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Leung ASY, Wai CYY, Leung NYH, Ngai NA, Chua GT, Ho PK, Lam ICS, Cheng JWCH, Chan OM, Li PF, Au AWS, Leung CHW, Cheng NS, Tang MF, Fong BLY, Rosa Duque JS, Wong JSC, Luk DCK, Ho MHK, Kwan MYW, Yau YS, Lee QU, Chan WH, Wong GWK, Leung TF. Real-World Sensitization and Tolerance Pattern to Seafood in Fish-Allergic Individuals. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:633-642.e9. [PMID: 37802255 DOI: 10.1016/j.jaip.2023.09.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 09/02/2023] [Accepted: 09/26/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Seafood is a common cause of food allergy and anaphylaxis, but there are limited published real-world data describing the clinical presentation of fish and shellfish allergies. OBJECTIVE This study aimed to examine the clinical characteristics, immunological profile, and tolerance pattern to fish, crustaceans, and mollusks in fish-allergic individuals. METHODS Patients presenting with IgE-mediated fish allergy between 2016 and 2021 were recruited. A comprehensive sensitization profile including specific IgE and skin prick test to various fish and shellfish species and a detailed clinical history including individuals' recent seafood consumption were evaluated. RESULTS A total of 249 fish-allergic individuals (aged 4.2 ± 5.8 years) were recruited from 6 allergy clinics in Hong Kong, and they had experienced their fish-allergic reaction 2.2 ± 3.4 years before enrollment. Seventy-five subjects (30%) reacted to either grass carp, salmon, grouper, or cod in oral food challenges. We identified an IgE sensitization gradient that corresponded to the level of β-parvalbumin in fish. In total, 40% of fish-allergic individuals reported tolerance to 1 or more types of fish, more commonly to fish with a lower β-parvalbumin level such as tuna and salmon, compared with β-parvalbumin-rich fish such as catfish and grass carp. Despite fish and shellfish cosensitization, 41% of individuals reported tolerance to crustaceans, mollusks, or both, whereas shellfish avoidance occurred in half of the fish-allergic individuals, of whom 33% lacked shellfish sensitization. CONCLUSIONS Fish allergy commonly presents in early childhood. A considerable proportion of fish-allergic patients are selectively tolerant to certain fish, typically those with lower levels of β-parvalbumin. There is an unmet need to promote precision medicine for seafood allergies.
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Affiliation(s)
- Agnes S Y Leung
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of the People's Republic of China, China; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of the People's Republic of China, China.
| | - Christine Y Y Wai
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of the People's Republic of China, China
| | - Nicki Y H Leung
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of the People's Republic of China, China
| | - Noelle Anne Ngai
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of the People's Republic of China, China
| | - Gilbert T Chua
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, the University of Hong Kong, Hong Kong Special Administrative Region of the People's Republic of China, China
| | - Po Ki Ho
- Department of Paediatrics, Queen Elizabeth Hospital, Hong Kong Special Administrative Region of the People's Republic of China, China
| | - Ivan C S Lam
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong Special Administrative Region of the People's Republic of China, China; Department of Paediatrics and Adolescent Medicine, Yan Chai Hospital, Hong Kong Special Administrative Region of the People's Republic of China, China
| | - James W C H Cheng
- Department of Paediatrics and Adolescent Medicine, United Christian Hospital, Hong Kong Special Administrative Region of the People's Republic of China, China
| | - Oi Man Chan
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of the People's Republic of China, China
| | - Pui Fung Li
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of the People's Republic of China, China
| | - Ann W S Au
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of the People's Republic of China, China
| | - Chloris H W Leung
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of the People's Republic of China, China
| | - Nam Sze Cheng
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of the People's Republic of China, China
| | - Man Fung Tang
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of the People's Republic of China, China; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of the People's Republic of China, China
| | - Brian L Y Fong
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of the People's Republic of China, China
| | - Jaime S Rosa Duque
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, the University of Hong Kong, Hong Kong Special Administrative Region of the People's Republic of China, China
| | - Joshua S C Wong
