Alergia na skorupiaki – Rokowania, prognozy i postęp choroby

Alergia na skorupiaki
Rokowania, prognozy i postęp choroby

Alergia na skorupiaki jest jedną z najczęstszych alergii pokarmowych, szczególnie w regionie Azji i Pacyfiku, dotykając około 3% dorosłych i ponad 1% dzieci w USA. W populacji kierowanej do poradni alergologicznej stanowi około 3,08% przypadków, z przewagą reakcji na skorupiaki pancerzowe (kraby, krewetki, homary) nad mięczakami. Średni wiek diagnozy to 50,2 lat, co sugeruje późniejsze narażenie lub odmienne mechanizmy uczulenia. U około 32% pacjentów występuje ryzyko anafilaksji, a ciężkie reakcje są 12,9 razy bardziej prawdopodobne w pierwszej godzinie po ekspozycji. Alergia ta często utrudnia pracę, zwłaszcza w zawodach związanych z przetwórstwem żywności, gdzie może wymagać reorientacji zawodowej. Obecnie jedynym skutecznym leczeniem jest dożywotnie unikanie alergenów i stosowanie autostrzykawki z adrenaliną w razie reakcji anafilaktycznej.

Wprowadzenie do alergii na skorupiaki
Przewidywanie przebiegu alergii na skorupiaki

Trwałość alergii
Wiek rozpoznania
Reakcje krzyżowe z innymi pokarmami

Ciężkość reakcji alergicznych i rokowanie

Anafilaksja
Czas wystąpienia ciężkich reakcji

Wpływ alergii na skorupiaki na życie zawodowe
Perspektywy leczenia i rokowanie długoterminowe

Obecne podejście terapeutyczne
Obiecujące kierunki rozwoju terapii
Potrzeba lepszych metod diagnostycznych

Podsumowanie prognozy

Kolejne rozdziały

Wprowadzenie do alergii na skorupiaki

Alergia na skorupiaki stanowi jedną z najczęstszych przyczyn alergii pokarmowych, szczególnie w regionie Azji i Pacyfiku. Dotyka ona około 3% dorosłych i ponad 1% dzieci w Stanach Zjednoczonych, będąc wiodącą przyczyną samodzielnie zgłaszanych alergii pokarmowych wśród osób dorosłych.¹² W populacji pacjentów kierowanych do specjalistycznej poradni alergologicznej, alergia na owoce morza stanowi około 3,08% wszystkich przypadków.³ Alergia na skorupiaki występuje częściej niż alergia na ryby, a w jej obrębie reakcje na skorupiaki pancerzowe (kraby, krewetki, homary) są częstsze niż na mięczaki.⁴ Odsetek przypadków alergii na skorupiaki jest generalnie wyższy wśród populacji azjatyckiej.⁵

Przewidywanie przebiegu alergii na skorupiaki

Trwałość alergii

Alergia na skorupiaki jest powszechnie uważana za dolegliwość trwającą przez całe życie.⁶⁷⁸ Większość pacjentów z tym typem alergii nie wyrasta z niej, co oznacza konieczność długoterminowego zarządzania chorobą.⁹ Jednak istnieją pewne obiecujące dane sugerujące możliwość ustąpienia reakcji alergicznych w niektórych przypadkach. Badania wykazały, że u 46% osób z alergią na krewetki dolegliwość ta ustąpiła w ciągu 10 lat.¹⁰ Ogólnie rzecz biorąc, niewielki odsetek pacjentów zgłasza całkowite ustąpienie objawów alergii na skorupiaki.¹¹

Wiek rozpoznania

Interesującym aspektem prognostycznym alergii na skorupiaki jest fakt, że średni wiek diagnozy wynosi około 50,2 lat.¹² Jest to stosunkowo późny wiek rozpoznania w porównaniu do innych alergii pokarmowych, co może wskazywać na odmienne mechanizmy rozwoju uczulenia lub późniejsze narażenie na alergen.

Reakcje krzyżowe z innymi pokarmami

Około jednej trzeciej pacjentów z alergią na owoce morza doświadcza reakcji na więcej niż jeden rodzaj owoców morza.¹³ Może to wskazywać na istnienie reakcji krzyżowych pomiędzy różnymi gatunkami skorupiaków lub innych owoców morza, co pogarsza rokowanie w kontekście możliwości rozszerzenia diety.

Ciężkość reakcji alergicznych i rokowanie

Anafilaksja

Najpoważniejszym powikłaniem alergii na skorupiaki jest wstrząs anafilaktyczny, który stanowi ciężką reakcję alergiczną mogącą zagrażać życiu.¹⁴ Prawdopodobieństwo wystąpienia anafilaksji u pacjentów z alergią na skorupiaki wynosi około 32% i nie różni się istotnie statystycznie od prawdopodobieństwa u osób z alergią na ryby.¹⁵ Warto zauważyć, że w Stanach Zjednoczonych produkty spożywcze są najczęstszą przyczyną anafilaksji (29,9%), a skorupiaki zajmują trzecie miejsce wśród pokarmów wywołujących reakcje anafilaktyczne (16,1%), po orzeszkach ziemnych (23,1%) i orzechach drzewnych (21,6%).¹⁶

Czas wystąpienia ciężkich reakcji

Badania wykazały, że ciężkie reakcje alergiczne na skorupiaki są 12,9 razy bardziej prawdopodobne w pierwszej godzinie po spożyciu w porównaniu z reakcjami o lżejszym przebiegu.¹⁷ Ta informacja ma istotne znaczenie prognostyczne i kliniczne, ponieważ wskazuje na kluczowy okres obserwacji po przypadkowym spożyciu alergenu.

