PDF(Pubmed)
Abstract：
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.
摘要：
贝类,包括各种软体动物(例如，贻贝,蛤蟆,和牡蛎)和甲壳类动物(例如，虾,对虾,龙虾,和螃蟹），由于其宝贵的蛋白质含量，已成为健康饮食建议的基石。与他们的消费同时，与贝类有关的过敏反应可能正在增加。对贝类的不良反应分为不同的组：（1）免疫反应，包括IgE和非IgE过敏反应；（2）非免疫反应，包括毒性反应和食物不耐受。IgE介导的反应发生在摄入贝类后约两小时内，范围从荨麻疹，血管性水肿,恶心,和呕吐的呼吸体征和症状，如支气管痉挛，喉水肿,和过敏反应。参与IgE介导的贝类过敏反应的最常见的变应原蛋白包括原肌球蛋白，精氨酸激酶，肌球蛋白轻链,肌浆钙结合蛋白，肌钙蛋白c,和磷酸丙糖异构酶.在过去的几十年里，在鉴定不同贝类过敏原的分子特征方面获得的知识改善了贝类过敏的过敏原免疫治疗的诊断和潜在设计。不幸的是,免疫治疗研究和一些诊断工具在研究背景下仍然受到限制,需要在应用于临床实践之前进行验证.然而,他们似乎有希望改善贝类过敏的管理策略。在这次审查中,流行病学,发病机制，临床特征,诊断,并介绍了儿童贝类过敏的管理。不同形式的贝类和免疫治疗方法之间的交叉反应性，包括未修饰的过敏原，低过敏原，基于肽的，和基于DNA的疫苗，也解决了。
