Characteristics of Chinese fish-allergic patients: Findings from double-blind placebo-controlled food challenges
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AbstractBackground: Diagnosis of fish allergy is challenging due to wide variety of consumable fish species and limited choice in fish allergens for specific IgEs (sIgEs) measurement.
Objective: We aimed to evaluate the clinical characteristics of oral food challenge-confirmed Chinese fish-allergic patients and diagnostic performance of sIgEs to fish allergens.
Methods: Twenty-eight subjects with history of fish-allergic reactions underwent double-blind placebo-controlled food challenges (DBPCFCs) to salmon, grass carp and placebo. Their blood samples were tested for IgE reactivity against cod and salmon extracts as well as recombinant parvalbumins to codfish (rGad c 1) and common carp (rCyp c 1) by the ImmunoCAP system.
Results: Eighty-one challenges were conducted in 28 subjects. Twenty patients (71%) had positive DBPCFCs, in which 14 cases were positive to grass carp, 1 case to salmon, and 5 cases to both grass carp and salmon. Use of rGad c 1 and rCyp c 1 yielded the highest area under the receiver operating characteristic curves (AUC) of 0.920 and 0.917 in grass carp-allergic subjects, whereas AUC to salmon extract is the highest in salmon-allergic subjects.
Conclusions & Clinical Relevance: A majority of patients were found to be partially tolerant to selective fish species by DBPCFCs. Choice of fish allergens for sIgE measurement is important in evaluating different fish-allergic patients. Recombinant parvalbumins to cod and carp have improved diagnostic performance in grass carp-allergic subjects but not in salmon-allergic subjects. Further research on fish allergen components, specifically grass carp and salmon components, is warranted.
Acceptance Date03/02/2020
All Author(s) ListAgnes Sze Yin Leung, Nicki Yat Hin Leung, Christine Yee Yan Wai, Kary Jia Ying Xu, Maco Cheuk Yin Lam, Yuki Yuk Shum, Tak Hong Lee, Marco Hok Kung Ho, Jaime Sou Da Rosa Duque, Gilbert T. Chua, Yat Sun Yau, Wai Hung Chan, Po Ki Ho, Gary Wing Kin Wong, Ting Fan Leung
Journal nameJournal of Allergy and Clinical Immunology: In Practice
Volume Number8
Issue Number6
Place of PublicationUSA
Pages2098 - 2100.e8
LanguagesEnglish-United States
KeywordsDouble-blind placebo-controlled food challenge, oral food challenge, fish allergy, anaphylaxis, allergen component, component-resolved diagnosis, cod, carp, salmon, parvalbumin

Last updated on 2021-17-09 at 00:18