Wpływ alergii na skorupiaki na życie zawodowe

Alergia na skorupiaki może mieć istotny wpływ na zdolność do pracy, szczególnie w zawodach związanych z przetwórstwem żywności. W przypadku zawodowych, zwłaszcza ogólnoustrojowych reakcji alergicznych na owoce morza, trudno jest bezpiecznie uniknąć narażenia na te silne alergeny. W wielu przypadkach nieunikniona staje się reorientacja zawodowa.¹⁸

Występowanie skorupiaków na ogólnym rynku pracy stanowi podstawę do stworzenia lub podtrzymania choroby związanej z pracą. Chociaż narażenie zawodowe na skorupiaki jest niezwykle ograniczone i może być dobrze zdefiniowane, alergia nabyta podczas tego narażenia zawodowego może manifestować się nie tylko na skórze, ale także w innych układach narządów jako choroba ogólnoustrojowa.¹⁹

Wpływ alergii na skorupiaki na zdolność do pracy może być oceniany jako łagodny, a w uzasadnionych indywidualnych przypadkach jako umiarkowany do ciężkiego.²⁰ W wielu krajach, w tym w Niemczech, istnieją specjalne procedury oceny takich przypadków w kontekście chorób zawodowych (np. BK nr 5101 w niemieckim rozporządzeniu o chorobach zawodowych).²¹

Perspektywy leczenia i rokowanie długoterminowe

Obecne podejście terapeutyczne

Obecnie nie istnieje przyczynowa terapia alergii na skorupiaki, a jedynym skutecznym postępowaniem pozostaje ścisłe i dożywotnie unikanie alergenów.²² Pacjentom zaleca się unikanie skorupiaków w diecie oraz stosowanie leków ratunkowych w przypadku wystąpienia epizodu alergicznego.²³ Osoby, które chciałyby dowiedzieć się, czy ich alergia ustąpiła, powinny skonsultować się z alergologiem. W międzyczasie powinny unikać pokarmów mogących wywoływać alergię oraz zawsze mieć przy sobie adrenalinę w przypadku przypadkowego spożycia.²⁴

Mimo wysokiej częstości występowania alergii na skorupiaki, aktywne opcje leczenia nie są jeszcze dostępne.²⁵ Aktualne metody diagnostyczne obejmują testy skórne na bazie ekstraktów alergenowych oraz pomiar specyficznych przeciwciał IgE, a postępowanie kliniczne polega na unikaniu pokarmów i stosowaniu w razie potrzeby autostrzykawki z adrenaliną w przypadku wystąpienia ciężkich reakcji alergicznych.²⁶

Obiecujące kierunki rozwoju terapii

Alergenowo swoista immunoterapia (AIT) stanowi nowatorską strategię desensytyzacji pacjentów z alergią pokarmową i przywrócenia tolerancji na pokarm. Choć skuteczność immunoterapii doustnej (OIT), podjęzykowej (SLIT) i naskórkowej (EPIT) w przypadku alergii na orzeszki ziemne, mleko krowie i jajka została udowodniona, te nowe metody leczenia nie zostały jeszcze przetestowane u pacjentów z alergią na skorupiaki.²⁷

Aktualne podejście do AIT polega na podawaniu stopniowo zwiększających się dawek ekstraktów alergenów lub rekombinowanych alergenów w celu wywołania desensytyzacji, a najlepiej tolerancji. Wartości immunoterapeutyczne niektórych preparatów (np. MEM49 i MED171) są podkreślane przez ich zdolność do indukcji przeciwciał IgG o zwalidowanych funkcjach hamujących.²⁸

Wady konwencjonalnej AIT, w tym zbyt częste i przedłużone wizyty kliniczne w celu ukończenia terapii, nawrót alergii po przerwaniu leczenia oraz brak odpowiedzi na AIT, stanowią dodatkowe bariery w opracowywaniu immunoterapii specyficznej dla alergii na skorupiaki.²⁹ Chociaż nowe podejścia do AIT są wciąż na etapie eksperymentalnym, oferują ekscytujące i obiecujące strategie dla badań klinicznych nad immunoterapią alergii na skorupiaki.³⁰

Potrzeba lepszych metod diagnostycznych

Istnieje pilna potrzeba wprowadzenia bardziej specyficznych metod diagnostycznych, a także skutecznych i bezpiecznych terapii dla pacjentów z alergią na skorupiaki.³¹ Wiedza uzyskana na temat identyfikacji i definiowania cech immunomolekularnych różnych alergenów skorupiaków w ciągu ostatnich dwóch dekad stopniowo przekłada się na projektowanie nowych opcji diagnostycznych i terapeutycznych.³²