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong Special Administrative Region of the People's Republic of China, China; Department of Paediatrics and Adolescent Medicine, Yan Chai Hospital, Hong Kong Special Administrative Region of the People's Republic of China, China
| | - David C K Luk
- Department of Paediatrics and Adolescent Medicine, United Christian Hospital, Hong Kong Special Administrative Region of the People's Republic of China, China
| | - Marco H K Ho
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, the University of Hong Kong, Hong Kong Special Administrative Region of the People's Republic of China, China
| | - Mike Y W Kwan
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong Special Administrative Region of the People's Republic of China, China; Department of Paediatrics and Adolescent Medicine, Yan Chai Hospital, Hong Kong Special Administrative Region of the People's Republic of China, China
| | - Yat Sun Yau
- Department of Paediatrics, Queen Elizabeth Hospital, Hong Kong Special Administrative Region of the People's Republic of China, China
| | - Qun Ui Lee
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong Special Administrative Region of the People's Republic of China, China; Department of Paediatrics and Adolescent Medicine, Yan Chai Hospital, Hong Kong Special Administrative Region of the People's Republic of China, China
| | - Wai Hung Chan
- Department of Paediatrics, Queen Elizabeth Hospital, Hong Kong Special Administrative Region of the People's Republic of China, China
| | - Gary W K Wong
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of the People's Republic of China, China
| | - Ting Fan Leung
- Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of the People's Republic of China, China; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of the People's Republic of China, China.
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2
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Mastrorilli C, Arasi S, Barni S, Caimmi D, Chiera F, Comberiati P, Dinardo G, Giannetti A, Gismondi M, Gracci S, Paravati F, Pelosi U, Miraglia Del Giudice M, Bernardini R, Pecoraro L. IgE-Mediated and Non-IgE-Mediated Fish Allergy in Pediatric Age: A Holistic Approach-A Consensus by Diagnostic Commission of the Italian Society of Pediatric Allergy and Immunology. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1651. [PMID: 37763770 PMCID: PMC10537060 DOI: 10.3390/medicina59091651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/29/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023]
Abstract
Fish is one of the "big nine" foods triggering allergic reactions. For this reason, fish allergens must be accurately specified on food labels. Fish allergy affects less than 1% of the world population, but a higher prevalence is observed in pediatric cohorts, up to 7%. Parvalbumin is the main fish allergen found in the muscles. In childhood, sensitization to fish allergens occurs most frequently through the ingestion of fish, rarely transcutaneously or by inhalation. Fish allergy symptoms usually appear within two hours of the allergen contact. The diagnosis begins with the collection of the history. If it is suggestive of fish allergy, prick tests or the measurement of serum-specific IgE should be performed to confirm the suspicion. The oral food challenge is the gold standard for the diagnosis. It is not recommended in case of a severe allergic reaction. It is important to make a differential diagnosis with anisakiasis or scombroid poisoning, which have overlapping clinical features but differ in pathogenesis. Traditionally, managing fish allergy involves avoiding the triggering species (sometimes all bony fish species) and requires an action plan for accidental exposures. The present review will analyze IgE- and non-IgE-mediated fish allergy in children from epidemiology, pathogenesis to clinical features. Moreover, clinical management will be addressed with a particular focus on potential nutritional deficiencies.
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Affiliation(s)
- Carla Mastrorilli
- Admission and Emergency Pediatric Medicine and Surgery Unit, University Hospital Consortium Corporation Polyclinic of Bari, Pediatric Hospital Giovanni XXIII, 70124 Bari, Italy; (C.M.); (M.G.)
| | - Stefania Arasi
- Area of Translational Research in Pediatric Specialities, Allergy Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
| | - Simona Barni
- Allergic Unit, Department of Pediatric, Meyer Children’s Hospital, 50139 Florence, Italy;
| | - Davide Caimmi
- Allergy Unit, CHU de Montpellier, Université de Montpellier, 34295 Montpellier, France;
- IDESP, UMR A11, Université de Montpellier, 34093 Montpellier, France
| | - Fernanda Chiera
- Department of Pediatrics, San Giovanni di Dio Hospital, 88900 Crotone, Italy; (F.C.); (F.P.)
| | - Pasquale Comberiati
- Section of Paediatrics, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy;
| | - Giulio Dinardo
- Department of Woman, Child and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.D.); (M.M.D.G.)
