davis, CA, USA
| | - Ka Hou Chu
- School of Life Sciences, The Chinese University of Hong Kong, HKSAR, China
- Southern Marine Science and Engineering Guangdong Laboratory (Guangzhou), Guangzhou, China
| | - Christine Y Y Wai
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, HKSAR, China.
- Hong Kong Hub of Paediatric Excellence (HK HOPE), Faculty of Medicine, The Chinese University of Hong Kong, HKSAR, China.
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Han X, Wang X, Chen X, Liu H, Liu J, Waye MMY, Liu G, Rao S. Intervention Efficacy of Slightly Processed Allergen/Meat in Oral Immunotherapy for Seafood Allergy: A Systematic Review, Meta-Analysis, and Meta-Regression Analysis in Mouse Models and Clinical Patients. Nutrients 2024; 16:667. [PMID: 38474795 DOI: 10.3390/nu16050667] [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: 12/19/2023] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
Background: Seafood allergy is a significant global health concern that greatly impacts a patient's quality of life. The intervention efficacy of oral immunotherapy (OIT), an emerging intervention strategy, for seafood allergy remains controversial. This study aimed to perform a systematic review and meta-analysis to evaluate the efficacy of slightly processed allergen/meat from fish and crustacea in OIT, both in mouse models and clinical patients. Methods: A comprehensive literature search was performed in four mainstream databases and the EBSCOhost database to identify all relevant case-control and cohort studies. The aim was to elucidate the intervention efficacy, encompassing various processing methods and assessing the efficacy of multiple major allergens in OIT. Results: The meta-analysis included five case-control studies on crustacean allergens in mouse models and 11 cohort studies on meat from fish and crustacea in clinical patients for final quantitative assessments. In mouse models, crustacean allergen substantially decreased the anaphylactic score after OIT treatment (mean difference (MD) = -1.30, p < 0.01). Subgroup analyses with low-level heterogeneities provided more reliable results for crab species (MD = -0.63, p < 0.01, I2 = 0), arginine kinase allergen (MD = -0.83, p < 0.01, I2 = 0), and Maillard reaction processing method (MD = -0.65, p < 0.01, I2 = 29%), respectively. In clinical patients, the main meta-analysis showed that the slightly processed meat significantly increased the incidence rate of oral tolerance (OT, incidence rate ratio (IRR) = 2.90, p < 0.01). Subgroup analyses for fish meat (IRR = 2.79, p < 0.01) and a simple cooking treatment (IRR = 2.36, p = 0.01) also demonstrated a substantial increase in the incidence rate of OT. Sensitivity and meta-regression analyses successfully identified specific studies contributing to heterogeneity in mouse models and clinical patients, although these studies did not impact the overall significant pooled effects. Conclusions: This meta-analysis provides preliminary evidence for the high intervention efficacy of slightly processed allergen/meat from fish and crustacea in OIT, both in mouse models and clinical patients. The Maillard reaction and cooking processing methods may emerge as potentially effective approaches to treating allergen/meat in OIT for clinical patients, offering a promising and specific treatment strategy for seafood allergy. However, these findings should be interpreted cautiously, and further supporting evidence is necessary.