Sugeruje się etapowe i kombinacyjne strategie diagnostyczne, aby postawić precyzyjną diagnozę alergii na skorupiaki. Dla pacjentów z niejednoznacznymi wynikami przy użyciu tradycyjnych testów standardowych, można zamówić testy drugiego etapu, które obejmują diagnostykę molekularną (CRD) i testy krzyżowego wiązania IgE. Próby prowokacyjne z pokarmem oferowane są tylko wtedy, gdy wyniki są niepewne, aby zminimalizować ryzyko dla pacjentów.³³

Podsumowanie prognozy

Alergia na skorupiaki jest dolegliwością bardzo dobrze poddającą się zarządzaniu. Poprzez unikanie skorupiaków i zachowanie odpowiednich środków ostrożności, pacjenci mogą prowadzić aktywne, zdrowe życie.³⁴ Chociaż alergia ta zazwyczaj utrzymuje się przez całe życie, perspektywa „wyleczenia” alergii na skorupiaki jest w zasięgu, dzięki postępom w immunoterapii i lepszemu zrozumieniu mechanizmów molekularnych.³⁵

Identyfikacja i walidacja optymalnego algorytmu diagnostycznego dla alergii na skorupiaki są bardzo potrzebne, aby umożliwić dokładniejsze prognozowanie przebiegu choroby i opracowanie skuteczniejszych metod leczenia.³⁶ Obecne rokowanie dla pacjentów z alergią na skorupiaki jest dobre pod warunkiem ścisłego przestrzegania diety eliminacyjnej i posiadania planu działania na wypadek przypadkowego narażenia na alergen.

