Mariona Pascal1, Galina Grishina2, Ariana C Yang3, Silvia Sánchez-García4, Jing Lin2, David Towle5, Maria Dolores Ibañez6, Joaquín Sastre7, Hugh A Sampson2, Rosalia Ayuso8. 1. Division of Allergy & Immunology and the Jaffe Food Allergy Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY; Servei d'Immunologia, Centre de Diagnòstic Biomèdic (CDB), Hospital Clínic, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. 2. Division of Allergy & Immunology and the Jaffe Food Allergy Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY. 3. Division of Clinical Immunology and Allergy, University of Saõ Paulo School of Medicine, Saõ Paulo, Brazil. 4. Allergy Department, Hospital Infantil Universitario del Niño Jesús, Madrid, Spain; Section of Allergy, Fundación Jimenez Díaz, Madrid, Spain. 5. Mount Desert Island Biological Laboratory (MDIBL), Salsbury Cove, Me. 6. Allergy Department, Hospital Infantil Universitario del Niño Jesús, Madrid, Spain. 7. Section of Allergy, Fundación Jimenez Díaz, Madrid, Spain. 8. Division of Allergy & Immunology and the Jaffe Food Allergy Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY; Ear, Nose and Throat Associates of New York, P.C., NY. Electronic address: rayuso2001@yahoo.com.
Abstract
BACKGROUND: The diagnosis of shellfish allergy remains a challenge for clinicians. Several shellfish allergens have been characterized and their IgE epitopes identified. However, the clinical relevance of this sensitization is still not clear. OBJECTIVE: The objective of this study was to identify allergens and epitopes associated with clinical reactivity to shrimp. METHODS: Shrimp-sensitized subjects were recruited and grouped based on the history of shrimp-allergic reactions and challenge outcome. IgE reactivity to recombinant crustacean allergens, and IgE and IgG4 reactivity to peptides were determined. Subjects sensitized to dust mites and/or cockroach without shrimp sensitization or reported allergic reactions, as well as nonatopic individuals, were used as controls. RESULTS: A total of 86 subjects were recruited with a skin prick test to shrimp; 74 reported shrimp-allergic reactions, 58 were allergic (38 positive double-blind placebo-controlled food challenge and 20 recent anaphylaxis), and 16 were tolerant. All subjects without a history of reactions had negative challenges. The individuals with a positive challenge more frequently recognized tropomyosin and sarcoplasmic calcium-binding proteins than those found tolerant by the challenge. Especially a sarcoplasmic-calcium-binding-protein positive test is very likely to result in a positive challenge, though the frequency of recognition is low. Subjects with dust mite and/or cockroach allergy not sensitized to shrimp recognized arginine kinase and hemocyanin. Several epitopes of these allergens may be important in predicting clinical reactivity. CONCLUSION: Tropomyosin and sarcoplasmic-calcium-binding-protein sensitization is associated with clinical reactivity to shrimp. Myosin light chain testing may help in the diagnosis of clinical reactivity. Arginine kinase and hemocyanin appear to be cross-reacting allergens between shrimp and arthropods. Detection of IgE to these allergens and some of their epitopes may be better diagnostic tools in the routine workup of shrimp allergy.
BACKGROUND: The diagnosis of shellfish allergy remains a challenge for clinicians. Several shellfish allergens have been characterized and their IgE epitopes identified. However, the clinical relevance of this sensitization is still not clear. OBJECTIVE: The objective of this study was to identify allergens and epitopes associated with clinical reactivity to shrimp. METHODS: Shrimp-sensitized subjects were recruited and grouped based on the history of shrimp-allergic reactions and challenge outcome. IgE reactivity to recombinant crustacean allergens, and IgE and IgG4 reactivity to peptides were determined. Subjects sensitized to dust mites and/or cockroach without shrimp sensitization or reported allergic reactions, as well as nonatopic individuals, were used as controls. RESULTS: A total of 86 subjects were recruited with a skin prick test to shrimp; 74 reported shrimp-allergic reactions, 58 were allergic (38 positive double-blind placebo-controlled food challenge and 20 recent anaphylaxis), and 16 were tolerant. All subjects without a history of reactions had negative challenges. The individuals with a positive challenge more frequently recognized tropomyosin and sarcoplasmic calcium-binding proteins than those found tolerant by the challenge. Especially a sarcoplasmic-calcium-binding-protein positive test is very likely to result in a positive challenge, though the frequency of recognition is low. Subjects with dust mite and/or cockroach allergy not sensitized to shrimp recognized arginine kinase and hemocyanin. Several epitopes of these allergens may be important in predicting clinical reactivity. CONCLUSION: Tropomyosin and sarcoplasmic-calcium-binding-protein sensitization is associated with clinical reactivity to shrimp. Myosin light chain testing may help in the diagnosis of clinical reactivity. Arginine kinase and hemocyanin appear to be cross-reacting allergens between shrimp and arthropods. Detection of IgE to these allergens and some of their epitopes may be better diagnostic tools in the routine workup of shrimp allergy.
Authors: Anna Pomés; Geoffrey A Mueller; Thomas A Randall; Martin D Chapman; L Karla Arruda Journal: Curr Allergy Asthma Rep Date: 2017-04 Impact factor: 4.806