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Affiliation(s)
- Xinyu Han
- College of Ocean Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Jimei University, Xiamen 361021, China
| | - Xinya Wang
- Department of Bioinformatics, Fujian Key Laboratory of Medical Bioinformatics, Institute of Precision Medicine, School of Medical Technology and Engineering, Fujian Medical University, Fuzhou 350122, China
| | - Xiaotong Chen
- Department of Bioinformatics, Fujian Key Laboratory of Medical Bioinformatics, Institute of Precision Medicine, School of Medical Technology and Engineering, Fujian Medical University, Fuzhou 350122, China
| | - Hong Liu
- College of Ocean Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Jimei University, Xiamen 361021, China
| | - Jingwen Liu
- College of Ocean Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Jimei University, Xiamen 361021, China
| | - Mary Miu Yee Waye
- The Nethersole School of Nursing, Croucher Laboratory for Human Genomics, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
| | - Guangming Liu
- College of Ocean Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Jimei University, Xiamen 361021, China
| | - Shitao Rao
- Department of Bioinformatics, Fujian Key Laboratory of Medical Bioinformatics, Institute of Precision Medicine, School of Medical Technology and Engineering, Fujian Medical University, Fuzhou 350122, China
- School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
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3
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Giannetti A, Pession A, Bettini I, Ricci G, Giannì G, Caffarelli C. IgE Mediated Shellfish Allergy in Children-A Review. Nutrients 2023; 15:3112. [PMID: 37513530 PMCID: PMC10386692 DOI: 10.3390/nu15143112] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/08/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Shellfish is a leading cause of food allergy and anaphylaxis worldwide. Recent advances in molecular characterization have led to a better understanding of the allergen profile. High sequence homology between shellfish species and between shellfish and house dust mites leads to a high serological cross-reactivity, which does not accurately correlate with clinical cross-reactions. Clinical manifestations are immediate and the predominance of perioral symptoms is a typical feature of shellfish allergy. Diagnosis, as for other food allergies, is based on SPTs and specific IgE, while the gold standard is DBPCFC. Cross-reactivity between shellfish is common and therefore, it is mandatory to avoid all shellfish. New immunotherapeutic strategies based on hypoallergens and other innovative approaches represent the new frontiers for desensitization.
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Affiliation(s)
- Arianna Giannetti
- Paediatrics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (A.G.); (A.P.)
| | - Andrea Pession
- Paediatrics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (A.G.); (A.P.)
| | - Irene Bettini
- Paediatrics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (A.G.); (A.P.)
| | - Giampaolo Ricci
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy;
| | - Giuliana Giannì
- Clinica Pediatrica, Azienda Ospedaliero-Universitaria, Medicine and Surgery Department, Università di Parma, 43126 Parma, Italy;
| | - Carlo Caffarelli
- Clinica Pediatrica, Azienda Ospedaliero-Universitaria, Medicine and Surgery Department, Università di Parma, 43126 Parma, Italy;
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Giovannini M, Beken B, Buyuktiryaki B, Barni S, Liccioli G, Sarti L, Lodi L, Pontone M, Bartha I, Mori F, Sackesen C, du Toit G, Lopata AL, Muraro A. IgE-Mediated Shellfish Allergy in Children. Nutrients 2023; 15:2714. [PMID: 37375617 DOI: 10.3390/nu15122714] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 05/27/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
Shellfish, including various species of mollusks (e.g., mussels, clams, and oysters) and crustaceans (e.g., shrimp, prawn, lobster, and crab), have been a keystone of healthy dietary recommendations due to their valuable protein content. In parallel with their consumption, allergic reactions related to shellfish may be increasing. Adverse reactions to shellfish are classified into different groups: (1) Immunological reactions, including IgE and non-IgE allergic reactions; (2) non-immunological reactions, including toxic reactions and food intolerance. The IgE-mediated reactions occur within about two hours after ingestion of the shellfish and range from urticaria, angioedema, nausea, and vomiting to respiratory signs and symptoms such as bronchospasm, laryngeal oedema, and anaphylaxis. The most common allergenic proteins involved in IgE-mediated allergic reactions to shellfish include tropomyosin, arginine kinase, myosin light chain, sarcoplasmic calcium-binding protein, troponin c, and triosephosphate isomerase. Over the past decades, the knowledge gained on the identification of the molecular features of different shellfish allergens improved the diagnosis and the potential design of allergen immunotherapy for shellfish allergy. Unfortunately, immunotherapeutic studies and some diagnostic tools are still restricted in a research context and need to be validated before being implemented into clinical practice. However, they seem promising for improving management strategies for shellfish allergy. In this review, epidemiology, pathogenesis, clinical features, diagnosis, and management of shellfish allergies in children are presented. The cross-reactivity among different forms of shellfish and immunotherapeutic approaches, including unmodified allergens, hypoallergens, peptide-based, and DNA-based vaccines, are also addressed.
