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Clinical Symptoms of Seafood Allergy, Anisakis- Related Allergy, Histamine Fish Poisoning, and Histamine Intolerance
Source publication
Seafood allergies have been increasing their presence in the last 2 decades. Allergic reactions to seafood can range from mild urticarial and oral allergy syndrome to life-threatening anaphylactic reactions. Ingestion of seafood infested with Anisakis larvae can cause a disease known as anisakiasis with symptoms similar to true seafood allergy. Fur...
Contexts in source publication
Context 1
... The most frequent clinical manifestations of seafood allergy include oral allergy syndrome, urticaria/angioedema, gastroin- testinal symptoms, and the most extreme form of reaction, which is life-threatening anaphylaxis [1] (Table 2). Generally, allergy reactions are immediate (within 2 hours); however, late phase reactions (up to 8 hours after ingestion) have also been reported, particularly in shellfish-allergic subjects [2,3]. ...
Context 2
... of seafood infested with the parasite Anisakis sim- plex can cause allergic reactions, which are associated with Anisakis allergens alone and not with fish allergens [85]. Con- sumption of seafood infested with Anisakis larvae can cause 2 major allergic disorders: gastro-allergic anisakiasis (GAA) and chronic urticarial (Table 2). GAA is accompanied by severe IgE-mediated allergic reactions presented with clinical mani- festations ranging from gastrointestinal reactions to urticaria and life-threatening anaphylactic shock. ...
Context 3
... are several non-immune-mediated adverse reac- tions to seafood that present with allergy-like symptoms. These clinical disorders include HFP (scombroid poisoning) and histamine intolerance (Table 2). HFP is caused by con- sumption of decomposed dark-muscled fish that contain ele- vated values of histamine in its edible parts [104]. ...
Context 4
... is not destroyed by cooking, freezing, or canning. Importantly, clinical symptoms in HFP, although nonallergic in origin, are similar to true IgE-mediated allergic reactions (Table 2). The onset of symptoms is usually within a few minutes after ingestion and duration of symptoms ranges from a few hours to 24 hours. ...
Similar publications
Anisakis simplex spp. sensitization rates have increased worldwide, with a significant impact on health-care systems. To date, no clear-cut diagnostic criteria and laboratory algorithm have been established, so anisakiasis still represents an under-reported health problem whose clinical manifestations, when present, mimic the much more common aller...
Citations
... Las membranas corioamnióticas están compuestas por dos capas histológicamente adosadas: amnios y corion. Estas capas, a su vez, están constituidas por elementos celulares sobrepuestos a capas de tejido conectivo con elevada concentración de varios tipos de colágeno que varían a lo largo de la gestación y proveen al feto la posibilidad de moverse, dada su resistencia tensil y elasticidad 1,2 . El amnios aporta el mayor porcentaje de resistencia, mientras el corion provee del 10 al 15% del total de su resistencia 3 . ...
The amniotic membrane, located on the inner side of the fetal placenta, has been the subject of multiple investigations to try to elucidate its embryological role and its therapeutic cellular potential. Currently, the limitations of the study in human fetuses mean that part of its functioning is unknown, however, some clinical and basic studies shed light on its role in modern medicine. A bibliographic review of the literature was carried out from 1960 to 2022, using databases such as PubMed, SciELO and Scopus, including a total of 50 articles and two embryology texts. The objective of this narrative review was to synthesize information on angiogenesis and its clinical importance. The information collected made it possible to show that the healing properties of the fetal skin are due to intrinsic factors of the fetus, and that human amniotic epithelial cells have a differentiation similar to embryonic stem cells, with the differentiation capacity similar to that of mesenchymal cells, highlighting their clinical importance due to their regenerative characteristics. In conclusion, human embryonic development remains relatively inexplicable, but its knowledge has allowed great advances, which could be useful in regeneration therapies, repair of injured tissues and organs.
... A range of adverse reactions can occur following seafood consumption, which can be misdiagnosed as SFA, including scombroid poisoning, toxins, and anisakis infection. 11,13 Each seafood species contains multiple isoforms of allergens or cross-reactive allergens. Furthermore, the commercial extracts of seafood used in daily practice for allergic testing contain variable levels of allergens, which may result in overdiagnosis or underdiagnosis Thus, a standard diagnostic approach for SFA is not suitable for all patients. ...
