IgE Mediated Shellfish Allergy in Children—A Review

Abstract

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.

The Sensitization Profile for Selected Food Allergens in Polish Children Assessed with the Use of a Precision Allergy Molecular Diagnostic Technique

“…Our study showed the highest Pen m 1-sIgE rates (1.86%) and levels (9.98 kU A /L) out of all five evaluated shrimp molecules. Shellfish allergy often develops in late childhood or during adolescence [27]. In our study, the rates of sIgE in Pen m 1 and Pen m 2 showed a significant increase between the age groups of 1-5 and 5-13 years, and all evaluated shrimp molecules showed the highest sIgE rates in the age group of 13-18-year-olds.…”

“…Protein profiles in shrimp with hypersensitivity may differ depending on the population, which is likely due to differences in genetics, environmental exposure, and dietary preferences. Therefore, it is important to determine the molecular profile for individual populations to ensure an optimal protein profile in shrimp allergy diagnostic tests [7,24,26,27].…”

The Natural History and Risk Factors for the Development of Food Allergies in Children and Adults

“…Fish and shellfish are common causes of food allergies worldwide, with higher prevalence found in Asian and Northern European countries where seafood is more frequently consumed. Ages of onset for fish and shellfish allergy are approximately 1 ½ years and 5 years, respectively, with a wide range reported for rates of resolution (Table 1 ) [ 21 , 60 , 61 ]. Sesame is an emerging culprit for food allergy in childhood, with estimated prevalence in children of 0.2–0.8% [ 25 , 62 , 63 ].…”