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Shrimp derived glucosamine is well-tolerated in shrimp allergic individuals
S92 Abstracts
Identification of Salmon Roe Allergens and Consideration of Cross-Reactivity Between Salmon Roe and Chicken Egg Y. Kondo1, M. Kakami1, M. Kawamura1, Y. Nakajima1, I. Tsuge1, A. Urisu1, T. Yasuda2; 1Pediatrics, Fujita Health University, Toyoake, Aichi, JAPAN, 2Toyo Suisan Kaisha, Ltd, Tokyo, JAPAN. RATIONALE: Salmon roe (ikura) anaphylaxis has often been reported in Japan; however, there have been no articles about its allergenicity. Especially in clinical work we are often confused as to whether patients allergic to chicken egg can eat salmon roe safety, because cross-reactivity between salmon roe and chicken egg was controversial. METHODS: Using patients’ sera from anaphylaxis to salmon roe, we attempted to identify the allergens of salmon roe by immunoblotting. On the other hand, an ELISA inhibition study was performed to examine the cross-reactivity between salmon roe and chicken egg yolk. RESULTS: Anaphylactic patients’ IgE binding patterns were similar with reactions to protein of 15 and 17 kDa. The N-terminal amino acid sequences of these proteins were almost identical to the vitellogenin precursor of rainbow trout. In ELISA inhibition study, IgE-binding to salmon roe was not inhibited by chicken egg yolk. CONCLUSIONS: Proteins derived from vitellogenin were suspected to be allergens of salmon roe. Vitellogenin is well known as a protein influenced by endocrine disruptors and exists in many kinds of fish and chicken yolk with various mutations. On the other hand, there was no crossreactivity between salmon roe and chicken egg yolk.
367
SUNDAY
Shrimp Derived Glucosamine Is Well-Tolerated in Shrimp Allergic Individuals J. F. Villacis1, J. M. El-Dahr2, L. Wild2, D. DeMerell2, D. F. Soteres2, L. R. Bucci3, S. B. Lehrer2; 1The Austin Diagnostic Clinic, Austin, TX, 2Department of Clinical Allergy, Immunology, and Rheumatology, Tulane University Health Science Center, New Orleans, LA, 3Weider Nutritional Group, Salt Lake City, UT. RATIONALE: Gluosamine is an aminomonosaccharide that is commercially available as a shrimp shell derived dietary supplement. Studies have shown that 1500 mg of daily glucosamine can potentially benefit patients suffering from osteoarthritis by improving symptoms and delaying disease progression. Since shellfish proteins derived from shellfish meat cause allergic reactions, the concern over contamination or cross-reactivity between the meat and the shell has led to warning labels recommending avoidance of the supplement in shellfish-allergic individuals. Limited studies have been conducted to show tolerance of shrimp shell derived glucosamine in individuals allergic to shellfish. METHODS: 17 adult shrimp allergic individuals participated. All had a strong clinical history of shrimp allergy, had an ImmunoCAP level of class II or greater, and were skin test positive to shrimp and shellfish extracts. Individuals were challenged with 1500mg of shrimp derived or synthetic glucosamine in a DBPC fashion. Vital signs, peak flows and subjective symptoms were recorded for one hour. Patients completed a questionnaire 24 hours after initial challenge to assess late symptoms. RESULTS: Although the subjects reported significant histories of shrimp allergy manifested by pruritus, urticaria, angioedema, dyspnea, nausea, vomiting, or diarrhea, all of the shellfish allergic individuals challenged with shrimp derived glucosamine tolerated it without evidence of an immediate systemic reaction. None of the subjects reported symptoms consistent with hypersensitivity one day after oral challenge. CONCLUSIONS: Shrimp derived glucosamine appears to be well tolerated in shrimp allergic individuals and poses no apparent risk of inducing an allergic reaction in these subjects. Funding: Weider Nutrition Group and Technical Sourcing, Inc.
