Patients Allergic to Fish Tolerate Ray Based on the Low Allergenicity of Its Parvalbumin

Tanja Kalic, Francoise Morel-Codreanu, Christian Radauer, Thimo Ruethers, Aya C Taki, Ines Swoboda, Christiane Hilger, Karin Hoffmann-Sommergruber, Markus Ollert, Christine Hafner, Andreas L Lopata, Martine Morisset, Heimo Breiteneder, Annette Kuehn

Publikation: Beitrag in Fachzeitschrift (peer-reviewed)Artikel in Fachzeitschrift

38 Zitate (Scopus)


BACKGROUND: Clinical reactions to bony fish species are common in patients with allergy to fish and are caused by parvalbumins of the β-lineage. Cartilaginous fish such as rays and sharks contain mainly α-parvalbumins and their allergenicity is not well understood.

OBJECTIVE: To investigate the allergenicity of cartilaginous fish and their α-parvalbumins in individuals allergic to bony fish.

METHODS: Sensitization to cod, salmon, and ray among patients allergic to cod, salmon, or both (n = 18) was explored by prick-to-prick testing. Clinical reactivity to ray was assessed in 11 patients by food challenges or clinical workup. IgE-binding to β-parvalbumins (cod, carp, salmon, barramundi, tilapia) and α-parvalbumins (ray, shark) was determined by IgE-ELISA. Basophil activation tests and skin prick tests were performed with β-parvalbumins from cod, carp, and salmon and α-parvalbumins from ray and shark.

RESULTS: Tolerance of ray was observed in 10 of 11 patients. Prick-to-prick test reactions to ray were markedly lower than to bony fish (median wheal diameter 2 mm with ray vs 11 mm with cod and salmon). IgE to α-parvalbumins was lower (median, 0.1 kU/L for ray and shark) than to β-parvalbumins (median, ≥1.65 kU/L). Furthermore, α-parvalbumins demonstrated a significantly reduced basophil activation capacity compared with β-parvalbumins (eg, ray vs cod, P < .001; n = 18). Skin prick test further demonstrated lower reactivity to α-parvalbumins compared with β-parvalbumins.

CONCLUSIONS: Most patients allergic to bony fish tolerated ray, a cartilaginous fish, because of low allergenicity of its α-parvalbumin. A careful clinical workup and in vitro IgE-testing for cartilaginous fish will improve patient management and may introduce an alternative to bony fish into patients' diet.

Seiten (von - bis)500-508.e11
FachzeitschriftJournal of Allergy and Clinical Immunology: In Practice
PublikationsstatusVeröffentlicht - Feb. 2019

ASJC Scopus Sachgebiete

  • Immunologie und Allergologie


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