Shrimp‐allergic patients in a multi‐food oral immunotherapy trial

Nguyen, D.; Sindher, Sayantani; Chinthrajah, R. Sharon; Nadeau, Kari; Davis, Carla M.

doi:10.1111/pai.13679

Cited by 11 publications

(15 citation statements)

References 11 publications

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“…Due to the high consistency in the types of major allergens and fish among the six studies, they were combined into one overall study called Combination-6 for the quantitative analyses. In total, six clinical studies were included, with four utilizing processed meat from cod fish [ 46 , 47 , 48 ] and one each from salmon [ 49 ] and shrimp [ 50 ]. The processing methods in these studies included simple cooking in three studies [ 46 , 48 , 50 ], enzymatic hydrolysis of protease in one study [ 49 ], and lyophilization in one study [ 47 ].…”

Section: Resultsmentioning

confidence: 99%

“…In total, six clinical studies were included, with four utilizing processed meat from cod fish [ 46 , 47 , 48 ] and one each from salmon [ 49 ] and shrimp [ 50 ]. The processing methods in these studies included simple cooking in three studies [ 46 , 48 , 50 ], enzymatic hydrolysis of protease in one study [ 49 ], and lyophilization in one study [ 47 ]. The Combination-6 study employed multiple processing methods, including cooking alone [ 8 , 42 ], dehydration and cooking [ 41 , 43 ], lyophilization [ 44 ], and dilution [ 45 ].…”

Section: Resultsmentioning

confidence: 99%

“…( A ) Main meta-analysis; ( B ) subgroup analysis of seafood species (crustacea and fish); ( C ) subgroup analysis of different processing methods (simple cooking and others). IRR: incidence rate ratio [ 46 , 47 , 48 , 49 , 50 ].…”

Section: Figurementioning

confidence: 99%

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Intervention Efficacy of Slightly Processed Allergen/Meat in Oral Immunotherapy for Seafood Allergy: A Systematic Review, Meta-Analysis, and Meta-Regression Analysis in Mouse Models and Clinical Patients

Han,

Wang,

Chen

et al. 2024

Nutrients

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Background: Seafood allergy is a significant global health concern that greatly impacts a patient’s quality of life. The intervention efficacy of oral immunotherapy (OIT), an emerging intervention strategy, for seafood allergy remains controversial. This study aimed to perform a systematic review and meta-analysis to evaluate the efficacy of slightly processed allergen/meat from fish and crustacea in OIT, both in mouse models and clinical patients. Methods: A comprehensive literature search was performed in four mainstream databases and the EBSCOhost database to identify all relevant case–control and cohort studies. The aim was to elucidate the intervention efficacy, encompassing various processing methods and assessing the efficacy of multiple major allergens in OIT. Results: The meta-analysis included five case–control studies on crustacean allergens in mouse models and 11 cohort studies on meat from fish and crustacea in clinical patients for final quantitative assessments. In mouse models, crustacean allergen substantially decreased the anaphylactic score after OIT treatment (mean difference (MD) = −1.30, p < 0.01). Subgroup analyses with low-level heterogeneities provided more reliable results for crab species (MD = −0.63, p < 0.01, I2 = 0), arginine kinase allergen (MD = −0.83, p < 0.01, I2 = 0), and Maillard reaction processing method (MD = −0.65, p < 0.01, I2 = 29%), respectively. In clinical patients, the main meta-analysis showed that the slightly processed meat significantly increased the incidence rate of oral tolerance (OT, incidence rate ratio (IRR) = 2.90, p < 0.01). Subgroup analyses for fish meat (IRR = 2.79, p < 0.01) and a simple cooking treatment (IRR = 2.36, p = 0.01) also demonstrated a substantial increase in the incidence rate of OT. Sensitivity and meta-regression analyses successfully identified specific studies contributing to heterogeneity in mouse models and clinical patients, although these studies did not impact the overall significant pooled effects. Conclusions: This meta-analysis provides preliminary evidence for the high intervention efficacy of slightly processed allergen/meat from fish and crustacea in OIT, both in mouse models and clinical patients. The Maillard reaction and cooking processing methods may emerge as potentially effective approaches to treating allergen/meat in OIT for clinical patients, offering a promising and specific treatment strategy for seafood allergy. However, these findings should be interpreted cautiously, and further supporting evidence is necessary.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Intervention Efficacy of Slightly Processed Allergen/Meat in Oral Immunotherapy for Seafood Allergy: A Systematic Review, Meta-Analysis, and Meta-Regression Analysis in Mouse Models and Clinical Patients

