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Fish Allergy Around the World—Precise Diagnosis to Facilitate Patient Management

The accurate and precise diagnosis of IgE-mediated fish allergy is one of the biggest challenges in allergy diagnostics. A wide range of fish species that belong to evolutionary distant classes are consumed globally. Moreover, each fish species may contain multiple isoforms of a given allergen that...

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Autores principales: Kalic, Tanja, Radauer, Christian, Lopata, Andreas L., Breiteneder, Heimo, Hafner, Christine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8974716/
https://www.ncbi.nlm.nih.gov/pubmed/35387047
http://dx.doi.org/10.3389/falgy.2021.732178
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author Kalic, Tanja
Radauer, Christian
Lopata, Andreas L.
Breiteneder, Heimo
Hafner, Christine
author_facet Kalic, Tanja
Radauer, Christian
Lopata, Andreas L.
Breiteneder, Heimo
Hafner, Christine
author_sort Kalic, Tanja
collection PubMed
description The accurate and precise diagnosis of IgE-mediated fish allergy is one of the biggest challenges in allergy diagnostics. A wide range of fish species that belong to evolutionary distant classes are consumed globally. Moreover, each fish species may contain multiple isoforms of a given allergen that often differ in their allergenicity. Recent studies indicated that the cross-reactivity between different fish species is limited in some cases and depends on the evolutionary conservation of the involved allergens. Fish allergens belong to several protein families with different levels of stability to food processing. Additionally, different preparation methods may contribute to specific sensitization patterns to specific fish species and allergens in different geographic regions. Here, we review the challenges and opportunities for improved diagnostic approaches to fish allergy. Current diagnostic shortcomings include the absence of important region-specific fish species in commercial in vitro and in vivo tests as well as the lack of their standardization as has been recently demonstrated for skin prick test solutions. These diagnostic shortcomings may compromise patients' safety by missing some of the relevant species and yielding false negative test results. In contrast, the avoidance of all fish as a common management approach is usually not necessary as many patients may be only sensitized to specific species and allergens. Although food challenges remain the gold standard, other diagnostic approaches are investigated such as the basophil activation test. In the context of molecular allergy diagnosis, we discuss the usefulness of single allergens and raw and heated fish extracts. Recent developments such as allergen microarrays offer the possibility to simultaneously quantify serum IgE specific to multiple allergens and allergen sources. Such multiplex platforms may be used in the future to design diagnostic allergen panels covering evolutionary distant fish species and allergens relevant for particular geographic regions.
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spelling pubmed-89747162022-04-05 Fish Allergy Around the World—Precise Diagnosis to Facilitate Patient Management Kalic, Tanja Radauer, Christian Lopata, Andreas L. Breiteneder, Heimo Hafner, Christine Front Allergy Allergy The accurate and precise diagnosis of IgE-mediated fish allergy is one of the biggest challenges in allergy diagnostics. A wide range of fish species that belong to evolutionary distant classes are consumed globally. Moreover, each fish species may contain multiple isoforms of a given allergen that often differ in their allergenicity. Recent studies indicated that the cross-reactivity between different fish species is limited in some cases and depends on the evolutionary conservation of the involved allergens. Fish allergens belong to several protein families with different levels of stability to food processing. Additionally, different preparation methods may contribute to specific sensitization patterns to specific fish species and allergens in different geographic regions. Here, we review the challenges and opportunities for improved diagnostic approaches to fish allergy. Current diagnostic shortcomings include the absence of important region-specific fish species in commercial in vitro and in vivo tests as well as the lack of their standardization as has been recently demonstrated for skin prick test solutions. These diagnostic shortcomings may compromise patients' safety by missing some of the relevant species and yielding false negative test results. In contrast, the avoidance of all fish as a common management approach is usually not necessary as many patients may be only sensitized to specific species and allergens. Although food challenges remain the gold standard, other diagnostic approaches are investigated such as the basophil activation test. In the context of molecular allergy diagnosis, we discuss the usefulness of single allergens and raw and heated fish extracts. Recent developments such as allergen microarrays offer the possibility to simultaneously quantify serum IgE specific to multiple allergens and allergen sources. Such multiplex platforms may be used in the future to design diagnostic allergen panels covering evolutionary distant fish species and allergens relevant for particular geographic regions. Frontiers Media S.A. 2021-10-13 /pmc/articles/PMC8974716/ /pubmed/35387047 http://dx.doi.org/10.3389/falgy.2021.732178 Text en Copyright © 2021 Kalic, Radauer, Lopata, Breiteneder and Hafner. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Allergy
Kalic, Tanja
Radauer, Christian
Lopata, Andreas L.
Breiteneder, Heimo
Hafner, Christine
Fish Allergy Around the World—Precise Diagnosis to Facilitate Patient Management
title Fish Allergy Around the World—Precise Diagnosis to Facilitate Patient Management
title_full Fish Allergy Around the World—Precise Diagnosis to Facilitate Patient Management
title_fullStr Fish Allergy Around the World—Precise Diagnosis to Facilitate Patient Management
title_full_unstemmed Fish Allergy Around the World—Precise Diagnosis to Facilitate Patient Management
title_short Fish Allergy Around the World—Precise Diagnosis to Facilitate Patient Management
title_sort fish allergy around the world—precise diagnosis to facilitate patient management
topic Allergy
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8974716/
https://www.ncbi.nlm.nih.gov/pubmed/35387047
http://dx.doi.org/10.3389/falgy.2021.732178
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