Department of Paediatrics, University Hospital of Ioannina, Ioannina, Greece.
Pediatr Allergy Immunol. 2012 Nov;23(7):608-15. doi: 10.1111/j.1399-3038.2012.01275.x. Epub 2012 May 3.
The increased consumption of fish and shellfish has resulted in more frequent reports of adverse reactions to seafood, emphasizing the need for more specific diagnosis and treatment of this condition and exploring reasons for the persistence of this allergy. This review discusses interesting and new findings in the area of fish and shellfish allergy. New allergens and important potential cross-reacting allergens have been identified within the fish family and between shellfish, arachnids, and insects. The diagnostic approach may require prick to-prick tests using crude extracts of both raw and cooked forms of seafood for screening seafood sensitization before a food challenge or where food challenge is not feasible. Allergen-specific immunotherapy can be important; mutated less allergenic seafood proteins have been developed for this purpose. The persistence of allergy because of seafood proteins' resistance after rigorous treatment like cooking and extreme pH is well documented. Additionally, IgE antibodies from individuals with persistent allergy may be directed against different epitopes than those in patients with transient allergy. For a topic as important as this one, new areas of technological developments will likely have a significant impact, to provide more accurate methods of diagnosing useful information to patients about the likely course of their seafood allergy over the course of their childhood and beyond.
鱼类和贝类消费的增加导致了更多关于海鲜不良反应的报告，这强调了需要更具体的诊断和治疗这种疾病，并探讨这种过敏持续存在的原因。这篇综述讨论了鱼类和贝类过敏领域的有趣和新发现。在鱼类家族内以及贝类、蛛形纲动物和昆虫之间，已经确定了新的过敏原和重要的潜在交叉反应过敏原。诊断方法可能需要在进行食物挑战之前或在食物挑战不可行的情况下，使用生的和熟的海鲜的粗提取物进行点刺试验，以筛选海鲜致敏。过敏原特异性免疫疗法可能很重要；为此目的已经开发了突变的、较少过敏原性的海鲜蛋白。由于经过像烹饪和极端 pH 值这样的严格处理后海鲜蛋白的抗性，过敏持续存在是有充分记录的。此外，持续性过敏个体的 IgE 抗体可能针对不同于短暂性过敏患者的表位。对于像这样一个重要的主题，新技术的发展领域可能会产生重大影响，为患者提供更准确的诊断方法和有用的信息，了解他们的海鲜过敏在儿童期及以后的可能发展过程。