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Affiliation(s)
- Mattia Giovannini
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
- Department of Health Sciences, University of Florence, 50139 Florence, Italy
| | - Burcin Beken
- Department of Pediatric Allergy & Immunology, School of Medicine, Acibadem University, 34303 Istanbul, Turkey
| | - Betul Buyuktiryaki
- Division of Pediatric Allergy, Department of Pediatrics, School of Medicine, Koc University, 34450 Istanbul, Turkey
| | - Simona Barni
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
| | - Giulia Liccioli
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
| | - Lucrezia Sarti
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
| | - Lorenzo Lodi
- Department of Health Sciences, University of Florence, 50139 Florence, Italy
- Immunology Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
| | - Matteo Pontone
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
- Department of Health Sciences, University of Florence, 50139 Florence, Italy
| | - Irene Bartha
- Pediatric Allergy Group, Department of Women and Children's Health, School of Life Course Sciences, King's College London, London SE1 9RT, UK
- Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London SE1 7EH, UK
| | - Francesca Mori
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
| | - Cansin Sackesen
- Division of Pediatric Allergy, Department of Pediatrics, School of Medicine, Koc University, 34450 Istanbul, Turkey
| | - George du Toit
- Pediatric Allergy Group, Department of Women and Children's Health, School of Life Course Sciences, King's College London, London SE1 9RT, UK
- Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London SE1 7EH, UK
- Peter Gorer Department of Immunobiology, School of Immunology & Microbial Sciences, King's College London, London SE5 9NU, UK
| | - Andreas L Lopata
- Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia
- Tropical Futures Institute, James Cook University, Singapore 387380, Singapore
| | - Antonella Muraro
- Food Allergy Referral Centre, Department of Mother and Child Health, University of Padua, 35128 Padua, Italy
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5
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Wai CYY, Leung NYH, Leung ASY, Ngai SM, Pacharn P, Yau YS, Rosa Duque JSD, Kwan M, Jirapongsananuruk O, Chan WH, Chua G, Lee QU, Piboonpocanun S, Ho PK, Wong JC, Li S, Xu KJY, Wong GWK, Chu K, Leung PSC, Vichyanond P, Leung TF. Comprehending the allergen repertoire of shrimp for precision molecular diagnosis of shrimp allergy. Allergy 2022; 77:3041-3051. [PMID: 35567339 PMCID: PMC9795902 DOI: 10.1111/all.15370] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 04/06/2022] [Accepted: 04/26/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Clinical management of shrimp allergy is hampered by the lack of accurate tests. Molecular diagnosis has been shown to more accurately reflect the clinical reactivity but the full spectrum of shrimp allergens and their clinical relevance are yet to be established. We therefore sought to comprehend the allergen repertoire of shrimp, investigate and compare the sensitization pattern and diagnostic value of the allergens in allergic subjects of two distinct populations. METHODS Sera were collected from 85 subjects with challenge-proven or doctor-diagnosed shrimp allergy in Hong Kong and Thailand. The IgE-binding proteins of Penaeus monodon were probed by Western blotting and identified by mass spectrometry. Recombinant shrimp allergens were synthesized and analyzed for IgE sensitization by ELISA. RESULTS Ten IgE-binding proteins were identified, and a comprehensive panel of 11 recombinant shrimp allergens was generated. The major shrimp allergens among Hong Kong subjects were troponin C (Pen m 6) and glycogen phosphorylase (Pen m 14, 47.1%), tropomyosin (Pen m 1, 41.2%) and sarcoplasmic-calcium binding protein (Pen m 4, 35.3%), while those among Thai subjects were Pen m 1 (68.8%), Pen m 6 (50.0%) and fatty acid-binding protein (Pen m 13, 37.5%). Component-based tests yielded significantly higher area under curve values (0.77-0.96) than shrimp extract-IgE test (0.70-0.75). Yet the best component test differed between populations; Pen m 1-IgE test added diagnostic value only in the Thai cohort, whereas sensitizations to other components were better predictors of shrimp allergy in Hong Kong patients. CONCLUSION Pen m 14 was identified as a novel shrimp allergen predictive of challenge outcome. Molecular diagnosis better predicts shrimp allergy than conventional tests, but the relevant component is population dependent.