| | - Arianna Giannetti
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Marco Gismondi
- Admission and Emergency Pediatric Medicine and Surgery Unit, University Hospital Consortium Corporation Polyclinic of Bari, Pediatric Hospital Giovanni XXIII, 70124 Bari, Italy; (C.M.); (M.G.)
| | - Serena Gracci
- Pediatrics and Neonatology Complex Unit, San Giuseppe Hospital, Azienda USL Toscana Centro, 50053 Empoli, Italy;
- Department of Pediatrics, University Hospital of Pisa, 56124 Pisa, Italy
| | - Francesco Paravati
- Department of Pediatrics, San Giovanni di Dio Hospital, 88900 Crotone, Italy; (F.C.); (F.P.)
| | - Umberto Pelosi
- Pediatric Unit, Santa Barbara Hospital, 09016 Iglesias, Italy;
| | - Michele Miraglia Del Giudice
- Department of Woman, Child and of General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.D.); (M.M.D.G.)
| | - Roberto Bernardini
- Pediatrics and Neonatology Complex Unit, San Giuseppe Hospital, Azienda USL Toscana Centro, 50053 Empoli, Italy;
| | - Luca Pecoraro
- Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37126 Verona, Italy;
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3
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Sližienė A, Plečkaitytė M, Rudokas V, Juškaitė K, Žvirblis G, Žvirblienė A. Cross-reactive monoclonal antibodies against fish parvalbumins as a tool for studying antigenic similarity of different parvalbumins and analysis of fish extracts. Mol Immunol 2023; 154:80-95. [PMID: 36621061 DOI: 10.1016/j.molimm.2023.01.001] [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: 08/31/2022] [Revised: 12/30/2022] [Accepted: 01/02/2023] [Indexed: 01/08/2023]
Abstract
Fish parvalbumins are heat-stable calcium-binding proteins that are highly cross-reactive in causing allergy symptoms in fish-sensitized patients. The reactivities of parvalbumin-specific monoclonal or polyclonal antibodies with parvalbumins of different fish species allowed their application for development of various immunoassays for allergen identification in fish samples. In this study, monoclonal antibodies (MAbs) were generated against two parvalbumins - natural Atlantic cod parvalbumin and recombinant common carp β-parvalbumin expressed in E. coli. Large collections of recombinant parvalbumins and natural allergen extracts of different fish species and other animals were used to identify the specificities of these MAbs using ELISA, Western blot, and dot blot. MAbs demonstrated different patterns of cross-reactivities with recombinant parvalbumins. Their binding affinities were affected by the addition and removal of Ca2+ ions. Moreover, all MAbs showed a broad reactivity with the target antigens in natural fish, chicken, and pork extracts. The ability of two MAbs (clones 7B2 and 3F6) to identify and isolate native parvalbumins from allergen extracts was confirmed by Western blot. Epitope mapping using recombinant fragments of Atlantic cod parvalbumin (Gad m 1) and common carp parvalbumin (Cyp c 1) revealed that 4 out of 5 MAbs recognize parvalbumin regions that contain calcium binding sites. In conclusion, the generated broadly reactive well-characterized MAbs against fish β-parvalbumins could be applied for investigation of parvalbumins of fish and other animals and their detection in allergen extracts.
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Affiliation(s)
- Aistė Sližienė
- Institute of Biotechnology, Life Sciences Center, Vilnius University, Saulėtekio al. 7, LT-10257 Vilnius, Lithuania.
| | - Milda Plečkaitytė
- Institute of Biotechnology, Life Sciences Center, Vilnius University, Saulėtekio al. 7, LT-10257 Vilnius, Lithuania.
| | - Vytautas Rudokas
- Institute of Biotechnology, Life Sciences Center, Vilnius University, Saulėtekio al. 7, LT-10257 Vilnius, Lithuania.
| | - Karolina Juškaitė
- Institute of Biotechnology, Life Sciences Center, Vilnius University, Saulėtekio al. 7, LT-10257 Vilnius, Lithuania.
| | - Gintautas Žvirblis
- Institute of Biotechnology, Life Sciences Center, Vilnius University, Saulėtekio al. 7, LT-10257 Vilnius, Lithuania.
| | - Aurelija Žvirblienė
- Institute of Biotechnology, Life Sciences Center, Vilnius University, Saulėtekio al. 7, LT-10257 Vilnius, Lithuania.
