title: Shrimp Allergy: Analysis of Commercially Available Extracts for In Vivo Diagnosis.
abstract: Skin prick testing (SPT) with commercial extracts is the first step in the diagnosis of shrimp allergy, although its clinical efficiency is unknown. Objective: To analyze the clinical usefulness of all commercial crustacean extracts available for SPT in Italy.
  
  
  
  We performed a multicenter study of 157 shrimp-allergic patients who underwent SPT with 5 commercial crustacean extracts and with house dust mite (HDM) extract. Commercial extracts were analyzed using SDS-PAGE and compared with a freshly prepared in-house shrimp extract. IgE to Pen a 1/Pen m 1, Pen m 2, and Pen m 4 was determined, and immunoblot analysis was performed on a large number of sera.
  
  
  
  The skin reactions caused by commercial crustacean extracts were extremely heterogeneous, resulting in 32 clinical profiles, with marked differences in protein content and missing proteins at molecular weights corresponding to those of major shrimp allergens. Only strong Pen a 1/Pen m 1 reactors reacted to both HDM and all 5 commercial extracts in SPT. Most patients, including those who were tropomyosin-negative, reacted to HDM. Patients reacted to a large and variable array of proteins, and IgE reactivity was common at high molecular weights (>50 kDa).
  
  
  
  The in vivo diagnosis of shrimp allergy must continue to be based on SPT with fresh material. Shrimp-allergic patients frequently react to a number of ill-defined high-molecular-weight allergens, thus leaving currently available materials for component-resolved diagnosis largely insufficient. Mites and crustaceans probably share several allergens other than tropomyosin.
authors.affiliation: Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano (MI), Italy.
authors.forename: R
authors.initials: R
authors.lastname: Asero
authors.affiliation: Istituto Dermopatico dell´Immacolata - IRCCS, Roma, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Scala
authors.affiliation: SSD di Allergologia e Immunologia Clinica, Azienda Ospedaliera S. Maria degli Angeli, Pordenone, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Villalta
authors.affiliation: UOC Clinical Allergy and Immunology, IRCCS Foundation Ca´ Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Pravettoni
authors.affiliation: Ambulatorio Allergologia, Azienda Usl 5 di Messina, Messina, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Arena
authors.affiliation: Department of Laboratory Medicine, University Hospital, Padova, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Billeri
authors.affiliation: Allergy and Clinical Immunology Unit, IRCCS San Raffaele Hospital, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Colombo
authors.affiliation: UO di Medicina Interna e Reumatologia, Azienda Sanitaria della Romagna, Rimini, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Cortellini
authors.affiliation: UOSD di Allergologia, Ospedale SS Filippo e Nicola di Avezzano, Avezzano (AQ), Italy.
authors.forename: F
authors.initials: F
authors.lastname: Cucinelli
authors.affiliation: Ambulatorio di Allergologia, Ospedale San Timoteo, Termoli (CB), Italy.
authors.forename: M L
authors.initials: ML
authors.lastname: De Cristofaro
authors.affiliation: Department of Laboratory Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Farioli
authors.affiliation: Allergy and Clinical Immunology Unit, ASST Fatebenefratelli/Sacco, Milano, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Iemoli
authors.affiliation: SSVD Allergologia, AO Spedali Civili di Brescia, Brescia, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Lodi Rizzini
authors.affiliation: Ambulatorio Territoriale di Allergologia, ASP Vibo Valentia, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Longo
authors.affiliation: Department of Allergology and Immunology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Losappio
authors.affiliation: Allergologia Immunologia Clinica, PO S Giovanni di Dio, Firenze, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Macchia
authors.affiliation: Ambulatorio di Allergologia Accreditato ASL, Lecce, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Maietta
authors.affiliation: UOC Allergologia IRCCS San Martino-IST, Genova, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Minale
authors.affiliation: UOSD di Allergologia, Ospedale SS Filippo e Nicola di Avezzano, Avezzano (AQ), Italy.
authors.forename: F
authors.initials: F
authors.lastname: Murzilli
authors.affiliation: Ambulatorio di Allergologia e Immunologia, AO Ordine Mauriziano, Torino, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Nebiolo
authors.affiliation: Department of Allergology and Immunology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
authors.forename: E A
authors.initials: EA
authors.lastname: Pastorello
authors.affiliation: Dipartimento di Medicina Interna, Immunologia e Malattie Infettive, Università di Bari, Policlinico, Bari, Italy.
authors.forename: M T
authors.initials: MT
authors.lastname: Ventura
authors.affiliation: UOC Allergologia IRCCS San Martino-IST, Genova, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Voltolini
authors.affiliation: R & D, Lofarma, Milano, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Amato
authors.affiliation: R & D, Lofarma, Milano, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Mistrello
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000485:Allergens / Q000276:immunology*; D000818:Animals; D060829:Arthropod Proteins / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D004591:Electrophoresis, Polyacrylamide Gel; D005260:Female; D006801:Humans; D015151:Immunoblotting; D007073:Immunoglobulin E / Q000276:immunology*; D007558:Italy; D008297:Male; D008875:Middle Aged; D039981:Pyroglyphidae / Q000276:immunology; D000067208:Shellfish Hypersensitivity / Q000175:diagnosis* / Q000276:immunology; D012882:Skin Tests; D014335:Tropomyosin / Q000276:immunology; D055815:Young Adult
chemical_list: D000485:Allergens; D060829:Arthropod Proteins; D014335:Tropomyosin; C058449:shrimp allergens Sa; D007073:Immunoglobulin E
keywords: Allergens; Allergy diagnosis; Food allergy; Shrimp allergy; Skin testing.