Kavita Reginald, Kashaf Nadeem, Ervin Zheng Yang Yap, Amir Hamzah Abdul Latiff
{"title":"Diving deep into fish allergen immunotherapy: Current knowledge and future directions.","authors":"Kavita Reginald, Kashaf Nadeem, Ervin Zheng Yang Yap, Amir Hamzah Abdul Latiff","doi":"10.12932/AP-030923-1687","DOIUrl":null,"url":null,"abstract":"<p><p>Fish allergy is one of the \"big nine\" categories of food allergens worldwide, and its prevalence is increasing with the higher demand for this nutritious food source. Fish allergies are a significant health concern as it is a leading cause of food anaphylaxis, accounting for 9% of all deaths from anaphylaxis. The gaps in treating fish allergies at present are the incomplete identification of fish allergens, lack of component-resolved diagnosis of fish allergens in the clinical setting, and the variability in sensitization profiles based on different fish consumption practices. Allergen immunotherapy (AIT) improves tolerance towards accidental consumption of fish and is longer lasting than pharmacotherapy. Current practice or research of fish AIT ranges from the use of whole fish via oral desensitization, to the use of purified recombinant parvalbumin and its hypoallergenic variant, passive IgG immunization, and modifying the allergenicity of parvalbumin by changing the diet of farmed fish. However, the focus of fish allergen-based studies in the context of AIT has been restricted to parvalbumins. More research is required to understand the involvement of other fish allergens, and several other strategies of AIT including peptide vaccines, DNA vaccines, hybrid allergens, and the use of nanobodies that have the capacity to treat multiple allergens have been proposed. For AIT, other important aspects to consider are the route of desensitization, and the biomarkers to assess the success of immunotherapy. Finally, we also address several clinical considerations for fish AIT.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":"1-13"},"PeriodicalIF":2.3000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asian Pacific journal of allergy and immunology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.12932/AP-030923-1687","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ALLERGY","Score":null,"Total":0}
引用次数: 0
Abstract
Fish allergy is one of the "big nine" categories of food allergens worldwide, and its prevalence is increasing with the higher demand for this nutritious food source. Fish allergies are a significant health concern as it is a leading cause of food anaphylaxis, accounting for 9% of all deaths from anaphylaxis. The gaps in treating fish allergies at present are the incomplete identification of fish allergens, lack of component-resolved diagnosis of fish allergens in the clinical setting, and the variability in sensitization profiles based on different fish consumption practices. Allergen immunotherapy (AIT) improves tolerance towards accidental consumption of fish and is longer lasting than pharmacotherapy. Current practice or research of fish AIT ranges from the use of whole fish via oral desensitization, to the use of purified recombinant parvalbumin and its hypoallergenic variant, passive IgG immunization, and modifying the allergenicity of parvalbumin by changing the diet of farmed fish. However, the focus of fish allergen-based studies in the context of AIT has been restricted to parvalbumins. More research is required to understand the involvement of other fish allergens, and several other strategies of AIT including peptide vaccines, DNA vaccines, hybrid allergens, and the use of nanobodies that have the capacity to treat multiple allergens have been proposed. For AIT, other important aspects to consider are the route of desensitization, and the biomarkers to assess the success of immunotherapy. Finally, we also address several clinical considerations for fish AIT.
鱼过敏是全球 "九大 "食物过敏原之一,随着人们对这种营养丰富的食物需求量的增加,鱼过敏的发病率也在不断上升。鱼过敏是一个重大的健康问题,因为它是食物过敏性休克的主要原因,占过敏性休克死亡总数的 9%。目前在治疗鱼过敏方面存在的不足是鱼过敏原的鉴定不完全、临床环境中缺乏对鱼过敏原成分的诊断,以及不同鱼类消费习惯导致的过敏特征的差异。过敏原免疫疗法(AIT)可改善对意外食用鱼类的耐受性,而且比药物疗法更持久。目前鱼类过敏原免疫疗法的实践或研究包括通过口服脱敏法使用整条鱼、使用纯化重组副卵白蛋白及其低过敏性变体、被动 IgG 免疫以及通过改变养殖鱼类的饮食来改变副卵白蛋白的过敏性。然而,基于鱼过敏原的 AIT 研究重点仅限于副卵白蛋白。要了解其他鱼类过敏原的参与情况,还需要进行更多的研究,而且还提出了其他几种 AIT 策略,包括肽疫苗、DNA 疫苗、混合过敏原以及使用可治疗多种过敏原的纳米抗体。对于 AIT 而言,需要考虑的其他重要方面包括脱敏途径和评估免疫疗法成功与否的生物标志物。最后,我们还讨论了鱼类 AIT 的几个临床考虑因素。
期刊介绍:
The Asian Pacific Journal of Allergy and Immunology (APJAI) is an online open access journal with the recent impact factor (2018) 1.747
APJAI published 4 times per annum (March, June, September, December). Four issues constitute one volume.
APJAI publishes original research articles of basic science, clinical science and reviews on various aspects of allergy and immunology. This journal is an official journal of and published by the Allergy, Asthma and Immunology Association, Thailand.
The scopes include mechanism, pathogenesis, host-pathogen interaction, host-environment interaction, allergic diseases, immune-mediated diseases, epidemiology, diagnosis, treatment and prevention, immunotherapy, and vaccine. All papers are published in English and are refereed to international standards.