Several allergens from Anisakis simplex are highly resistant to heat and pepsin treatments.

Ingestion of raw or undercooked fish can lead to infection with Anisakis simplex. Sensitized patients show specific IgE to proteins from this parasite. The aim of this study was to assess the frequency of specific IgE recognition directed to heat and/or pepsin-resistant allergens from A. simplex among sensitized patients. Twenty-seven patients with positive specific IgE and immunoblotting with a crude parasite extract were included in the study. Specific IgE detection against allergens resistant to boiling for 30 min and/or a pepsin digestion of an A. simplex extract was performed by immunoblotting. A total of 81% of the patients showed specific IgE to pepsin-resistant allergens and 67% had specific IgE to heat-resistant allergens. Thirty percent of patients recognized allergens after both treatments, one being the allergen detected by 75% of the patients of this group. Heat- and/or pepsin-resistant allergens from A. simplex could explain reactions and symptoms after the ingestion of well-cooked or canned fish.