Alonso A, Moreno-Ancillo A, Daschner A, López-Serrano M C
Section of Allergy, La Paz General University Hospital, Madrid, Spain.
Allergy. 1999 May;54(5):517-20. doi: 10.1034/j.1398-9995.1999.00046.x.
Anisakis simplex can cause allergic reactions in sensitized patients. Some of these reactions are related to acute parasitism, as is shown in gastroallergic anisakiasis (anisakiasis with digestive and predominantly allergic symptoms). At present, a nonseafood diet is recommended for all patients with any kind of A. simplex allergy. We wished to confirm the clinical suspicion that patients with allergic symptoms after ingestion of raw or undercooked seafood who are sensitized to A. simplex, and diagnosed with gastroallergic anisakiasis, can tolerate the ingestion of seafood when the parasites are dead and noninfective.
We included patients diagnosed with gastroallergic anisakiasis (positive skin prick test or/and serum specific IgE to A. simplex, with one or more parasites found by gastroscopy in the stomach). Patients included in the study gave written, informed consent. Specimens of A. simplex about 2 cm long were selected, placed in capsules, and frozen at -20 degrees C for more than 48 h to make them noninfective. We administered 11 specimens to every patient at the hospital. If they tolerated the larvae, they were told to eat well-frozen seafood (-20 degrees C at least 48 h). After 6 months, the patients were re-evaluated.
Five patients accepted the challenge with noninfective A. simplex larvae. All tolerated the noninfective larvae. After eating deep-frozen seafood for 6 months, no patient suffered a reaction.
In gastroallergic anisakiasis, the antigens of the live parasite probably cause the allergic symptoms. Patients with this disease can tolerate deep-frozen seafood, in which the parasites are dead.
简单异尖线虫可在致敏患者中引发过敏反应。其中一些反应与急性寄生虫感染有关，如胃过敏性异尖线虫病（伴有消化症状且主要为过敏症状的异尖线虫病）所示。目前，对于任何类型简单异尖线虫过敏的所有患者，均建议采用非海鲜饮食。我们希望证实一种临床怀疑，即对简单异尖线虫致敏、在摄入生的或未煮熟的海鲜后出现过敏症状且被诊断为胃过敏性异尖线虫病的患者，在寄生虫死亡且无感染性时能够耐受海鲜摄入。
我们纳入了被诊断为胃过敏性异尖线虫病的患者（皮肤点刺试验阳性或/和血清中针对简单异尖线虫的特异性IgE阳性，且胃镜检查在胃中发现一条或多条寄生虫）。纳入研究的患者签署了书面知情同意书。选取约2厘米长的简单异尖线虫标本，装入胶囊，在 -20℃下冷冻超过48小时使其失去感染性。我们在医院给每位患者服用11个标本。如果他们耐受这些幼虫，就告知他们食用冷冻良好的海鲜（至少在 -20℃下保存48小时）。6个月后，对患者进行重新评估。
5名患者接受了对无感染性简单异尖线虫幼虫的激发试验。所有人都耐受了无感染性的幼虫。食用深度冷冻海鲜6个月后，没有患者出现反应。
在胃过敏性异尖线虫病中，活寄生虫的抗原可能导致过敏症状。患有这种疾病的患者能够耐受其中寄生虫已死亡的深度冷冻海鲜。
