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      Shellfish and House Dust Mite Allergies: Is the Link Tropomyosin?

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          Abstract

          Crustacean shellfish allergy is an important cause of food allergy and anaphylaxis in Asia. The major allergen in shellfish allergy is tropomyosin, a pan-allergen that is also found in house dust mites and cockroaches. Tropomyosins from house dust mites (HDMs) have a high sequence homology to shellfish tropomyosins, and cross-reactivity between HDM and shrimp tropomyosins has been demonstrated. Exposure to inhaled tropomyosins from house dust mites has been postulated to be the primary sensitizer for shellfish allergy, in a reaction analogous to the oral allergy (inhalant-food) syndrome. This notion is supported by indirect data from the effects of HDM immunotherapy on shellfish allergy, and strong correlations of shellfish and HDM sensitization. HDM immunotherapy has been reported to induce both shrimp allergy in non-allergic patients and shrimp tolerance in shrimp-allergic patients. Epidemiological surveys have also demonstrated a strong correlation between shellfish and HDM sensitization in both hospital-based and community-based studies. Unexposed populations have also been shown to develop sensitization-shellfish sensitization in orthodox Jews with no history of shellfish consumption was associated with HDM sensitization. Reciprocally, HDM sensitization in an Icelandic population living in a HDM-free environment was associated with shrimp sensitization. In vitro IgE inhibition studies on sera in shrimp-allergic Spanish patients indicate that mites are the primary sensitizer in shrimp-allergic patients living in humid and warm climates. Current data supports the hypothesis that tropomyosin is the link between HDM and shellfish allergies. The role of tropomyosin in HDM and shellfish allergies is a fertile field for investigation as it may provide novel immunotherapeutic strategies for shellfish allergy.

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          Molecular and biochemical classification of plant-derived food allergens.

          Molecular biology and biochemical techniques have significantly advanced the knowledge of allergens derived from plant foods. Surprisingly, many of the known plant food allergens are homologous to pathogenesis-related proteins (PRs), proteins that are induced by pathogens, wounding, or certain environmental stresses. PRs have been classified into 14 families. Examples of allergens homologous to PRs include chitinases (PR-3 family) from avocado, banana, and chestnut; antifungal proteins such as the thaumatin-like proteins (PR-5) from cherry and apple; proteins homologous to the major birch pollen allergen Bet v 1 (PR-10) from vegetables and fruits; and lipid transfer proteins (PR-14) from fruits and cereals. Allergens other than PR homologs can be allotted to other well-known protein families such as inhibitors of alpha-amylases and trypsin from cereal seeds, profilins from fruits and vegetables, seed storage proteins from nuts and mustard seeds, and proteases from fruits. As more clinical data and structural information on allergenic molecules becomes available, we may finally be able to answer what characteristics of a molecule are responsible for its allergenicity.
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            Allergic airway diseases in a tropical urban environment are driven by dominant mono-specific sensitization against house dust mites

            Background Southeast Asian populations are increasingly affected by allergic airway diseases. Etiology and specific causes, however, are still unknown. The aim of this study is therefore to identify allergens and risk factors for the high prevalence of allergic airway disease in the tropical urban environment. Methods Symptoms of allergic rhinitis (AR), asthma, and allergic dermatitis were recorded in two independent cohorts of 576 and 7373 ethnic Chinese individuals living in Singapore. Reactivity against common allergens was determined by skin prick tests (SPT); specific immunoglobulin E (sIgE) titers against 12 common allergens, as well as total serum IgE (tIgE), were measured in the smaller cohort. Results Immunoglobulin E sensitization was almost exclusively directed against house dust mite (HDM) allergens. More than 80% of individuals were HDM-sIgE positive. Of these, less than 30% also had sIgE for other allergens, and similarly, few of the HDM-sIgE-negative individuals reacted to other allergens. Titers for HDM-sIgE were 8–30 times higher than other non-HDM allergen titers and correlated directly with total serum tIgE levels. Migrants from nontropical countries typically arrived with low or undetectable HDM-sIgE but developed substantial titers in a time-dependent fashion. Importantly, prolonged stay in Singapore also resulted in the manifestation of AR and asthma symptoms, contributing to some of the highest national prevalence rates worldwide. Conclusion In a tropical urban environment, the allergic response is dominated by a single allergen class. The mono-specific IgE sensitization against HDM translates into increased prevalence of allergic airway diseases, which now impact a large proportion of the population in Singapore.
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              A population-based questionnaire survey on the prevalence of peanut, tree nut, and shellfish allergy in 2 Asian populations.