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Affiliation(s)
- Christine Y. Y. Wai
- Department of Paediatrics, Prince of Wales HospitalThe Chinese University of Hong KongHong KongChina
| | - Nicki Y. H. Leung
- Department of Paediatrics, Prince of Wales HospitalThe Chinese University of Hong KongHong KongChina
| | - Agnes S. Y. Leung
- Department of Paediatrics, Prince of Wales HospitalThe Chinese University of Hong KongHong KongChina
| | - Sai Ming Ngai
- State Key Laboratory of AgrobiotechnologyThe Chinese University of Hong KongHong KongChina,School of Life SciencesThe Chinese University of Hong KongHong KongChina
| | - Punchama Pacharn
- Division of Allergy and Immunology, Department of Pediatrics, Faculty of MedicineSiriraj Hospital, Mahidol UniversityBangkokThailand
| | - Yat Sun Yau
- Department of PaediatricsQueen Elizabeth HospitalHong KongChina
| | - Jaime Sou Da Rosa Duque
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of MedicineThe University of Hong KongHong KongChina
| | - Mike Y. W. Kwan
- Department of Paediatrics and Adolescent MedicinePrincess Margaret Hospital and Yan Chai HospitalHong KongChina
| | - Orathai Jirapongsananuruk
- Division of Allergy and Immunology, Department of Pediatrics, Faculty of MedicineSiriraj Hospital, Mahidol UniversityBangkokThailand
| | - Wai Hung Chan
- Department of PaediatricsQueen Elizabeth HospitalHong KongChina
| | - Gilbert T. Chua
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of MedicineThe University of Hong KongHong KongChina
| | - Qun Ui Lee
- Department of Paediatrics and Adolescent MedicinePrincess Margaret Hospital and Yan Chai HospitalHong KongChina
| | | | - Po Ki Ho
- Department of PaediatricsQueen Elizabeth HospitalHong KongChina
| | - Joshua S. C. Wong
- Department of Paediatrics and Adolescent MedicinePrincess Margaret Hospital and Yan Chai HospitalHong KongChina
| | - Shanshan Li
- School of Life SciencesThe Chinese University of Hong KongHong KongChina
| | - Kary J. Y. Xu
- Department of Paediatrics, Prince of Wales HospitalThe Chinese University of Hong KongHong KongChina
| | - Gary W. K. Wong
- Department of Paediatrics, Prince of Wales HospitalThe Chinese University of Hong KongHong KongChina
| | - Ka Hou Chu
- School of Life SciencesThe Chinese University of Hong KongHong KongChina
| | - Patrick S. C. Leung
- Division of Rheumatology, Allergy and Clinical ImmunologyUniversity of CaliforniaDavisCaliforniaUSA
| | - Pakit Vichyanond
- Division of Allergy and Immunology, Department of Pediatrics, Faculty of MedicineSiriraj Hospital, Mahidol UniversityBangkokThailand,Samitivej Allergy InstituteSamitivej Thonburi HospitalBangkokThailand
| | - Ting Fan Leung
- Department of Paediatrics, Prince of Wales HospitalThe Chinese University of Hong KongHong KongChina,Hong Kong Hub of Paediatric ExcellenceThe Chinese University of Hong KongHong KongChina
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6
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Dong X, Raghavan V. Recent advances of selected novel processing techniques on shrimp allergenicity: A review. Trends Food Sci Technol 2022. [DOI: 10.1016/j.tifs.2022.04.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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7
