Helbling et al. (1996) [1727] describe the symptoms of 39 fish allergic patients to 20 fish species. Only 2/39 specifically noted pollack as causing symptoms. However, pollack was third to anchovy and perch in the number of positve skin tests and after perch, sole, salmon and whitefish in the number of positive RAST tests. Thus symptoms for all 39 patients with fish can be listed as pruritus (27/39), hives (27/39), asthma and wheezing (21/39), angioedema (20/39), dyspepsia and cramps (7/39), vomiting (3/39), shock (3/39) and fainting (2/39).
Skin Prick Test
Number of Studies:
1-5
Food/Type of allergen:
Helbling et al. (1996) [1727] made an extract of Alaska pollack (and of anchovy, mackerel, rainbow trout, salmon and tuna) by blending 500g of raw fish in 1L of 0.01M PBS, pH 7.2, in a Waring blender for 1-3 minutes at room temperature. The mixture was extracted overnight at 4°C and centrifuged (70,000 g). Supernatants were concentrated with an Amicon YM1 filter (molecular weight cut-off 1 kDa) and recentrifuged (180,000 g). The extracts were sterile filtered and checked for sterility. Samples were diluted to 10 mg./ml. with sterile glycerol. 4 crustacea were extracted similarly except that the flesh was initially boiled for 15 minutes. Results were compared with 16 commercial extracts of fish as well as 12 inhalant allergens.
Protocol:
(controls, definition of positive etc)
Helbling et al. (1996) [1727] defined a positive skin prick as producing a 3 mm diameter wheal in a patient who reacted to the positive control (1 mg/ml histamine diphosphate) and not to 50% glycerol in PBS. Results were recorded after 15 minutes.
Helbling et al. (1996) [1727] found that 18/35 fish allergic subjects gave a positive skin test to pollack.
IgE assay (by RAST, CAP etc)
Number of Studies:
1-5
Food/Type of allergen:
Van Do et al. (2004) [1364] used extracts and purified parvalbumins from Alaska pollack and cod. Recombinant pollack parvalbumin was also used.
Helbling et al. (1996) [1727] used the same extract as for skin prick testing without sterile filtration or dilution with glycerol.
IgE protocol:
Van Do et al. (2004) [1364] used CAP FEIA and immunoblotting.
Hamada et al. (2000) [1725] used ELISA.
Helbling et al. (1996) [1727] used RAST and RAST inhibition.
Number of Patients:
Van Do et al. (2004) [1364] used tested 12 sera from patients with clinical histories of fish allergy and 3 control sera. 6 sera from patients with clinical histories of fish allergy, positive skin prick test, and CAP FEIA classes 4–5 were used for immunoblotting.
Hamada et al. (2000) [1725] used sera from 2 fish allergic patients.
Helbling et al. (1996) [1727] tested 21 fish allergic patients with pollack extract out of 39 total patients.
Summary of Results:
Van Do et al. (2004) [1364] report that the 12 sera were CAP FEIA classes 3–5. The concentration required for obtaining 50% inhibition of IgE-binding to cod parvalbumin was 18% higher for pollack parvalbumin than Gad c 1 itself. Recombinant pollack parvalbumin bound IgE 1000 times less strongly than the native allergens.
Hamada et al. (2000) [1725] tested fish meat paste products (kamaboko, tubular kamaboko called chikuwa, boiled kamaboko called hampen, square shaped fried kamaboko called satsuma-age, fish ball called tsumire and fish sausage) and surimi from walleye (Alaska) pollack. IgE from one serum bound only to fish ball. IgE from the other patient bound to all the products and was shown to bind to fish collagen.
Helbling et al. (1996) [1727] report a positive RAST with sera from 12/21 patients. This is similar to RAST results with several other fish extracts with the same patients such as bass (7/12), catfish (11/21), cod (8/12), flounder (12/21), haddock (8/11), herring (9/22), mackerel (9/23), perch (13/24), salmon (13/24), snapper (11/21), trout (11/22) and whitefish (13/24). However, extracts from anchovy (4/29) and tuna (5/27) showed fewer responses. RAST inhibition studies showed similar cross-reactivity with tuna extract as the least effective inhibitor.
Immunoblotting
Immunoblotting separation:
Van Do et al. (2004) [1364] followed the procedure of Laemmli (1970) [948] with a 15% acrylamide separating gel at 200 V (Van Do et al. 2003) [1367] .
