Clinical Relevance of Immunologic Diagnosis of Shrimp Allergy in Adults.

IF 4.1 2区医学 Q2 ALLERGY

Allergy, Asthma & Immunology Research Pub Date : 2025-05-01 DOI:10.4168/aair.2025.17.3.359

Young-Min Ye, Bo Youn Choi, Bastsetseg Ulambayar, Thi Bich Tra Cao

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Abstract

Purpose: Shrimp is a predominant allergic food in adults and adolescents. This study aims to evaluate the clinical efficacy of immunologic diagnosis in differentiating the clinical phenotypes of shrimp allergy.

Methods: We enrolled 85 adults diagnosed with shrimp allergy based on clinical symptoms that occurred at least twice after shrimp ingestion and who had specific immunoglobulin E (IgE) results for shrimp extract, were enrolled in the study. Patients were classified into 2 groups: anaphylaxis (ANA) and non-ANA. Serum-specific IgEs to shrimp and recombinant tropomyosin from both house dust mite (HDM) and shrimp were measured using ImmunoCAP.

Results: Among the patients (mean age 38 years; 51.8% female), 32 were diagnosed with shrimp-induced ANA. The remaining 53 were classified into the non-ANA group, including 46 acute urticaria/angioedema and 7 isolated oropharyngeal manifestations. There were no significant differences in shrimp-specific IgE positivity (78.1% vs. 60.4%) or skin prick test (SPT) positivity (16.7% vs. 25.9%) between groups. However, specific IgE to shrimp extract was significantly higher in the ANA group. Receiver operating characteristic analysis indicated that a shrimp-specific IgE level > 0.7 kU/L was an appropriate cutoff for identifying ANA among patients with shrimp allergy (area under the curve 0.643, P = 0.028). No significant differences were observed in specific IgEs to recombinant shrimp and the HDM tropomyosin between the groups. The ANA group had a greater prevalence of nonsteroidal anti-inflammatory drug hypersensitivity (31.3% vs. 7.5%, P = 0.006) and chronic urticaria (35.5% vs. 15.4%, P = 0.035).

Conclusions: Patients with shrimp-induced ANA presented higher levels of specific IgE to shrimp extract compared to those with acute urticaria or localized oropharyngeal symptoms. Neither SPTs nor specific IgE tests for recombinant tropomyosin effectively differentiate ANA among shrimp allergy patients.

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成人虾类过敏免疫诊断的临床意义。

目的：虾是成年人和青少年的主要过敏食物。本研究旨在探讨免疫学诊断在鉴别对虾过敏临床表型中的临床疗效。方法：我们招募了85名被诊断为虾过敏的成年人，这些成年人的临床症状是在摄入虾后至少发生两次，并且对虾提取物有特异性免疫球蛋白E （IgE）结果。患者分为2组：过敏反应（ANA）和非ANA。采用免疫cap法测定了屋尘螨（HDM）和虾的血清特异性IgEs和重组原肌球蛋白的含量。结果：患者中(平均年龄38岁；51.8%为女性)，32例为虾源性ANA。其余53例分为非ana组，其中急性荨麻疹/血管性水肿46例，孤立性口咽症状7例。各组间虾类特异性IgE阳性（78.1%比60.4%）和皮肤点刺试验（SPT）阳性（16.7%比25.9%）差异无统计学意义。然而，ANA组对虾提取物的特异性IgE显著升高。接受者工作特征分析表明，虾类特异性IgE水平> 0.7 kU/L是虾类过敏患者识别ANA的合适临界值（曲线下面积0.643,P = 0.028）。对重组虾的特异性IgEs和HDM原肌球蛋白在两组间无显著差异。ANA组非甾体类抗炎药超敏反应（31.3%比7.5%,P = 0.006）和慢性荨麻疹（35.5%比15.4%,P = 0.035）患病率更高。结论：与急性荨麻疹或局部口咽症状患者相比，虾诱导的ANA患者对虾提取物的特异性IgE水平更高。重组原肌球蛋白的特异性IgE检测和SPTs检测均不能有效区分对虾过敏患者的ANA。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Allergy, Asthma & Immunology Research ALLERGY-IMMUNOLOGY

CiteScore

6.10

自引率

6.80%

发文量

审稿时长

>12 weeks

期刊介绍： The journal features cutting-edge original research, brief communications, and state-of-the-art reviews in the specialties of allergy, asthma, and immunology, including clinical and experimental studies and instructive case reports. Contemporary reviews summarize information on topics for researchers and physicians in the fields of allergy and immunology. As of January 2017, AAIR do not accept case reports. However, if it is a clinically important case, authors can submit it in the form of letter to the Editor. Editorials and letters to the Editor explore controversial issues and encourage further discussion among physicians dealing with allergy, immunology, pediatric respirology, and related medical fields. AAIR also features topics in practice and management and recent advances in equipment and techniques for clinicians concerned with clinical manifestations of allergies and pediatric respiratory diseases.