Purpose
Increasing seafood consumption is associated with more frequent reports of food allergy. Little is known about seafood allergy (SFA) among adults in Vietnam. We investigated the characteristics of individuals with SFA and the risk factors for severe SFA.
Patients and methods
A cross-sectional, web-based survey was conducted among individuals aged ≥ 18 years from universities in Ho Chi Minh City (Vietnam) between December 2021 and July 2022. The survey was based on a structured, validated questionnaire related to FA. Strict definitions of “convincing allergy” were used. Multivariate analysis was used to estimate the risk factors for severe SFA after adjusting for covariates. Data were analyzed using JASP (v.0.16.3) and SPSS (v.22.0).
Results
Totally, 1038 out of 2137 (48.57%) individuals completed the questionnaire, of whom 285 (27.46%) had reported SFA. Convincing SFA accounted for 20.13% (209/1038) of the cases, with convincing shellfish allergy being more common than fish allergy. Participants with comorbid shellfish and fish allergy had higher prevalence of atopic dermatitis, peanut/nut allergy, other food allergy, and cutaneous and upper airway symptoms compared to participants with shellfish allergy (p < 0.05). The spectrum of reactive seafood was diverse and characterized by local species. The age of symptom onset was most commonly during late childhood and adolescence, with most reactions persisting into adulthood. A history of anaphylaxis, comorbid peanut, and tree nut allergy, and ≥3 allergens were associated with severe SFA.
Conclusion
Features of causative, coexisting seafood allergy, and risk factors for severe SFA were demonstrated, which can provide a reference for future studies.
... Alergija na kikiriki, jezgrasto voće i animalnu hranu iz mora obično ostaje doživotno, dok je na ostalu hranu najčešće prolazna pojava [47][48][49][50][51] . Tako, na primer, alergija na proteine kravljeg mleka, soje, jaja i pšeničnog brašna se kod oko 80% dece gubi do pete godine 18,28 . ...
... Allergy to peanuts, tree nuts, and seafood typically remains lifelong, while allergies to other foods are often transient [47][48][49][50][51] . For example, allergies to cow's milk, soy, eggs, and wheat flour are lost in about 80% of children by the age of five 18,28 . ...
Food allergy is a frequent and continuously growing problem of modern humanity. It is present in all periods of life, most often in the first years after birth, and especially in genetically predisposed infants to artificial feeding. The tendency to an allergic reaction is non-selective, and food allergy is often multiple and to a high degree associated with respiratory and/ or skin hypersensitivity. Due to the antigenic similarity of some types of food, such as legumes and nuts or cow's milk and other animal milk, the allergy can be cross-related. The most common allergens in children, responsible for over 80-90% of nutritional allergies, are proteins from cow's milk, eggs, peanuts, nuts, soy, wheat flour, and foods from water (fish, shellfish, squid, crabs). The disorder is characterized by a very wide spectrum of clinical manifestations. Extremely severe systemic reactions, sometimes fatal, are also possible. The diagnosis of food allergy is based on the analysis of personal and family history, a complete physical examination and laboratory and other procedures by the type of reaction and type of manifestations, and treatment on a strict elimination diet. Although nutritional allergy in children is most often transient, to some foods, such as peanuts, nuts, and animal food from water, it is in a high percentage lifelong.
... It has been reported that the tilapia allergen demonstrates high homology to human tropomyosin and potentially triggers inflammatory bowel diseases (Annette Kuehn et al., 2014). As mentioned before, tropomyosin is the major allergen in shellfish and responsible for ingestion-related allergic reactions (Prester, 2016). Tropomyosin is a muscle protein with a molecular weight of 34−38 kDa. ...
Seafood is rich in nutrients and plays a significant role in human health. However, seafood allergy is a worldwide health issue by inducing adverse reactions ranging from mild to life‐threatening in seafood‐allergic individuals. Seafood consists of fish and shellfish, with the major allergens such as parvalbumin and tropomyosin, respectively. In the food industry, effective processing techniques are applied to seafood allergens to lower the allergenicity of seafood products. Also, sensitive and rapid allergen‐detection methods are developed to identify and assess allergenic ingredients at varying times. This review paper provides an overview of recent advances in processing techniques (thermal, nonthermal, combined [hybrid] treatments) and main allergen‐detection methods for seafood products. The article starts with the seafood consumption and classification, proceeding with the prevalence and symptoms of seafood allergy, followed by a description of biochemical characteristics of the major seafood allergens. As the topic is multidisciplinary in scope, it is intended to provide information for further research essential for food security and safety.
