Emerging approaches in the diagnosis and therapy in shellfish allergy

Wai, Christine; Leung, Patrick S.C.

doi:10.1097/aci.0000000000000827

Cited by 9 publications

(9 citation statements)

References 46 publications

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“…Despite the ongoing advancements of different diagnostic techniques, achieving a diagnosis with a single-step test is not easy. Hence, a stepwise approach to conclude the shellfish allergy diagnosis is advised ( Figure 2 ) [ 108 , 109 ].…”

Section: Diagnosismentioning

confidence: 99%

“…Tests can be performed by applying commercial whole allergen extracts, or, by fresh allergens (prick-to-prick tests (PTP)). However, some factors must be taken into consideration when analyzing the results, such as the likelihood of cross-reactivity among shellfish, house dust mites, and cockroaches, the variability of test protocols used, the lack of standardization in allergen preparations used in the test, and the fact that the shelf-life and the stability of the reagent can interfere with the sensitivity and specificity of these conventional tests [ 109 ]. In a study including children and adults, five commercial shellfish SPT extracts reported a high variability of IgE reactivity in immunoblotting [ 112 ], with a sensitivity range of 59–79%.…”

Section: Diagnosismentioning

confidence: 99%

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IgE-Mediated Shellfish Allergy in Children

et al. 2023

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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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Section: Diagnosismentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

IgE-Mediated Shellfish Allergy in Children

et al. 2023

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“…The test is based on the idea that the measurement of luciferase’s signal reflects the degree of IgE crosslinking [ 129 ]. ExiLe technology has been promisingly demonstrated to have better diagnostic accuracy than SPTs and sIgE [ 125 , 130 ].…”

Section: Diagnosismentioning

confidence: 99%

“…Since tropomyosin is highly allergenic, research in shellfish immunotherapy has also focused on the development of hypoallergenic variants of tropomyosin to improve the safety of AIT. Hypoallergenic tropomyosin is obtained through methods including enzymatic crosslinking, polypeptide fragmentation and epitope manipulation [ 130 , 148 , 149 ].…”

Section: Managementmentioning

confidence: 99%

IgE Mediated Shellfish Allergy in Children—A Review

et al. 2023

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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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“…Specific immunotherapy for foods such as wheat [2], peanuts [3], tree nuts [4], shellfish [5] or milk [6] are able to increase the respective thresholds of reactivity, but they are not able to restore a full persistent tolerance. The use of biologics proved to be safer and more effective [7][8][9], but equally unable to modify the natural history of the disease.…”

mentioning

confidence: 99%