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Materiały źródłowe

#1 Shellfish allergy: What symptoms you should watch for and how itâs diagnosed and treatedmenu iconsearch iconsubscribe iconsearch iconarrow up right icon
https://health.ucdavis.edu/blog/good-food/shellfish-allergy-what-symptoms-you-should-watch-for-and-how-its-diagnosed-and-treated/2024/09
Shellfish is the leading cause of self-reported food allergy in U.S. adults. It affects about 3% of adults and just over 1% of children. […] Most people do not outgrow shellfish allergies. In general, a small percentage of patients report outgrowing their allergy. […] People who would like to know if they their allergy has resolved should see an allergist for further review. In the meantime, they should avoid the food that may be causing an allergy. They should also keep epinephrine on hand in the case of an accidental ingestion.
#2 Overcoming Shellfish Allergy: How Far Have We Come?
https://www.mdpi.com/1422-0067/21/6/2234
Shellfish allergy caused by undesirable immunological responses upon ingestion of crustaceans and mollusks is a common cause of food allergy, especially in the Asia-Pacific region. […] While the prevalence of shellfish allergy is increasing, the mainstay of clinical diagnosis for these patients includes extract-based skin prick test and specific IgE measurement while clinical management consists of food avoidance and as-needed use of adrenaline autoinjector should they develop severe allergic reactions. […] There is a pressing need to introduce more specific diagnostic methods, as well as effective and safe therapies for patients with shellfish allergy. […] Knowledge gained on the identifications and defining the immuno-molecular features of different shellfish allergens over the past two decades have gradually translated into the design of new diagnostic and treatment options for shellfish allergy.
#3 Adult seafood allergy in the Texas Medical Center: A 13-year experience
https://pmc.ncbi.nlm.nih.gov/articles/PMC3390121/
There is a paucity of data regarding prevalence and characteristics of adult seafood allergy in United States cohorts. […] The likelihood of having anaphylaxis (32%) was not statistically different between shellfish- and fish-allergic subjects. […] The percentage of seafood allergy in this adult allergy referral population was 3.08%. […] Seafood allergy is thought to be lifelong. […] The average age of diagnosis was 50.2 years. […] Shellfish allergy was more common than fish and crustacean allergy was more common than mollusk. […] Approximately one-third of seafood-allergic patients had reactions to more than one seafood. […] Shellfish- and fish-allergic subjects had the same likelihood of having a severe reaction or anaphylaxis. […] Severe reactions were 12.9 times more likely to occur within the 1st hour of ingestion compared with nonsevere reactions.
#4 Adult seafood allergy in the Texas Medical Center: A 13-year experience
https://pmc.ncbi.nlm.nih.gov/articles/PMC3390121/
There is a paucity of data regarding prevalence and characteristics of adult seafood allergy in United States cohorts. […] The likelihood of having anaphylaxis (32%) was not statistically different between shellfish- and fish-allergic subjects. […] The percentage of seafood allergy in this adult allergy referral population was 3.08%. […] Seafood allergy is thought to be lifelong. […] The average age of diagnosis was 50.2 years. […] Shellfish allergy was more common than fish and crustacean allergy was more common than mollusk. […] Approximately one-third of seafood-allergic patients had reactions to more than one seafood. […] Shellfish- and fish-allergic subjects had the same likelihood of having a severe reaction or anaphylaxis. […] Severe reactions were 12.9 times more likely to occur within the 1st hour of ingestion compared with nonsevere reactions.
#5 Overcoming Shellfish Allergy: How Far Have We Come?
https://www.mdpi.com/1422-0067/21/6/2234
The prospect of a âcureâ for shellfish allergy is within reach. […] Allergy to shellfish usually persists throughout life. […] Food represents the top cause of anaphylaxis at 29.9% in the United States with shellfish being the third most common food eliciting anaphylactic reactions (16.1%) following peanut (23.1%) and tree nuts (21.6%). […] The prevalence of shellfish allergy is generally higher among Asians. […] Most epidemiological studies reported allergy to crustaceans (shrimp, crab and lobster) but not mollusks. […] The delineation of molecular characteristics of shellfish allergens over the past decade paves the way for the design of different immunotherapeutic strategies to treat this prevalent allergic disease. […] In spite of the high prevalence of shellfish allergy, active treatment options are not yet available.
#6 Adult seafood allergy in the Texas Medical Center: A 13-year experience
https://pmc.ncbi.nlm.nih.gov/articles/PMC3390121/
There is a paucity of data regarding prevalence and characteristics of adult seafood allergy in United States cohorts. […] The likelihood of having anaphylaxis (32%) was not statistically different between shellfish- and fish-allergic subjects. […] The percentage of seafood allergy in this adult allergy referral population was 3.08%. […] Seafood allergy is thought to be lifelong. […] The average age of diagnosis was 50.2 years. […] Shellfish allergy was more common than fish and crustacean allergy was more common than mollusk. […] Approximately one-third of seafood-allergic patients had reactions to more than one seafood. […] Shellfish- and fish-allergic subjects had the same likelihood of having a severe reaction or anaphylaxis. […] Severe reactions were 12.9 times more likely to occur within the 1st hour of ingestion compared with nonsevere reactions.
#7 Shellfish Allergy: Causes, Symptoms, Diagnosis & Treatment
https://my.clevelandclinic.org/health/diseases/11319-allergies-shellfish
A shellfish allergy is very manageable. By avoiding shellfish and taking some precautions, you can enjoy an active, healthy life. […] The most life-threatening complication of a shellfish allergy is anaphylactic shock, a severe type of allergic reaction. […] Most people who have a shellfish allergy have it for life. It doesn’t go away over time.
#8 Overcoming Shellfish Allergy: How Far Have We Come?
https://www.mdpi.com/1422-0067/21/6/2234
