[A study comparing the clinical phenotypes of fish-allergic patients with their specific IgE profiles to fish parvalbumin, enolase, aldolase and gelatin].

March 01, 2014 By:
  • Kuehn A
  • Metz-Favre C
  • Pauli G
  • Lehners-Weber C
  • Codreanu-Morel F
  • Hentges F
  • Auriol P
  • Bienvenu F
  • Braun C
  • Crepin C
  • Foessel A
  • Guenard L
  • Krieger P
  • Renaudin JM
  • Tuyeras JF
  • de Blay F
  • Morisset M
  • Hilger C.

Study objective
The aim of this study was to investigate the added value of using a panel of fish allergens in component-resolved diagnosis of fish-allergic patients.
Patients and methods
Sixty-two patients were diagnosed as being allergic to fish by clinical history and with positive skin prick-tests and specific IgE to fish extracts (cod, salmon and tuna). Allergen-specific IgE levels to fish parvalbumin, enolase, aldolase and gelatin were quantified by Elisa.
Forty-five of the patients were sensitized to parvalbumin. Among the cod parvalbumin-sensitized patients, 50% were also sensitized to both enolase and aldolase. Of the patients with positive skin tests to salmon and to tuna (75.6% and 67.6%, respectively), isolated sensitization to parvalbumin was observed. Mean levels of specific IgE to cod and enolase parvalbumin were positively correlated with the severity of the patients’ clinical symptoms; this was not the case for cod aldolase. Patients were clustered into three groups according to their parvalbumin-specific IgE-reactivity. In the first group, the 36 patients who were sensitized to three different fish reported mild to severe symptoms; their symptoms were correlated with the presence of IgE to total cod extract and to cod parvalbumin. The second group of 9 mono-sensitized patients had only minor symptoms of fish allergy, most often to salmon; their symptoms were positively correlated with specific IgE levels of salmon extract and cod parvalbumin-specific IgE. The third group consisted of 17 patients who were sensitized to a small number of fish; they had moderate to severe symptoms. While this group of patients had no detectable parvalbumin-specific IgE, 70.6% of them were found to have IgE specific for fish aldolase, enolase or gelatin; in this group, the presence of IgE specific for cod was rarely observed.
The use of a panel with a number of allergenic fish proteins may contribute to the improvement of the diagnosis of fish allergy. Specific sensitization profiles appear to be associated with certain profiles of clinical symptoms.

2014 Mar. Rev Fr Allergol.54(2):51–60. Epub 2014 Jan 27.
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