Usefulness of currently available methods for the diagnosis of Anisakis simplex allergy

Abstract

On the basis of these results, we suggest that the most appropriate procedure for diagnosis of Anisakis allergy suspected on clinical grounds is the antigen-capture ELISA using UA3, or, alternatively, a preliminary skin prick test with a positive result subsequently confirmed by UA3-ELISA.

Anisakis pegreffii-Induced Airway Hyperresponsiveness Is Mediated by Gamma Interferon in the Absence of Interleukin-4 Receptor Alpha Responsiveness

“…This outcome suggests the presence of heat-stable somatic allergens and confirms evidence that cooking of contaminated fish may not be sufficient to prevent allergic reactions to Anisakis (10,35). Furthermore, our additional finding that intranasal sensitization/challenge with an Anisakis extract induced allergic airway inflammation and AHR in the absence of a detectable antibody response may have consequences for the diagnosis of Anisakis allergies, which currently relies on the detection of specific IgE antibodies (29).…”

Anisakis simplex: from Obscure Infectious Worm to Inducer of Immune Hypersensitivity

“…Moreover, a significant number of fishmongers and fishermen in Italy and African fish-processing workers, as well as 13% of healthy blood donors, are sensitized to this parasite (82,201,221). It should be borne in mind, however, that specific immunoglobulin E (IgE) detection by ImmunoCAP assay can overestimate the number of sensitized subjects (165,167), so the above estimates may be exaggerated. However, there is clearly cause for concern, and a need for further analysis using more-refined methods and serodiagnostic tools.…”

“…Since sera from an A. simplex-free population also present these antibodies, A. simplex biotinyl enzymes on their own do not seem to be the cause of sensitization. False positives may also be due to immunodominant carbohydrates that may be present in parasite glycoproteins (167), as was demonstrated using a deglycosylated antigenic fraction (named UA3R) which improved allergy diagnosis specificity (165).…”

“…cDNA encoding the target antigen was then cloned by Sugane et al (255), and Spanish authors developed five further MAbs, among which was UA3, whose target antigen is recognized by antibody in most patients with an antigen capture ELISA (166,167). Interestingly, UA3 was found to be useful for both anisakidosis and allergy diagnosis, the latter using an O-deglycosylated antigen (165). The predominant epitopes therefore seem not to be carbohydrate in nature, and this is consistent with the observation that crude extracts of A. simplex retained their allergenic activity following treatment with sodium periodate, and the peptide nature of allergen epitopes also applied to defined allergens of a related parasite (54,186).…”

The physiological and pathophysiological roles of eosinophils in the gastrointestinal tract

“…Histologically, an eosinophilic inflammation is found in the affected segments of the gastrointestinal tract, nevertheless, even this method fails to identify the parasite. Confirmation requires determination of IgE antibodies by immunoblotting techniques, which indicate that the tissue eosinophilia is indeed caused by an Anisakis simplex infection (89).…”