Identification of Potentially Tolerated Fish Species by Multiplex IgE Testing of a Multinational Fish-Allergic Patient Cohort.

Abstract

BACKGROUND:

Although recent studies indicated that many fish-allergic patients may safely consume certain fish species, no clinical guidelines are available for identification of the exact species tolerated by specific patients.

OBJECTIVE:

To investigate whether multiplex immunoglobulin E (IgE) testing reveals potentially tolerated fish through absence of IgE to parvalbumin (PV) and extracts from specific species.

METHODS:

Sera from 263 clinically well-defined fish-allergic patients from Austria, China, Denmark, Luxembourg, Norway, and Spain were used in a research version of the ALEX2 multiplex IgE quantification assay. Specific IgE to PVs from 10 fish species (9 bony and 1 cartilaginous), and to extracts from 7 species was quantified. The IgE signatures of individual patients and patient groups were analyzed using SPSS and R.

RESULTS:

Up to 38% of the patients were negative to cod PV, the most commonly used molecule in fish allergy diagnosis. Forty-five patients (17%) tested negative to PVs but positive to the respective fish extracts, underlining the requirement for extracts for accurate diagnosis. Between 60% (Spain) and 90% (Luxembourg) of the patients were negative to PV and extracts from ray, a cartilaginous fish, indicating its potential tolerance. Up to 21% of the patients were negative to at least 1 bony fish species. Of the species analyzed, negativity to mackerel emerged as the best predictive marker of negativity to additional bony fish, such as herring and swordfish.

CONCLUSIONS:

Parvalbumins and extracts from multiple fish species relevant for consumption should be used in fish-allergy diagnosis, which may help identify potentially tolerated species for individual patients.

• Authors: Tanja Kalic, Annette Kuehn, Martina Aumayr, Joan Bartra, Carsten Bindslev-Jensen, Françoise Codreanu-Morel, Olga Domínguez, Peter Forstenlechner, Wolfgang Hemmer, Sandip D Kamath, Agnes Leung, Nicki Leung, Yuri Lifanov, Charlotte G Mortz, Mariona Pascal, Robin Ristl, Martin Sørensen, Öykü Üzülmez, Lusine Yeghiazaryan, Gary Wong, Christine Hafner, Heimo Breiteneder
• Journal: The journal of allergy and clinical immunology. In practice (J Allergy Clin Immunol Pract) Vol. 10 Issue 12 Pg. 3284-3292 (Dec 2022) ISSN: 2213-2201 [Electronic] United States
• PMID: 36002102 (Publication Type: Journal Article)
• Copyright: Copyright © 2022. Published by Elsevier Inc.

Chemical References

• Allergens
• Immunoglobulin E
• Parvalbumins

Topics

• Animals
• Humans
• Allergens
• Food Hypersensitivity (diagnosis)
• Immunoglobulin E
• Fishes
• Parvalbumins