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4
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Li MS, Xia F, Liu Q, Chen Y, Yun X, Liu M, Chen GX, Wang L, Cao MJ, Liu GM. IgE Epitope Analysis for Scy p 1 and Scy p 3, the Heat-Stable Myofibrillar Allergens in Mud Crab. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2022; 70:12189-12202. [PMID: 36110087 DOI: 10.1021/acs.jafc.2c04849] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Tropomyosin (Scy p 1) and myosin light chain (Scy p 3) are investigated to be important heat-stable allergens in Scylla paramamosain. However, the epitopes of Scy p 1 and Scy p 3 are limited. In this study, recombinant Scy p 1 and Scy p 3 had similar IgE-binding capacity to natural proteins. Mimotopes of Scy p 1 and Scy p 3 were analyzed by bioinformatics, phage display, and one-bead-one-compound technology. Ten linear epitopes of Scy p 1 and seven linear epitopes of Scy p 3 were identified by synthetic peptides and inhibition dot blot. Meanwhile, three conformational epitopes of Scy p 1 and seven conformational epitopes of Scy p 3 were verified by site-directed mutagenesis and the serological test. Furthermore, strong IgE-binding epitopes of Scy p 1 and Scy p 3 were conserved in multiple crustaceans. Overall, these epitopes could enhance our understanding of crab allergens, which lay the foundation for a cross-reaction.
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Affiliation(s)
- Meng-Si Li
- College of Ocean Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, National & Local Joint Engineering Research Center of Processing Technology for Aquatic Products, Jimei University, Xiamen, Fujian 361021, China
| | - Fei Xia
- College of Ocean Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, National & Local Joint Engineering Research Center of Processing Technology for Aquatic Products, Jimei University, Xiamen, Fujian 361021, China
| | - Qingmei 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, National & Local Joint Engineering Research Center of Processing Technology for Aquatic Products, Jimei University, Xiamen, Fujian 361021, China
| | - Yiyu Chen
- College of Ocean Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, National & Local Joint Engineering Research Center of Processing Technology for Aquatic Products, Jimei University, Xiamen, Fujian 361021, China
| | - Xiao Yun
- College of Ocean Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, National & Local Joint Engineering Research Center of Processing Technology for Aquatic Products, Jimei University, Xiamen, Fujian 361021, China
| | - Meng 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, National & Local Joint Engineering Research Center of Processing Technology for Aquatic Products, Jimei University, Xiamen, Fujian 361021, China
| | - Gui-Xia Chen
- Women and Children's Hospital Affiliated to Xiamen University, Xiamen, Fujian 361003, China
| | - Li Wang
- College of Ocean Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, National & Local Joint Engineering Research Center of Processing Technology for Aquatic Products, Jimei University, Xiamen, Fujian 361021, China
| | - Min-Jie Cao
- College of Ocean Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, National & Local Joint Engineering Research Center of Processing Technology for Aquatic Products, Jimei University, Xiamen, Fujian 361021, China
| | - Guang-Ming 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, National & Local Joint Engineering Research Center of Processing Technology for Aquatic Products, Jimei University, Xiamen, Fujian 361021, China
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5
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Villalta D, Scala E, Deleonardi G, Busa M, Rivolta F, Boni E, Gabrielli G, Farioli L, Cappelletti C, Buzzulini F, Conte M, Pravettoni V, Asero R. A comprehensive molecular approach in fish allergy: Usefulness in daily clinical practice. Clin Chim Acta 2022; 533:104-108. [PMID: 35716706 DOI: 10.1016/j.cca.2022.06.010] [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: 05/01/2022] [Revised: 05/15/2022] [Accepted: 06/07/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND AND AIMS Diagnosis of fish may represent an important challenge for the allergists. This study aimed to evaluate the diagnostic sensitivity of an in vitro multiplex assay using a comprehensive panel of fish allergens and the cross-reactivity patterns between different molecular components. METHODS 56 subjects with fish allergy were enrolled. All patients underwent specific IgE measurement using the Allergy Explorer-Alex 2™ multiplex assay (Macroarray Diagnostics, Vienna, Austria) RESULTS: The single ß-parvalbumins Clu h 1, Cyp c 1, Gad m 1, Sal s 1, Sco s 1, Thu a 1 and Xyp g 1 scored positive in 75.0%, 67.8%, 62.5%, 80.3%,80.3%, 78.8% and 73,2% patients, respectively. 14.3% scored positive for the α-parvalbumin (Raj c-parvalbumin), and 16.1% for the aldolase + enolase (Gad m 2 + 3) components. 92.8% reacted to at least one ß-parvalbumin and 96.4% to at least one of the allergens tested. Overall sensitivity was higher than that obtained using commercial extracts of cod, salmon and tuna for skin prick test (75.8%) and IgE detection (92.3%). CONCLUSIONS The Alex 2 showed high diagnostic sensitivity and it might be used as an additional assay to investigate the cross-reactivity patterns between different molecular components, looking for potentially safe fish species.
