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Nutrients Jun 2023Shellfish, 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... (Review)
Review
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.
Topics: Animals; Humans; Child; Shellfish Hypersensitivity; Food Hypersensitivity; Shellfish; Mollusca; Allergens
PubMed: 37375617
DOI: 10.3390/nu15122714 -
Allergy, Asthma, and Clinical... Nov 2011Food allergy is defined as an adverse immunologic response to a dietary protein. Food-related reactions are associated with a broad array of signs and symptoms that may...
Food allergy is defined as an adverse immunologic response to a dietary protein. Food-related reactions are associated with a broad array of signs and symptoms that may involve many bodily systems including the skin, gastrointestinal and respiratory tracts, and cardiovascular system. Food allergy is a leading cause of anaphylaxis and, therefore, referral to an allergist for appropriate and timely diagnosis and treatment is imperative. Diagnosis involves a careful history and diagnostic tests, such as skin prick testing, serum-specific immunoglobulin E (IgE) testing and, if indicated, oral food challenges. Once the diagnosis of food allergy is confirmed, strict elimination of the offending food allergen from the diet is generally necessary. For patients with significant systemic symptoms, the treatment of choice is epinephrine administered by intramuscular injection into the lateral thigh. Although most children "outgrow" allergies to milk, egg, soy and wheat, allergies to peanut, tree nuts, fish and shellfish are often lifelong. This article provides an overview of the epidemiology, pathophysiology, diagnosis, management and prognosis of patients with food allergy.
PubMed: 22166142
DOI: 10.1186/1710-1492-7-S1-S7 -
Journal of Investigational Allergology... 2020Seafood is a major cause of food allergy and anaphylaxis worldwide. Shellfish is included among the "big eight" food groups, which are responsible for more than 90% of... (Review)
Review
Seafood is a major cause of food allergy and anaphylaxis worldwide. Shellfish is included among the "big eight" food groups, which are responsible for more than 90% of all cases of food allergy. Approximately 2.5% of the world's population has experienced an adverse reaction to seafood. Seafood allergy is one of the most frequent and lethal allergies that exist. The several allergenic proteins involved in allergic reactions that have been described in recent years include tropomyosin, arginine kinase, myosin light chain, and sarcoplasmic calcium-binding protein. Despite all the data reported in the last few years, shellfish allergy is still diagnosed and treated as it was 50 years ago. The only effective treatment to prevent allergic reactions to shellfish is avoidance. This review aims to update recently published data on shellfish allergy and to highlight those areas that have yet to be resolved.
Topics: Algorithms; Allergens; Animals; Clinical Decision-Making; Cross Reactions; Disease Management; Disease Susceptibility; Epitopes; Humans; Immunoglobulin E; Risk Factors; Shellfish; Shellfish Hypersensitivity; Symptom Assessment
PubMed: 32694101
DOI: 10.18176/jiaci.0565 -
Immunology and Allergy Clinics of North... Feb 2012Food-induced anaphylaxis (FIA) is a serious allergic reaction that may cause death rapidly in otherwise healthy individuals. There is no universal agreement on its...
Food-induced anaphylaxis (FIA) is a serious allergic reaction that may cause death rapidly in otherwise healthy individuals. There is no universal agreement on its definition or criteria for diagnosis. Hospital admissions for FIA have more than doubled in the last decade. Food is one of the most common causes of anaphylaxis, with most surveys indicating that food-induced reactions account for 30% to 50% of cases. The most commonly implicated foods are peanut, tree nuts, milk, eggs, sesame seeds, fish, and shellfish. The only life-saving treatment for anaphylaxis is allergen avoidance, and epinephrine injection if an anaphylactic event occurs.
