The Anisakis allergy debate: does an evolutionary approach help?

Ecology and Genetic Structure of Zoonotic Anisakis spp. from Adriatic Commercial Fish Species

“…In humans, larvae penetrate the mucosa of the stomach, small intestine, or colon, causing eosinophilic granuloma formation with severe symptoms of disease (for a review, see references 10, 14, and 15). The other clinical form is triggered by repeated consumption of thermally processed seafood that contains the whole nematode or its molecular traces, inducing hypersensitivity in the consumer and an array of allergic symptoms: acute urticaria and angioedema, bronchospasm, fatal respiratory arrest, and anaphylaxis (16,17). Rheumatologic diseases and disorders like asthma, gingivostomatitis, conjunctivitis, and contact dermatitis have also been related to occupational exposure to allergens in fishmongers, fishermen, or employees of the fish-processing industry (18).…”

Travelling with <b><i>Anisakis</i></b> Allergens

“…However, Anisakis- induced allergy differs from food allergy because it does not require an atopic predisposition and because for presentation of clinical symptoms the Anisakis allergens must enter the tissues of the alimentary tract at certain locations (e.g. the submucosa of the stomach) [5]. The hypothesis that Anisakis only provokes allergic symptoms when it parasitizes the alimentary tract was confirmed in provocation studies showing that patients with allergy to Anisakis tolerate ingestion of Anisakis allergens [6,7,8].…”

Paucisymptomatic gastric anisakiasis: endoscopical removal of Anisakis sp. larva

“…Diagnosis is currently performed by the molecular identification of the parasite removed by gastric endoscopy associated to a seroimmunological assay. Also, a delayed allergic manifestation, named gastroallergic anisakiasis (GAA) [6,7] , may occur in association with rash, urticaria, isolated angioedema and anaphylaxis [8] . In this respect, Daschner et al [6] described the GAA as an acute allergic reaction with symptoms of hypersensitivity appearing several hours after the ingestion associated with penetration of larvae into the gastric mucosa [9] .…”

“…Also, a delayed allergic manifestation, named gastroallergic anisakiasis (GAA) [6,7] , may occur in association with rash, urticaria, isolated angioedema and anaphylaxis [8] . In this respect, Daschner et al [6] described the GAA as an acute allergic reaction with symptoms of hypersensitivity appearing several hours after the ingestion associated with penetration of larvae into the gastric mucosa [9] . In addition, the presence of an IgE antibody response in individuals with no apparent symptoms has been also detected 1 month after the acute GAA episode [10] .…”