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Abstract：
Background: Seafood allergy is a significant global health concern that greatly impacts a patient\'s quality of life. The intervention efficacy of oral immunotherapy (OIT), an emerging intervention strategy, for seafood allergy remains controversial. This study aimed to perform a systematic review and meta-analysis to evaluate the efficacy of slightly processed allergen/meat from fish and crustacea in OIT, both in mouse models and clinical patients. Methods: A comprehensive literature search was performed in four mainstream databases and the EBSCOhost database to identify all relevant case-control and cohort studies. The aim was to elucidate the intervention efficacy, encompassing various processing methods and assessing the efficacy of multiple major allergens in OIT. Results: The meta-analysis included five case-control studies on crustacean allergens in mouse models and 11 cohort studies on meat from fish and crustacea in clinical patients for final quantitative assessments. In mouse models, crustacean allergen substantially decreased the anaphylactic score after OIT treatment (mean difference (MD) = -1.30, p < 0.01). Subgroup analyses with low-level heterogeneities provided more reliable results for crab species (MD = -0.63, p < 0.01, I2 = 0), arginine kinase allergen (MD = -0.83, p < 0.01, I2 = 0), and Maillard reaction processing method (MD = -0.65, p < 0.01, I2 = 29%), respectively. In clinical patients, the main meta-analysis showed that the slightly processed meat significantly increased the incidence rate of oral tolerance (OT, incidence rate ratio (IRR) = 2.90, p < 0.01). Subgroup analyses for fish meat (IRR = 2.79, p < 0.01) and a simple cooking treatment (IRR = 2.36, p = 0.01) also demonstrated a substantial increase in the incidence rate of OT. Sensitivity and meta-regression analyses successfully identified specific studies contributing to heterogeneity in mouse models and clinical patients, although these studies did not impact the overall significant pooled effects. Conclusions: This meta-analysis provides preliminary evidence for the high intervention efficacy of slightly processed allergen/meat from fish and crustacea in OIT, both in mouse models and clinical patients. The Maillard reaction and cooking processing methods may emerge as potentially effective approaches to treating allergen/meat in OIT for clinical patients, offering a promising and specific treatment strategy for seafood allergy. However, these findings should be interpreted cautiously, and further supporting evidence is necessary.
摘要：
背景：海鲜过敏是一个重要的全球健康问题，极大地影响患者的生活质量。口服免疫治疗（OIT）的干预效果，一种新兴的干预战略，对于海鲜过敏仍然存在争议。本研究旨在进行系统评价和荟萃分析，以评估OIT中鱼和甲壳类动物的轻微加工过敏原/肉的功效。在小鼠模型和临床患者中。方法：在四个主流数据库和EBSCOhost数据库中进行了全面的文献检索，以确定所有相关的病例对照和队列研究。目的是阐明干预效果，包括各种处理方法，并评估OIT中多种主要过敏原的功效。结果：荟萃分析包括5项关于小鼠模型中甲壳类过敏原的病例对照研究和11项关于临床患者中鱼和甲壳类动物肉的队列研究，以进行最终定量评估。在老鼠模型中，甲壳类过敏原在OIT治疗后显著降低了过敏性评分(平均差异(MD)=-1.30,p<0.01)。具有低水平异质性的亚组分析为螃蟹物种提供了更可靠的结果（MD=-0.63，p<0.01，I2=0），精氨酸激酶过敏原（MD=-0.83，p<0.01，I2=0），和美拉德反应处理方法(MD=-0.65，p<0.01，I2=29%)，分别。在临床患者中，主要的荟萃分析表明，稍微加工的肉类显着增加了口服耐受性的发生率（OT，发病率比(IRR)=2.90,p<0.01)。鱼肉的亚组分析（IRR=2.79，p<0.01）和简单的烹饪处理（IRR=2.36，p=0.01）也证明了OT发生率的显着增加。敏感性和荟萃回归分析成功确定了导致小鼠模型和临床患者异质性的特定研究，尽管这些研究并未影响总体显著的汇集效应.结论：这项荟萃分析为OIT中鱼类和甲壳类动物的轻微加工过敏原/肉类的高干预功效提供了初步证据，在小鼠模型和临床患者中。美拉德反应和烹饪加工方法可能会成为临床患者治疗OIT中过敏原/肉类的潜在有效方法。为海鲜过敏提供有希望和具体的治疗策略。然而,这些发现应该谨慎解释，进一步的支持证据是必要的。
