{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.
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.