... The chemical released during degranulation are histamines, tryptase, leukotrienes, cytokines, etc. are responsible for the symptoms that arise due to allergic reactions. Seafood allergy may be simple as urticaria and may cause life-threatening anaphylactic reactions (Prester, 2016) [40] . Depending on the location of the attack seafood allergy is categorized into four classes: dermatological allergy, gastrointestinal allergy, respiratory allergy, and systemic allergy, and the specific details are included in Table1. ...
... The chemical released during degranulation are histamines, tryptase, leukotrienes, cytokines, etc. are responsible for the symptoms that arise due to allergic reactions. Seafood allergy may be simple as urticaria and may cause life-threatening anaphylactic reactions (Prester, 2016) [40] . Depending on the location of the attack seafood allergy is categorized into four classes: dermatological allergy, gastrointestinal allergy, respiratory allergy, and systemic allergy, and the specific details are included in Table1. ...
... The food trigger reported the most frequently in our study was shrimp. Shrimp is a commonly seen as food allergen, while shellfish has been reported as a histamine releaser, as well as being a source of histamine [18]. Pseudoallergic reaction was preferred to food allergy, based on the association of low-histamine diet efficacy with CU exacerbated by shrimp consumption. ...
Background:
Chronic urticaria (CU) is comprised of diverse phenotypes, and thus, a shift towards a precision medical approach is warranted in its management.
Methods:
This study enrolled 78 patients with CU. Serum erythrocyte sedimentation rate, hemoglobin, hematocrit, eosinophil count, IgE, antinuclear antibody (ANA), and serum diamine oxidase (DAO) levels of the patients were measured and were compared according to the patient's response to second-generation antihistamines (sgAH), corticosteroids, leukotriene receptor antagonist (LTRA), H2 blockers, and low-histamine diet.
Results:
Age- and sex-adjusted logistic regression analysis showed that patients with duration of CU > 3 years (adjusted odd ratio [aOR] = 4.39) and a DAO level < 10 U/mL (aOR = 3.90) were significantly associated with a good sgAH response. Age > 50 years (aOR = 0.02), duration of chronic urticaria > 3 years (aOR =0.06), and an ANA titer ≥ 1 : 80 (aOR = 0.03) were significantly and inversely associated with corticosteroid response. A low-histamine diet response was significantly associated with LTRA response (aOR = 67.29). In addition, a DAO level < 5.4 U/mL (aOR = 71.95) was significantly associated with H2 blocker response. Furthermore, concomitant angioedema (aOR = 10.56), multiple food triggers (aOR = 11.69), and a DAO level < 5.4 U/mL (aOR = 3.78) were significantly associated with a low-histamine diet response. Conversely, dermatographic urticaria and a hematocrit level < 36% were significantly and inversely associated with low-histamine diet response.
Conclusions:
Several promising biomarkers were identified in this study to predict the efficacy of chronic urticaria treatment. DAO could be a novel biomarker for predicting the efficacy not only of dietary intervention but also for antagonists of H1 and H2 receptors.
... Ingestion of Anisakis larvae-infested seafood can develop anisakiasis, a disease with symptoms similar to real seafood allergy. In addition, some adverse reactions to seafood, such as histamine fish poisoning and histamine intolerance, can cause clinical symptoms that, while not allergic in nature, are comparable to allergic reactions [4]. ...
... Shrimp is one of the most popular edible seafoods, with a global market in 2020 of 18.30 billion USD, and China and Ecuador are major producing countries (Research and Markets, 2021;FAO, 2021). Growing shrimp production and consumption have been accompanied by an increasing number of reports of adverse health reactions among both consumers and processing workers (Prester, 2016;Faber et al., 2017;Ruethers et al., 2018;Fu et al., 2019). Indeed, more than 2.5% of the worldwide population suffers IgE-mediated Type-I allergic reactions to shrimp proteins such as tropomyosin (TM, Lit v 1), arginine kinase (AK, Lit v 2), myosin light chain (MLC, Lit v 3), and sarcoplasmic calciumbinding protein (SCP, Lit v 4), among others (Ayuso et al., 2009;Ayuso et al., 2010a, Faber et al., 2017Ruethers et al., 2018). ...
