A Kuehn1, F Codreanu-Morel2, C Lehners-Weber2, V Doyen3, S-A Gomez-André4, F Bienvenu5, J Fischer6, N Ballardini7,8,9, M van Hage10, J-M Perotin11, S Silcret-Grieu12, H Chabane13, F Hentges1,2, M Ollert1,14, C Hilger1, M Morisset2. 1. Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg. 2. National Unit of Immunology and Allergology, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg. 3. Clinic of Immuno-Allergology, CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium. 4. Pediatric Pneumology Unit, Hôpital Femme-Mère-Enfant, Bron, France. 5. Allergology Unit, Immunology Laboratory, Centre Hospitalier Lyon-Sud, Lyon, France. 6. Allergy Unit, Department of Dermatology, Faculty of Medicine, Eberhard Karls University, Tübingen, Germany. 7. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. 8. Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden. 9. St John's Institute of Dermatology, King's College London, London, UK. 10. Immunology and Allergy Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. 11. Department of Respiratory Medicine, INSERM UMRS 903, University Hospital, Reims, France. 12. Groupe Hospitalier Cochin, Service de Pathologie Professionnelle, Université Paris Descartes, Paris, France. 13. Department of Pediatrics, Hôpital Delafontaine, Saint Denis, France. 14. Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis, University of Southern Denmark, Odense, Denmark.
Abstract
BACKGROUND: Fish is one of the most allergenic foods. While clinical cross-reactivity among different fishes is a widely accepted feature of fish allergy, associations with other food allergies are not well understood. This study aims at analyzing the relevance of clinical cross-reactivity between fish and chicken meat in patients with allergy to chicken meat without sensitization to hen's eggs. METHODS: Patients with food allergy to fish and chicken meat (n = 29) or chicken meat only (n = 7) were recruited. IgE-reactive chicken proteins were identified (Edman, MS analysis) and quantified (ELISA). Allergens were used in IgE ELISA and skin testing. RESULTS: Chicken parvalbumin and two new allergens, aldolase and enolase, were identified at 12, 40, and 50 kDa, respectively. They were recognized by sIgE of 61%, 75%, and 83% of all patient sera which were in the majority of the cases positive for the fish homologues as well. Fish and chicken meat allergens were highly cross-reactive while high inhibition rates with fish or chicken allergens correlated with the patients' primary sensitization to fish or chicken. In cooked or roasted foods, enolase and aldolase were detectable in chicken breast while parvalbumin was detectable in chicken legs and wings. CONCLUSIONS: Fish and chicken meat are cross-reactive foods; both fish-allergic and chicken meat-allergic patients might be at risk of developing a food allergy to chicken meat or to fish, respectively. This clinical phenomenon is proposed to be termed 'fish-chicken syndrome' with cross-reactive allergens involved being parvalbumins, enolases, and aldolases.
BACKGROUND: Fish is one of the most allergenic foods. While clinical cross-reactivity among different fishes is a widely accepted feature of fish allergy, associations with other food allergies are not well understood. This study aims at analyzing the relevance of clinical cross-reactivity between fish and chicken meat in patients with allergy to chicken meat without sensitization to hen's eggs. METHODS:Patients with food allergy to fish and chicken meat (n = 29) or chicken meat only (n = 7) were recruited. IgE-reactive chicken proteins were identified (Edman, MS analysis) and quantified (ELISA). Allergens were used in IgE ELISA and skin testing. RESULTS:Chickenparvalbumin and two new allergens, aldolase and enolase, were identified at 12, 40, and 50 kDa, respectively. They were recognized by sIgE of 61%, 75%, and 83% of all patient sera which were in the majority of the cases positive for the fish homologues as well. Fish and chicken meat allergens were highly cross-reactive while high inhibition rates with fish or chicken allergens correlated with the patients' primary sensitization to fish or chicken. In cooked or roasted foods, enolase and aldolase were detectable in chicken breast while parvalbumin was detectable in chicken legs and wings. CONCLUSIONS: Fish and chicken meat are cross-reactive foods; both fish-allergic and chicken meat-allergicpatients might be at risk of developing a food allergy to chicken meat or to fish, respectively. This clinical phenomenon is proposed to be termed 'fish-chicken syndrome' with cross-reactive allergens involved being parvalbumins, enolases, and aldolases.
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