Fish allergy tolerance 16 months after diagnosis

Fish allergy is generally thought to be persistent, and approximately 80% of patients with fish allergies do not develop tolerance even 10 years after diagnosis. There have been no reports of rapid tolerance development in patients with severe fish allergies. We report the development of tolerance 16 months after the diagnosis of fish allergies. A 13-month-old boywas diagnosed with rosefish allergy (Sebastes matsubarae) and Japanese jack mackerel allergy (Trachurus japonicus). To find out which species of fish he could consume safely, he underwentseveral oral food challenge (OFC) tests. It was determined that he could consume tuna, salmon, cod, sardine, chub mackerel (Scomber japonicus), and Japanese amberjack (Seriola quinqueradiata) without eliciting signs of allergy. He continued to eat the fish that did not produce allergic reactions three to four times a week. The titer of serum allergen-specific immunoglobulin E (IgE) to fish had decreased in a subsequent ImmunoCAP®-specific IgE bloodtest performed 16 months after the diagnosis of the rosefish allergy. Following this test result, he underwent OFCs with rosefish and Japanese jack mackerel, both of which turned out to be negative, and it was determined that he had developed tolerance to fish. In this case, the repeated OFCs were useful in identifying fish species that were safe for consumption. In addition, the decrease in allergen-specific IgE was useful in predicting the development of tolerance. We hypothesize that proactive consumption of available fish species may lead to this rapid induction of tolerance to fish allergens

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Fish allergy in patients with parvalbumin-specific immunoglobulin E depends on parvalbumin content rather than molecular differences in the protein among fish species

Bioscience Biotechnology and Biochemistry ◽

10.1080/09168451.2016.1189318 ◽

2016 ◽

Vol 80 (10) ◽

pp. 2018-2021 ◽

Cited By ~ 14

Author(s):

Ayako Kobayashi ◽

Yukihiro Kobayashi ◽

Kazuo Shiomi

Keyword(s):

Fish Species ◽

Immunoglobulin E ◽

Fish Allergy ◽

Specific Immunoglobulin E ◽

Specific Immunoglobulin

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Food Allergy: Unproven diagnostics and therapeutics

Journal of Food Allergy ◽

10.2500/jfa.2020.2.200013 ◽

2020 ◽

Vol 2 (1) ◽

pp. 91-94

Author(s):

Megan F. Patterson ◽

Stacy L. Dorris

Keyword(s):

Food Allergy ◽

Adverse Reactions ◽

Immunoglobulin E ◽

Skin Prick Testing ◽

Scientific Evidence ◽

Food Challenge ◽

Clinical History ◽

Specific Ige ◽

Therapeutic Modalities ◽

Diagnostic Modalities

Food allergy or intolerance is often attributed by patients as the cause of many symptoms unknown to be directly related to food ingestion. For immunoglobulin E (IgE) mediated food allergy, diagnostic modalities are currently limited to the combination of clinical history, evidence of sensitization with food-specific IgE testing and skin-prick testing, and oral food challenge. Many patients find an appeal in the promise of identification of the etiology of their symptoms through alternative food allergy or intolerance diagnostic modalities. These patients may seek guidance from allergists or their general providers as to the legitimacy of these tests or interpretation of results. These tests include food-specific serum IgG or IgG4 testing, flow cytometry to measure the change in leukocyte volume after exposure to food, intradermal or sublingual provocation-neutralization, electrodermal testing, applied kinesiology, hair analysis, and iridology. In addition, there are some unconventional therapeutic modalities for adverse reactions to foods, including rotary diets. None of these have been supported by scientific evidence, and some even carry the risk of severe adverse reactions. It is important that we offer our patients evidence-based, accurate counseling of these unproven modalities by understanding their methods, their paucity of credible scientific support, and their associated risks.

