Anisakis simplex Hypersensitivity Is Associated with Chronic Urticaria in Endemic AreasVentura M.T.a · Napolitano S.a · Menga R.a · Cecere R.a · Asero R.b
aDepartment of Internal Medicine, Immunology and Infectious Diseases (MIDIM), University of Bari Medical School, Policlinico, Bari, and bAmbulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Italy
Do you have an account?
- Rent for 48h to view
- Buy Cloud Access for unlimited viewing via different devices
- Synchronizing in the ReadCube Cloud
- Printing and saving restrictions apply
Rental: USD 8.50
Cloud: USD 20.00
Article / Publication Details
Background: Chronic urticaria (CU) may affect up to 1% of the general population. Anisakis simplex hypersensitivity is frequent in areas where raw fish is consumed and A. simplex allergy represents a relevant cause of acute urticaria. We assessed the possible association between CU and A. simplex sensitization in an area where marinated fish is very frequently eaten. Methods: A thorough history of CU was sought in 919 adults seen at the Allergy Center, Bari. CU patients and 187 controls underwent skin-prick testing with a commercial extract of A. simplex, and reactors were recommended a 6-month raw-fish-free diet regimen. Responders were followed after a further 3 months. Results: Of 919 subjects, 213 (23%) met the criteria for CU and 106/213 (49.7%) were sensitized to A. simplex with a significant difference between patients aged >65 or <65 years (56 vs. 41%, respectively; p < 0.05). All patients hypersensitive to A. simplex were regular consumers of marinated fish. In a control population without CU, the prevalence of A. simplex sensitization was 16% (p < 0.001). The 6-month diet regimen led to the disappearance of urticaria in 82/106 cases (77%) versus 1/42 (2%) subjects who did not change their dietary habits (p < 0.001). All nonresponders were sensitized to house-dust mites. Of 75 responders who were followed-up after 3 months, CU relapsed in 88% of those who had reintroduced raw fish versus 14% of those who were still on the diet (p < 0.001). Conclusion: In areas where raw or marinated fish is frequently eaten, A. simplex hypersensitivity is a frequent cause of CU.
© 2012 S. Karger AG, Basel
- Greaves MW: Chronic urticaria. J Allergy Clin Immunol 2000;105:664–672.
- Greaves MW: Chronic urticaria. N Engl J Med 1995;332:1767–1772.
- Grattan CE: Autoimmune urticaria. Immunol Allergy Clin North Am 2004;24:163–181.
- Kaplan AP: Chronic urticaria and angioedema. N Engl J Med 2002;346:175–179.
- Buendia E: Anisakis, anisakidosis, and allergy to Anisakis. Allergy 1997;52:481–482.
- Daschner A, Pascual CY: Anisakis simplex: sensitization and clinical allergy. Curr Opin Allergy Clin Immunol 2005;5:281–285.
- Audicana M, Garcia M, Del Pozo MD, Diez J, Munoz D, Fernandez E, et al: Clinical manifestations of allergy to Anisakis simplex. Allergy 2000;55(suppl 59):28–33.
- Zuberbier T, Asero R, Bindslev-Jensen C, Canonica GW, Church MK, et al: EAACI/GA(2)LEN/EDF/WAO guideline: definition, classification and diagnosis of urticaria. Allergy 2009;64:1417–1426.
- Daschner A, De Frutos C, Valls A, Vega F: Anisakis simplex sensitization-associated urticaria: short-lived immediate type or prolonged acute urticaria. Arch Dermatol Res 2010;302:625–629.
- Daschner A, Pascual CY: Anisakis simplex: sensitization and clinical allergy. Curr Opin Allergy Clin Immunol 2005;5:281–285
- Daschner A, Vega de la Osada F, Pascual CY: Allergy and parasites reevaluated: wide-scale induction of chronic urticaria by the ubiquitous fish-nematode Anisakis simplex in an endemic region. Allergol Immunopathol 2005;33:31–37.
López-Sáez MP, Zubeldia JM, Caloto M, Olalde S, Pelta R, Rubio M, Baeza ML: Is Anisakis simplex responsible for chronic urticaria? Allergy Asthma Proc 2003;24:339–345.
- AAITO/IFIACI Anisakis Consortium. Anisakis hypersensitivity in Italy: prevalence and clinical studies. A multicenter study. Allergy 2011;66:1563–1569.
Sub-Committee on Skin Tests of the European Academy of Allergology and Clinical Immunology: Skin tests used in type I allergy testing. Pos Paper. Allergy 1989:44(suppl 10):51–59.
- Ventura MT, Gelardi M, D’Amato A, Buquicchio R, Tummolo R, Misciagna G, Canonica GW, Passalacqua G: Clinical and cytological characteristics of allergic rhinitis in elderly patients. Ann Allergy Asthma Immunol 2012;108:141–144.
- Polimeno L, Loiacono M, Pesetti B, Mallamaci R, Mastrodonato M, Azzarone A, Annoscia E, Gatti F, Amoruso A, Ventura MT: Anisakiasis, an underestimated infection: effect on intestinal permeability of Anisakis simplex-sensitized patients. Foodborne Pathog Dis 2010;7:809–814.
- Daschner A, De Frutos C, Valls A, Vega de la Osada F: Different clinical presentation of Anisakis simplex-associated urticaria is dependent on the frequency of raw fish intake. Allergol Immunopathol 2010;38:166–167.
Article / Publication Details
Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.