368
J ALLERGY CLIN IMMUNOL FEBRUARY 2005
Seafood Extracts: Raw or Boiled for the Diagnosis of Allergic Patients? A. Ferrer1, J. Huertas2, J. Carnés3, M. Casanovas4, E. Fernández-Caldas3; 1Hospital de la Vega Baja, Orihuela, SPAIN, 2Allergy Department, Hospital General Básico de Defensa, Cartagena, SPAIN, 3Laboratorios LETI, S.L., Tres Cantos, SPAIN, 4Medical Department, Laboratorios LETI, S.L., Tres Cantos, SPAIN. RATIONALE: Seafood is an important component of the human diet. The aim of this study was to evaluate what kind of extract (boiled or raw) is more effective to diagnose seafood allergy. METHODS: Raw (A) and boiled (B) extracts from 2 types of lobsters, prawns, squid, octopus, mussels and clams were manufactured. Extracts B were prepared after the raw materials were boiled for 30 minutes. Extract A and B were homogenized, separately, and extracted for 4 hours. Afterwards, the content was centrifuged, dialyzed, filtered, frozen and freezedried. Antigenic profile of extract A and B were compared by SDS-PAGE and the protein content determined. Fifty-six seafood allergic patients were included in the study. They were allergic to at least one of the seafood tested. All of them were skin prick tested with all A and B extracts. RESULTS: Important antigenic differences were detected in the antigenic profile of both types of extracts by SDS-PAGE. However, the protein content remained similar. In vivo results showed that extracts B induced statistically significant larger wheal sizes than extracts A in all cases except for clams, where extract A and B induced similar wheal sizes. This could be explained because clams can be ingested either boiled, or raw. In vitro experiments by direct ELISA confirmed the in vivo results. CONCLUSIONS: The use of boiled extracts seems to be more effective to detect seafood allergy. The antigenic profile of B extracts is considerably modified after boiling. Funding: Laboratorios LETI, S.L.
369
IgE Antibody Activity of Shrimp Allergic Subjects to Inhalant and Food Allergens M. W. Reder1, L. G. Wild1, J. M. El-Dahr1, J. Villacis1, D. Demerell1, D. Soteres1, L. Bucci2, S. B. Lehrer1; 1Medicine- Section of Clinical Immunology, Allergy, and Rheumatology, Tulane University Medical Center, New Orleans, LA, 2Weider Nutritional Group, Salt Lake City, UT. RATIONALE: Shrimp is an important allergenic seafood. The major shrimp allergen is the muscle protein tropomyosin. Since tropomyosin is present in other inhaled and ingested allergens, it was of interest to determine potential sensitivity of shrimp allergic subjects to these other allergens. METHODS: Shrimp allergic subjects were recruited by advertisement. 58 subjects (25 male, 33 female) ages 18-63, with definitive histories of shrimp allergy, as determined by questionnaire, were selected. Subjects were skin prick tested (ST) with aeroallergen and shellfish food extracts from Hollister-Stier; positive ST was determined by wheal with flare. IgE antibody responses to shrimp were measured by CAP-RAST. RESULTS: 37/58 subjects were ST positive to at least 1 shrimp extract (64%). 41 (71%) were positive to either crab, lobster, crawfish, or oyster, 51 (88%) to either cockroach or DM, 19 (33%) to tree pollens, and 14 (24%) to grass pollens. Of the 37 subjects ST positive for shrimp, 35 (96%) were positive to crab, lobster, or crawfish. 36 (97%) reacted to either cockroach or DM. Of the 58 original subjects, 28 (48%) had undetectable IgE to shrimp (class 0) on CAP-RAST analysis. Of the 37 shrimp ST positive subjects, only 10 (27%) had undetectable IgE to shrimp. CONCLUSIONS: Shrimp allergic subjects show significant reactivity to other shellfish, the greatest was to lobster, the least to oysters. Significant reactivity was observed to cockroach and DM extracts which is probably due in part to cross reactivity of invertebrate tropomyosin allergens. Better understanding of this should help improve diagnosis and therapy of food allergy. Funding: Weider Nutritional Group