Han,

Wang,

Chen

et al. 2024

Nutrients

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“…Shrimp is a delicacy widely eaten by consumers worldwide. However, SA is often associated with severe allergic reactions [30], including life-threatening anaphylaxis [31]. Therefore, SA has become a major public health concern.…”

Section: Discussionmentioning

confidence: 99%

Widely Targeted Lipidomics and Transcriptomics Analysis Revealed Changes of Lipid Metabolism in Spleen Dendritic Cells in Shrimp Allergy

Sun

Luo

et al. 2022

Foods

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Shrimp allergy (SA) is pathological type 2 inflammatory immune responses against harmless shrimp protein allergen, which is caused by complex interactions between dendritic cells (DCs) and other immune cells. Lipid metabolism in different DCs states are significantly changed. However, the lipid metabolism of spleen DCs in SA remain ambiguous. In this study, we established a BALB/c mouse shrimp protein extract-induced allergy model to determine the lipid profile of spleen DCs in SA, and the molecular mechanism between lipid metabolism and immune inflammation was preliminarily studied. Spleen DCs were sorted by fluorescence-activated cell sorting, and then widely targeted lipidomics and transcriptomics analysis were performed. Principal component analysis presented the lipidome alterations in SA. The transcriptomic data showed that Prkcg was involved in lipid metabolism, immune system, and inflammatory signaling pathway. In the correlation analysis, the results suggested that Prkcg was positively correlated with triacylglycerol (Pearson correlation coefficient = 0.917, p = 0.01). The lipidomics and transcriptomics integrated pathway analysis indicated the activated metabolic conversion from triacylglycerol to 1,2-diacyl-sn-glycerol and the transmission of lipid metabolism to immune inflammation (from triacylglycerol and ceramide to Prkcg) in SA spleen DCs, and cellular experiments in vitro showed that glyceryl trioleate and C16 ceramide treatment induced immune function alteration in DCs.

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“…Overall, despite the lack of baseline and end-point oral food challenge results, this small scale trial suggested sublingual AIT was safe, well-tolerated and efficacious for shrimp allergy. Another small scale study reported the safety and effect of omalizumab-facilitated oral immunotherapy (OIT) for shrimp allergy [33 ▪ ]. Three patients with multiple food allergy including shrimp were administered with omalizumab from Weeks 1–16 and received multi-OIT since Week 8 until Week 30 at a maintenance dose of ≥ 1 g of shrimp powder ( Litopenaeus setiferus ).…”

Section: Allergen-specific Immunotherapymentioning

confidence: 99%

Emerging approaches in the diagnosis and therapy in shellfish allergy

Wai

Leung

2022

Current Opinion in Allergy &Amp; Clinical Immunology

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Purpose of reviewDespite the high prevalence of shellfish allergy, the clinical management of seafood allergy has remained unchanged over decades. Here, we examined the current status in the diagnosis and clinical management of shellfish allergy and highlighted the imminent need for more specific diagnostic methods, as well as effective and safe therapeutic approaches for shellfish allergy.Recent findingsWith the advancement in the molecular identifications and definition of reactive epitopes of shellfish allergens, new diagnostic designs such as component-resolved diagnosis, basophil activation test (BAT) and the emerging IgE-crosslinking-induced luciferase expression are emerging. Furthermore, various allergen-specific immunotherapy strategies (such as shellfish extracts and allergens, hypoallergens, hypoallergen DNA vaccines, mimotopes and peptide-based therapies) are being explored at preclinical stages whereas limited nonallergen specific immunotherapy approaches are under clinical trials.SummaryWith an increasing understanding of the underlying immunological mechanisms and molecular features of shellfish allergy, the future for developing precise diagnostic and therapeutic strategies to better manage shellfish allergy is promising.

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Shrimp‐allergic patients in a multi‐food oral immunotherapy trial

Cited by 11 publications

References 11 publications

Intervention Efficacy of Slightly Processed Allergen/Meat in Oral Immunotherapy for Seafood Allergy: A Systematic Review, Meta-Analysis, and Meta-Regression Analysis in Mouse Models and Clinical Patients

Intervention Efficacy of Slightly Processed Allergen/Meat in Oral Immunotherapy for Seafood Allergy: A Systematic Review, Meta-Analysis, and Meta-Regression Analysis in Mouse Models and Clinical Patients

Widely Targeted Lipidomics and Transcriptomics Analysis Revealed Changes of Lipid Metabolism in Spleen Dendritic Cells in Shrimp Allergy

Emerging approaches in the diagnosis and therapy in shellfish allergy

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