Abstract：
Seafood is a common cause of food allergy and anaphylaxis, but there are limited published real-world data describing the clinical presentation of fish and shellfish allergies.
This study aimed to examine the clinical characteristics, immunological profile, and tolerance pattern to fish, crustaceans, and mollusks in fish-allergic individuals.
Patients presenting with IgE-mediated fish allergy between 2016 and 2021 were recruited. A comprehensive sensitization profile including specific IgE and skin prick test to various fish and shellfish species and a detailed clinical history including individuals\' recent seafood consumption were evaluated.
A total of 249 fish-allergic individuals (aged 4.2 ± 5.8 years) were recruited from 6 allergy clinics in Hong Kong, and they had experienced their fish-allergic reaction 2.2 ± 3.4 years before enrollment. Seventy-five subjects (30%) reacted to either grass carp, salmon, grouper, or cod in oral food challenges. We identified an IgE sensitization gradient that corresponded to the level of β-parvalbumin in fish. In total, 40% of fish-allergic individuals reported tolerance to 1 or more types of fish, more commonly to fish with a lower β-parvalbumin level such as tuna and salmon, compared with β-parvalbumin-rich fish such as catfish and grass carp. Despite fish and shellfish cosensitization, 41% of individuals reported tolerance to crustaceans, mollusks, or both, whereas shellfish avoidance occurred in half of the fish-allergic individuals, of whom 33% lacked shellfish sensitization.
Fish allergy commonly presents in early childhood. A considerable proportion of fish-allergic patients are selectively tolerant to certain fish, typically those with lower levels of β-parvalbumin. There is an unmet need to promote precision medicine for seafood allergies.
This study aimed to examine the clinical characteristics, immunological profile, and tolerance pattern to fish, crustaceans, and mollusks in fish-allergic individuals.
Patients presenting with IgE-mediated fish allergy between 2016 and 2021 were recruited. A comprehensive sensitization profile including specific IgE and skin prick test to various fish and shellfish species and a detailed clinical history including individuals\' recent seafood consumption were evaluated.
A total of 249 fish-allergic individuals (aged 4.2 ± 5.8 years) were recruited from 6 allergy clinics in Hong Kong, and they had experienced their fish-allergic reaction 2.2 ± 3.4 years before enrollment. Seventy-five subjects (30%) reacted to either grass carp, salmon, grouper, or cod in oral food challenges. We identified an IgE sensitization gradient that corresponded to the level of β-parvalbumin in fish. In total, 40% of fish-allergic individuals reported tolerance to 1 or more types of fish, more commonly to fish with a lower β-parvalbumin level such as tuna and salmon, compared with β-parvalbumin-rich fish such as catfish and grass carp. Despite fish and shellfish cosensitization, 41% of individuals reported tolerance to crustaceans, mollusks, or both, whereas shellfish avoidance occurred in half of the fish-allergic individuals, of whom 33% lacked shellfish sensitization.
Fish allergy commonly presents in early childhood. A considerable proportion of fish-allergic patients are selectively tolerant to certain fish, typically those with lower levels of β-parvalbumin. There is an unmet need to promote precision medicine for seafood allergies.
摘要：
背景：海鲜是食物过敏和过敏反应的常见原因，但是描述鱼类和贝类过敏临床表现的真实数据有限。
目的：本研究旨在检查临床特征，免疫学特征，和对鱼的宽容模式，甲壳类动物,和鱼类过敏个体的软体动物。
方法：招募了2016年至2021年患有IgE介导的鱼类过敏的患者。评估了全面的致敏概况，包括对各种鱼类和贝类的特异性IgE和皮肤点刺试验，以及包括个人最近食用海鲜在内的详细临床病史。
结果:共有249名鱼类过敏人士(年龄4.2±5.8岁)从香港的6个过敏诊所招募,他们在入组前2.2±3.4年经历过鱼类过敏反应。75名受试者(30%)对草鱼有反应，鲑鱼,石斑鱼,或鳕鱼在口服食物挑战。我们确定了与鱼中β-小白蛋白水平相对应的IgE致敏梯度。总的来说,40%的鱼类过敏个体报告对一种或更多种类型的鱼类有耐受性，更常见的是具有较低β-小白蛋白水平的鱼类，如金枪鱼和鲑鱼，与富含β-小白蛋白的鱼如鲶鱼和草鱼相比。尽管鱼类和贝类共致敏，41%的个体报告对甲壳类动物有耐受性，软体动物,或者两者兼而有之,而一半的鱼类过敏个体避免贝类，其中33%缺乏贝类敏感性。
结论：鱼过敏通常出现在儿童早期。相当比例的鱼类过敏患者对某些鱼类有选择性的耐受，通常是β-小清蛋白水平较低的那些。对于促进针对海鲜过敏的精准医学存在未满足的需求。
目的：本研究旨在检查临床特征，免疫学特征，和对鱼的宽容模式，甲壳类动物,和鱼类过敏个体的软体动物。
方法：招募了2016年至2021年患有IgE介导的鱼类过敏的患者。评估了全面的致敏概况，包括对各种鱼类和贝类的特异性IgE和皮肤点刺试验，以及包括个人最近食用海鲜在内的详细临床病史。
结果:共有249名鱼类过敏人士(年龄4.2±5.8岁)从香港的6个过敏诊所招募,他们在入组前2.2±3.4年经历过鱼类过敏反应。75名受试者(30%)对草鱼有反应，鲑鱼,石斑鱼,或鳕鱼在口服食物挑战。我们确定了与鱼中β-小白蛋白水平相对应的IgE致敏梯度。总的来说,40%的鱼类过敏个体报告对一种或更多种类型的鱼类有耐受性，更常见的是具有较低β-小白蛋白水平的鱼类，如金枪鱼和鲑鱼，与富含β-小白蛋白的鱼如鲶鱼和草鱼相比。尽管鱼类和贝类共致敏，41%的个体报告对甲壳类动物有耐受性，软体动物,或者两者兼而有之,而一半的鱼类过敏个体避免贝类，其中33%缺乏贝类敏感性。
结论：鱼过敏通常出现在儿童早期。相当比例的鱼类过敏患者对某些鱼类有选择性的耐受，通常是β-小清蛋白水平较低的那些。对于促进针对海鲜过敏的精准医学存在未满足的需求。
