ORIGINAL RESEARCH article
Front. Allergy
Sec. Allergy Diagnosis
Volume 6 - 2025 | doi: 10.3389/falgy.2025.1598583
Tropomyosin-Based Cross-Reactivity and Asymptomatic Shellfish Sensitization in Patients with Perennial Allergy
Provisionally accepted
- 1University Medical Center Göttingen, Göttingen, Germany
- 2Lower Saxony Institute of Occupational Dermatology, Göttingen, Germany
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Mites, cockroach, and shellfish (crab, clam, and shrimp) proteins share allergenic epitopes.Determination of specific IgE (sIgE) against cockroach (Blatella germanica, relevant in asthma) and shellfish allergens (relevant in food-allergy) using whole-body extracts necessitates detailed knowledge about IgE cross-reactivity.Objective: This study aimed to evaluate whether cross-reactivity between aero-and food allergens is clinically relevant and whether subjects with mite and/or cockroach sensitization are at risk of false-positive findings in shellfish-food allergy diagnostics.Methods: In this cross-sectional, single-centre study, we recruited at random 200 patients with elevated sIgE against ≥1 allergen from our outpatient clinic and assessed allergic comorbidity. We analyzed sIgE against mites (Dermatophagoides pteronyssinus, Dermatophagoides farinae, or Blomia tropicalis), German cockroach (Blatella germanica), crab, clam, and shrimp whole allergen extract as well as sIgE against mite tropomyosin Der p 10 and shrimp tropomyosin Pen a 1 (in a subpopulation) using automated ImmunoCAP Specific IgE Tests.Results: During allergologic assessment, two participants reported previous anaphylaxis to fish and/or seafood and were excluded from further analysis. The final study population comprised 150 female and 48 male participants. From these, 93 showed positive sIgE against mites. As expected, participants with mite sensitization displayed an elevated prevalence of perennial asthma or allergic rhinitis (p < 0.001). Further, they were more often sensitized against German cockroach, crab, claw, or shrimp (each p < 0.001). Der p 10 and Pen a 1 sIgE levels were below cutoff (<0.35 kU/l) in all subjects. Yet, correlation analyses revealed tropomyosin sIgE explained between 24% and 55% of variance (R 2 ) in sIgE against clam, crab, German cockroach, or shrimp (each p < 0.001).Conclusion: Patients with mite-sensitization have higher asymptomatic sIgE to shellfish. Even in patients with anti-tropomyosin sIgE below cutoff, anti-tropomyosin sIgE correlates strongly with sIgE against German cockroach, crab, clam, and shrimp. Our findings suggest falsepositive sIgE to shellfish findings on a large scale when analyzing patients with mite-or cockroach sensitization.
Keywords: Tropomyosin, Cockroach, Perennial allergy, food allergy, Ige cross-reactivity, Shellfish
Received: 23 Mar 2025; Accepted: 06 Jun 2025.
Copyright: © 2025 Hollstein, Schuppe, Hahn, Dasari, Forkel and Buhl. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Moritz Hollstein, University Medical Center Göttingen, Göttingen, Germany
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