Cross-reacting allergens between fish, shellfish, arachnids, and insects

The increased consumption of fish and shellfish has resulted in more frequent reports of adverse reactions to seafood.

Cross-reactivity is a problem

Potential cross-reacting allergens have been identified within the fish family and between shellfish, arachnids, and insects.

Prick-to-prick tests may be needed

The diagnostic approach may require prick-to-prick tests using crude extracts of both raw and cooked forms of seafood for screening seafood sensitization. This approach may be required before a food challenge or where food challenge is not feasible.

Different epitopes may explain different disease severity

IgE antibodies from individuals with persistent allergy may be directed against different epitopes than those in patients with transient allergy.

Mutated proteins as future immunotherapy

Mutated less allergenic seafood proteins have been developed for allergen-specific immunotherapy but this approach is still experimental and not ready for prime time.

References:

Fish and shellfish allergy in children: Review of a persistent food allergy. Tsabouri S, Triga M, Makris M, Kalogeromitros D, Church MK, Priftis KN. Pediatr Allergy Immunol. 2012 May 3. doi: 10.1111/j.1399-3038.2012.01275.x. [Epub ahead of print]
http://www.ncbi.nlm.nih.gov/pubmed/22554093?dopt=Abstract

Image source: Gadus morhua, Atlantic cod. Wikipedia, public domain.

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Dr. Ellis @DrAnneEllis: Crustaceans are the "bugs of the sea"