Immunoblotting detection method:
Van Do et al. (2004) [1364] transferred proteins onto nitrocellulose membranes (0.45 µm, Schleicher and Schuell, Dassel, Germany) in a mini trans-blot cell (BIO-RAD) for 1 h at 100 V. These were incubated overnight with 1:4 v/v diluted sera and IgE binding was revealed by antibody binding and BCIP/NBT (SIGMA FAST™).
Immunoblotting results:
Van Do et al. (2004) [1364] show that all 6 sera bound to a band at 12 kDa in both pollack and cod extract. Purified pollack parvalbumin ran at this position and also bound the IgE.
Oral provocation
Number of Studies:
0
Food used and oral provocation
vehicle
Blind?
Number of Patients?
Dose response
Symptoms
No oral provocation reported with Alaska pollack
IgE cross-reactivity and Polysensitisation
Helbling et al. (1996) [1725] found that 18/35 fish allergic subjects gave a positive skin test to pollack and 12/21 gave a positive RAST. Thus reaction was slightly more common to pollack than to most of the 20 fish tested. RAST inhibition suggested strong IgE cross-reactivity between salmon, pollack, trout and tuna.
Other Clinical information
Alaska or walleye pollack is the fish most sold by weight as fresh or frozen in the USA and perhaps second only to tuna overall (http://www.st.nmfs.gov/st1/fus/fus03/05_process2003.pdf). It is the fish most often used to make fish paste or surimi, although surimi is also made from cod (Mata et al. 1994 [1728]). Surimi has been reported as a hidden allergen as both pizza topping (Helbling et al. 1992 [1724]) and as imitation crab meat (Musmand et al. 1996 [1726]). Musmand et al. note that surimi is used as an ingredient for imitation crab, shrimp, scallops, and seafood snacks and also surimi-meat blend products, such as “meatless” hot dogs, hybrid ham and bologna, sausages, pepperoni sticks, and pizza toppings.
Reviews (2)
Taylor, S. L., Kabourek, J. L., Hefle, S. L.
Fish allergy: Fish and products thereof Journal of Food Science 69 (8) R175-R180. 2004
PUBMED ID:
unknown
[1604]
Wild LG, Lehrer SB.
Fish and shellfish allergy. Curr Allergy Asthma Rep. 5(1):74-79. 2005
PUBMED ID:
15659268
Hamada Y, Genka E, Ohira M, Nagashima Y, Shiomi K
[Allergenicity of fish meat paste products and surimi from walleye pollack] Japanese JOURNAL OF THE FOOD HYGIENIC SOCIETY OF JAPAN 41 (1): 38-43
2000
PUBMED ID:
unknown
[1725]
HELBLING A, LOPEZ M, LEHRER SB
FISH ALLERGY - IS IT A REAL PROBLEM WITH SURIMI-BASED PRODUCT INTERNATIONAL ARCHIVES OF ALLERGY AND IMMUNOLOGY 99 (2-4): 452-455
1992
PUBMED ID:
unknown
[1724]
Helbling A, McCants ML, Musmand JJ, Schwartz HJ, Lehrer SB.
Immunopathogenesis of fish allergy: identification of fish-allergic adults by skin test and radioallergosorbent test. Ann Allergy Asthma Immunol. 77(1):48-54. 1996
PUBMED ID:
8705636
Mata E, Favier C, Moneret-Vautrin DA, Nicolas JP, Han Ching L, Gueant JL.
Surimi and native codfish contain a common allergen identified as a 63-kDa protein. Allergy 49(6):442-447.
1994
PUBMED ID:
7521143
Van Do T, Elsayed S, Florvaag E, Hordvik I, Endresen C.
Allergy to fish parvalbumins: studies on the cross-reactivity of allergens from 9 commonly consumed fish. J Allergy Clin Immunol. 116(6):1314-1320. 2005
PUBMED ID:
16337465
Van Do T, Hordvik I, Endresen C, Elsayed S.
The major allergen (parvalbumin) of codfish is encoded by at least two isotypic genes: cDNA cloning, expression and antibody binding of the recombinant allergens. Mol Immunol. 39(10):595-602. 2003
PUBMED ID:
12431393
Van Do T, Hordvik I, Endresen C, Elsayed S.
Characterization of parvalbumin, the major allergen in Alaska pollack, and comparison with codfish Allergen M. Mol Immunol. 42(3):345-353.
2005
PUBMED ID:
15589323
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