title: Molecular Diagnosis of Shrimp Allergy: Efficiency of Several Allergens to Predict Clinical Reactivity.
abstract: BACKGROUND
  The diagnosis of shellfish allergy remains a challenge for clinicians. Several shellfish allergens have been characterized and their IgE epitopes identified. However, the clinical relevance of this sensitization is still not clear.
  
  
  OBJECTIVE
  The objective of this study was to identify allergens and epitopes associated with clinical reactivity to shrimp.
  
  
  METHODS
  Shrimp-sensitized subjects were recruited and grouped based on the history of shrimp-allergic reactions and challenge outcome. IgE reactivity to recombinant crustacean allergens, and IgE and IgG4 reactivity to peptides were determined. Subjects sensitized to dust mites and/or cockroach without shrimp sensitization or reported allergic reactions, as well as nonatopic individuals, were used as controls.
  
  
  RESULTS
  A total of 86 subjects were recruited with a skin prick test to shrimp; 74 reported shrimp-allergic reactions, 58 were allergic (38 positive double-blind placebo-controlled food challenge and 20 recent anaphylaxis), and 16 were tolerant. All subjects without a history of reactions had negative challenges. The individuals with a positive challenge more frequently recognized tropomyosin and sarcoplasmic calcium-binding proteins than those found tolerant by the challenge. Especially a sarcoplasmic-calcium-binding-protein positive test is very likely to result in a positive challenge, though the frequency of recognition is low. Subjects with dust mite and/or cockroach allergy not sensitized to shrimp recognized arginine kinase and hemocyanin. Several epitopes of these allergens may be important in predicting clinical reactivity.
  
  
  CONCLUSIONS
  Tropomyosin and sarcoplasmic-calcium-binding-protein sensitization is associated with clinical reactivity to shrimp. Myosin light chain testing may help in the diagnosis of clinical reactivity. Arginine kinase and hemocyanin appear to be cross-reacting allergens between shrimp and arthropods. Detection of IgE to these allergens and some of their epitopes may be better diagnostic tools in the routine workup of shrimp allergy.
authors.affiliation: Division of Allergy & Immunology and the Jaffe Food Allergy Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY; Servei d'Immunologia, Centre de Diagnòstic Biomèdic (CDB), Hospital Clínic, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
authors.forename: Mariona
authors.initials: M
authors.lastname: Pascal
authors.affiliation: Division of Allergy & Immunology and the Jaffe Food Allergy Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Galina
authors.initials: G
authors.lastname: Grishina
authors.affiliation: Division of Clinical Immunology and Allergy, University of Saõ Paulo School of Medicine, Saõ Paulo, Brazil.
authors.forename: Ariana C
authors.initials: AC
authors.lastname: Yang
authors.affiliation: Allergy Department, Hospital Infantil Universitario del Niño Jesús, Madrid, Spain; Section of Allergy, Fundación Jimenez Díaz, Madrid, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Sánchez-García
authors.affiliation: Division of Allergy & Immunology and the Jaffe Food Allergy Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Jing
authors.initials: J
authors.lastname: Lin
authors.affiliation: Mount Desert Island Biological Laboratory (MDIBL), Salsbury Cove, Me.
authors.forename: David
authors.initials: D
authors.lastname: Towle
authors.affiliation: Allergy Department, Hospital Infantil Universitario del Niño Jesús, Madrid, Spain.
authors.forename: Maria Dolores
authors.initials: MD
authors.lastname: Ibañez
authors.affiliation: Section of Allergy, Fundación Jimenez Díaz, Madrid, Spain.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Sastre
authors.affiliation: Division of Allergy & Immunology and the Jaffe Food Allergy Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Hugh A
authors.initials: HA
authors.lastname: Sampson
authors.affiliation: Division of Allergy & Immunology and the Jaffe Food Allergy Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY; Ear, Nose and Throat Associates of New York, P.C., NY. Electronic address: rayuso2001@yahoo.com.
authors.forename: Rosalia
authors.initials: R
authors.lastname: Ayuso
mesh_terms: D000485:Allergens / Q000276:immunology*; D000818:Animals; D001122:Arginine Kinase / Q000276:immunology; D060829:Arthropod Proteins / Q000276:immunology; D002135:Calcium-Binding Proteins / Q000276:immunology*; D000939:Epitopes; D005512:Food Hypersensitivity / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D006433:Hemocyanins / Q000276:immunology; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007074:Immunoglobulin G / Q000276:immunology; D033561:Penaeidae / Q000276:immunology*; D011994:Recombinant Proteins / Q000276:immunology; D012758:Shellfish; D012882:Skin Tests; D014335:Tropomyosin / Q000276:immunology*
chemical_list: D000485:Allergens; D060829:Arthropod Proteins; D002135:Calcium-Binding Proteins; D000939:Epitopes; D007074:Immunoglobulin G; D011994:Recombinant Proteins; D014335:Tropomyosin; D007073:Immunoglobulin E; D006433:Hemocyanins; D001122:Arginine Kinase
keywords: Arginine kinase; Component-resolved diagnosis; DBPCFC; Epitope; Fatty-acid-binding protein; Hemocyanin; Microarray; Myosin light chain; Sarcoplasmic calcium-binding protein; Shellfish allergy; Tropomyosin; Troponin C