Fanta fish gelatin11/5/2023 ![]() So far, no cross-reactivity has been shown for fish and other seafood allergens while in some cases, a co-sensitization to both allergen sources might occur ( 27). In addition, in case reports, clinical monosensitivity to single fishes has been proven for sole, swordfish, pangasius/tilapia, tuna/marlin, and more recently, for salmon and salmonid fishes ( 19– 26). On the other hand, it has been shown that even highly fish-sensitized patients can tolerate certain fish species, such as tuna ( 17, 18). This clinical cross-reactivity seems to be even more pronounced between closely related fishes. Cross-reactivity among fish species has been commonly reported for fish allergy ( 11, 15, 16). However, already low milligram amounts of fish seem to be sufficient to trigger allergic symptoms in sensitized patients ( 14). There are only a few clinical studies addressing minimal eliciting doses of fish allergy. Fish aeroallergens can be important triggers of atopic dermatitis ( 13). Common clinical manifestations are oral allergy syndrome, rhinitis, abdominal pain, diarrhea, urticaria, angioedema, asthma, and in severe cases, even life-threatening anaphylaxis ( 10– 12). Patients become sensitized by allergen exposure via the gastro-intestinal tract during ingestion, which is the major route of sensitization, or via the respiratory system by fish aeroallergens or skin contact ( 6– 9). Clinical Featuresįish allergy is a pathophysiological, IgE-mediated immune response to specific fish proteins. Therefore, the prevalence of fish allergy is greater in countries with high fish consumption and fish-processing industries ( 5). However, the exposure to fish is an important factor determining the reported prevalence of fish allergy. It is estimated that up to 0.2% of the general population is affected by fish allergy ( 3, 4). While many literature sources indicate that allergies to fish are on the rise, the actual prevalence is not well established as most studies are based on self-reported food allergies ( 2). Although the fish consumption in European countries is quite stable, the global demand for fish and fish products is increasing still steadily ( 1). In human diet, fish is a valuable source of essential amino acids, polyunsaturated fatty acids, and lipid-soluble vitamins. These findings were useful for the advancement of the IgE-based diagnosis and also for the management of fish allergies consisting of advice and treatment of fish-allergic patients. New clinical and molecular insights advanced the knowledge and understanding of fish allergy in the last years. In addition to the parvalbumins, several other fish proteins, enolases, aldolases, and fish gelatin, seem to be important allergens. This was shown for salmon homologs, where only a single parvalbumin (beta-1) isoform was identified as allergen in specific patients. Furthermore, different parvalbumin isoforms and isoallergens are present in the same fish and might display variable allergenicity. On the other hand, some individuals have IgE antibodies directed against unique, species-specific parvalbumin epitopes, and these patients show clinical symptoms only with certain fish species. These patients might experience clinical reactions with various fish species. They represent highly cross-reactive allergens for patients with specific IgE to conserved epitopes. ![]() They are members of the calcium-binding EF-hand protein family characterized by a conserved protein structure. The major fish allergens are the parvalbumins. Only a limited number of proteins induce specific IgE-mediated immune reactions.
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