title: Gastro-allergic anisakiasis as a consequence of simultaneous primary and secondary immune response.
abstract: Gastro-allergic anisakiasis has been reported as an entity in which an acute parasitism by Anisakis simplex is accompanied by an immunoglobulin (Ig)E-mediated systemic allergic reaction. Serum samples were obtained from 24 patients within 24 h after the onset of symptoms (day 0) and after 1 month (day 30) and in 13 patients after 6 months. Total IgE was assessed by the Imx method. Specific IgE was assessed by CAP-FEIA. Specific IgM, IgG, IgG4 and IgA antibodies were assessed by enzyme-linked immunosorbent assay against crude extract (CE) and excretory-secretory products (ESP). IgE immunoblotting (IB) was directed against CE or ESP (day 0 and day 30). We found a rise of total IgE, specific IgE, number of bands in IgE-IB, IgG and IgG4 between day 0 and day 30 with a fall to near basal levels after 6 months. IgM levels were highest at day 0, falling over the next 6 months and IgA levels remained almost unchanged. Correlation studies revealed a parallel stimulation of nearly all Ig isotypes, except IgM anti-ESP, whose antibody levels correlated negatively with specific IgG levels. We found an extension of the IgE antibody repertoire in IB. We conclude that the allergic IgE-mediated reaction in the course of gastro-allergic anisakiasis involves a parallel secondary Th2 type memory response and a primary immunologic stimulation of both Th2 and Th1 lymphocyte subsets against previously unrecognized antigens.
authors.affiliation: Seccion de Alergia, Hospital Universitario La Princesa, C/Diego de Leon 62, E-28006, Madrid, Spain. adaschmer@meditex.es
authors.forename: Alvaro
authors.initials: A
authors.lastname: Daschner
authors.forename: Carmen
authors.initials: C
authors.lastname: Cuéllar
authors.forename: Sofia
authors.initials: S
authors.lastname: Sánchez-Pastor
authors.forename: Cristina-Yolanda
authors.initials: CY
authors.lastname: Pascual
authors.forename: Manuel
authors.initials: M
authors.lastname: Martín-Esteban
mesh_terms: D000818:Animals; D017129:Anisakiasis / Q000276:immunology*; D017163:Anisakis / Q000276:immunology; D000909:Antibodies, Helminth / Q000096:biosynthesis*; D005399:Fishes / Q000469:parasitology; D006967:Hypersensitivity / Q000276:immunology*; D015151:Immunoblotting; D007070:Immunoglobulin A / Q000032:analysis; D007073:Immunoglobulin E / Q000032:analysis; D007074:Immunoglobulin G / Q000032:analysis; D007132:Immunoglobulin Isotypes; D007075:Immunoglobulin M / Q000032:analysis; D007136:Immunoglobulins / Q000032:analysis* / Q000145:classification; D007700:Kinetics; D013270:Stomach / Q000033:anatomy & histology / Q000469:parasitology
chemical_list: D000909:Antibodies, Helminth; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007132:Immunoglobulin Isotypes; D007075:Immunoglobulin M; D007136:Immunoglobulins; D007073:Immunoglobulin E