Shrimp sensitization in house dust mite algerian allergic patients: A single center experience

Lydia Lamara Mahammed; Brahim Belaid; Lylia Meriem Berkani; Fatma Merah; Sarah Yasmine Rahali; Anis Ait Kaci; Ismahane Berkane; Wafa Sayah; Ines Allam; Reda Djidjik

doi:10.1016/j.waojou.2022.100642

Shrimp sensitization in house dust mite algerian allergic patients: A single center experience

World Allergy Organ J. 2022 Apr 5;15(4):100642. doi: 10.1016/j.waojou.2022.100642. eCollection 2022 Apr.

Affiliation

¹ Immunology Department, Beni-Messous Teaching Hospital, Faculty of Pharmacy, University of Algiers, Algiers, Algeria.

Abstract

Background: Cross-reactivity between shrimp and house dust mite (HDM) proteins has been widely documented. However, a significant geographical variability in sensitization patterns and cross-reactive allergens has been reported which may impact the diagnosis and management of shrimp allergy among HDM-shrimp co-sensitized patients. This study aimed to investigate the prevalence of shrimp and tropomyosin sensitization among HDM-allergic patients in order to understand the local epidemiology to inform the development of targeted diagnostic and therapeutic tools.

Methods: Four hundred forty-six (446) HDM-allergic patients and 126 atopic controls were screened for shrimp-specific IgE using the IMMULITE 2000 XPI® System. HDM-shrimp sensitized subjected were also tested for IgE tropomyosin (nPen m 1) and thoroughly interviewed about their shellfish consumption habits. Tropomyosin sensitized patients were subjected to further analysis including measurement of IgE specific to squid and crab.

Results: The prevalence of shrimp sensitization in the HDM-allergic population was 20.4% vs 0% in the control group. Of them 63.7% were clinically allergic to shrimp, while 9 cases had no history of allergic reaction to this food and 24 patients reported not having consumed shrimp before. Besides, 72.5% of the HDM-shrimp sensitized subjects had tropomyosin-specific IgE with a positivity rate of 82.8% among shrimp-allergic patients. Among tropomyosin reactors, 95.5% were sensitized to crab and 89.5% to squid, none of them had previously ingested neither crab nor squid. Nevertheless, one-third of HDM-shrimp sensitized patients who never consumed shrimp before did not react to tropomyosin.

Conclusions: Shrimp allergy seems to be strictly dependent on HDM sensitization, at least in this geographical area. Therefore, HDM allergic patients should be systematically screened for shrimp sensitization and asked about the consumption of shellfish. Tropomyosin is a major and clinically relevant shrimp allergen that accounts for shellfish-HDM cross-reactivity. However, other components could be involved.

Keywords: AK, arginine kinase; Allergy; CLEIA, chemiluminescent enzyme immunoassay; CRD, component resolved diagnostic; Cross-reactivity; DBPCFC, double-blind placebo-controlled food challenge; House dust mites; MLC, myosin light chain; OFC, oral food challenge; SCBP, sarcoplasmic calcium-binding protein; SPT, skin prick test; Shrimp; TM, tropomyosin; Tropomyosin.