Kalic Tanja, Kuehn Annette, Aumayr Martina, Bartra Joan, Bindslev-Jensen Carsten, Codreanu-Morel Françoise, Domínguez Olga, Forstenlechner Peter, Hemmer Wolfgang, Kamath Sandip D, Leung Agnes, Leung Nicki, Lifanov Yuri, Mortz Charlotte G, Pascal Mariona, Ristl Robin, Sørensen Martin, Üzülmez Öykü, Yeghiazaryan Lusine, Wong Gary, Hafner Christine, Breiteneder Heimo
Department of Dermatology, University Hospital St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria; Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg.
J Allergy Clin Immunol Pract. 2022 Dec;10(12):3284-3292. doi: 10.1016/j.jaip.2022.08.019. Epub 2022 Aug 21.
Although recent studies indicated that many fish-allergic patients may safely consume certain fish species, no clinical guidelines are available for identification of the exact species tolerated by specific patients.
To investigate whether multiplex immunoglobulin E (IgE) testing reveals potentially tolerated fish through absence of IgE to parvalbumin (PV) and extracts from specific species.
Sera from 263 clinically well-defined fish-allergic patients from Austria, China, Denmark, Luxembourg, Norway, and Spain were used in a research version of the ALEX multiplex IgE quantification assay. Specific IgE to PVs from 10 fish species (9 bony and 1 cartilaginous), and to extracts from 7 species was quantified. The IgE signatures of individual patients and patient groups were analyzed using SPSS and R.
Up to 38% of the patients were negative to cod PV, the most commonly used molecule in fish allergy diagnosis. Forty-five patients (17%) tested negative to PVs but positive to the respective fish extracts, underlining the requirement for extracts for accurate diagnosis. Between 60% (Spain) and 90% (Luxembourg) of the patients were negative to PV and extracts from ray, a cartilaginous fish, indicating its potential tolerance. Up to 21% of the patients were negative to at least 1 bony fish species. Of the species analyzed, negativity to mackerel emerged as the best predictive marker of negativity to additional bony fish, such as herring and swordfish.
Parvalbumins and extracts from multiple fish species relevant for consumption should be used in fish-allergy diagnosis, which may help identify potentially tolerated species for individual patients.
尽管最近的研究表明，许多鱼类过敏患者可能可以安全食用某些鱼类，但尚无临床指南可用于确定特定患者确切能耐受的鱼类品种。
研究多重免疫球蛋白E（IgE）检测能否通过对小清蛋白（PV）及特定鱼类品种提取物无IgE反应来揭示潜在可耐受的鱼类。
来自奥地利、中国、丹麦、卢森堡、挪威和西班牙的263例临床明确诊断为鱼类过敏的患者的血清，用于ALEX多重IgE定量检测的研究版本。对10种鱼类（9种硬骨鱼和1种软骨鱼）的PV以及7种鱼类提取物的特异性IgE进行定量检测。使用SPSS和R软件分析个体患者及患者组的IgE特征。
高达38%的患者对鳕鱼PV呈阴性反应，而鳕鱼PV是鱼类过敏诊断中最常用的分子。45例患者（17%）对PV呈阴性反应，但对相应的鱼类提取物呈阳性反应，这突出了使用提取物进行准确诊断的必要性。60%（西班牙）至90%（卢森堡）的患者对软骨鱼鳐鱼的PV和提取物呈阴性反应，表明其具有潜在耐受性。高达21%的患者对至少1种硬骨鱼类呈阴性反应。在分析的鱼类品种中，对鲭鱼呈阴性反应是对其他硬骨鱼类（如鲱鱼和旗鱼）呈阴性反应的最佳预测指标。
鱼类过敏诊断应使用与食用相关的多种鱼类的小清蛋白和提取物，这可能有助于确定个体患者潜在可耐受的鱼类品种。
