{Reference Type}: Journal Article
{Title}: Real-World Sensitization and Tolerance Pattern to Seafood in Fish-Allergic Individuals.
{Author}: Leung ASY;Wai CYY;Leung NYH;Ngai NA;Chua GT;Ho PK;Lam ICS;Cheng JWCH;Chan OM;Li PF;Au AWS;Leung CHW;Cheng NS;Tang MF;Fong BLY;Rosa Duque JS;Wong JSC;Luk DCK;Ho MHK;Kwan MYW;Yau YS;Lee QU;Chan WH;Wong GWK;Leung TF;
{Journal}: J Allergy Clin Immunol Pract
{Volume}: 12
{Issue}: 3
{Year}: 2024 03 5
暂无{DOI}: 10.1016/j.jaip.2023.09.038
{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.<BR>This study aimed to examine the clinical characteristics, immunological profile, and tolerance pattern to fish, crustaceans, and mollusks in fish-allergic individuals.<BR>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.<BR>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.<BR>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.