Azofra J, Echechipía S, Irazábal B, Muñoz D, Bernedo N, García B E, Gastaminza G, Goikoetxea M J, Joral A, Lasa E, Gamboa P, Díaz C, Beristain A, Quiñones D, Bernaola G, Echenagusia M A, Liarte I, García E, Cuesta J, Martínez M D, Velasco M, Longo N, Pastor-Vargas C
Sección de Alergia, Área de Gestión del Pulmón, Hospital Universitario Central de Asturias, Oviedo, Spain.
Servicio de Alergia, Complejo Hospitalario de Navarra, Pamplona, Spain.
J Investig Allergol Clin Immunol. 2024 Oct 1;27(4):252-260. doi: 10.18176/jiaci.0137. Epub 2017 Jan 3.
Allergy to mollusks has been the focus of fewer studies than allergy to crustaceans. Furthermore, allergy to mollusks is less well characterized. Objectives: To describe the clinical characteristics of mollusk-allergic patients, to identify the responsible allergens, and to assess cross-reactivity.
We performed a prospective multicenter study including 45 patients with mollusk allergy, which was diagnosed based on a suggestive clinical history and a positive skin test result with the agent involved. Fractions were identified using SDS-PAGE and immunoblotting. The proteins responsible were subsequently identified using mass spectrometry. ELISA inhibition studies were performed with mollusks, dust mites, and crustaceans.
We found that 25 patients (55%) were allergic to cephalopods, 14 (31%) to bivalves, and 11 (24%) to gastropods. Limpet was the third most frequent cause of allergy (15% of cases). In 31 patients (69%), the manifestation was systemic; 10 (22%) exhibited oral allergy syndrome, and 7 (15%) experienced contact urticaria. Most major allergens were found between 27 kDa and 47 kDa. ELISA inhibition assays revealed a high degree of inhibition of cephalopods and bivalves from all the groups of mollusks, mites, and crustaceans. Mass spectrometry identified tropomyosin, actin, and myosin as the major allergens.
Cephalopods, especially squid, are the mollusks that most frequently trigger allergic symptoms. The very frequent occurrence of allergy to limpets is striking, given their low consumption in our area. It is worth highlighting the heterogeneity observed, exemplified by the gastropods. Tropomyosin appears to be responsible for the high cross-reactivity found between mollusks, mites, and crustaceans. Three new mollusk allergens were also identified, namely, actin, enolase, and a putative C1q domain-containing protein.
相较于对甲壳类动物的过敏研究，对软体动物的过敏研究较少。此外，对软体动物过敏的特征描述也不够充分。目的：描述软体动物过敏患者的临床特征，确定相关过敏原，并评估交叉反应性。
我们进行了一项前瞻性多中心研究，纳入45例软体动物过敏患者，这些患者根据提示性的临床病史和对相关试剂的阳性皮肤试验结果进行诊断。使用SDS-PAGE和免疫印迹法鉴定组分。随后使用质谱法鉴定相关蛋白质。用软体动物、尘螨和甲壳类动物进行ELISA抑制研究。
我们发现25例患者（55%）对头足类动物过敏，14例（31%）对双壳贝类过敏，11例（24%）对腹足类动物过敏。帽贝是第三常见的过敏原因（占病例的15%）。31例患者（69%）表现为全身性过敏；10例（22%）出现口腔过敏综合征，7例（15%）发生接触性荨麻疹。大多数主要过敏原在27 kDa至47 kDa之间。ELISA抑制试验显示，所有软体动物、螨虫和甲壳类动物组中的头足类动物和双壳贝类之间存在高度抑制。质谱鉴定原肌球蛋白、肌动蛋白和肌球蛋白为主要过敏原。
头足类动物，尤其是鱿鱼，是最常引发过敏症状的软体动物。鉴于在我们地区帽贝的消费量较低，对其过敏的频繁发生令人惊讶。值得强调的是观察到的异质性，腹足类动物就是一个例子。原肌球蛋白似乎是软体动物、螨虫和甲壳类动物之间高交叉反应性的原因。还鉴定出三种新的软体动物过敏原，即肌动蛋白、烯醇化酶和一种假定的含C1q结构域蛋白。