370
Identification of Salmon Roe Allergens and Consideration of Cross-Reactivity Between Salmon Roe and Chicken Egg Y. Kondo1, M. Kakami1, M. Kawamura1, Y. Nakajima1, I. Tsuge1, A. Urisu1, T. Yasuda2; 1Pediatrics, Fujita Health University, Toyoake, Aichi, JAPAN, 2Toyo Suisan Kaisha, Ltd, Tokyo, JAPAN. RATIONALE: Salmon roe (ikura) anaphylaxis has often been reported in Japan; however, there have been no articles about its allergenicity. Especially in clinical work we are often confused as to whether patients allergic to chicken egg can eat salmon roe safety, because cross-reactivity between salmon roe and chicken egg was controversial. METHODS: Using patients’ sera from anaphylaxis to salmon roe, we attempted to identify the allergens of salmon roe by immunoblotting. On the other hand, an ELISA inhibition study was performed to examine the cross-reactivity between salmon roe and chicken egg yolk. RESULTS: Anaphylactic patients’ IgE binding patterns were similar with reactions to protein of 15 and 17 kDa. The N-terminal amino acid sequences of these proteins were almost identical to the vitellogenin precursor of rainbow trout. In ELISA inhibition study, IgE-binding to salmon roe was not inhibited by chicken egg yolk. CONCLUSIONS: Proteins derived from vitellogenin were suspected to be allergens of salmon roe. Vitellogenin is well known as a protein influenced by endocrine disruptors and exists in many kinds of fish and chicken yolk with various mutations. On the other hand, there was no crossreactivity between salmon roe and chicken egg yolk.
367
SUNDAY
Shrimp Derived Glucosamine Is Well-Tolerated in Shrimp Allergic Individuals J. F. Villacis1, J. M. El-Dahr2, L. Wild2, D. DeMerell2, D. F. Soteres2, L. R. Bucci3, S. B. Lehrer2; 1The Austin Diagnostic Clinic, Austin, TX, 2Department of Clinical Allergy, Immunology, and Rheumatology, Tulane University Health Science Center, New Orleans, LA, 3Weider Nutritional Group, Salt Lake City, UT. RATIONALE: Gluosamine is an aminomonosaccharide that is commercially available as a shrimp shell derived dietary supplement. Studies have shown that 1500 mg of daily glucosamine can potentially benefit patients suffering from osteoarthritis by improving symptoms and delaying disease progression. Since shellfish proteins derived from shellfish meat cause allergic reactions, the concern over contamination or cross-reactivity between the meat and the shell has led to warning labels recommending avoidance of the supplement in shellfish-allergic individuals. Limited studies have been conducted to show tolerance of shrimp shell derived glucosamine in individuals allergic to shellfish. METHODS: 17 adult shrimp allergic individuals participated. All had a strong clinical history of shrimp allergy, had an ImmunoCAP level of class II or greater, and were skin test positive to shrimp and shellfish extracts. Individuals were challenged with 1500mg of shrimp derived or synthetic glucosamine in a DBPC fashion. Vital signs, peak flows and subjective symptoms were recorded for one hour. Patients completed a questionnaire 24 hours after initial challenge to assess late symptoms. RESULTS: Although the subjects reported significant histories of shrimp allergy manifested by pruritus, urticaria, angioedema, dyspnea, nausea, vomiting, or diarrhea, all of the shellfish allergic individuals challenged with shrimp derived glucosamine tolerated it without evidence of an immediate systemic reaction. None of the subjects reported symptoms consistent with hypersensitivity one day after oral challenge. CONCLUSIONS: Shrimp derived glucosamine appears to be well tolerated in shrimp allergic individuals and poses no apparent risk of inducing an allergic reaction in these subjects. Funding: Weider Nutrition Group and Technical Sourcing, Inc.
