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Seafood allergens have emerged as a significant concern in recent years, given the rising prevalence of allergic reactions associated with the consumption of various seafood products. Seafood allergens encompass a diverse range of proteins found in fish and shellfish, with some species more likely to trigger allergic reactions than others. The complexity of seafood allergens stems from their structural diversity and the potential for cross-reactivity with allergens from related or even unrelated species. These tests, such as enzyme-linked immunosorbent assays and molecular assays are essential for both allergen detection in food products and the diagnosis of seafood allergies in individuals. [ABSTRACT FROM AUTHOR]

Tu HK Trinh,1 Chi N Duong,2 Tu HT Pham,3 Hao DT Au,3 Loc T Tran,3 Cuong V Nguyen,3 Han BG Nguyen,3 Nguyen M Tran,3 Quy Q Phan,3 Thu NA Le,3 Nga Nguyen4 1Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam; 2University of Massachusetts Lowell, Lowell, MA, USA; 3Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam; 4Hasaki Clinic, Ho Chi Minh City, VietnamCorrespondence: Tu HK Trinh, Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street, Ward 11, District 5, Ho Chi Minh City, Vietnam, Tel +84-906 927 123, Email kim.tu.vn@ump.edu.vnPurpose: 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.Keywords: seafood allergy, shellfish allergy, fish allergy, Vietnam

Background: Seafood allergy (SA), including allergy to shellfish (crustacean and mollusks) and fish, is among the 4 most common food allergies causing anaphylaxis, but there are limited data showing SA clinical management in different countries. Objective: We sought to characterize a large cohort of patients with fish and shellfish allergy and to facilitate standardization of future care for this increasingly common allergic disease. Methods: We performed a retrospective, observational, noninterventional study from 945 patients from 2015 to 2019 in 7 hospitals in the United States and the United Kingdom to evaluate SA. A chi-square test was used to detect differences in family history, medical history, and current symptoms between patients in 2 countries. Results: Underdiagnosed anaphylaxis in patients with SA was associated with underuse of epinephrine (adrenaline) autoinjectors in both countries. Oral food challenge was used only when skin or serologic test results were negative. Asthma and allergic rhinitis were more common in the US patients with SA, but eczema was more common in UK patients with SA (P < .001). Respiratory, gastrointestinal, and neurological symptoms were higher in UK patients with SA than in US patients with SA (P < .001). Conclusions: In international multicenter cohorts of patients with fish and shellfish allergy, there are opportunities for improvement in management. Physician identification of anaphylaxis, use of diagnostic oral food challenges, and anaphylaxis treatment with epinephrine are areas with significant knowledge gaps in need of improvement in the United Kingdom and the United States. There is an opportunity for the development of unified, standardized diagnostic protocols for SA with distribution for allergists and trainees.

BACKGROUND: Clinical management of shrimp allergy is hampered by the lack of accurate tests. Molecular diagnosis has been shown to more accurately reflect the clinical reactivity but the full spectrum of shrimp allergens and their clinical relevance are yet to be established. We therefore sought to comprehend the allergen repertoire of shrimp, investigate and compare the sensitization pattern and diagnostic value of the allergens in allergic subjects of two distinct populations. METHODS: Sera were collected from 85 subjects with challenge-proven or doctor-diagnosed shrimp allergy in Hong Kong and Thailand. The IgE-binding proteins of Penaeus monodon were probed by Western blotting and identified by mass spectrometry. Recombinant shrimp allergens were synthesized and analyzed for IgE sensitization by ELISA. RESULTS: Ten IgE-binding proteins were identified, and a comprehensive panel of 11 recombinant shrimp allergens was generated. The major shrimp allergens among Hong Kong subjects were troponin C (Pen m 6) and glycogen phosphorylase (Pen m 14, 47.1%), tropomyosin (Pen m 1, 41.2%) and sarcoplasmic-calcium binding protein (Pen m 4, 35.3%), while those among Thai subjects were Pen m 1 (68.8%), Pen m 6 (50.0%) and fatty acid-binding protein (Pen m 13, 37.5%). Component-based tests yielded significantly higher area under curve values (0.77-0.96) than shrimp extract-IgE test (0.70-0.75). Yet the best component test differed between populations; Pen m 1-IgE test added diagnostic value only in the Thai cohort, whereas sensitizations to other components were better predictors of shrimp allergy in Hong Kong patients. CONCLUSION: Pen m 14 was identified as a novel shrimp allergen predictive of challenge outcome. Molecular diagnosis better predicts shrimp allergy than conventional tests, but the relevant component is population dependent.

