ALEX2 multiplex examination – results of specific IgE to fish and shrimps in patients suffering from atopic dermatitis

Figures & data

Table 1. Major and relevant minor fish allergenic molecules (WHO/IUIS Allergen Nomenclature Sub-Committee Allergen Nomenclature).

	Allergen	Molecular component	Biochemical name Proten family
Clupeiformes	Herring (Clupea harengus)	Clu h 1*	Parvalbumin
	Pilchard (Sardinops sagax)	Sar sa 1	Parvalbumin
Cypriniformes	Carp (Cyprinus carpio)	Cyp c 1	Parvalbumin
Gadiformes	Atlantic cod (Gadus callarias)	Gad c 1	Parvalbumin
	Atlantic cod (Gadus morhua)	Gad m 1*	Parvalbumin
		Gad m 2*	Enolase
		Gad m 3*	Aldolase
Perciformes	Tuna (Thunnus albacares)	Thu a 1*	Parvalbumin
		Thu a 2	Enolase
		Thu a 3	Aldolase
	Swordfish	Xip g 1*	Parvalbumin
Pleuronectiformes	Megrim, whiff (Lepidorhombus whiffiagonis)	Lep w 1	Parvalbumin
Salmoniformes	Pacific salmon (Oncorhynchus keta)	Onc k 5	Vitellogenin
	Rainbow trout (Oncorhynchus mykiss)	Onc m 1	Parvalbumin
	Salmon (Salmo salar)	Sal s 1*	Parvalbumin
		Sal s 2	Enolase
		Sal s 3	Aldolase
Scorpaeniformes	Redfish (Sebastes marinus)	Seb m 1	Parvalbumin
Scombriformes	Atlantis macrel	Sco s 1*	Parvalbumin
Ascaridia	Herring worm	Ani s 1*	unknown function, similar to Kunitz serine protease inhibitors
Ascaridia	Herring worm	Ani s 3*	Tropomyosin

*Molecular components examined in ALEX 2 Allergy Explorer are shown extra bold.

Table 2. Allergenic molecules present in crustacean species. Registered allergen names are stated in accordance with WHO/IUIS Alergen Nomenclature (WHO/IUIS Allergen Nomenclature Sub-Committee Allergen Nomenclature).

Allergen	Molecular component	Biochemical name Proten family
Flowery crab	Cha f 1	Tropomyosin
North Sea shrimp	Cra c 1	Tropomyosin
	Cra c 2	Arginine kinase
	Cra c 4	Sarcoplasmic calcium-binding protein
	Cra c 5	Myosin, light chain 1
	Cra c 6	Troponin C
	Cra c 8	Triosephosphate isomerase
Chinese mitten crab	Eri s 2	Ovary development-related protein
American lobster	Hom a 1	Tropomyosin
	Hom a 3	Myosin light chain 2
	Hom a 6	Troponin C
White-leg shrimp	Lit v 1	Tropomyosin
	Lit v 2	Arginine kinase
	Lit v 3	Myosin, light chain 2
	Lit v 4	Sarcoplasmic calcium-binding protein
Giant freshwater prawn	Mac r 1	Tropomyosin
King prawn	Mel l 1	Tropomyosin
Greasyback shrimp	Met e 1	Tropomyosin
Northern shrimp	Pan b 1	Tropomyosin
Spiny lobster	Pan s 1	Tropomyosin
Brown shrimp	Pen a 1	Tropomyosin
Indian prawn	Pen i 1	Tropomyosin
Black tiger prawn	Pen m 1*	Tropomyosin
	Pen m 2*	Arginine kinase
	Pen m 3*	Myosin light chain 2
	Pen m 4*	Sarcoplasmic calcium binding protein
	Pen m 6	Troponin C
Narrowclawed crayfish	Pon l 4	Sarcoplasmic calcium-binding protein
	Pon l 17	Troponin I
Blue swimmer crab	Por p 1	Tropomyosin

*Molecular components examined in ALEX 2 Allergy Explorer testing are shown extra bold.

Table 3. Allergenic extracts from fish and shrimp in ALEX2 Allergy Explorer testing.