368
J ALLERGY CLIN IMMUNOL FEBRUARY 2005
Seafood Extracts: Raw or Boiled for the Diagnosis of Allergic Patients? A. Ferrer1, J. Huertas2, J. Carnés3, M. Casanovas4, E. Fernández-Caldas3; 1Hospital de la Vega Baja, Orihuela, SPAIN, 2Allergy Department, Hospital General Básico de Defensa, Cartagena, SPAIN, 3Laboratorios LETI, S.L., Tres Cantos, SPAIN, 4Medical Department, Laboratorios LETI, S.L., Tres Cantos, SPAIN. RATIONALE: Seafood is an important component of the human diet. The aim of this study was to evaluate what kind of extract (boiled or raw) is more effective to diagnose seafood allergy. METHODS: Raw (A) and boiled (B) extracts from 2 types of lobsters, prawns, squid, octopus, mussels and clams were manufactured. Extracts B were prepared after the raw materials were boiled for 30 minutes. Extract A and B were homogenized, separately, and extracted for 4 hours. Afterwards, the content was centrifuged, dialyzed, filtered, frozen and freezedried. Antigenic profile of extract A and B were compared by SDS-PAGE and the protein content determined. Fifty-six seafood allergic patients were included in the study. They were allergic to at least one of the seafood tested. All of them were skin prick tested with all A and B extracts. RESULTS: Important antigenic differences were detected in the antigenic profile of both types of extracts by SDS-PAGE. However, the protein content remained similar. In vivo results showed that extracts B induced statistically significant larger wheal sizes than extracts A in all cases except for clams, where extract A and B induced similar wheal sizes. This could be explained because clams can be ingested either boiled, or raw. In vitro experiments by direct ELISA confirmed the in vivo results. CONCLUSIONS: The use of boiled extracts seems to be more effective to detect seafood allergy. The antigenic profile of B extracts is considerably modified after boiling. Funding: Laboratorios LETI, S.L.
369
IgE Antibody Activity of Shrimp Allergic Subjects to Inhalant and Food Allergens M. W. Reder1, L. G. Wild1, J. M. El-Dahr1, J. Villacis1, D. Demerell1, D. Soteres1, L. Bucci2, S. B. Lehrer1; 1Medicine- Section of Clinical Immunology, Allergy, and Rheumatology, Tulane University Medical Center, New Orleans, LA, 2Weider Nutritional Group, Salt Lake City, UT. RATIONALE: Shrimp is an important allergenic seafood. The major shrimp allergen is the muscle protein tropomyosin. Since tropomyosin is present in other inhaled and ingested allergens, it was of interest to determine potential sensitivity of shrimp allergic subjects to these other allergens. METHODS: Shrimp allergic subjects were recruited by advertisement. 58 subjects (25 male, 33 female) ages 18-63, with definitive histories of shrimp allergy, as determined by questionnaire, were selected. Subjects were skin prick tested (ST) with aeroallergen and shellfish food extracts from Hollister-Stier; positive ST was determined by wheal with flare. IgE antibody responses to shrimp were measured by CAP-RAST. RESULTS: 37/58 subjects were ST positive to at least 1 shrimp extract (64%). 41 (71%) were positive to either crab, lobster, crawfish, or oyster, 51 (88%) to either cockroach or DM, 19 (33%) to tree pollens, and 14 (24%) to grass pollens. Of the 37 subjects ST positive for shrimp, 35 (96%) were positive to crab, lobster, or crawfish. 36 (97%) reacted to either cockroach or DM. Of the 58 original subjects, 28 (48%) had undetectable IgE to shrimp (class 0) on CAP-RAST analysis. Of the 37 shrimp ST positive subjects, only 10 (27%) had undetectable IgE to shrimp. CONCLUSIONS: Shrimp allergic subjects show significant reactivity to other shellfish, the greatest was to lobster, the least to oysters. Significant reactivity was observed to cockroach and DM extracts which is probably due in part to cross reactivity of invertebrate tropomyosin allergens. Better understanding of this should help improve diagnosis and therapy of food allergy. Funding: Weider Nutritional Group
370