Food allergy represents a failure of oral tolerance mechanisms to dietary antigens. Over the past few years, food allergies have become a growing public health problem worldwide. Gut microbiota is believed to have a significant impact on oral tolerance to food antigens and in initiation and maintenance of food allergies. Therefore, probiotics have also been proposed in this field as a possible strategy for modulating both the gut microbiota and the immune system. In recent years, results from preclinical and clinical studies suggest a promising role for probiotics in food allergy prevention and treatment. However, future studies are needed to better understand the mechanisms of action of probiotics in food allergies and to design comparable study protocols using specific probiotic strains, defined doses and exposure times, and longer follow-up periods. [ABSTRACT FROM AUTHOR]

This article discusses the variability in allergen repertoire among commercial shellfish skin prick test (SPT) extracts. The study found that widely used commercial SPT extracts for shellfish allergy diagnosis are generally not standardized, limiting the diagnostic value of the results. The researchers analyzed 11 commercial crustacean and five mollusc SPT extracts and found significant variability in protein content and allergen repertoire. The study concludes that standardization of allergen extracts is urgently needed to improve the accuracy and reliability of SPT for shellfish allergy diagnosis. [Extracted from the article]

Background: The use of iodophor-impregnated adhesive drapes have become almost universally incorporated into standard practice of arthroplasty draping technique. Iodine-related allergies in patients planned for joint replacement present a challenge in terms of the best course of action to minimize complications and optimize outcomes. Methods: This is a retrospective case series of patients that received an iodophor-impregnated drape as part of draping for a total hip or knee arthroplasty at a single orthopaedic-specific hospital with documented iodine-related allergies. From 2015 to 2023, 9816 total hip arthroplasty and total knee arthroplasty cases were reviewed, and 135 were documented to have an iodine-related allergy for a prevalence of 1.38%. Intraoperative and postoperative records were reviewed to screen for an allergic reaction or wound healing issues that may have been related to an adverse reaction to the use of the iodophor-impregnated drape. Results: Of the 135 patients, 43 had iodine listed as an allergy, 85 had shellfish, 20 had iodinated contrast media, and 3 had povidone iodine. Sixteen patients had a cluster of iodine-related allergies. There were no intraoperative reports of an allergic reaction to this drape. There were four superficial wound problems, none of which were documented to relate to an allergic dermatitis reaction, and none required further surgery. Conclusions: Patients reporting iodine-related allergies were present in 1.38% of patients undergoing hip or knee arthroplasty in our series. We encountered no allergic reactions or adverse outcomes that could be attributed to the use of iodiphor impregnated drapes in these patients.

Shellfish is a leading cause of food allergy and anaphylaxis worldwide. Recent advances in molecular characterization have led to a better understanding of the allergen profile. High sequence homology between shellfish species and between shellfish and house dust mites leads to a high serological cross-reactivity, which does not accurately correlate with clinical cross-reactions. Clinical manifestations are immediate and the predominance of perioral symptoms is a typical feature of shellfish allergy. Diagnosis, as for other food allergies, is based on SPTs and specific IgE, while the gold standard is DBPCFC. Cross-reactivity between shellfish is common and therefore, it is mandatory to avoid all shellfish. New immunotherapeutic strategies based on hypoallergens and other innovative approaches represent the new frontiers for desensitization. [ABSTRACT FROM AUTHOR]

Food allergy represents a failure of oral tolerance mechanisms to dietary antigens. Over the past few years, food allergies have become a growing public health problem worldwide. Gut microbiota is believed to have a significant impact on oral tolerance to food antigens and in initiation and maintenance of food allergies. Therefore, probiotics have also been proposed in this field as a possible strategy for modulating both the gut microbiota and the immune system. In recent years, results from preclinical and clinical studies suggest a promising role for probiotics in food allergy prevention and treatment. However, future studies are needed to better understand the mechanisms of action of probiotics in food allergies and to design comparable study protocols using specific probiotic strains, defined doses and exposure times, and longer follow-up periods.