Allergenic extracts
Clu h	Herring (Clupea harengus)
Gad m	Atlantic cod (Gadus callarias)
Hom g	Lobster
Chi spp	Crab
Lit s	Shrimp
Lol spp	Squid
Myt e	Common mussel
Ost e	Oyster
Pan b	Northern shrimp
Pecc spp.	Scallop
Raj c	Thornback ray
Raj c parvalbumin	Thornback ray
Rud spp	Clam
Sal s	Atlantic Salmon
Sco s	Atlantic mackerel
Thu a	Yellowfin tuna

Table 4. The Review of allergen reagents (molecular components) in ALEX2 Allergy Explorer. We show the number of patients with positive results of specific IgE Classes 1–4 to allergen reagents (molecular components, allergen extracts) in 100 atopic dermatitis patients.

Allergen reagents, molecular components	Protein family	Allergen	Number of patients with positive results of specific IgE (in Classes 1 – 4)
Ani s 1	Unknown function, similar to Kunitz serine protease inhibitors	Ascaridia, Herring worm	0%
Ani s 3	Tropomyosin	Ascaridia, Herring worm	4.0%
Clu h		Atlantic herring	3.0%
Clu h 1	Beta-parvalbumin	Atlantic herring	5.0%
Cra c 6	Troponin C	North Sea shrimp	7. 0%
Cyp c 1	Beta-parvalbumin	Common carp	6.0%
Gad m		Atlantic cod	4.0%
Gad m 1	Beta-parvalbumin	Atlantic cod	3.0%
Gad m 2 + Gad m 3	Beta-enolase + Aldolase A	Atlantic cod	3.0%
Hom g		Lobster	15. 0%
Chi spp		Crab	9.0%
Lit s		Shrimp	6.0%
Lol spp.		Squid	12.0%
Myt e		Common mussel	4.0%
Ost e		Oyster	4.0%
Pan b		Northern shrimp	12.0%
Pec spp.		Scallop	11.0%
Pen m 1	Tropomyosin	Black tiger shrimp	5.0%
Pen m 2	Arginine kinase	Black tiger shrimp	18.0%
Pen m 3	Myosin light chain 2	Black tiger shrimp	1.0%
Pen m 4	Sarcoplasmic calcium binding protein	Black tiger shrimp	2.0%
Raj c		Thornback ray	0%
Rud spp.		Clam	8.0%
Sal s		Atlantic Salmon	2.0%
Sal s 1	Beta-parvalbumin 1	Atlantic salmon	7.0%
Sco s		Atlantic mackerel	6.0%
Sco s 1	Beta-parvalbumin	Atlantic mackerel	6.0%
Thu a		Yellowfin tuna	5.0%
Thu a 1	Beta-parvalbumin	Yellowfin tuna	7.0%
Xip g 1	Beta-parvalbumin	Swordfish	6.0%

Table 5. The detailed overview of fish and shrimp allergen reagents (allergenic extracts and molecular components) according to the frequency of sensitisation in classes 0, 1, 2, 3, 4 in 100 atopic dermatitis patients ( = 100%).

