[Component-resolved diagnosis: enhancing precision diagnosis and clinical management of shellfish allergies]

Shellfish, being one of the eight major food allergens, affects approximately 3% of the global population. The occurrence of shellfish allergy is not only related to the individual's immune system sensitivity but is also influenced by geographical environment, food availability, and dietary habits. Although crustaceans (such as shrimp, crab, and lobster) and mollusks (such as oysters, mussels, and squid) are collectively referred to as shellfish, they exhibit significant differences in biological evolution and the spectrum of allergenic molecules they contain, leading to various allergic reactions. Accurate identification of allergenic proteins is crucial for the diagnosis and management of shellfish allergies, with key allergenic protein families including tropomyosin, arginine kinase, and hemocyanin. Furthermore, due to the diversity of shellfish allergens and their cross-reactivity with dust mite and insect allergens, diagnosing and managing shellfish allergies is complex, especially concerning tropomyosin and arginine kinase protein families. Currently, there are no specific immunotherapy treatments for shellfish allergies, and clinical management primarily relies on avoiding allergens and using anti-allergy medications. This article thoroughly interprets the " Molecular Allergology User's Guide 2.0 (MAUG 2.0)" published by the European Academy of Allergy and Clinical Immunology (EAACI) and the latest research on shellfish allergies both domestically and internationally. It highlights the significant role of allergen component diagnostics in optimizing the diagnostic and treatment processes for shellfish allergies, effectively assisting clinicians in accurately identifying common allergens and cross-reactions, thereby providing patients with more personalized diagnosis and treatment plans.