Fish allergy

Abstract

Parvalbumin is a sarcoplasmic protein and a major fish allergen. It is present in nearly all fish species, and patients with fish allergies often exhibit symptoms after consuming multiple fish species due to cross-reactivity between fish species. Over 10 types of other allergens, including collagen, aldolase, and enolase, have been reported. Scombroid poisoning and Anisakis allergy are important differential diseases. Fish allergy diagnosis cannot be made based on the specific immunoglobulin E antibody alone in many cases. Ultimately, a confirmatory oral food challenge test is required. Fish is a major source of vitamin D. Moreover, increasing the number of fish species that can be ingested is important from a nutritional perspective. Fish stock and canned tuna can be consumed without symptoms in many cases. Redfish, such as tuna, marlin, and skipjack are low in parvalbumin and are good candidates to try first. Thus, immunotherapy using hypoallergenic fish is being attempted as a new treatment.