Shellfish is a leading cause of food allergy and anaphylaxis worldwide. Recent advances in molecular characterization have led to a better understanding of the allergen profile. High sequence homology between shellfish species and between shellfish and house dust mites leads to a high serological cross-reactivity, which does not accurately correlate with clinical cross-reactions. Clinical manifestations are immediate and the predominance of perioral symptoms is a typical feature of shellfish allergy. Diagnosis, as for other food allergies, is based on SPTs and specific IgE, while the gold standard is DBPCFC. Cross-reactivity between shellfish is common and therefore, it is mandatory to avoid all shellfish. New immunotherapeutic strategies based on hypoallergens and other innovative approaches represent the new frontiers for desensitization.

Introduction: Iodine is a vital mineral of the human body that acts by maintaining the health of the thyroid gland. Research has shown that iodine-rich food allergy (i.e., seafood allergy) is not caused by iodine itself; instead, it is caused by other proteins including tropomyosin and parvalbumin in shellfish and fish, respectively. Amiodarone is a commonly used antiarrhythmic agent containing a significant amount of iodine. Objective: This study's objective was to assess pharmacists' knowledge, attitude, and practices toward the misconception of iodine allergy and the cross-reactivity with amiodarone. Methods: In February 2020, a cross-sectional study was conducted by sending out an online survey to three pharmaceutical organizations (Saudi Pharmaceutical Society, Kuwait Pharmaceutical Association, and Oman Pharmaceutical Society). Additionally, an electronic questionnaire was administered to pharmacists attending the Dubai International Pharmaceuticals and Technologies Conference and Exhibition 2020 (DUPHAT). Chi-square or Fisher's exact test, when appropriate, were used to compare categorical variables. The statistical analyses were carried out using SPSS software. Results: Data were collected from 66 respondents. However, only 61 (92.4%) were included in the final analysis following the exclusion of incomplete responses. The mean age of participants was 35 ± 8.48 years. The majority of participants did not have the Board of Pharmacy Specialties Certification (54.1%). Moreover, (41%) of participants licensed as pharmacists with more than 10 years of initial pharmacy licensure. Forty-three (70.5%) of participants had the misconception that iodine allergy should be considered before amiodarone administration, 20/32 (62.5%) of whom considered iodine allergy alone thought that premedication with corticosteroids and/or antihistamines is necessary. Concerning iodine allergy and amiodarone use, there was no significant difference in knowledge between the pharmacists who have board certification and those who did not. Conclusion: Pharmacists' misconception concerning iodine allergy and cross-reactivity with amiodarone was evident. Implementation of educational programs targeting pharmacists is necessary to correct these misconceptions. [ABSTRACT FROM AUTHOR]

Tropomyosin in shellfish is considered a major cross-reactive allergen in house dust mites and cockroaches; however, the specific epitopes have not been elucidated. Therefore, this study aimed to identify the consensus antigenic determinant among shrimp, house dust mites, and cockroaches using in silico methods. The protein sequences of tropomyosin, including Der f 10, Mac r 1, Pen a 1, Pen m 1, Per a 7, and Bla g 7, were retrieved from the UniProt database. The 3D structures were derived from the AlphaFold or modeled using the Robetta. The determination of linear epitopes was performed by AlgPRED and BepiPRED for B cell epitope, and NetMHCIIpan and NetMHCII for T cell epitope, while Ellipro was used to evaluate conformational epitopes. Fourteen peptides were discovered as the consensus linear B cell epitopes, while seventeen peptides were identified as linear T cell epitopes specific to high-frequency HLA-DR and HLA-DQ alleles. The conformational determination of B cell epitopes provided nine peptides, in which residues 209, 212, 255–256, and 258–259 were found in both linear B cell and linear T cell epitope analysis. This data could be utilized for further in vitro study and may contribute to immunotherapy for allergic diseases associated with tropomyosin. [ABSTRACT FROM AUTHOR]