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Affiliation(s)
- Danilo Villalta
- Immunologia e allergologia, Ospedale S, Maria degli Angeli, Pordenone, Italy.
| | - Enrico Scala
- Istituto Dermopatico dell'Immacolata, Rome, Italy
| | | | - Moira Busa
- UOS Dermatologia, Ospedale di Mirano, Venice, Italy
| | - Federica Rivolta
- UOC Medicina Generale Immunologia e Allergologia - IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Elisa Boni
- Allergologia e Immunologia, LUM AUSL, Bologna, Italy
| | - Giulia Gabrielli
- Scuola si specializzazione in Allergologia e Immunologia, Alma Mater Studiorum University, Bologna, Italy
| | - Laura Farioli
- Dipartimento di Allergologia, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | | | - Francesca Buzzulini
- Immunologia e allergologia, Ospedale S, Maria degli Angeli, Pordenone, Italy
| | | | - Valerio Pravettoni
- UOC Medicina Generale Immunologia e Allergologia - IRCCS Foundation Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Riccardo Asero
- Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Milan, Italy
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6
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Romeu ME, Camacho AL, Moreno Aguilar C, Jurado Roger A, Moreno Benítez F. Identification of myosin light chain protein as a major fish allergen. Clin Exp Allergy 2022; 52:1101-1104. [PMID: 35707958 PMCID: PMC9545155 DOI: 10.1111/cea.14186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 05/27/2022] [Accepted: 05/29/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Marisa Espinazo Romeu
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC)/ Reina Sofia University Hospital/ University of Cordoba, Cordoba, Spain.,National Network ARADyAL. Health Institute Carlos III, Madrid, Spain
| | | | - Carmen Moreno Aguilar
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC)/ Reina Sofia University Hospital/ University of Cordoba, Cordoba, Spain.,National Network ARADyAL. Health Institute Carlos III, Madrid, Spain
| | - Aurora Jurado Roger
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC)/ Reina Sofia University Hospital/ University of Cordoba, Cordoba, Spain.,National Network ARADyAL. Health Institute Carlos III, Madrid, Spain
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7
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Berni Canani R, Caffarelli C, Calvani M, Martelli A, Carucci L, Cozzolino T, Alvisi P, Agostoni C, Lionetti P, Marseglia GL. Diagnostic therapeutic care pathway for pediatric food allergies and intolerances in Italy: a joint position paper by the Italian Society for Pediatric Gastroenterology Hepatology and Nutrition (SIGENP) and the Italian Society for Pediatric Allergy and Immunology (SIAIP). Ital J Pediatr 2022; 48:87. [PMID: 35689252 PMCID: PMC9188074 DOI: 10.1186/s13052-022-01277-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 05/10/2022] [Indexed: 11/10/2022] Open
Abstract
Epidemiologic data suggest an increased prevalence of pediatric food allergies and intolerances (FAIs) during the last decades. This changing scenario has led to an increase in the overall healthcare costs, due to a growing demand for diagnostic and treatment services. There is the need to establish Evidence-based practices for diagnostic and therapeutic intervention that could be adopted in the context of public health policies for FAIs are needed. This joint position paper has been prepared by a group of experts in pediatric gastroenterology, allergy and nutrition from the Italian Society for Pediatric Gastroenterology Hepatology and Nutrition (SIGENP) and the Italian Society for Pediatric Allergy and Immunology (SIAIP). The paper is focused on the Diagnostic Therapeutic Care Pathway (DTCP) for pediatric FAIs in Italy.
