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    The journal of allergy and clinical immunology. In practice. 2022 Aug 21. pii: S2213-2198(22)00824-8. doi: 10.1016/j.jaip.2022.08.019
    Identification of potentially tolerated fish species by multiplex IgE testing of a multinational fish-allergic patient cohort.
    Kalic T1,  Kuehn A2,  Aumayr M3,  Bartra J4,  Bindslev-Jensen C5,  Codreanu-Morel F6,  Domínguez O7,  Forstenlechner P8,  Hemmer W9,  Kamath SD10,  Leung A11,  Leung N12,  Lifanov Y13,  Mortz CG14,  Pascal M15,  Ristl R16,  Sørensen M17,  Üzülmez Ö18,  Yeghiazaryan L19,  Wong G20,  Hafner C21,  Breiteneder H22
    Author information
    1Department 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.
    2Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg.
    3MacroArray Diagnostics, Vienna, Austria.
    4Allergology Section, Pneumology Department, Hospital Clínic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain; Allergy Network ARADyAL, Instituto de Salud Carlos III, Madrid, Spain.
    5Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis, Odense University Hospital, University of Southern Denmark, Odense, Denmark.
    6Department of Allergology and Immunology, Centre Hospitalier de Luxembourg-Kanner Klinik, Luxembourg.
    7Allergy and Clinical Immunology Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain.
    8MacroArray Diagnostics, Vienna, Austria.
    9Floridsdorf Allergy Center, Vienna, Austria.
    10Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria; Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia.
    11Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
    12Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
    13craftworks GmbH, Vienna, Austria.
    14Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis, Odense University Hospital, University of Southern Denmark, Odense, Denmark.
    15Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain; Allergy Network ARADyAL, Instituto de Salud Carlos III, Madrid, Spain; Immunology Department, Centre de Diagnostic Biomedic, Hospital Clínic de Barcelona.
    16Centre for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
    17Department of Pediatric and Adolescent Medicine, University Hospital of North Norway, Tromsø, Norway.
    18Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
    19Centre for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
    20Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
    21Department of Dermatology, University Hospital St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria; Karl Landsteiner Institute of Dermatological Research, Karl Landsteiner Gesellschaft, St. Pölten, Austria.
    22Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria. Electronic address: heimo.breiteneder@meduniwien.ac.at.
    Abstract

    BACKGROUND: 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.

    OBJECTIVE: To investigate whether multiplex IgE testing reveals potentially tolerated fish through absence of IgE to parvalbumin and extracts from specific species.

    METHODS: Sera from 263 clinically well-defined fish-allergic patients from Austria, China, Denmark, Luxembourg, Norway and Spain were used in a research version of ALEX multiplex IgE quantification assay. Specific IgE to parvalbumins from 10 fish species (9 bony and 1 cartilaginous), and to extracts from 7 species was quantified. IgE-signatures of individual patients and patient groups were analyzed using SPSS and R.

    RESULTS: Up to 38% of the patients were negative to cod parvalbumin, the most commonly used molecule in fish allergy diagnosis. 45 patients (17%) tested negative to parvalbumins 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 parvalbumin and extracts from ray, a cartilaginous fish, indicating its potential tolerance. Up to 21% of the patients were negative to at least one 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.

    CONCLUSION: 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.


    Copyright © 2022. Published by Elsevier Inc.

    KEYWORDS: IgE, fish allergy, fish extracts, fish tolerance, food allergy, multiplex allergy diagnosis, parvalbumin, patient management

    Publikations ID: 36002102
    Quelle: öffnen
     
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