Introduction Iodine is a vital mineral of the human body that acts by maintaining the health of the thyroid gland. Research has shown that iodine-rich food allergy (i.e., seafood allergy) is not caused by iodine itself; instead, it is caused by other proteins including tropomyosin and parvalbumin in shellfish and fish, respectively. Amiodarone is a commonly used antiarrhythmic agent containing a significant amount of iodine. Objective This study’s objective was to assess pharmacists’ knowledge, attitude, and practices toward the misconception of iodine allergy and the cross-reactivity with amiodarone. Methods In February 2020, a cross-sectional study was conducted by sending out an online survey to three pharmaceutical organizations (Saudi Pharmaceutical Society, Kuwait Pharmaceutical Association, and Oman Pharmaceutical Society). Additionally, an electronic questionnaire was administered to pharmacists attending the Dubai International Pharmaceuticals and Technologies Conference and Exhibition 2020 (DUPHAT). Chi-square or Fisher’s exact test, when appropriate, were used to compare categorical variables. The statistical analyses were carried out using SPSS software. Results Data were collected from 66 respondents. However, only 61 (92.4%) were included in the final analysis following the exclusion of incomplete responses. The mean age of participants was 35 ± 8.48 years. The majority of participants did not have the Board of Pharmacy Specialties Certification (54.1%). Moreover, (41%) of participants licensed as pharmacists with more than 10 years of initial pharmacy licensure. Forty-three (70.5%) of participants had the misconception that iodine allergy should be considered before amiodarone administration, 20/32 (62.5%) of whom considered iodine allergy alone thought that premedication with corticosteroids and/or antihistamines is necessary. Concerning iodine allergy and amiodarone use, there was no significant difference in knowledge between the pharmacists who have board certification and those who did not. Conclusion Pharmacists’ misconception concerning iodine allergy and cross-reactivity with amiodarone was evident. Implementation of educational programs targeting pharmacists is necessary to correct these misconceptions.

Purpose: In excess of 100 million procedures using iodinated radio-contrast media are conducted each year. There is a common misunderstanding regarding the links between allergy to iodinated substances and the risk of allergic reaction to intravenous iodinated contrast agents. These perceived risks are managed via administration of corticosteroids or avoidance of iodinated contrast altogether. Methods: An extensive review of published literature on scientific databases and international guidelines was conducted in order to inform the research question. A questionnaire was formulated and distributed to hospital doctors in four tertiary centres. Within this questionnaire, hospital doctors were presented with six different scenarios of bona fide allergy to iodinated substances (e.g. shellfish) and asked to select the treatment response option which they deemed to be the most suitable from a choice of three (standard contrast scan/delay scan with pre-medication/change to non-contrast scan). Results: Eighty-seven questionnaire responses were received. Contrast (standard protocol) was the most appropriate regimen in the setting of all the listed allergies. This was identified correctly by 76%, 69%, 44%, 32%, 18% and 14% for kiwi, fish, poly-food, shellfish, betadine and tincture of iodine allergies, respectively. Conclusions: There is a lack of understanding amongst local junior medical staff regarding administration of iodinated contrast media to patients with a history of allergy to iodinated substances. These misconceptions may potentiate the unnecessary usage of pre-medication and ordering of non-contrast scans in the setting of a gold-standard enhanced scan. Findings from this study suggest that there is a need for future education efforts targeted during the basic specialty training stage. [ABSTRACT FROM AUTHOR]