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Affiliation(s)
- Roberto Berni Canani
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy. .,CEINGE-Biotecnologie Avanzate s.c.ar.l. University of Naples Federico II, Naples, Italy. .,European Laboratory for the Investigation of Food-Induced Diseases, University of Naples, Federico II, Naples, Italy. .,Task Force for Microbiome Studies, University of Naples Federico II, Naples, Italy.
| | - Carlo Caffarelli
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Mauro Calvani
- Pediatric Unit, S. Camillo Forlanini Hospital, Rome, Italy
| | - Alberto Martelli
- Department of Pediatrics, G. Salvini Hospital, Garbagnate Milanese, Milan, Italy
| | - Laura Carucci
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate s.c.ar.l. University of Naples Federico II, Naples, Italy
| | - Tommaso Cozzolino
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate s.c.ar.l. University of Naples Federico II, Naples, Italy
| | - Patrizia Alvisi
- Pediatric Gastroenterology Unit, Maggiore Hospital, Bologna, Italy
| | - Carlo Agostoni
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Pediatric Intermediate Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Lionetti
- Pediatric Gastroenterology and Nutrition Unit, Meyer Children's Hospital, Florence, Italy
| | - Gian Luigi Marseglia
- Pediatric Clinic, IRCCS "S. Matteo" Foundation, University of Pavia, Pavia, Italy
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8
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Wu Y, Lu Y, Huang Y, Lin H, Xu M, Ahmed I, Chen G, Chen Y, Li Z. Fish allergens of turbot ( Scophthalmus maximus) parvalbumin triggers food allergy via inducing maturation of bone marrow derived dendritic cells and driving Th2 immune response. Food Funct 2022; 13:4194-4204. [PMID: 35322825 DOI: 10.1039/d1fo04070g] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Aquatic food allergy has become a key food safety problem and therefore it is urgent to study the mechanism of aquatic food allergy. Turbot parvalbumin (PV) is a major marine food allergen that could cause allergic reactions but the cellular and molecular mechanisms remain to be defined. In this study, we used flow cytometry and ELISA, a coupled co-culture system of dendritic cells and T cells, and revealed that PV could promote the maturation of dendritic cells, mainly by inducing bone marrow-derived dendritic cells (BMDCs) to express MHC II and CD86, and promote the cytokines/chemokines IL-6, IFN-γ, IL-23, and IL-12p70, whereas inhibiting TNF-α expression. Our results suggested that murine BMDCs play a crucial role in the effect of PV on the induction of Th2 responses.
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Affiliation(s)
- Yeting Wu
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong Province 266000, China.
| | - Youyou Lu
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan, Hubei Province 430070, China
| | - Yuhao Huang
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong Province 266000, China.
| | - Hong Lin
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong Province 266000, China.
| | - Mengyao Xu
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong Province 266000, China.
| | - Ishfaq Ahmed
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong Province 266000, China.
| | - Guanzhi Chen
- Dermatological department, the Affiliated Hospital of Medical College Qingdao University, Qingdao, Shandong Province 266071, China
| | - Yan Chen
- Chinese Academy of Medical Sciences Research Unit (No. 2019RU014), China National Center for Food Safety Risk Assessment, Beijing 100021, China
| | - Zhenxing Li
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong Province 266000, China.