The prospect of a âcureâ for shellfish allergy is within reach. […] Allergy to shellfish usually persists throughout life. […] Food represents the top cause of anaphylaxis at 29.9% in the United States with shellfish being the third most common food eliciting anaphylactic reactions (16.1%) following peanut (23.1%) and tree nuts (21.6%). […] The prevalence of shellfish allergy is generally higher among Asians. […] Most epidemiological studies reported allergy to crustaceans (shrimp, crab and lobster) but not mollusks. […] The delineation of molecular characteristics of shellfish allergens over the past decade paves the way for the design of different immunotherapeutic strategies to treat this prevalent allergic disease. […] In spite of the high prevalence of shellfish allergy, active treatment options are not yet available.
#9 Shellfish Allergy: Causes, Symptoms, Diagnosis & Treatment
https://my.clevelandclinic.org/health/diseases/11319-allergies-shellfish
A shellfish allergy is very manageable. By avoiding shellfish and taking some precautions, you can enjoy an active, healthy life. […] The most life-threatening complication of a shellfish allergy is anaphylactic shock, a severe type of allergic reaction. […] Most people who have a shellfish allergy have it for life. It doesn’t go away over time.
#10 What you need to know about the latest in shellfish allergy diagnosis and treatment
https://health.ucdavis.edu/news/headlines/what-you-need-to-know-about-the-latest-in-shellfish-allergy-diagnosis-and-treatment/2022/10
Studies show that 46% of people allergic to shrimp had their allergy resolved in 10 years. […] Patients are advised to avoid shellfish in their diet and take rescue medication in case of an allergic episode. […] Clearly, identification and validation of the optimal diagnostic algorithm for shellfish allergy are much needed. […] So, we suggest stepwise and combinatorial diagnostic strategies to conclude the diagnosis of shellfish allergy. […] For patients with inconclusive results using traditional standard testing, second-step tests can be ordered, which include CRD and IgE crosslinking tests. […] Food challenges are offered only when the results are uncertain to minimize risk to patients.
#11 Shellfish allergy: What symptoms you should watch for and how itâs diagnosed and treatedmenu iconsearch iconsubscribe iconsearch iconarrow up right icon
https://health.ucdavis.edu/blog/good-food/shellfish-allergy-what-symptoms-you-should-watch-for-and-how-its-diagnosed-and-treated/2024/09
Shellfish is the leading cause of self-reported food allergy in U.S. adults. It affects about 3% of adults and just over 1% of children. […] Most people do not outgrow shellfish allergies. In general, a small percentage of patients report outgrowing their allergy. […] People who would like to know if they their allergy has resolved should see an allergist for further review. In the meantime, they should avoid the food that may be causing an allergy. They should also keep epinephrine on hand in the case of an accidental ingestion.
#12 Adult seafood allergy in the Texas Medical Center: A 13-year experience
https://pmc.ncbi.nlm.nih.gov/articles/PMC3390121/
There is a paucity of data regarding prevalence and characteristics of adult seafood allergy in United States cohorts. […] The likelihood of having anaphylaxis (32%) was not statistically different between shellfish- and fish-allergic subjects. […] The percentage of seafood allergy in this adult allergy referral population was 3.08%. […] Seafood allergy is thought to be lifelong. […] The average age of diagnosis was 50.2 years. […] Shellfish allergy was more common than fish and crustacean allergy was more common than mollusk. […] Approximately one-third of seafood-allergic patients had reactions to more than one seafood. […] Shellfish- and fish-allergic subjects had the same likelihood of having a severe reaction or anaphylaxis. […] Severe reactions were 12.9 times more likely to occur within the 1st hour of ingestion compared with nonsevere reactions.
#13 Adult seafood allergy in the Texas Medical Center: A 13-year experience
https://pmc.ncbi.nlm.nih.gov/articles/PMC3390121/
There is a paucity of data regarding prevalence and characteristics of adult seafood allergy in United States cohorts. […] The likelihood of having anaphylaxis (32%) was not statistically different between shellfish- and fish-allergic subjects. […] The percentage of seafood allergy in this adult allergy referral population was 3.08%. […] Seafood allergy is thought to be lifelong. […] The average age of diagnosis was 50.2 years. […] Shellfish allergy was more common than fish and crustacean allergy was more common than mollusk. […] Approximately one-third of seafood-allergic patients had reactions to more than one seafood. […] Shellfish- and fish-allergic subjects had the same likelihood of having a severe reaction or anaphylaxis. […] Severe reactions were 12.9 times more likely to occur within the 1st hour of ingestion compared with nonsevere reactions.
#14 Shellfish Allergy: Causes, Symptoms, Diagnosis & Treatment
https://my.clevelandclinic.org/health/diseases/11319-allergies-shellfish
A shellfish allergy is very manageable. By avoiding shellfish and taking some precautions, you can enjoy an active, healthy life. […] The most life-threatening complication of a shellfish allergy is anaphylactic shock, a severe type of allergic reaction. […] Most people who have a shellfish allergy have it for life. It doesn’t go away over time.
#15 Adult seafood allergy in the Texas Medical Center: A 13-year experience
https://pmc.ncbi.nlm.nih.gov/articles/PMC3390121/
There is a paucity of data regarding prevalence and characteristics of adult seafood allergy in United States cohorts. […] The likelihood of having anaphylaxis (32%) was not statistically different between shellfish- and fish-allergic subjects. […] The percentage of seafood allergy in this adult allergy referral population was 3.08%. […] Seafood allergy is thought to be lifelong. […] The average age of diagnosis was 50.2 years. […] Shellfish allergy was more common than fish and crustacean allergy was more common than mollusk. […] Approximately one-third of seafood-allergic patients had reactions to more than one seafood. […] Shellfish- and fish-allergic subjects had the same likelihood of having a severe reaction or anaphylaxis. […] Severe reactions were 12.9 times more likely to occur within the 1st hour of ingestion compared with nonsevere reactions.