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Emerging approaches in the diagnosis and therapy in shellfish allergy. Curr Opin Allergy Clin Immunol 2022; 22:202-212. [DOI: 10.1097/aci.0000000000000827] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jacquet A. Perspectives in Allergen-Specific Immunotherapy: Molecular Evolution of Peptide- and Protein-Based Strategies. Curr Protein Pept Sci 2020; 21:203-223. [PMID: 31416410 DOI: 10.2174/1389203720666190718152534] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 05/30/2019] [Accepted: 06/20/2019] [Indexed: 12/13/2022]
Abstract
Allergen-specific Immunotherapy (AIT), through repetitive subcutaneous or sublingual administrations of allergen extracts, represents up to now the unique treatment against allergic sensitizations. However, the clinical efficacy of AIT can be largely dependent on the quality of natural allergen extracts. Moreover, the long duration and adverse side effects associated with AIT negatively impact patient adherence. Tremendous progress in the field of molecular allergology has made possible the design of safer, shorter and more effective new immunotherapeutic approaches based on purified and characterized natural or recombinant allergen derivatives and peptides. This review will summarize the characteristics of these different innovative vaccines including their effects in preclinical studies and clinical trials.
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Affiliation(s)
- Alain Jacquet
- Center of Excellence in Vaccine Research and Development, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
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Wai CY, Leung NY, Chu KH, Leung PS, Leung AS, Wong GW, Leung TF. Overcoming Shellfish Allergy: How Far Have We Come? Int J Mol Sci 2020; 21:ijms21062234. [PMID: 32210187 PMCID: PMC7139905 DOI: 10.3390/ijms21062234] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/03/2020] [Accepted: 03/19/2020] [Indexed: 12/25/2022] Open
Abstract
Shellfish allergy caused by undesirable immunological responses upon ingestion of crustaceans and mollusks is a common cause of food allergy, especially in the Asia-Pacific region. While the prevalence of shellfish allergy is increasing, the mainstay of clinical diagnosis for these patients includes extract-based skin prick test and specific IgE measurement while clinical management consists of food avoidance and as-needed use of adrenaline autoinjector should they develop severe allergic reactions. Such a standard of care is unsatisfactory to both patients and healthcare practitioners. There is a pressing need to introduce more specific diagnostic methods, as well as effective and safe therapies for patients with shellfish allergy. Knowledge gained on the identifications and defining the immuno-molecular features of different shellfish allergens over the past two decades have gradually translated into the design of new diagnostic and treatment options for shellfish allergy. In this review, we will discuss the epidemiology, the molecular identification of shellfish allergens, recent progress in various diagnostic methods, as well as current development in immunotherapeutic approaches including the use of unmodified allergens, hypoallergens, immunoregulatory peptides and DNA vaccines for the prevention and treatment of shellfish allergy. The prospect of a “cure “for shellfish allergy is within reach.