Topics: Adrenergic beta-Agonists; Anaphylaxis; Epinephrine; Food; Food Hypersensitivity; Glucocorticoids; Histamine Antagonists; Humans; Risk Factors
PubMed: 22244239
DOI: 10.1016/j.iac.2011.10.002 -
Clinical and Experimental Allergy :... Apr 2021Food allergy presents a significant global health concern with up to 10% of the population affected in developed nations and a steadily increasing prevalence. In many... (Review)
Review
Food allergy presents a significant global health concern with up to 10% of the population affected in developed nations and a steadily increasing prevalence. In many cases, particularly with peanut, tree nut and shellfish, food allergy is a lifelong and potentially life-threatening diagnosis. While no 'cure' for IgE-mediated food allergy exists, oral immunotherapy (OIT) is a promising treatment modality with the peanut OIT drug Palforzia (Aimmune Therapeutics) the only treatment for food allergy that is currently approved by the United States Food and Drug Administration. OIT primarily induces a state of desensitization with only a minority of subjects achieving sustained unresponsiveness, a state of limited clinical remission that appears to be immunologically distinct from natural tolerance. Early humoural changes during OIT include an initial increase in allergen-specific IgE, which eventually decreases to below baseline levels as OIT progresses, and a gradual increase in allergen-specific IgA and IgG4 that continues throughout the course of OIT. Basophil hyporesponsiveness and decreased skin prick test wheal size are observed within the first year of OIT, and persistence after completion of therapy has been associated with sustained unresponsiveness. In the T-cell compartment, there is an initial expansion followed by a decline in the number and activity of T helper 2 (T 2) cells, the latter of which may be dependent on an expansion of IL-10-producing cells, including regulatory T-cells. Our understanding of the immunomodulatory effects of OIT continues to evolve, with new technologies such as single-cell transcriptional profiling and antibody epitope analysis allowing for more detailed study of T-cell and B-cell responses to OIT. In this review, we present evidence to illustrate what is currently known about the immunologic changes induced by OIT, explore potential mechanisms and emphasize knowledge gaps where future research is needed.
Topics: Administration, Oral; Allergens; B-Lymphocytes; Basophils; Desensitization, Immunologic; Food Hypersensitivity; Humans; Immunity, Innate; Immunoglobulin E; Immunologic Memory; Mast Cells; Plasma Cells; Th2 Cells
PubMed: 33417257
DOI: 10.1111/cea.13824 -
Journal of Asthma and Allergy 2018Seafood allergy is a hypersensitive disorder with increasing prevalence worldwide. Effective and accurate diagnostic workup for seafood allergy is essential for... (Review)
Review
Seafood allergy is a hypersensitive disorder with increasing prevalence worldwide. Effective and accurate diagnostic workup for seafood allergy is essential for clinicians and patients. Parvalbumin and tropomyosin are the most common fish and shellfish allergens, respectively. The diagnosis of seafood allergies is complicated by cross-reactivity among fish allergens and between shellfish allergens and other arthropods. Current clinical diagnosis of seafood allergy is a complex algorithm that includes clinical assessment, skin prick test, specific IgE measurement, and oral food challenges. Emerging diagnostic strategies, such as component-resolved diagnosis (CRD), which uses single allergenic components for assessment of epitope specific IgE, can provide critical information in predicting individualized sensitization patterns and risk of severe allergic reactions. Further understanding of the molecular identities and characteristics of seafood allergens can advance the development of CRD and lead to more precise diagnosis and improved clinical management of seafood allergies.
PubMed: 30323632
DOI: 10.2147/JAA.S142476 -
Nutrients Jul 2023Shellfish is a leading cause of food allergy and anaphylaxis worldwide. Recent advances in molecular characterization have led to a better understanding of the allergen... (Review)
Review
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.
Topics: Humans; Child; Shellfish Hypersensitivity; Immunoglobulin E; Shellfish; Food Hypersensitivity; Seafood; Allergens
PubMed: 37513530
DOI: 10.3390/nu15143112 -
Annals of Allergy, Asthma & Immunology... Sep 2016Accurate information on the prevalence of food allergy facilitates a more evidence-based approach to planning of allergy services and can identify important geographic... (Review)
Review
BACKGROUND
Accurate information on the prevalence of food allergy facilitates a more evidence-based approach to planning of allergy services and can identify important geographic variations.
OBJECTIVE
To conduct a systematic review to assess the age-specific prevalence of fish and shellfish allergy worldwide.