#16 Overcoming Shellfish Allergy: How Far Have We Come?
https://www.mdpi.com/1422-0067/21/6/2234
The prospect of a âcureâ for shellfish allergy is within reach. […] Allergy to shellfish usually persists throughout life. […] Food represents the top cause of anaphylaxis at 29.9% in the United States with shellfish being the third most common food eliciting anaphylactic reactions (16.1%) following peanut (23.1%) and tree nuts (21.6%). […] The prevalence of shellfish allergy is generally higher among Asians. […] Most epidemiological studies reported allergy to crustaceans (shrimp, crab and lobster) but not mollusks. […] The delineation of molecular characteristics of shellfish allergens over the past decade paves the way for the design of different immunotherapeutic strategies to treat this prevalent allergic disease. […] In spite of the high prevalence of shellfish allergy, active treatment options are not yet available.
#17 Adult seafood allergy in the Texas Medical Center: A 13-year experience
https://pmc.ncbi.nlm.nih.gov/articles/PMC3390121/
There is a paucity of data regarding prevalence and characteristics of adult seafood allergy in United States cohorts. […] The likelihood of having anaphylaxis (32%) was not statistically different between shellfish- and fish-allergic subjects. […] The percentage of seafood allergy in this adult allergy referral population was 3.08%. […] Seafood allergy is thought to be lifelong. […] The average age of diagnosis was 50.2 years. […] Shellfish allergy was more common than fish and crustacean allergy was more common than mollusk. […] Approximately one-third of seafood-allergic patients had reactions to more than one seafood. […] Shellfish- and fish-allergic subjects had the same likelihood of having a severe reaction or anaphylaxis. […] Severe reactions were 12.9 times more likely to occur within the 1st hour of ingestion compared with nonsevere reactions.
#18 Assessment of the effects of a work-related allergy to seafood on the reduction of earning capacity in the context of BK No. 5101
https://pmc.ncbi.nlm.nih.gov/articles/PMC7814778/
Fish, crustaceans, and mollusks are among the most potent allergenic foods of animal origin and are thus important triggers of work-related immediate-food allergies. […] There is no causal therapy of seafood allergy, only the strict and lifelong avoidance of allergens remains. […] For the estimation of MdE in the general labor market, the impact of a seafood allergy can therefore be assessed, depending on its clinical severity, as generally mild to severe in justified individual cases. […] In the case of occupational, especially systemic allergic reactions to seafood, it is difficult to safely avoid exposure to the potent allergens. In many cases, occupational reorientation is inevitable. […] The assessment procedure may include a contextual review primarily on the question of the presence of an occupational disease (BK (German fr Berufskrankheit)) according to No. 5101 of the Annex to the German Ordinance on Occupational Diseases.
#19 Assessment of the effects of a work-related allergy to seafood on the reduction of earning capacity in the context of BK No. 5101
https://pmc.ncbi.nlm.nih.gov/articles/PMC7814778/
The occurrence of seafood in the general labor market provides the basis for creating or sustaining a work-related disease. […] Thus, although the occupational exposure to seafood is extremely limited and can be well defined, an allergy acquired during this occupational exposure may manifest itself not only onto the skin but also onto other organ systems as a systemic disease. […] Impact of an allergy to seafood: mild, in justified individual cases moderate to severe. […] From multi-organ involvement onwards, the involvement of skin and respiratory tract organs can result in the combined presence of a BK No. 5101 and BK No. 4301 that are to be considered as a single insurance case under the aspect of a systemic disease.
#20 Assessment of the effects of a work-related allergy to seafood on the reduction of earning capacity in the context of BK No. 5101
https://pmc.ncbi.nlm.nih.gov/articles/PMC7814778/
The occurrence of seafood in the general labor market provides the basis for creating or sustaining a work-related disease. […] Thus, although the occupational exposure to seafood is extremely limited and can be well defined, an allergy acquired during this occupational exposure may manifest itself not only onto the skin but also onto other organ systems as a systemic disease. […] Impact of an allergy to seafood: mild, in justified individual cases moderate to severe. […] From multi-organ involvement onwards, the involvement of skin and respiratory tract organs can result in the combined presence of a BK No. 5101 and BK No. 4301 that are to be considered as a single insurance case under the aspect of a systemic disease.
#21 Assessment of the effects of a work-related allergy to seafood on the reduction of earning capacity in the context of BK No. 5101
https://pmc.ncbi.nlm.nih.gov/articles/PMC7814778/
Fish, crustaceans, and mollusks are among the most potent allergenic foods of animal origin and are thus important triggers of work-related immediate-food allergies. […] There is no causal therapy of seafood allergy, only the strict and lifelong avoidance of allergens remains. […] For the estimation of MdE in the general labor market, the impact of a seafood allergy can therefore be assessed, depending on its clinical severity, as generally mild to severe in justified individual cases. […] In the case of occupational, especially systemic allergic reactions to seafood, it is difficult to safely avoid exposure to the potent allergens. In many cases, occupational reorientation is inevitable. […] The assessment procedure may include a contextual review primarily on the question of the presence of an occupational disease (BK (German fr Berufskrankheit)) according to No. 5101 of the Annex to the German Ordinance on Occupational Diseases.
#22 Assessment of the effects of a work-related allergy to seafood on the reduction of earning capacity in the context of BK No. 5101
https://pmc.ncbi.nlm.nih.gov/articles/PMC7814778/