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Affiliation(s)
- Christine Y.Y. Wai
- Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Nicki Y.H. Leung
- Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - Ka Hou Chu
- School of Life Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong;
| | - Patrick S.C. Leung
- Division of Rheumatology/Allergy, School of Medicine, University of California, Davis, CA 95616, USA;
| | - Agnes S.Y. Leung
- Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - Gary W.K. Wong
- Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - Ting Fan Leung
- Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Shatin, Hong Kong
- Correspondence: ; Tel.: +852-3505-2981; Fax: +852-2636-0020
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10
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Wai CYY, Leung NYH, Leung PSC, Chu KH. Modulating Shrimp Tropomyosin-Mediated Allergy: Hypoallergen DNA Vaccines Induce Regulatory T Cells to Reduce Hypersensitivity in Mouse Model. Int J Mol Sci 2019; 20:ijms20184656. [PMID: 31546958 PMCID: PMC6769673 DOI: 10.3390/ijms20184656] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 09/07/2019] [Accepted: 09/17/2019] [Indexed: 12/18/2022] Open
Abstract
Shellfish allergy is one of the most common food allergies, with tropomyosin as the major cross-reactive allergen. However, no allergen-specific immunotherapy is clinically available. Recently, we designed two shrimp hypoallergens MEM49 and MED171. This study aimed to examine and compare the efficacy of the MEM49- and MED171-based DNA vaccines (pMEM49 and pMED171) in modulating shrimp allergy in a murine model of shrimp tropomyosin sensitivity. Intradermal immunization of BALB/c mice with pMEM49 or pMED171 effectively down-modulated allergic symptoms, tropomyosin-specific IgE levels, intestinal Th2 cytokines expression, and inflammatory cell infiltration. Both pMEM49 and pMED171 increased the frequency of regulatory T cells, but to a greater extent by pMED171 with upregulation of gut-homing molecules integrin-α4β7. The functionality of the pMED171-induced Treg cells was further illustrated by anti-CD25-mediated depletion of Treg cells and the adoptive transfer of CD4+CD25+Foxp3+Treg cells. Collectively, the data demonstrate that intradermal administration of pMED171 leads to the priming, activation, and migration of dermal dendritic cells which subsequently induce Treg cells, both locally and systemically, to downregulate the allergic responses to tropomyosin. This study is the first to demonstrate the potency of hypoallergen-encoding DNA vaccines as a therapeutic strategy for human shellfish allergy via the vigorous induction of functional Treg cells.
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Affiliation(s)
- Christine Y Y Wai
- School of Life Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Department of Paediatrics, School of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Nicki Y H Leung
- School of Life Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Department of Paediatrics, School of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Patrick S C Leung
- Division of Rheumatology/Allergy, School of Medicine, University of California, Davis, CA 95616, USA.
| | - Ka Hou Chu
- School of Life Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
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11
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Glycosylated nanostructures in sublingual immunotherapy induce long-lasting tolerance in LTP allergy mouse model. Sci Rep 2019; 9:4043. [PMID: 30858392 PMCID: PMC6411722 DOI: 10.1038/s41598-019-40114-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 02/08/2019] [Indexed: 12/25/2022] Open
Abstract
An effective specific immunotherapy should contain elements to generate specific recognition (T-cell peptides) and to modulate the immunological response towards a Th1/Treg pattern by enhancing dendritic cells (DCs). We propose a novel sublingual immunotherapy for peach allergy, using systems, that combine Prup3-T-cell peptides with mannose dendrons (D1ManPrup3 and D4ManPrup3). Peach anaphylactic mice were treated 1, 2 and 5 nM concentrations. Tolerance was assessed one/five weeks after finishing treatment by determining in vivo/in vitro parameters after challenge with Prup3. Only mice receiving D1ManPrup3 at 2 nM were protected from anaphylaxis (no temperature changes, decrease in Prup3-sIgE and -sIgG1 antibody levels, and secreting cells) compared to PBS-treated mice. Moreover, an increase of Treg-cells and regulatory cytokines (IL-10+/IFN-γ+) in CD4+-T-cells and DCs were found. These changes were maintained at least five weeks after stopping treatment. D1ManPrup3 is an effective new approach of immunotherapy inducing protection from anaphylaxis which persists after finishing treatment.
