Overcoming Shellfish Allergy: How Far Have We Come?

Shellfish allergy caused by undesirable immunological responses upon ingestion of crustaceans and mollusks is a common cause of food allergy, especially in the Asia-Pacific region. While the prevalence of shellfish allergy is increasing, the mainstay of clinical diagnosis for these patients includes extract-based skin prick test and specific IgE measurement while clinical management consists of food avoidance and as-needed use of adrenaline autoinjector should they develop severe allergic reactions. Such a standard of care is unsatisfactory to both patients and healthcare practitioners. There is a pressing need to introduce more specific diagnostic methods, as well as effective and safe therapies for patients with shellfish allergy. Knowledge gained on the identifications and defining the immuno-molecular features of different shellfish allergens over the past two decades have gradually translated into the design of new diagnostic and treatment options for shellfish allergy. In this review, we will discuss the epidemiology, the molecular identification of shellfish allergens, recent progress in various diagnostic methods, as well as current development in immunotherapeutic approaches including the use of unmodified allergens, hypoallergens, immunoregulatory peptides and DNA vaccines for the prevention and treatment of shellfish allergy. The prospect of a "cure "for shellfish allergy is within reach.

Introduction of various allergenic foods during infancy reduces risk of IgE sensitization at 12 months of age: a birth cohort study.

BackgroundIn this study, we aimed to determine whether introducing various allergenic foods during infancy is associated with IgE sensitization at 12 months of age.MethodsDetailed information on feeding practices regarding six possible allergenic foods (fruits, egg white, egg yolk, fish, shellfish, and peanuts) was obtained by administering age-specific questionnaires to parents of infants at ages 6 and 12 months. Fecal secretory IgA (sIgA), fecal eosinophil cationic protein (ECP), and serum levels of total IgE and IgE specific to 20 foods, and IgE specific to 20 inhalant allergens were also quantified at 12 months of age.ResultsAt 12 months of age, infants with IgE sensitization had been introduced to fewer allergenic food items during infancy (3.2±1.4 vs. 3.7±1.3 items). Compared with infants who were given 0-2 allergenic food items, infants introduced to 3-4 or ≥5 allergenic food items showed a significantly lower risk of IgE sensitization (odds ratios (ORs) 0.62 and 0.61, respectively) and lower total IgE levels. In addition, non-introduction of egg white or egg yolk was significantly related to IgE sensitization (ORs 1.41 and 1.26, respectively).ConclusionIncreasing the diversity of allergenic foods in infancy, including fruits, egg white, egg yolk, fish, shellfish, and peanuts, may protect infants from IgE sensitization at 12 months of age.

Application of commercial kits using DNA-based and immunochemical methods for determination of shrimp allergens in kimchi and its ingredients.

Shrimps cause a significant part of crustacea-related allergies. It is used in processed foods, including fermented Korean foods, such as kimchi. Even low amounts of shrimp allergens can provoke reactions in consumers allergic to shrimp. Accurate food labeling is the most effective means of preventing the consumption of allergenic ingredients. To validate labeling compliance and minimize the risk of cross-contaminations, the effectiveness of methodologies used for the detection of allergens in foods should be compared. Here, seven commercial kits, based on quantitative real-time polymerase chain reaction (PCR) or enzyme-linked immunosorbent assay (ELISA), were assessed for their ability to detect the presence of shrimp allergens in food. Our results showed that SureFood real-time PCR kit and Ridascreen ELISA kit had the highest recovery, whereas five other kits underperformed in the determination of allergen content of kimchi and its ingredients. The variation in recovery among the kits depended on the limit of detection and reactivity to the shrimp allergens, tropomyosin, and sarcoplasmic calcium-binding protein. PRACTICAL APPLICATION: This research confirms the performance of commercial kits to detect the presence of shrimp allergens in kimchi, and demonstrates that the sensitivity of these kits depends on reactivity to the specific shrimp allergenic proteins. These results can be used to food allergy labeling and can be applied by the food industry to develop allergen test kits for fermented foods with improved performance.

Immunomodulatory Effect of Laccase/Caffeic Acid and Transglutaminase in Alleviating Shrimp Tropomyosin (Met e 1) Allergenicity.

This work aimed to investigate the effect of enzymatic cross-linking on the allergenic potential of shrimp tropomyosin (TM), Met e 1. The cross-linked TM with laccase (CL), laccase/caffeic acid (CLC and CLC+), and transglutaminase (CTG and CTG+) formed macromolecules and altered the allergen conformation. The IgG/IgE-binding potentials of the cross-linked TM were reduced as confirmed by Western blotting and ELISA. Enzymatic cross-linking improved the gastrointestinal digestibility and induced a lower level of degranulation in RBL-2H3 and KU812 cells. Moreover, cross-linked TM decreased anaphylactic symptoms, as well as reduced the serum levels of IgG1, IgE, histamine, tryptase, and mMCP-1. In spleen cells, CLC+ and CTG+ downregulated the Th2-related cytokines and upregulated IFN-γ and IL-10. These findings revealed that CTG+ has shown more potential than CLC+ in mitigating the allergenicity of TM by influencing the conformational structure, enhancing the digestibility, decreasing the cellular degranulation process, and positively modulating the Th1/Th2 immunobalance.

Assessment of the sensitizing capacity and allergenicity of enzymatic cross-linked arginine kinase, the crab allergen.

SCOPE: The enzymatic cross-linking of an allergen by food processing may alter its sensitization potential. In this study, the IgE-binding activity and allergenicity of cross-linked thermal polymerized arginine kinase (CL-pAK) were investigated. METHODS AND RESULTS: The IgE-binding activity and stability of CL-pAK were analyzed by immunological and proteomics methods. The sensitization and potency to induce oral tolerance of CL-pAK were tested using in vivo assays and a cell model. According to the results of inhibition of ELISA, the half inhibitory concentration of AK after cross-linking changed from 1.13 to 228.36 µg/mL. The results of in vitro digestion demonstrated that CL-pAK showed more resistance to gastrointestinal digestion than native AK. Low allergenicity and capacity to induce oral tolerance in mice were shown by the sera levels of AK-specific antibodies and T-cell cytokine production. Exposure of RBL-2H3 cells to CL-pAK compared with AK, resulted in lower levels of mast degranulation and histamine. CONCLUSION: Enzymatic cross-linking with thermal polymerization of AK by tyrosinase and caffeic acid had high potential in mitigating IgE-binding activity and allergenicity, which were influenced by altering the molecular and immunological features of the shellfish protein.