贝类种类繁多,作为海鲜的主要成分,并因其营养价值而在全球广泛消费。因此,IgE介导的海鲜过敏报告的增加尤其是与贝类相关的食物。海鲜相关贝类由甲壳类动物(十足动物,口足类动物,藤壶,和euphausiids)和软体动物(腹足类,双壳类,和头足类)及其产品可从轻度局部症状开始,并通过摄入导致严重的全身过敏反应,吸入,或者像大多数其他食物过敏原一样接触。全球范围内,最常见的致病贝类是虾,螃蟹,龙虾,蛤蟆,牡蛎,还有贻贝.贝类过敏的患病率估计为普通人群的0.5-2.5%,但在贝类占饮食很大比例的亚洲沿海国家中,贝类过敏的患病率更高。过敏原的多样性,如原肌球蛋白,精氨酸激酶,肌球蛋白轻链,肌浆结合蛋白来自甲壳类动物,而原肌球蛋白,副肌球蛋白,肌钙蛋白,肌动蛋白,淀粉酶,据报道,软体动物贝类中含有海血色素。原肌球蛋白是主要的过敏原,负责贝类和其他无脊椎动物之间的交叉反应,在甲壳类动物中,在软体动物体内,甲壳类动物与软体动物以及贝类和鱼类之间。致敏性诊断需要有临床病史,体内皮肤点刺试验,IgE的体外定量,免疫CAP,并通过口腔挑战测试进行确认,除非其产生的反应危及生命。这篇全面的综述提供了贝类过敏领域的最新和新发现,包括人口统计学,过敏原的多样性,变应原性,它们的交叉反应性,以及创新的分子遗传学方法来诊断和管理这种危及生命和终身疾病。
Shellfish are diverse, serve as main constituents of seafood, and are extensively consumed globally because of their nutritional values. Consequently, increase in reports of IgE-mediated seafood allergy is particularly food associated to shellfish. Seafood-associated shellfish consists of crustaceans (decapods, stomatopods, barnacles, and euphausiids) and molluskans (gastropods, bivalves, and cephalopods) and its products can start from mild local symptoms and lead to severe systemic anaphylactic reactions through ingestion, inhalation, or contact like most other food allergens. Globally, the most commonly causative shellfish are shrimps, crabs, lobsters, clams, oysters, and mussels. The prevalence of shellfish allergy is estimated to be 0.5-2.5% of the general population but higher in coastal Asian countries where shellfish constitute a large proportion of the diet. Diversity in allergens such as tropomyosin, arginine kinase, myosin light chain, and sarcoplasmic binding protein are from crustaceans whereas tropomyosin, paramyosin, troponin, actine, amylase, and hemoyanin are reported from molluskans shellfish. Tropomyosin is the major allergen and is responsible for cross-reactivity between shellfish and other invertebrates, within crustaceans, within molluskans, between crustaceans vs. molluskans as well as between shellfish and fish. Allergenicity diagnosis requires clinical history, in vivo skin prick testing, in vitro quantification of IgE, immunoCAP, and confirmation by oral challenge testing unless the reactions borne by it are life-threatening. This comprehensive review provides the update and new findings in the area of shellfish allergy including demographic, diversity of allergens, allergenicity, their cross-reactivity, and innovative molecular genetics approaches in diagnosing and managing this life-threatening as well as life-long disease.