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Leung ASY, Leung NYH, Wai CYY, Leung TF, Wong GWK. Allergen immunotherapy for food allergy from the Asian perspective: key challenges and opportunities. Expert Rev Clin Immunol 2018; 15:153-164. [PMID: 30488732 DOI: 10.1080/1744666x.2019.1554432] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Introduction: Prevalence of food allergy is rising in different regions of the world. Asia has not been spared from this epidemic, but epidemiological data have revealed a different pattern of food allergens in this continent. Allergen-specific immunotherapy (AIT) for food allergy, which has been revolutionary as the main focus of research in recent years, needs to be adapted for the different populations in Asia. Areas covered: Recent evidence shows increasing popularity and superiority of AIT over strict food avoidance as the cornerstone of food allergy management. Asia is a distinctive continent with specific food allergy triggers, in particular, seafood, and wheat. Peanut, on the contrary, is not a common food allergen in most parts of Asia. The common Asian food allergens, as well as the rapidly developing food-specific AIT in this region will be covered in this article. Expert commentary: Evidence on oral immunotherapy for wheat allergy and preclinical data on shellfish AIT are promising. Further work should be done on resolving cross-sensitization between environmental allergens with wheat and shellfish allergens, and a modified AIT approach to enhance the safety and effectiveness of food-specific immunotherapy.
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Affiliation(s)
- Agnes Sze Yin Leung
- a Department of Paediatrics , The Chinese University of Hong Kong, Prince of Wales Hospital Shatin , New Territories , Hong Kong
| | - Nicki Yat Hin Leung
- a Department of Paediatrics , The Chinese University of Hong Kong, Prince of Wales Hospital Shatin , New Territories , Hong Kong
| | - Christine Yee Yan Wai
- a Department of Paediatrics , The Chinese University of Hong Kong, Prince of Wales Hospital Shatin , New Territories , Hong Kong
| | - Ting Fan Leung
- a Department of Paediatrics , The Chinese University of Hong Kong, Prince of Wales Hospital Shatin , New Territories , Hong Kong
| | - Gary Wing Kin Wong
- a Department of Paediatrics , The Chinese University of Hong Kong, Prince of Wales Hospital Shatin , New Territories , Hong Kong
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Adams OJ, von Gunten S. Recent Advances in Experimental Allergy. Int Arch Allergy Immunol 2018; 177:281-289. [PMID: 30423562 DOI: 10.1159/000494440] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 10/10/2018] [Indexed: 11/19/2022] Open
Abstract
Atopic disorders are on the rise and pose a great burden on society. A better understanding of the underlying mechanisms is required for the development of improved or novel therapeutic strategies. Here we aim to highlight recent advances in experimental allergy, with a particular focus on proposed treatment alternatives for airway disorders, atopic dermatitis, and food allergy. Furthermore, we discuss recent work focusing on molecular and cellular mechanisms that might offer candidates for future preventive or therapeutic intervention.
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Seafood allergy: A comprehensive review of fish and shellfish allergens. Mol Immunol 2018; 100:28-57. [PMID: 29858102 DOI: 10.1016/j.molimm.2018.04.008] [Citation(s) in RCA: 183] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 04/11/2018] [Accepted: 04/16/2018] [Indexed: 11/23/2022]
Abstract
Seafood refers to several distinct groups of edible aquatic animals including fish, crustacean, and mollusc. The two invertebrate groups of crustacean and mollusc are, for culinary reasons, often combined as shellfish but belong to two very different phyla. The evolutionary and taxonomic diversity of the various consumed seafood species poses a challenge in the identification and characterisation of the major and minor allergens critical for reliable diagnostics and therapeutic treatments. Many allergenic proteins are very different between these groups; however, some pan-allergens, including parvalbumin, tropomyosin and arginine kinase, seem to induce immunological and clinical cross-reactivity. This extensive review details the advances in the bio-molecular characterisation of 20 allergenic proteins within the three distinct seafood groups; fish, crustacean and molluscs. Furthermore, the structural and biochemical properties of the major allergens are described to highlight the immunological and subsequent clinical cross-reactivities. A comprehensive list of purified and recombinant allergens is provided, and the applications of component-resolved diagnostics and current therapeutic developments are discussed.
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