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Specific IgE levels as an outcome predictor in egg-allergic children

Allergologia et Immunopathologia ◽

10.15586/aei.v49i1.22 ◽

2021 ◽

Vol 49 (1) ◽

pp. 79-86

Author(s):

Jesús Rodríguez-Catalán ◽

Alba Manasa González-Arias ◽

Almudena Vallespin Casas ◽

Genoveva Del Río Camacho

Keyword(s):

Immunoglobulin E ◽

Food Challenge ◽

Clinical History ◽

Threshold Level ◽

Specific Ige ◽

Positive Skin Prick Test ◽

Roc Curve Analysis ◽

Positive Skin ◽

Prick Test ◽

Challenge Testing

Background: Diagnosis of immunoglobulin E (IgE)-mediated egg allergy is often based on both a compatible clinical history and either elevated IgE levels or a positive skin prick test. However, the gold standard is the oral food challenge (OFC). Previous studies have pointed to a correlation between IgE levels and OFC outcomes. Objective: This study aimed to determine the relationship between IgE levels and the outcome of OFC, seeking to establish cut-off OFC values that indicate a high likelihood of positive OFC results. Methods: A total of 198 patients who underwent OFC (and a serological IgE antibody assay within the three preceding months) were reviewed and divided by OFC type (i.e., baked, cooked, or raw egg). IgE-specific levels were assessed against the challenge outcome as well as cut-offs proposed by other authors. Results: Receiver-operating characteristic (ROC) curve analysis yielded a potentially useful ovomucoid IgE-specific cutoff used in OFC with cooked egg and several egg white and ovalbumin IgE-specific cut-offs for OFC with raw egg. We found no significant relationship between other specific IgE concentrations and the challenge threshold level with baked eggs. Conclusions: IgE-specific concentrations are useful as predictors of OFC outcome and should be considered when selecting patients challenge testing with boiled or raw egg. However, patients should undergo OFC with baked egg regardless of IgE levels.

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Fish allergy: is cross-reactivity among fish species relevant? Double-blind placebo-controlled food challenge studies of fish allergic adults

Annals of Allergy Asthma & Immunology ◽

10.1016/s1081-1206(10)62862-1 ◽

1999 ◽

Vol 83 (6) ◽

pp. 517-523 ◽

Cited By ~ 71

Author(s):

Arthur Helbling ◽

Robert Haydel ◽

Marjorie L. McCants ◽

Jon J. Musmand ◽

Jane El-Dahr ◽

...

Keyword(s):

Fish Species ◽

Food Challenge ◽

Cross Reactivity ◽

Double Blind ◽

Double Blind Placebo ◽

Fish Allergy

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Effect of Processing on Fish Protein Antigenicity and Allergenicity

Foods ◽

10.3390/foods10050969 ◽

2021 ◽

Vol 10 (5) ◽

pp. 969

Author(s):

Xingyi Jiang ◽

Qinchun Rao

Keyword(s):

Fish Species ◽

Protein Denaturation ◽

Ex Vivo ◽

Protein Solubility ◽

Future Research ◽

Food Protein ◽

In Vivo Evaluation ◽

Fish Allergy

Fish allergy is a life-long food allergy whose prevalence is affected by many demographic factors. Currently, there is no cure for fish allergy, which can only be managed by strict avoidance of fish in the diet. According to the WHO/IUIS Allergen Nomenclature Sub-Committee, 12 fish proteins are recognized as allergens. Different processing (thermal and non-thermal) techniques are applied to fish and fishery products to reduce microorganisms, extend shelf life, and alter organoleptic/nutritional properties. In this concise review, the development of a consistent terminology for studying food protein immunogenicity, antigenicity, and allergenicity is proposed. It also summarizes that food processing may lead to a decrease, no change, or even increase in fish antigenicity and allergenicity due to the change of protein solubility, protein denaturation, and the modification of linear or conformational epitopes. Recent studies investigated the effect of processing on fish antigenicity/allergenicity and were mainly conducted on commonly consumed fish species and major fish allergens using in vitro methods. Future research areas such as novel fish species/allergens and ex vivo/in vivo evaluation methods would convey a comprehensive view of the relationship between processing and fish allergy.

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