It is important to develop tools that can be used to understand the effects of processing on allergenic foods in order to achieve personalized food labeling. To evaluate the effect of heating on the allergy-relevant structural properties of tropomyosin (TM), arginine kinase (AK), myosin light chain (MLC) and sarcoplasmic calcium-binding protein (SCP) shrimp allergens, trypsin digests of raw, fried and baked shrimp extracts were analyzed by peptidomics and epitope correlations. Processing altered the number of peptides released from the distinct allergens, and each treatment generated a specific epitope-matched peptide allergen fingerprint. Among the four allergens, TM led to a number of released peptides and epitope changes being detected, and AK provided the epitope-matched ³³¹MGLTEFQAVK³⁴⁰ sequence as a common differentiating peptide for heat processing. These results provide new views on the structural effects of processing on major shrimp allergens and peptide candidates as processing biomarkers.
... Due to this assumption, crustacean-allergic patients are often advised to also avoid mollusc. Although allergen cross-reactivity between crustaceans and mollusc has been documented clinically and experimentally [29], group-specific allergy has also been reported [30], suggesting that the clinical recommendation of total seafood avoidance may not be accurate. In this study, IgE reactivity between oyster TM Cra g 1, prawn Pen m 1, and dust mite Der p 10 was evaluated by ELISA. ...
The Pacific oyster is a commercially important mollusc and, in contrast to most other shellfish species, frequently consumed without prior heat treatment. Oysters are rich in many nutrients but can also cause food allergy. Knowledge of their allergens and cross-reactivity remains very limited. These limitations make an optimal diagnosis of oyster allergy difficult, in particular to the Pacific oyster (Crassostrea gigas), the most cultivated and consumed oyster species worldwide. This study aimed to characterise IgE sensitisation profiles of 21 oyster-sensitised patients to raw and heated Pacific oyster extract using immunoblotting and advanced mass spectrometry, and to assess the relevance of recombinant oyster allergen for improved diagnosis. Tropomyosin was identified as the major allergen recognised by IgE from 18 of 21 oyster-sensitised patients and has been registered with the WHO/IUIS as the first oyster allergen (Cra g 1). The IgE-binding capacity of oyster-sensitised patients’ IgE to purified natural and recombinant tropomyosin from oyster, prawn, and dust mite was compared using enzyme-linked immunosorbent assay. The degree of IgE binding varied between patients, indicating partial cross-sensitisation and/or co-sensitisation. Amino acid sequence alignment of tropomyosin from these three species revealed five regions that contain predicted IgE-binding epitopes, which are most likely responsible for this cross-reactivity. This study fully biochemically characterises the first and major oyster allergen Cra g 1 and demonstrates that the corresponding recombinant tropomyosin should be implemented in improved component-resolved diagnostics and guide future immunotherapy.
... The high homology in the sequence is up to 98% among crustacean TMs, and 68%−100% among TA B L E 3 Prediction of B-cell epitopes in TM (Exo m 1) from prawn (E. modestus; Zhang et al., 2020) (Ruethers et al., 2018) molluskan TMs (Duan et al., 2021;Palmer et al., 2020;Prester, 2016). Similarly, the high homology in the sequence is 80%−97% among crustaceans and house dust mite TMs and 78%−98% among crustacean and cockroach TMs. ...
Tropomyosin (TM) is a major allergen in crustaceans, which often causes allergy and is fatal to some consumers. Currently, the most effective treatment is to avoid ingesting TM, although most adverse events occur in accidental ingestion. In this review, the molecular characterization, epitopes, cross‐reactivity, and pathogenesis of TM are introduced and elucidated. Modification of TM by traditional processing methods such as heat treatment and enzymatic hydrolysis, and innovative processing technologies including high‐pressure treatment, cold plasma (CP), ultrasound, pulsed electric field (PEF), pulsed ultraviolet, microwave and irradiation are discussed in detail. Particularly, enzymolysis, PEF, and CP technologies show great potential for modifying TM and more studies are needed to verify their effectiveness for the seafood industry. Possible mechanisms and the advantages/disadvantages of these technologies for the mitigation of TM allergenicity are also highlighted. Further work should be conducted to investigate the allergenicity caused by protein segments such as epitopes, examine the interaction sites between the allergen and the processing techniques and reveal the reduction mechanism of allergenicity.