METHODS
Searches were conducted using Web of Science and PubMed. Population-based cross-sectional studies and cohort studies that examined the prevalence of fish and shellfish allergy (IgE mediated and non-IgE mediated) at an identifiable point in time were eligible for inclusion in the study. Reviewers extracted general study information and study design, type of food allergy considered, food(s) assessed, method of diagnosis, sampling strategy, and sample characteristics. Raw data were extracted and percentage prevalence and 95% confidence intervals calculated.
RESULTS
A total of 7,333 articles were identified of which 61 studies met the inclusion criteria and were included in this review. The prevalence of fish allergy ranged from 0% to 7% and the prevalence of shellfish allergy from 0% to 10.3%, depending on the method of diagnosis. Where food challenges were used, the prevalence for fish allergy was found to be 0% to 0.3% and for shellfish allergy was 0% to 0.9%.
CONCLUSION
Few studies have established the prevalence of fish or shellfish allergy using the gold standard double-blind, placebo-controlled challenge criteria, with most instead relying on self-reported questionnaire-based methods. The limited data available suggest that fish allergy prevalence is similar worldwide; however, shellfish allergy prevalence may be higher in the Southeast Asia region.
Topics: Animals; Fishes; Food Hypersensitivity; Humans; Prevalence; Shellfish
PubMed: 27613460
DOI: 10.1016/j.anai.2016.07.015 -
Srpski Arhiv Za Celokupno Lekarstvo 2016Food allergy represents a highly up-to-date and continually increasing problem of modern man. Although being present in all ages, it most often occures in children aged... (Review)
Review
Food allergy represents a highly up-to-date and continually increasing problem of modern man. Although being present in all ages, it most often occures in children aged up to three years. Sensitization most often occurs by a direct way, but it is also possible to be caused by mother's milk, and even transplacentally. Predisposition of inadequate immune response to antigen stimulation, reaginic or nonreaginic, is of non-selective character so that food allergy is often multiple and to a high rate associated with inhalation and/or contact hypersensitivity. Also, due to antigen closeness of some kinds of food, cross-reactive allergic reaction is also frequent, as is the case with peanuts, legumes and tree nuts or cow's, sheep's and goat's milk. Most frequent nutritive allergens responsible for over 90% of adverse reactions of this type are proteins of cow's milk, eggs, peanuts, tree nuts, wheat, soy, fish, shellfish, crustaceans, and cephalopods. Allergy intolerance of food antigens is characterized by a very wide spectrum of clinical manifestations. Highly severe systemic reactions, sometimes fatal, are also possible.The diagnosis of food allergy is based on a detailed personal and family medical history, complete clinical examination, and corresponding laboratory and other examinations adapted to the type of hypersensitivity and the character of patient's complaints, and therapy on the elimination diet. A positive effect of elimination diet also significantly contributes to the diagnosis. Although most children "outgrow" their allergies, allergy to peanuts, tree nuts, fish, shellfish, crustaceans, and cephalopods are generally life-long allergies.
Topics: Child; Food Hypersensitivity; Humans
PubMed: 27276868
DOI: 10.2298/sarh1602099r -
European Annals of Allergy and Clinical... Nov 2017Currently, the management of people diagnosed with shellfish allergy relies on the avoidance of those foods. HDM immunotherapy has been reported to induce both shrimp... (Review)
Review
Currently, the management of people diagnosed with shellfish allergy relies on the avoidance of those foods. HDM immunotherapy has been reported to induce both shrimp allergy in non-allergic patients, and shrimp tolerance in shrimp-allergic patients. This article summarizes therapeutic options other than avoidance diet for shrimp allergic patients available once the diagnostic is established, such as production of hypoallergenic shrimp, use of immunotherapy with modified allergens, probiotics and Chinese herbal formulations.
Topics: Allergens; Animals; Desensitization, Immunologic; Drugs, Chinese Herbal; Epitopes, T-Lymphocyte; Humans; Immunoglobulin E; Penaeidae; Probiotics; Pyroglyphidae; Seafood; Shellfish Hypersensitivity; Sublingual Immunotherapy; Treatment Outcome; Tropomyosin; Vaccination
PubMed: 29249132
DOI: 10.23822/EurAnnACI.1764-1489.16