Bessot J C, Metz-Favre C, Rame J M, De Blay F, Pauli G
Association ARIALE, Hôpital Civil, 1 place de l'Hôpital, 67000 Strasbourg, France.
Eur Ann Allergy Clin Immunol. 2010 Feb;42(1):3-10.
Since tropomyosin is cross reactive in many arthropods, it was assumed that this highly conserved protein could be responsible for cross reactions in house dust mite (HDM) allergic patients who experienced adverse reactions after crustacean and mollusc ingestion. Here we report two clinical cases where the role of tropomyosin is a matter of debate. In the first case, the clinical history, as well as the results of in vivo and in vitro investigations, are in favour of a shrimp allergy without any snail allergy in a patient sensitized to HDM. In the second, the clinical history and the cutaneous tests are in favour of an allergy to snails without any allergy to shrimps in a patient suffering from HDM allergies. The clinical presentation is different in shrimp and snail allergies. In shrimp allergy, symptoms are mainly urticaria or angio-oedema. In snail allergies, adverse reactions are especially severe asthma. Shrimp tropomyosin is a dominant allergen in crustaceans whereas has a much less prominent role in HDM sensitization. Cross reactivities between HDM and snails have been confirmed by inhibition experiments. However, tropomyosin appears to be a minor allergen or even is not involved in snail allergy. It is necessary to clarify the allergens shared between HDMI and snails. The effects of HDM immunotherapy in snail allergy are questioned. Knowledge of taxonomy can contribute to more precise evaluation of cross reactivities between crustaceans and molluscs.
由于原肌球蛋白在许多节肢动物中具有交叉反应性，因此人们认为这种高度保守的蛋白质可能是导致屋尘螨（HDM）过敏患者在摄入甲壳类动物和软体动物后出现不良反应的交叉反应的原因。在此，我们报告两例关于原肌球蛋白作用存在争议的临床病例。在第一例中，一名对HDM致敏的患者的临床病史以及体内和体外研究结果均表明其对虾过敏，而对蜗牛不过敏。在第二例中，一名患有HDM过敏的患者的临床病史和皮肤试验表明其对蜗牛过敏，而对虾不过敏。虾过敏和蜗牛过敏的临床表现有所不同。在虾过敏中，症状主要为荨麻疹或血管性水肿。在蜗牛过敏中，不良反应尤其为严重哮喘。虾原肌球蛋白是甲壳类动物中的主要过敏原，而在HDM致敏中作用则小得多。HDM与蜗牛之间的交叉反应已通过抑制实验得到证实。然而，原肌球蛋白似乎是一种次要过敏原，甚至不参与蜗牛过敏。有必要明确HDM与蜗牛之间共有的过敏原。HDM免疫疗法对蜗牛过敏的效果受到质疑。分类学知识有助于更精确地评估甲壳类动物和软体动物之间的交叉反应。
