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Basophil Activation Test for Allergy Diagnosis

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Published on: May 31, 2021

[Allergy to fish].

Rima Mahdi Aljedani¹, Camillo Ribi¹

¹Service d'immunologie et allergie, Département de médecine, CHUV, 1011 Lausanne.

Revue Medicale Suisse

|April 4, 2019

Summary

This summary is machine-generated.

Fish allergies can be severe, often caused by IgE-mediated reactions to beta-parvalbumin. Diagnosis involves history, skin tests, and IgE levels, with avoidance being key for prevention.

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Area of Science:

Allergy and Immunology
Food Science

Background:

Fish allergies represent a significant health concern, potentially leading to life-threatening reactions like anaphylaxis.
Common reactions include food protein-induced enterocolitis syndrome, alongside confounders such as Anisakis parasite reactions and scombroid poisoning.

Purpose of the Study:

To detail various fish-induced allergic reactions and their underlying mechanisms.
To identify key allergens and diagnostic approaches for fish allergy.
To provide guidance on prevention strategies.

Main Methods:

Review of IgE-mediated allergic reactions to fish.
Identification of specific fish proteins responsible for allergies, particularly beta-parvalbumin.
Discussion of diagnostic tools including medical history, skin-prick testing, specific IgE testing, and food challenges.

Main Results:

Most IgE-mediated fish allergies are attributed to beta-parvalbumin, a heat-stable protein conserved across bony fish species, explaining cross-reactivity.
Alpha-parvalbumin in cartilaginous fish (e.g., rays) may serve as a safe alternative for individuals allergic to beta-parvalbumin.
Accurate diagnosis is achievable through a combination of clinical history and specific immunological and challenge tests.

Conclusions:

Beta-parvalbumin is the primary allergen in most IgE-mediated fish allergies, leading to cross-reactivity among bony fish.
Individuals with fish allergies can potentially tolerate cartilaginous fish due to different parvalbumin types.
Strict avoidance of allergenic fish products is the cornerstone of managing fish allergy and preventing adverse reactions.