              There has been a substantial increase in the prevalence of peanut and tree nut allergy in Western populations in the last 2 decades. However, there is an impression that peanut and tree nut allergy is relatively uncommon in Asia. To evaluate the prevalence of peanut, tree nut, and shellfish allergy in schoolchildren in 2 Asian countries (Singapore and Philippines). A structured written questionnaire was administered to local and expatriate Singapore (4-6 and 14-16 years old) and Philippine (14-16 years old) schoolchildren. A total of 25,692 schoolchildren responded to the survey (response rate, 74.2%). Of these, 23,425 responses fell within the study protocol's 4 to 6 and 14 to 16 year age groups and were included in the analysis. The prevalence of convincing peanut and tree nut allergy were similar in both local Singapore (4-6 years, 0.64%, 0.28%; 14-16 years, 0.47%, 0.3%, respectively) and Philippine (14-16, 0.43%, 0.33%, respectively) schoolchildren, but was higher in the Singapore expatriates (4-6 years, 1.29%, 1.12%; 14-16 years, both 1.21%, respectively; 4-6 years, expatriates vs local Singaporeans: peanut, P = .019; tree nut, P = .0017; 14-16 years, P > .05). Conversely, shellfish allergy was more common in the local Singapore (4-6 years, 1.19%; 14-16 years, 5.23%) and Philippine (14-16 years, 5.12%) schoolchildren compared with expatriate children (4-6 years, 0.55%; 14-16 years, 0.96%; P < .001). When data were pooled, respondents born in Western countries were at higher risk of peanut (adjusted odds ratios [95% CIs]: 4-6 years, 3.47 [1.35-8.93]; 14-16 years, 5.56 [1.74-17.76]) and tree nut allergy (adjusted odds ratios [95% CIs]: 4-6 years, 10.40 [1.61-67.36]; 14-16 years, 3.53 [1.00-12.43]) compared with those born in Asia. This study substantiates the notion that peanut and tree nut allergy is relatively low in Asian children, and instead shellfish allergy predominates. Environmental factors that are yet to be defined are likely to contribute to these differences. Copyright 2010 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.
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                Author and article information

                Journal
                Allergy Asthma Immunol Res
                Allergy Asthma Immunol Res
                AAIR
                Allergy, Asthma & Immunology Research
                The Korean Academy of Asthma, Allergy and Clinical Immunology; The Korean Academy of Pediatric Allergy and Respiratory Disease
                2092-7355
                2092-7363
                March 2016
                14 July 2015
                : 8
                : 2
                : 101-106
                Affiliations
                [1 ]Pediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore.
                [2 ]Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
                Author notes
                Correspondence to: Bee Wah Lee, MD, Division of Allergy and Immunology Department of Pediatrics, National University Hospital, Level 12, NUHS Tower Block, 1E Kent Ridge Road, Singapore 119228. Tel: +65-67724411; Fax: +65-67797486; bee_wah_lee@ 123456nuhs.edu.sg
                Article
                10.4168/aair.2016.8.2.101
                4713872
                26739402
                9e3c1a6f-7f66-4750-8567-fcfa26db7fdb
                Copyright © 2016 The Korean Academy of Asthma, Allergy and Clinical Immunology • The Korean Academy of Pediatric Allergy and Respiratory Disease

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 31 March 2015
                : 12 May 2015
                Categories
                Review

                Immunology
                house dust mite,shellfish allergy,tropomyosin,asia
                Immunology
                house dust mite, shellfish allergy, tropomyosin, asia

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