Anaphylaxis, desensitization, food allergen, food allergy, omalizumab, oral immunotherapy, shellfish allergy, shrimp allergy, sustained unresponsiveness In addition, commercial shrimp extracts are heterogeneous with variable allergen representation.11 The differing allergens may result in varied responses in SPT and IgE results, which may explain Patient B's apparent negative shrimp IgE test. Keywords: anaphylaxis; desensitization; food allergen; food allergy; omalizumab; oral immunotherapy; shellfish allergy; shrimp allergy; sustained unresponsiveness EN anaphylaxis desensitization food allergen food allergy omalizumab oral immunotherapy shellfish allergy shrimp allergy sustained unresponsiveness 1 4 4 01/05/22 20220101 NES 220101 AUTHOR CONTRIBUTIONS B Diem-Tran Nguyen: b Data curation (equal); Investigation (equal); Project administration (lead); Visualization (lead); Writing-original draft (lead); Writing-review & editing (equal). [Extracted from the article]

Background: Seafood allergy (SA), including allergy to shellfish (crustacean and mollusks) and fish, is among the 4 most common food allergies causing anaphylaxis, but there are limited data showing SA clinical management in different countries., Objective: We sought to characterize a large cohort of patients with fish and shellfish allergy and to facilitate standardization of future care for this increasingly common allergic disease., Methods: We performed a retrospective, observational, noninterventional study from 945 patients from 2015 to 2019 in 7 hospitals in the United States and the United Kingdom to evaluate SA. A chi-square test was used to detect differences in family history, medical history, and current symptoms between patients in 2 countries., Results: Underdiagnosed anaphylaxis in patients with SA was associated with underuse of epinephrine (adrenaline) autoinjectors in both countries. Oral food challenge was used only when skin or serologic test results were negative. Asthma and allergic rhinitis were more common in the US patients with SA, but eczema was more common in UK patients with SA ( P  < .001). Respiratory, gastrointestinal, and neurological symptoms were higher in UK patients with SA than in US patients with SA ( P  < .001)., Conclusions: In international multicenter cohorts of patients with fish and shellfish allergy, there are opportunities for improvement in management. Physician identification of anaphylaxis, use of diagnostic oral food challenges, and anaphylaxis treatment with epinephrine are areas with significant knowledge gaps in need of improvement in the United Kingdom and the United States. There is an opportunity for the development of unified, standardized diagnostic protocols for SA with distribution for allergists and trainees., Competing Interests: Disclosure of potential conflict of interest: K. Nadeau reported receiving grants from the 10.13039/100000060National Institute of Allergy and Infectious Diseases, the National Heart, Lung, and Blood Institute, the 10.13039/100000066National Institute of Environmental Health Sciences, and Food Allergy Research and Education; serving as director of the World Allergy Organization; serving as advisor for Cour Pharma; serving on the National Scientific Committee of the 10.13039/100014247Immune Tolerance Network and the National Institutes of Health clinical research centers; being cofounder of Before Brands, Latitude, Alladapt, and IgGenix outside the submitted work; and having patents for an oral formula for decreasing food allergy risk and treatment for food allergy, for granulocyte-based methods for detecting and monitoring immune system disorders issued, for methods and assays for detecting and quantifying pure subpopulations of white blood cells in immune system disorders, and for microfluidic device and diagnostic methods for allergy testing based on detection of basophil activation pending. S. B. Sindher is funded by the National Institute of Allergy and Infectious Disease, Consortium for Food Allergy Research (CoFAR), Regeneron, DBV Technologies, Aimmune Therapeutics, Novartis, and Sanofi, and is an advisory member for AstraZeneca. P. Sriaroon is funded by Food Allergy Research and Education. C. M. Davis receives research contract funding from DBV Technologies, Regeneron, and Aimmune Therapeutics, grant funding from the National Institute of Allergy and Infectious Disease (grant no. R34AI157948) (CoFAR and Consortium of Eosinophilic Gastrointestinal Disease Researchers), and the Food Allergy Research and Education. The rest of the authors declare that they have no relevant conflicts of interest., (© 2024 The Author(s).)

