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Vol. 158, No. 3, 2012
Issue release date: June 2012
Int Arch Allergy Immunol 2012;158:232–240

Anisakis simplex Recombinant Allergens Increase Diagnosis Specificity Preserving High Sensitivity

Caballero M.L. · Umpierrez A. · Perez-Piñar T. · Moneo I. · de Burgos C. · Asturias J.A. · Rodríguez-Pérez R.
Departments of aImmunology, bAllergy and cClinical Epidemiology, Hospital Carlos III, Madrid, and dBial-Arístegui Research and Development Department, Bilbao, Spain

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Background: So far, the frequency of Anisakis simplex-specific IgE antibodies has been determined by skin prick tests (SPTs) and the ImmunoCAP system. These commercial methods have good sensitivity, but their specificity is poor because they use complete parasite extracts. Our aim was to determine the frequency of sensitization to A. simplex using recombinant Ani s 1, Ani s 3, Ani s 5, Ani s 9 and Ani s 10 and to evaluate these allergens for diagnosis, comparing their performance with the commercial methods. Patients and Methods: We conducted a descriptive, cross-sectional validation study performed in an allergy outpatient hospital clinic. Patients without fish-related allergy (tolerant patients, n = 99), and A. simplex-allergic patients (n = 35) were studied by SPTs, ImmunoCAP assays and detection of specific IgE to A. simplex recombinant allergens by dot blotting. Results: SPTs and ImmunoCAP assays were positive in 18 and 17% of tolerant patients, respectively. All A. simplex-allergic patients had positive SPTs and ImmunoCAP assays. Specific IgE against at least one of the A. simplex recombinant allergens tested was detected in 15% of sera from tolerant patients and in 100% of sera from A. simplex-allergic patients. Detection of at least one A. simplex recombinant allergen by dot blotting and ImmunoCAP assay using complete extract showed a diagnostic sensitivity of 100% with both methods. However, the specificity of dot blotting with A. simplex recombinant allergens was higher compared with ImmunoCAP (84.85 vs. 82.83%). Conclusions: There are 15% of tolerant patients with specific IgE against important A. simplex allergens. The recombinant allergens studied here increase the specificity of A. simplex diagnosis while keeping the highest sensitivity. A. simplex recombinant allergens should be included with A. simplex allergy diagnostic tests to improve their specificity.

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  1. Ishikura H, Kikuchi K, Nagasawa K, Ooiwa T, Takamiya H, Sato N, Sugane K: Anisakidae and Anisakidosis. Prog Clin Parasitol 1993;3:43–102.
  2. Del Pozo MD, Audícana M, Diez JM, Munoz D, Ansotegui IJ, Fernández E, García M, Etxenagusia M, Moneo I, Fernández de Corres L: Anisakis simplex, a relevant etiologic factor in acute urticaria. Allergy 1997;52:576–579.
  3. Audicana MT, Fernandez de Corres L, Munoz D, Fernandez E, Navarro JA, del Pozo MD: Recurrent anaphylaxis caused by Anisakis simplex parasitizing fish. J Allergy Clin Immunol 1996;96:558–560.
  4. Bousquet J, Anto JM, Bachert C, Bousquet PJ, Colombo P, Crameri R, Daëron M, Fokkens W, Leynaert B, Lahoz C, Maurer M, Passalacqua G, Valenta R, van Hage M, Van Ree R: Factors responsible for differences between asymptomatic subjects and patients presenting an IgE sensitization to allergens A GA2LEN project. Allergy 2006;61:671–680.
  5. Lopez-Saez MP, Zubeldia JM, Matheu V, Gracia MT, De Barrio M, Tornero P, Herrero, T Rubio M, Baeza ML: Sensitization to Anisakis simplex: prevalence in an allergy outpatient clinic of Madrid. Rev Esp Alergol Inmunol Clin 1999;14:23–29.
  6. Fernandez de Corres L, Del Pozo MD, Aizpuru F: Prevalence of sensitization to Anisakis simplex in three Spanish areas, regarding the rates of fish consumption. Relevance of Anisakis simplex allergy. Alergol Inmunol Clin 2001;16:337–346.
  7. Pascual CY, Crespo JF, San Martin S, Ornia N, Ortega N, Caballero T, Muñoz-Pereira M, Martin-Esteban M: Cross-reactivity between IgE-binding proteins from Anisakis, German cockroach, and chironomids. Allergy 1997;52:514–520.
  8. Johansson E, Aponno M, Lundberg M, van Hage-Hamsten M:Allergenic cross-reactivity between the nematode Anisakis simplex and the dust mites Acarus siro, Lepidoglyphus destructor, Tyrophagus putrescentiae, and Dermatophagoides pteronyssinus. Allergy2001;56:660–666.
  9. Moneo I, Audicana MT, Alday E, Curiel G, del Pozo MD, Garcia M: Periodate treatment of Anisakis simplex allergens. Allergy 1997;52:565–569.
  10. Rodriguez-Perez R, Caballero ML, Gonzalez-Munoz M, Rodriguez-Mahillo A, Moneo I: Cloning and expression of a biologically active Anisakis simplex allergen Ani s 1 in the yeast Pichia pastoris. Mol Biochem Parasitol 2007;154:115–118.
  11. Perez-Perez J, Fernandez-Caldas E, Marañon F, sastre J, Bernal ML, Rodriguez J, Bedate CA: Molecular cloning of paramyosin, a new allergen of Anisakis simplex. Int Arch Allergy Immunol 2000;123:120–129.
  12. Asturias JA, Eraso E, Martinez A: Cloning and high level expression in Escherichia coli of an Anisakis simplex tropomyosin isoform. Mol Biochem Parasitol 2000;108:263–267.
  13. Moneo I, Caballero ML, Gonzalez-Munoz M, Rodriguez-Mahillo AI, Rodriguez-Perez R, Silva A: Isolation of a heat resistant allergen from the fish parasite Anisakis simplex. Parasitol Res 2005;96:285–289.

