Fish Allergenicity Ladder and Parvalbumin Epitopes for Predicting Clinical Cross-Reactivity and Reintroduction in...

Area of Science:

• Immunology
• Allergology
• Food Science

Background:

• IgE-mediated fish allergy is often generalized due to high parvalbumin cross-reactivity.
• Clinical tolerance to specific fish indicates distinct allergenicity profiles.
• Accurate diagnosis and management of fish allergy require understanding these differences.

Purpose of the Study:

• To construct a fish allergenicity ladder based on clinical data and parvalbumin content.
• To identify specific parvalbumin epitopes for improved diagnosis of fish allergy.
• To differentiate between fish-allergic and fish-tolerant individuals.

Main Methods:

• Analyzed clinical history and serum-specific IgE (sIgE) in 200 Chinese subjects.
• Measured relative parvalbumin content across various fish species.
• Performed epitope mapping using peptide arrays on parvalbumins from different fish.
• Validated the allergenicity ladder through double-blind placebo-controlled food challenges.

Main Results:

• Developed a 3-step fish allergenicity ladder (least to highly allergenic: tuna, salmon, cod; herring, grouper; catfish, grass carp, tilapia).
• Identified a grouper parvalbumin epitope (AA64-78) for general fish allergy diagnosis.
• Discovered a salmon parvalbumin epitopic region (AA19-33) as a biomarker for specific fish tolerance.
• Epitope-specific IgE, not sIgE to fish extract or parvalbumin, differentiated patient groups.

Conclusions:

• The developed fish allergenicity ladder and identified epitopes enable precise differentiation of allergic and tolerant individuals.
• This approach innovates fish allergy care by guiding safe fish reintroduction strategies.
• The findings support personalized management of fish allergy based on specific allergen sensitivities.