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9
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Kalic T, Radauer C, Lopata AL, Breiteneder H, Hafner C. Fish Allergy Around the World—Precise Diagnosis to Facilitate Patient Management. FRONTIERS IN ALLERGY 2021; 2:732178. [PMID: 35387047 PMCID: PMC8974716 DOI: 10.3389/falgy.2021.732178] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/17/2021] [Indexed: 02/03/2023] Open
Abstract
The accurate and precise diagnosis of IgE-mediated fish allergy is one of the biggest challenges in allergy diagnostics. A wide range of fish species that belong to evolutionary distant classes are consumed globally. Moreover, each fish species may contain multiple isoforms of a given allergen that often differ in their allergenicity. Recent studies indicated that the cross-reactivity between different fish species is limited in some cases and depends on the evolutionary conservation of the involved allergens. Fish allergens belong to several protein families with different levels of stability to food processing. Additionally, different preparation methods may contribute to specific sensitization patterns to specific fish species and allergens in different geographic regions. Here, we review the challenges and opportunities for improved diagnostic approaches to fish allergy. Current diagnostic shortcomings include the absence of important region-specific fish species in commercial in vitro and in vivo tests as well as the lack of their standardization as has been recently demonstrated for skin prick test solutions. These diagnostic shortcomings may compromise patients' safety by missing some of the relevant species and yielding false negative test results. In contrast, the avoidance of all fish as a common management approach is usually not necessary as many patients may be only sensitized to specific species and allergens. Although food challenges remain the gold standard, other diagnostic approaches are investigated such as the basophil activation test. In the context of molecular allergy diagnosis, we discuss the usefulness of single allergens and raw and heated fish extracts. Recent developments such as allergen microarrays offer the possibility to simultaneously quantify serum IgE specific to multiple allergens and allergen sources. Such multiplex platforms may be used in the future to design diagnostic allergen panels covering evolutionary distant fish species and allergens relevant for particular geographic regions.
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Affiliation(s)
- Tanja Kalic
- Department of Dermatology, University Hospital St. Poelten, Karl Landsteiner University of Health Sciences, St. Poelten, Austria
- Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Christian Radauer
- Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Andreas L. Lopata
- Molecular Allergy Research Laboratory, Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia
- Tropical Futures Institute, James Cook University, Singapore, Singapore
| | - Heimo Breiteneder
- Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Christine Hafner
- Department of Dermatology, University Hospital St. Poelten, Karl Landsteiner University of Health Sciences, St. Poelten, Austria
- Karl Landsteiner Institute for Dermatological Research, Karl Landsteiner Society, St. Poelten, Austria
- *Correspondence: Christine Hafner
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10
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Xepapadaki P, Christopoulou G, Stavroulakis G, Freidl R, Linhart B, Zuidmeer L, Lakoumentas J, van Ree R, Valenta R, Papadopoulos NG. Natural History of IgE-Mediated Fish Allergy in Children. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:3147-3156.e5. [PMID: 33866031 DOI: 10.1016/j.jaip.2021.04.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Fish allergy is not uncommon, especially in countries with high fish consumption, it can frequently be severe and may affect dietetic and lifestyle choices. Nevertheless, data on its clinical course and natural history are scarce. OBJECTIVE To describe the natural history of immunoglobulin E-mediated fish allergy and the potential differential reactivity to various fish species and identify prognostic markers in children with confirmed disease. METHODS Clinical history, specific immunoglobulin E, and skin prick tests to various fish were recorded in 126 children with confirmed immunoglobulin E-mediated fish allergy. Immunoglobulin E reactivity was also evaluated by immunoblotting. Eligible participants proceeded to a series of food challenges to tuna, swordfish, and codfish. In total, 234 challenges were performed. RESULTS Fifty-eight children (9.7 ± 3.9 years) were included in the analysis. Age at first reaction was 0.5 to 5 years (median, 1.3 years). Thirteen children (22%) tolerated all fish tested, including cod, 1 to 14 years (mean, 8.2 ± 4.2 years) following their first reported reaction. Complete fish tolerance increased with age, ranging from 3.4% in preschool children to over 45% in adolescents (95% confidence interval, 26.3%-79.7%). Most children were able to tolerate swordfish (94%) and tuna (95%). Prechallenge specific immunoglobulin E to cod greater than 4.87 kUA/L was the best positive predictive marker for fish allergy persistence (94%), followed by skin prick tests to sardine greater than 6.5 mm (92%). CONCLUSIONS A considerable proportion of fish-allergic children develop tolerance around adolescence. Most fish-allergic children can consume tuna and swordfish, which, thus, provide safe alternatives for a balanced diet.