Tropomyosin in shellfish is considered a major cross-reactive allergen in house dust mites and cockroaches; however, the specific epitopes have not been elucidated. Therefore, this study aimed to identify the consensus antigenic determinant among shrimp, house dust mites, and cockroaches using in silico methods. The protein sequences of tropomyosin, including Der f 10, Mac r 1, Pen a 1, Pen m 1, Per a 7, and Bla g 7, were retrieved from the UniProt database. The 3D structures were derived from the AlphaFold or modeled using the Robetta. The determination of linear epitopes was performed by AlgPRED and BepiPRED for B cell epitope, and NetMHCIIpan and NetMHCII for T cell epitope, while Ellipro was used to evaluate conformational epitopes. Fourteen peptides were discovered as the consensus linear B cell epitopes, while seventeen peptides were identified as linear T cell epitopes specific to high-frequency HLA-DR and HLA-DQ alleles. The conformational determination of B cell epitopes provided nine peptides, in which residues 209, 212, 255–256, and 258–259 were found in both linear B cell and linear T cell epitope analysis. This data could be utilized for further in vitro study and may contribute to immunotherapy for allergic diseases associated with tropomyosin.

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.

Background: The use of iodophor-impregnated adhesive drapes have become almost universally incorporated into standard practice of arthroplasty draping technique. Iodine-related allergies in patients planned for joint replacement present a challenge in terms of the best course of action to minimize complications and optimize outcomes., Methods: This is a retrospective case series of patients that received an iodophor-impregnated drape as part of draping for a total hip or knee arthroplasty at a single orthopaedic-specific hospital with documented iodine-related allergies. From 2015 to 2023, 9816 total hip arthroplasty and total knee arthroplasty cases were reviewed, and 135 were documented to have an iodine-related allergy for a prevalence of 1.38%. Intraoperative and postoperative records were reviewed to screen for an allergic reaction or wound healing issues that may have been related to an adverse reaction to the use of the iodophor-impregnated drape., Results: Of the 135 patients, 43 had iodine listed as an allergy, 85 had shellfish, 20 had iodinated contrast media, and 3 had povidone iodine. Sixteen patients had a cluster of iodine-related allergies. There were no intraoperative reports of an allergic reaction to this drape. There were four superficial wound problems, none of which were documented to relate to an allergic dermatitis reaction, and none required further surgery., Conclusions: Patients reporting iodine-related allergies were present in 1.38% of patients undergoing hip or knee arthroplasty in our series. We encountered no allergic reactions or adverse outcomes that could be attributed to the use of iodiphor impregnated drapes in these patients., (© 2023 The Authors.)

Shellfish allergy represents a crucial public health problem, resulting in an urgent requirement for an accurate, simple, and reliable method to quantify shellfish allergens in the complex food system. Tropomyosin (TM) is known as the major allergen in shellfish. Herein, a novel switch-conversional ratiometric fluorescent biosensor, using TM-specific aptamer as the recognition probe, was developed to detect TM in the complex food system. The proposed aptasensor exhibited good accuracy, stability, and selectivity for the quantification of TM in foodstuffs. Furthermore, the applicability of this proposed aptasensor in complex food samples was verified using seven different shellfish samples. Therefore, this ratiometric fluorescent aptasensor enables accurately detecting the presence of TM traces in foods, providing technical support for allergen label supervision. • A EXPAR based-ratiometric aptasensor was developed to detect shellfish allergen TM. • TM could achieve the highly specific and accurate detection. • Applicability of proposed sensor in food samples was validated. [ABSTRACT FROM AUTHOR]

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 withAnisakislarvae can cause a disease known as anisakiasis with symptoms similar to true seafood allergy. Furthermore, some adverse reactions to seafood including histamine fish poisoning (HFP), and intolerance to histamine can trigger clinical symptoms, which, although nonallergic in origin, are similar to true immunoglobulin E (IgE)-mediated allergic reactions. Because seafood allergy usually remains a lifelong food allergy, this review focuses on the current knowledge on fish and shellfish allergens and emphasizes the importance of differentiating seafood allergy from other allergy-like reactions (anisakiasis, HFP, and intolerance to histamine). Key teaching points: • Fish and shellfish are potent allergens that can provoke serious IgE antibody-mediated adverse reactions in sensitive individuals. • Sensitization to seafood allergens can be achieved by ingestion, inhalation, or skin contact. • Shellfish major allergen, tropomyosin, shares significant homology to arthropods (dust mites and cockroaches). • Accidental exposures to seafood products cross-contaminated with fish or shellfish allergens (hidden allergens) during processing may present a health risk for sensitive individuals. • Allergens of fish parasiteA. simplexpresent common hidden allergens in seafood, particularly in raw and undercooked home-made fish dishes. • Symptoms caused by HFP, histamine intolerance, and anisakiasis are similar to true seafood allergy. [ABSTRACT FROM PUBLISHER]

