Extract-based and molecular diagnostics in fish allergy. In Molecular allergy diagnostics: Innovation for a better patient management. (Book Chapter)

Although fish is an elementary component of a healthy diet, it is also a food with high allergenic potential. In most cases, allergic reactions are induced by parvalbumins – small, stable proteins found in the muscle tissue. Many parvalbumin-positive individuals present with clinical reactions to various fish species, which can be explained through cross-reacting IgE antibodies.
Thus far, complete fish extracts and two recombinant parvalbumins are available for IgE-based routine diagnostic procedures. Other important fish allergens are the enolases, the aldolases, and tropomyosin derived from fish muscle and vitellogenin from fish eggs, whose availability for diagnostics would allow more precise analysis of the sensitization profile of a fish-allergic patient. To date, there is no specific immunotherapy for fish allergy available. However, molecular biotechnological approaches have already led to the development of the first hypoallergenic molecules, which offer low-risk therapeutic prospects for the future.