Fish, crustaceans, and mollusks are among the most potent allergenic foods of animal origin and are thus important triggers of work-related immediate-food allergies. […] There is no causal therapy of seafood allergy, only the strict and lifelong avoidance of allergens remains. […] For the estimation of MdE in the general labor market, the impact of a seafood allergy can therefore be assessed, depending on its clinical severity, as generally mild to severe in justified individual cases. […] In the case of occupational, especially systemic allergic reactions to seafood, it is difficult to safely avoid exposure to the potent allergens. In many cases, occupational reorientation is inevitable. […] The assessment procedure may include a contextual review primarily on the question of the presence of an occupational disease (BK (German fr Berufskrankheit)) according to No. 5101 of the Annex to the German Ordinance on Occupational Diseases.
#23 What you need to know about the latest in shellfish allergy diagnosis and treatment
https://health.ucdavis.edu/news/headlines/what-you-need-to-know-about-the-latest-in-shellfish-allergy-diagnosis-and-treatment/2022/10
Studies show that 46% of people allergic to shrimp had their allergy resolved in 10 years. […] Patients are advised to avoid shellfish in their diet and take rescue medication in case of an allergic episode. […] Clearly, identification and validation of the optimal diagnostic algorithm for shellfish allergy are much needed. […] So, we suggest stepwise and combinatorial diagnostic strategies to conclude the diagnosis of shellfish allergy. […] For patients with inconclusive results using traditional standard testing, second-step tests can be ordered, which include CRD and IgE crosslinking tests. […] Food challenges are offered only when the results are uncertain to minimize risk to patients.
#24 Shellfish allergy: What symptoms you should watch for and how itâs diagnosed and treatedmenu iconsearch iconsubscribe iconsearch iconarrow up right icon
https://health.ucdavis.edu/blog/good-food/shellfish-allergy-what-symptoms-you-should-watch-for-and-how-its-diagnosed-and-treated/2024/09
Shellfish is the leading cause of self-reported food allergy in U.S. adults. It affects about 3% of adults and just over 1% of children. […] Most people do not outgrow shellfish allergies. In general, a small percentage of patients report outgrowing their allergy. […] People who would like to know if they their allergy has resolved should see an allergist for further review. In the meantime, they should avoid the food that may be causing an allergy. They should also keep epinephrine on hand in the case of an accidental ingestion.
#25 Overcoming Shellfish Allergy: How Far Have We Come?
https://www.mdpi.com/1422-0067/21/6/2234
The prospect of a âcureâ for shellfish allergy is within reach. […] Allergy to shellfish usually persists throughout life. […] Food represents the top cause of anaphylaxis at 29.9% in the United States with shellfish being the third most common food eliciting anaphylactic reactions (16.1%) following peanut (23.1%) and tree nuts (21.6%). […] The prevalence of shellfish allergy is generally higher among Asians. […] Most epidemiological studies reported allergy to crustaceans (shrimp, crab and lobster) but not mollusks. […] The delineation of molecular characteristics of shellfish allergens over the past decade paves the way for the design of different immunotherapeutic strategies to treat this prevalent allergic disease. […] In spite of the high prevalence of shellfish allergy, active treatment options are not yet available.
#26 Overcoming Shellfish Allergy: How Far Have We Come?
https://www.mdpi.com/1422-0067/21/6/2234
Shellfish allergy caused by undesirable immunological responses upon ingestion of crustaceans and mollusks is a common cause of food allergy, especially in the Asia-Pacific region. […] While the prevalence of shellfish allergy is increasing, the mainstay of clinical diagnosis for these patients includes extract-based skin prick test and specific IgE measurement while clinical management consists of food avoidance and as-needed use of adrenaline autoinjector should they develop severe allergic reactions. […] There is a pressing need to introduce more specific diagnostic methods, as well as effective and safe therapies for patients with shellfish allergy. […] Knowledge gained on the identifications and defining the immuno-molecular features of different shellfish allergens over the past two decades have gradually translated into the design of new diagnostic and treatment options for shellfish allergy.
#27 Overcoming Shellfish Allergy: How Far Have We Come?
https://www.mdpi.com/1422-0067/21/6/2234
Allergen-specific immunotherapy (AIT) represents a novel strategy to desensitize these food-allergic patients and restore their food tolerance. […] Although the effectiveness of oral (OIT), sublingual (SLIT) and epicutaneous (EPIT) immunotherapy for peanut, cowâs milk and egg allergies has been demonstrated, these emerging treatments have not been tested in patients with shellfish allergy. […] The current AIT paradigm involves the administration of gradually increasing amounts of the allergen extracts or the recombinant allergens in an attempt to induce desensitization, and more preferentially, tolerance. […] The immunotherapeutic values of MEM49 and MED171 are thus highlighted by their capacity to induce IgG with validated inhibitory functions. […] The use of shellfish extracts or allergens in AIT for shellfish allergy is currently not in clinical use, and relevant published studies are scarce.
#28 Overcoming Shellfish Allergy: How Far Have We Come?
https://www.mdpi.com/1422-0067/21/6/2234
Allergen-specific immunotherapy (AIT) represents a novel strategy to desensitize these food-allergic patients and restore their food tolerance. […] Although the effectiveness of oral (OIT), sublingual (SLIT) and epicutaneous (EPIT) immunotherapy for peanut, cowâs milk and egg allergies has been demonstrated, these emerging treatments have not been tested in patients with shellfish allergy. […] The current AIT paradigm involves the administration of gradually increasing amounts of the allergen extracts or the recombinant allergens in an attempt to induce desensitization, and more preferentially, tolerance. […] The immunotherapeutic values of MEM49 and MED171 are thus highlighted by their capacity to induce IgG with validated inhibitory functions. […] The use of shellfish extracts or allergens in AIT for shellfish allergy is currently not in clinical use, and relevant published studies are scarce.