Background: Shellfish (SF) allergy is a leading cause of systemic anaphylaxis in humans. An adjuvant-free mouse model to evaluate allergenicity and oral anaphylaxis to SF is currently unavailable. Here, we tested the hypothesis that transdermal exposure (TDE) to SF protein extract (SFPE) not only elicits a systemic allergic immune response but also will clinically sensitize mice for oral anaphylaxis. Methods: Adult BALB/c female mice (6-8 weeks of age) were exposed to saline or SFPE once a week for 4 weeks using a transder-mal sensitization method. Systemic SF-specific IgE, IgG1 and IgG2a and total (t)IgE responses were measured using ELISA. Systemic anaphylaxis upon oral SFPE administration was assessed according to clinical symptoms and the hypothermia shock response (HSR). Using individual mouse data, the correlation between the readouts of allergenicity was determined using Pearson's analysis. Spleen-cell IL-4 and IFN-γ responses were determined using primary cell culture and ELISA. Results:TDE to SFPE resulted in marked systemic specific (s)IgE, tIgE, IgG1 and IgG2a responses. Oral challenge with SFPE in sensitized mice (but not controls) elicited systemic anaphylactic clinical reactions and HSR. A strong correlation was observed between sIgE, tIgE and HSR. Spleen cells isolated from allergic mice (but not controls) exhibited memory IL-4 and IFN-γ cytokine responses. Conclusion: We report a novel adjuvant-free mouse model of SF allergy with robust quantifiable and correlated readouts of allergenicity that may be used in basic biomedical, preclinical and applied food/nutrition research on SF allergy. [ABSTRACT FROM AUTHOR]

Shellfish allergy is of increasing concern, as its prevalence has risen in recent years. Many advances have been made in allergen characterization. B cell epitopes in the major allergen tropomyosin have been characterized. In addition to tropomyosin, arginine kinase, sarcoplasmic calcium-binding protein, and myosin light chain have recently been reported in shellfish. All are proteins that play a role in muscular contraction. Additional allergens such as hemocyanin have also been described. The effect of processing methods on these allergens has been studied, revealing thermal stability and resistance to peptic digestion in some cases. Modifications after Maillard reactions have also been addressed, although in some cases with conflicting results. In recent years, new hypoallergenic molecules have been developed, which constitute a new therapeutic approach to allergic disorders. A recombinant hypoallergenic tropomyosin has been developed, which opens a new avenue in the treatment of shellfish allergy. Cross-reactivity with species that are not closely related is common in shellfish-allergic patients, as many of shellfish allergens are widely distributed panallergens in invertebrates. Cross-reactivity with house dust mites is well known, but other species can also be involved in this phenomenon. [ABSTRACT FROM AUTHOR]

