College of Ocean Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Jimei University, Xiamen 361021, China.
Department of Bioinformatics, Fujian Key Laboratory of Medical Bioinformatics, Institute of Precision Medicine, School of Medical Technology and Engineering, Fujian Medical University, Fuzhou 350122, China.
Nutrients. 2024 Feb 27;16(5):667. doi: 10.3390/nu16050667.
: Seafood allergy is a significant global health concern that greatly impacts a patient's quality of life. The intervention efficacy of oral immunotherapy (OIT), an emerging intervention strategy, for seafood allergy remains controversial. This study aimed to perform a systematic review and meta-analysis to evaluate the efficacy of slightly processed allergen/meat from fish and crustacea in OIT, both in mouse models and clinical patients. : A comprehensive literature search was performed in four mainstream databases and the EBSCOhost database to identify all relevant case-control and cohort studies. The aim was to elucidate the intervention efficacy, encompassing various processing methods and assessing the efficacy of multiple major allergens in OIT. : The meta-analysis included five case-control studies on crustacean allergens in mouse models and 11 cohort studies on meat from fish and crustacea in clinical patients for final quantitative assessments. In mouse models, crustacean allergen substantially decreased the anaphylactic score after OIT treatment (mean difference (MD) = -1.30, < 0.01). Subgroup analyses with low-level heterogeneities provided more reliable results for crab species (MD = -0.63, < 0.01, I = 0), arginine kinase allergen (MD = -0.83, < 0.01, I = 0), and Maillard reaction processing method (MD = -0.65, < 0.01, I = 29%), respectively. In clinical patients, the main meta-analysis showed that the slightly processed meat significantly increased the incidence rate of oral tolerance (OT, incidence rate ratio (IRR) = 2.90, < 0.01). Subgroup analyses for fish meat (IRR = 2.79, < 0.01) and a simple cooking treatment (IRR = 2.36, = 0.01) also demonstrated a substantial increase in the incidence rate of OT. Sensitivity and meta-regression analyses successfully identified specific studies contributing to heterogeneity in mouse models and clinical patients, although these studies did not impact the overall significant pooled effects. : This meta-analysis provides preliminary evidence for the high intervention efficacy of slightly processed allergen/meat from fish and crustacea in OIT, both in mouse models and clinical patients. The Maillard reaction and cooking processing methods may emerge as potentially effective approaches to treating allergen/meat in OIT for clinical patients, offering a promising and specific treatment strategy for seafood allergy. However, these findings should be interpreted cautiously, and further supporting evidence is necessary.
: 海鲜过敏是一个严重的全球健康问题，极大地影响了患者的生活质量。口服免疫疗法（OIT）作为一种新兴的干预策略，其对海鲜过敏的干预效果仍存在争议。本研究旨在进行系统评价和荟萃分析，以评估鱼类和甲壳类动物过敏原/肉经轻微加工后在 OIT 中的疗效，包括在小鼠模型和临床患者中的疗效。 : 我们在四个主流数据库和 EBSCOhost 数据库中进行了全面的文献检索，以确定所有相关的病例对照和队列研究。目的是阐明干预效果，包括各种加工方法，并评估 OIT 中多种主要过敏原的疗效。 : 荟萃分析纳入了五项关于甲壳类过敏原的小鼠模型病例对照研究和十一项关于鱼类和甲壳类动物肉的临床患者队列研究，以进行最终的定量评估。在小鼠模型中，OIT 治疗后甲壳类过敏原的过敏评分显著降低（平均差异（MD）=-1.30，<0.01）。低水平异质性的亚组分析为蟹种（MD=-0.63，<0.01，I=0）、精氨酸激酶过敏原（MD=-0.83，<0.01，I=0）和美拉德反应处理方法（MD=-0.65，<0.01，I=29%）提供了更可靠的结果。在临床患者中，主要荟萃分析显示，经轻微加工的肉显著增加了口服耐受（OT）的发生率（比值比（IRR）=2.90，<0.01）。亚组分析表明，鱼类（IRR=2.79，<0.01）和简单烹饪处理（IRR=2.36，<0.01）的 OT 发生率也显著增加。敏感性和荟萃回归分析成功确定了对小鼠模型和临床患者异质性有贡献的特定研究，但这些研究并未影响整体显著的汇总效应。 : 本荟萃分析为鱼类和甲壳类动物过敏原/肉经轻微加工后在 OIT 中具有较高的干预效果提供了初步证据，包括在小鼠模型和临床患者中。美拉德反应和烹饪处理方法可能成为 OIT 治疗过敏原/肉的有效方法，为海鲜过敏提供了一种有前途和特定的治疗策略。然而，这些发现应谨慎解释，需要进一步的支持证据。