#29 Overcoming Shellfish Allergy: How Far Have We Come?
https://www.mdpi.com/1422-0067/21/6/2234
The drawbacks of conventional AIT, including too-frequent and extended clinical visits to complete an AIT, recurrence of allergy after discontinuation of treatment and unresponsiveness to AIT present additional barriers in formulating shellfish allergy-specific immunotherapy. […] Although the novel AIT approaches discussed herein are still at the experimental stages, they provide exciting and promising strategies for clinical trials of AIT for shellfish allergy.
#30 Overcoming Shellfish Allergy: How Far Have We Come?
https://www.mdpi.com/1422-0067/21/6/2234
The drawbacks of conventional AIT, including too-frequent and extended clinical visits to complete an AIT, recurrence of allergy after discontinuation of treatment and unresponsiveness to AIT present additional barriers in formulating shellfish allergy-specific immunotherapy. […] Although the novel AIT approaches discussed herein are still at the experimental stages, they provide exciting and promising strategies for clinical trials of AIT for shellfish allergy.
#31 Overcoming Shellfish Allergy: How Far Have We Come?
https://www.mdpi.com/1422-0067/21/6/2234
Shellfish allergy caused by undesirable immunological responses upon ingestion of crustaceans and mollusks is a common cause of food allergy, especially in the Asia-Pacific region. […] While the prevalence of shellfish allergy is increasing, the mainstay of clinical diagnosis for these patients includes extract-based skin prick test and specific IgE measurement while clinical management consists of food avoidance and as-needed use of adrenaline autoinjector should they develop severe allergic reactions. […] There is a pressing need to introduce more specific diagnostic methods, as well as effective and safe therapies for patients with shellfish allergy. […] Knowledge gained on the identifications and defining the immuno-molecular features of different shellfish allergens over the past two decades have gradually translated into the design of new diagnostic and treatment options for shellfish allergy.
#32 Overcoming Shellfish Allergy: How Far Have We Come?
https://www.mdpi.com/1422-0067/21/6/2234
Shellfish allergy caused by undesirable immunological responses upon ingestion of crustaceans and mollusks is a common cause of food allergy, especially in the Asia-Pacific region. […] While the prevalence of shellfish allergy is increasing, the mainstay of clinical diagnosis for these patients includes extract-based skin prick test and specific IgE measurement while clinical management consists of food avoidance and as-needed use of adrenaline autoinjector should they develop severe allergic reactions. […] There is a pressing need to introduce more specific diagnostic methods, as well as effective and safe therapies for patients with shellfish allergy. […] Knowledge gained on the identifications and defining the immuno-molecular features of different shellfish allergens over the past two decades have gradually translated into the design of new diagnostic and treatment options for shellfish allergy.
#33 What you need to know about the latest in shellfish allergy diagnosis and treatment
https://health.ucdavis.edu/news/headlines/what-you-need-to-know-about-the-latest-in-shellfish-allergy-diagnosis-and-treatment/2022/10
Studies show that 46% of people allergic to shrimp had their allergy resolved in 10 years. […] Patients are advised to avoid shellfish in their diet and take rescue medication in case of an allergic episode. […] Clearly, identification and validation of the optimal diagnostic algorithm for shellfish allergy are much needed. […] So, we suggest stepwise and combinatorial diagnostic strategies to conclude the diagnosis of shellfish allergy. […] For patients with inconclusive results using traditional standard testing, second-step tests can be ordered, which include CRD and IgE crosslinking tests. […] Food challenges are offered only when the results are uncertain to minimize risk to patients.
#34 Shellfish Allergy: Causes, Symptoms, Diagnosis & Treatment
https://my.clevelandclinic.org/health/diseases/11319-allergies-shellfish
A shellfish allergy is very manageable. By avoiding shellfish and taking some precautions, you can enjoy an active, healthy life. […] The most life-threatening complication of a shellfish allergy is anaphylactic shock, a severe type of allergic reaction. […] Most people who have a shellfish allergy have it for life. It doesn’t go away over time.
#35 Overcoming Shellfish Allergy: How Far Have We Come?
https://www.mdpi.com/1422-0067/21/6/2234
The prospect of a âcureâ for shellfish allergy is within reach. […] Allergy to shellfish usually persists throughout life. […] Food represents the top cause of anaphylaxis at 29.9% in the United States with shellfish being the third most common food eliciting anaphylactic reactions (16.1%) following peanut (23.1%) and tree nuts (21.6%). […] The prevalence of shellfish allergy is generally higher among Asians. […] Most epidemiological studies reported allergy to crustaceans (shrimp, crab and lobster) but not mollusks. […] The delineation of molecular characteristics of shellfish allergens over the past decade paves the way for the design of different immunotherapeutic strategies to treat this prevalent allergic disease. […] In spite of the high prevalence of shellfish allergy, active treatment options are not yet available.
#36 What you need to know about the latest in shellfish allergy diagnosis and treatment
https://health.ucdavis.edu/news/headlines/what-you-need-to-know-about-the-latest-in-shellfish-allergy-diagnosis-and-treatment/2022/10
Studies show that 46% of people allergic to shrimp had their allergy resolved in 10 years. […] Patients are advised to avoid shellfish in their diet and take rescue medication in case of an allergic episode. […] Clearly, identification and validation of the optimal diagnostic algorithm for shellfish allergy are much needed. […] So, we suggest stepwise and combinatorial diagnostic strategies to conclude the diagnosis of shellfish allergy. […] For patients with inconclusive results using traditional standard testing, second-step tests can be ordered, which include CRD and IgE crosslinking tests. […] Food challenges are offered only when the results are uncertain to minimize risk to patients.