Background: The prevalence of shellfish allergy is ∼1.3% in the United States, with shrimp most commonly reported. Shellfish is one of the top causes of food-induced anaphylactic reactions, yet there are no reported rates of pediatric shrimp anaphylaxis in the literature. In previously reported adults with shrimp allergy, the rate of anaphylaxis to shrimp was 42%. Objective: To describe the rate of anaphylaxis among children with shrimp allergy, demographics, clinical presentation, and cross-reactive sensitization. Methods: Retrospective chart review of children ≤18 years old who presented with shrimp allergy to Texas Children's Hospital Allergy and Immunology Clinic over 11 years. Results: Sixty-eight patients were identified with shrimp allergy (61% male, 39% female), with a median age of diagnosis at 5.6 years (range, 0.96-16.6 years). The rate of anaphylaxis was 12%, and mucocutaneous symptoms were most common (skin symptoms, 70%; urticaria, 58%; and angioedema, 58%). No factors were positively associated with anaphylaxis, whereas patients without anaphylaxis had a significantly higher rate of eczema compared with those with anaphylaxis (p = 0.02). African Americans and Asian Americans were disproportionately affected (p < 0.001). There were low rates of cross-sensitization for other crustaceans and for mollusks (57% and 26%, respectively). Conclusion: The rate of anaphylaxis to shrimp was significantly lower in children with shrimp allergy than in adults, and anaphylactic reactions were negatively associated with eczema. Cross-reactivity to other crustaceans and mollusks does not uniformly occur. Prospective studies with double blinded placebo-controlled food challenges are needed to further characterize patients with shrimp allergy. [ABSTRACT FROM AUTHOR]

Background and Objectives: Shellfish allergy is a major cause of food allergy and anaphylaxis worldwide. Several allergenic proteins have been described in the last few years, but the only diagnostic tool that still enables discrimination between allergic and nonallergic sensitized persons is the oral food challenge (OFC). The aim of this study was to evaluate the usefulness of the nasal allergen provocation test (NAPT) as a diagnostic tool in shellfish allergy., Methods: Forty-five patients with confirmed sensitization to shrimp by a positive skin prick test (SPT) result with a commercial shrimp extract were recruited and classified as sensitized-allergic or sensitized-nonallergic based on current tolerance to shrimp intake, the result of an OFC with a freeze-dried cooked shrimp mixture extract, or a recent history of anaphylaxis induced by shrimp ingestion. These patients and 10 controls not sensitized to shrimp underwent NAPT with a freeze-dried cooked shrimp mixture extract. The response was evaluated using acoustic rhinometry and a visual analog scale., Results: Significant differences (P=.001) were found between the sensitized-allergic group (18/20 positive NAPT, 90%) and both the sensitized-nonallergic group (2/18 positive NAPT, 11.1%) and controls (0/10 positive NAPT). NAPT enables differentiation between allergic and nonallergic persons with a sensitivity of 90%, specificity of 89%, positive predictive value of 90%, and negative predictive value of 89%., Conclusions: Our results indicate that NAPT makes it possible to differentiate between sensitized symptomatic patients and sensitized tolerant patients and could be a valuable diagnostic tool when assessing shrimp allergy.

• SWATH-MS-based proteomics described the splenic and intestinal traits of tropomyosin allergy. • In the spleen, allergy is characterized by the upregulation of the Ig κ chain V-III region PC 7175. • In the intestine, allergy concurred with the downregulated expression of 35 proteins. • The downregulated proteins are involved in metabolic, absorption and wound-healing processes. Type-I food allergies are hypersensitive reactions compromising the immune organs and epithelial barriers. To investigate the organ-specific proteomic alterations of the allergy responses, the spleen and intestine of mice sensitized with high (shrimp and clam) and weak (fish) allergenic tropomyosins were analyzed using sequential windowed acquisition of all theoretical fragment ion mass spectra (SWATH-MS)-based proteomics. The results showed that Th1 and Th2 tropomyosin-induced responses in the spleen are characterized by the unique upregulation of innate (cochlin) and adaptive (Ig κ chain V-III region PC 7175) immune regulators, respectively. In the intestine, tropomyosin allergy concurred with the downregulation of 35 differentiating proteins featuring the overall impairment of metabolic pathways, absorption processes and ammonium ion responses. These data provide new functional biomarkers of tropomyosin-induced immune responses as well as candidate targets for intervention. [ABSTRACT FROM AUTHOR]

Highlights: [•] Arginine kinase (AK) from Scylla paramamosain was purified, cloned, and expressed. [•] The IgE epitopes of S. paramamosain AK were elucidated and identified. [•] The conformational IgE epitopes of S. paramamosain AK were the predominant epitopes. [ABSTRACT FROM AUTHOR]