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Affiliation(s)
- Paraskevi Xepapadaki
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgia Christopoulou
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - George Stavroulakis
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Raphaela Freidl
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Birgit Linhart
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Laurian Zuidmeer
- Department of Experimental Immunology, Amsterdam University Medical Centers, location AMC, Amsterdam, The Netherlands
| | - John Lakoumentas
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Ronald van Ree
- Department of Experimental Immunology, Amsterdam University Medical Centers, location AMC, Amsterdam, The Netherlands; Department of Otorhinolaryngology, Amsterdam University Medical Centers, location AMC, Amsterdam, The Netherlands
| | - Rudolf Valenta
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria; NRC Institute of Immunology FMBA of Russia; Laboratory for Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First, Moscow State Medical University, Moscow, Russia; Laboratory for Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, Moscow, Russia; Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Nikolaos G Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece; Division of Infection, Immunity, and Respiratory Medicine, The University of Manchester, Manchester, United Kingdom.
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11
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Buyuktiryaki B, Masini M, Mori F, Barni S, Liccioli G, Sarti L, Lodi L, Giovannini M, du Toit G, Lopata AL, Marques-Mejias MA. IgE-Mediated Fish Allergy in Children. ACTA ACUST UNITED AC 2021; 57:medicina57010076. [PMID: 33477460 PMCID: PMC7830012 DOI: 10.3390/medicina57010076] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/08/2021] [Accepted: 01/11/2021] [Indexed: 12/14/2022]
Abstract
Fish allergy constitutes a severe problem worldwide. Its prevalence has been calculated as high as 7% in paediatric populations, and in many cases, it persists into adulthood with life-threatening signs and symptoms. The following review focuses on the epidemiology of Immunoglobulin E (IgE)-mediated fish allergy, its pathogenesis, clinical manifestations, and a thorough approach to diagnosis and management in the paediatric population. The traditional approach for managing fish allergy is avoidance and rescue medication for accidental exposures. Food avoidance poses many obstacles and is not easily maintained. In the specific case of fish, food is also not the only source of allergens; aerosolisation of fish proteins when cooking is a common source of highly allergenic parvalbumin, and elimination diets cannot prevent these contacts. Novel management approaches based on immunomodulation are a promising strategy for the future of these patients.
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Affiliation(s)
- Betul Buyuktiryaki
- Division of Pediatric Allergy, Koc University Hospital, 34010 Istanbul, Turkey;
| | - Marzio Masini
- Department of Pediatrics, Sapienza University of Rome, 00185 Rome, Italy;
| | - Francesca Mori
- Allergy Unit, Department of Pediatrics, Meyer Children’s University Hospital, 50139 Florence, Italy; (F.M.); (S.B.); (G.L.); (L.S.)
| | - Simona Barni
- Allergy Unit, Department of Pediatrics, Meyer Children’s University Hospital, 50139 Florence, Italy; (F.M.); (S.B.); (G.L.); (L.S.)
| | - Giulia Liccioli
- Allergy Unit, Department of Pediatrics, Meyer Children’s University Hospital, 50139 Florence, Italy; (F.M.); (S.B.); (G.L.); (L.S.)
| | - Lucrezia Sarti
- Allergy Unit, Department of Pediatrics, Meyer Children’s University Hospital, 50139 Florence, Italy; (F.M.); (S.B.); (G.L.); (L.S.)
| | - Lorenzo Lodi
- Department of Health Sciences, Division of Immunology, Section of Pediatrics, University of Florence and Meyer Children’s Hospital, 50139 Florence, Italy;
| | - Mattia Giovannini
- Allergy Unit, Department of Pediatrics, Meyer Children’s University Hospital, 50139 Florence, Italy; (F.M.); (S.B.); (G.L.); (L.S.)
- Pediatric Allergy Group, Department of Women and Children’s Health, School of Life Course Sciences, King’s College London, London SE5 9NU, UK; (G.d.T.); (M.A.M.-M.)
- Correspondence:
| | - George du Toit
- Pediatric Allergy Group, Department of Women and Children’s Health, School of Life Course Sciences, King’s College London, London SE5 9NU, UK; (G.d.T.); (M.A.M.-M.)
- 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 Ludwig 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;
| | - Maria Andreina Marques-Mejias
- Pediatric Allergy Group, Department of Women and Children’s Health, School of Life Course Sciences, King’s College London, London SE5 9NU, UK; (G.d.T.); (M.A.M.-M.)
- Children’s Allergy Service, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 7EH, UK
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