Suzuki Shintaro, Miyata Yoshito, Jinno Megumi, Kishino Yasunari, Homma Tetsuya, Ota Shin, Tanaka Akihiko, Yokoe Takuya, Ohnishi Tsukasa, Sagara Hironori, Kurata Naomi, Shimakura Kuniyoshi, Kurose Kouichi
Department of Internal Medicine, Division of Allergology and Respiratory Medicine, Showa University School of Medicine.
Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg.
Arerugi. 2017;66(6):804-808. doi: 10.15036/arerugi.66.804.
A 35-year-old female, professional diver, reported nausea, vomiting, and systemic hives 20 to 30 minutes after ingestion of antipasto made with jellyfish. Patient reported prior episodes of swelling after stings from several different creatures, including jelly fish. She also developed a systemic allergic reaction after sting from an unknown creature while diving. On the initial visit to our hospital, serum total IgE level was 545IU/ml. We extracted crude allergen from jellyfish and evaluated allergen specific IgE antibody levels using ELISA. Patient samples showed higher levels of jellyfish-derived allergen specific IgE than healthy control samples. Basophils were isolated from the peripheral blood of patient. Stimulation with jellyfish-derived allergen showed expression of surface antigens on basophils increased in a concentration-dependent manner. Methods using sodium dodecyl sulfate poly acrylamide gel electrophoresis and immunoblotting showed acid-soluble collagen fraction from jellyfish contained above 250kDa weighed protein that may have caused this current event. A provocation test using jellyfish samples was not performed due to risk of anaphylactic shock. The patient was diagnosed with a jellyfish allergy due to IgE mediated anaphylaxis after ingestion. She was asked to refrain from consuming any food containing jellyfish. IgE-mediated food allergy caused by jellyfish is rare worldwide. Collagen was speculated to be an allergen in this study. Additional study to detect specific allergens related to jellyfish allergy would be particularly useful to specify disease phenotypes and individual care in future.
一名35岁的职业潜水女性在食用了用海蜇制作的开胃菜后20至30分钟，出现恶心、呕吐和全身性荨麻疹。患者报告在被几种不同生物蜇伤后曾有过肿胀发作，包括海蜇。她在潜水时被一种不明生物蜇伤后还出现了全身性过敏反应。在初次就诊于我院时，血清总IgE水平为545IU/ml。我们从海蜇中提取了粗过敏原，并使用酶联免疫吸附测定法评估过敏原特异性IgE抗体水平。患者样本显示海蜇源性过敏原特异性IgE水平高于健康对照样本。从患者外周血中分离出嗜碱性粒细胞。用海蜇源性过敏原刺激显示嗜碱性粒细胞表面抗原的表达呈浓度依赖性增加。使用十二烷基硫酸钠聚丙烯酰胺凝胶电泳和免疫印迹的方法显示，海蜇的酸溶性胶原蛋白部分含有可能导致此次事件的分子量超过250kDa的蛋白质。由于存在过敏性休克风险，未进行海蜇样本激发试验。该患者因摄入后IgE介导的过敏反应被诊断为海蜇过敏。她被要求避免食用任何含有海蜇的食物。海蜇引起的IgE介导的食物过敏在全球范围内都很罕见。本研究推测胶原蛋白是一种过敏原。进一步研究检测与海蜇过敏相关的特定过敏原对于未来明确疾病表型和个体化治疗将特别有用。