    External Resources

  14. Kobayashi Y, Ishizaki S, Shimakura K, Nagashima Y, Shiomi K: Molecular cloning and expression of two new allergens from Anisakis simplex. Parasitol Res 2007;100:1233–1241.

    External Resources

  15. Kobayashi Y, Ishizaki S, Shimakura K, Nagashima Y, Shiomi K: Molecular cloning and expression of two new allergens from Anisakis simplex. Parasitol Res 2007;100:1233–1241.

    External Resources

  16. Kobayashi Y, Shimakura K, Ishizaki S, Nagashima Y, Shiomi K: Purification and cDNA cloning of a new heat-stable allergen from Anisakis simplex. Mol Biochem Parasitol 2007;155:138–145.
  17. Rodriguez-Perez R, Moneo I, Rodriguez-Mahillo A, Caballero ML: Cloning and expression of Ani s 9, a new Anisakis simplex allergen. Mol Biochem Parasitol 2008;159:92–97.
  18. Caballero ML, Umpierrez A, Moneo I, Rodriguez-Perez R: Ani s 10, a new Anisakis simplex allergen: cloning and heterologous expression. Parasitol Int 2011;60:209–212.
  19. Kobayashi Y, Ohsaki K, Ikeda K, Kakemoto S, Ishizaki S, Shimakura K, Nagashima Y, Shiomi K: Identification of novel three allergens from Anisakis simplex by chemiluminescent immunoscreening of an expression cDNA library. Parasitol Int 2011;60:144–150.
  20. Rodriguez E, Anadon AM, Garcia-Bodas E, Romaris F, Iglesias R, Garate T, Ubeira FM: Novel sequences and epitopes of diagnostic value derived from the Anisakis simplex Ani s 7 major allergen. Allergy 2008;63:219–225.
  21. Moneo I, Caballero ML, Gomez F, Ortega E, Alonso MJ: Isolation and characterization of a major allergen from the fish parasite Anisakis simplex. J Allergy Clin Immunol 2000;106:177–182.
  22. Malandain H, Giroux F, Cano Y: The influence of carbohydrate structures present in common allergen sources on specific IgE results. Eur Ann Allergy Clin Immunol 2007;39:216–220.
  23. Monsour MJ, Evans AT, Kupper LL: Confidence intervals for post-test probability. Stat Med 1991;10:443–456.
  24. Wöhrl S: The potential of allergen biochips. Recent Pat Inflamm Allergy Drug Discov 2008;2:186–190.

    External Resources

  25. Ferrer M, Sanz ML, Sastre J, Bartra J, del Cuvillo A, Montoro J, Jauregy I, Davila I, Mullol J, Valero A: Molecular diagnosis in allergology: application of the microarray technique. J Investig Allergol Clin Immunol 2009;19:19–24.
  26. Bublin M, Pfister M, Radauer C, Oberhuber C, Bulley S, Dewitt AM, Lidholm J, Reese G, Vieths S, Breiteneder H, Hoffmann-Sommergruber K, Ballmer-Weber BK: Component-resolved diagnosis of kiwifruit allergy with purified natural and recombinant kiwifruit allergens. J Allergy Clin Immunol 2010;125:687–694.
  27. Saarne T, Grönlund H, Kull I, Almqvist C, Wickman M, van Hage M: Cat sensitization identified by recombinant Fel d 1 several years before symptoms results from the BAMSE cohort. Pediatr Allergy Immunol 2010;21:277–283.

    External Resources

  28. Twardosz-Kropfmüller A, Singh MB, Niederberger V, Horak F, Kraft D, Spitzauer S, et al: Association of allergic patients’ phenotypes with IgE reactivity to recombinant pollen marker allergens. Allergy 2010;65:296–303.

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