Allergen reagents	Results of specific IgE in classes 0–4 to allergen reagents (molecular components) of fish and shrimps in 100 atopic dermatitis patients (100 patients = 100%)
	Class 0	Class 1	Class 2	Class 3	Class 4
Ani s 1	100.0%	0.0%	0.0%	0.0%	0.0%
Ani s 3	96.0%	0.0%	0.0%	1.0%	3.0%
Clu h	97.0%	0.0%	2.0%	1.0%	0.0%
Clu h 1	95.0%	2.0%	0.0%	0.0%	3.0%
Cra c 6	93.0%	0.0%	2.0%	2.0%	3.0%
Cyp c 1	94.0%	2.0%	1.0%	0.0%	3.0%
Gad m	96.0%	1.0%	1.0%	1.0%	1.0%
Gad m 1	97.0%	0.0%	1.0%	1.0%	1.0%
Gad m 2+3	97.0%	2.0%	1.0%	0.0%	0.0%
Hom g	85.0%	2.0%	7.0%	2.0%	4.0%
Chi spp_	91.0%	1.0%	2.0%	3.0%	3.0%
Lit s	94.0%	1.0%	2.0%	1.0%	2.0%
Lol spp	88.0%	4.0%	3.0%	3.0%	2.0%
Myt e	96.0%	3.0%	0.0%	1.0%	0.0%
Ost e	96.0%	1.0%	1.0%	1.0%	1.0%
Pan b	88.0%	0.0%	5.0%	5.0%	2.0%
Pan m	92.0%	5.0%	3.0%	0.0%	0.0%
Pec spp_	89.0%	7.0%	4.0%	0.0%	0.0%
Pen m 1	95.0%	0.0%	1.0%	1.0%	3.0%
Pen m 2	82.0%	0.0%	6.0%	5.0%	7.0%
Pen m 3	99.0%	0.0%	0.0%	1.0%	0.0%
Pen m 4	98.0%	0.0%	2.0%	0.0%	0.0%
Raj c	100.0%	0.0%	0.0%	0.0%	0.0%
RajcParvalbumin	99.0%	0.0%	0.0%	0.0%	1.0%
Rud spp_	92.0%	5.0%	1.0%	1.0%	1.0%
Sal s	98.0%	0.0%	1.0%	1.0%	0.0%
Sal s 1	93.0%	2.0%	1.0%	1.0%	3.0%
Sco s	94.0%	5.0%	1.0%	0.0%	0.0%
Sco s 1	94.0%	1.0%	2.0%	0.0%	3.0%
Thu a	95.0%	5.0%	0.0%	0.0%	0.0%
Thu a 1	93.0%	2.0%	2.0%	0.0%	3.0%
Xip g 1	94.0%	1.0%	0.0%	2.0%	3.0%

Explanation:

Class 0 – negative (< 0.3 kU_A/L)

Class 1 – low positivity (0.3–1 kU_A/L)

Class 2 – moderate positivity (1–5 kU_A/L)

Class 3 – high positivity (5–15 kUA/L)

Class 4 – very high positivity (> 15 kU_A/L).

Table

Class – level of specific IgE	Allergen reagnets (Molecular components, allergen extracts)	Number of patients with positive results of sIgE
The very high level of specific IgE (Class 4)	Pen m 2	7%
	Hom g	4%
	Ani s 3, Clu h 1, Cyp c 1, Chispp, Pen m 1, Sal s 1, Sco s 1, Thu a 1, Xip g 1	3%
	Lit s, Pan b	2%
	Gad m 1, Raj c, Rud spp	1%
The high level of specific IgE (Class 3)	Lol p 1	10%
	Pen m 2, Pan b	5%
	Chispp	3%
	Hom g, Xip g	2%
	Ani s 3, Clu h, Gad m, Gad m 1, to Lit s, Myt e, Ost e, Pen m 1, Pen m 3, Rud spp, Sal s, Sal s 1	1%
The moderate level of specific IgE (Class 2)	Hom g	7%
	Lol p 1, Pen m 2	6%
	Pan b	5%
	Clu h, Chispp, Pen m 4, Sco s 1, Thu a 1	2%
	Cyp c 1, Gad m 1, Gad m 2+3, Ost e, Pen m 1, Rudspp, Sal s, Sal s 1, Sco s	1%
The low level of specific IgE (Class 1)	Pec spp, Lol p 1	7%
	Pan m, Rud spp, Soc s, Thu a	5%
	Clu h 1, Cyp c 1, Gad m 2+3, Hom g, Sal s 1, Thu a 1	2%
	Gad m, Chi spp, Lit s, Ost e, Sco s 1, Xip g 1	1%

Table 6. Results of specific IgE to allergen reagents (molecular components) in atopic dermatitis patients with the clinical reaction to fish and in patients without clinical reaction to fish. Results of specific IgE to allergen reagents (molecular components) of fish/shrimps are evaluated as positive (classes of specific IgE 1–4) and negative (Class 0).

	Number of patients – clinical reaction to fish			Sensitivity Rates and Confidence Intervals 95% C. I.
Specific IgE to allergen reagents (molecular components)	yes 9 (9%)	no 91 (91%)	p- value	value	lower	upper
Ani s 1 +	0	0	Tests cannot be computed for 1×2 tables.
Ani s 1 −	9	91
Ani s 3 +	1	3
Ani s 3 −	8	88	0.31841	0.1111	0.0028	0.4825
Clu h +	3	0
Clu h −	6	91	0.00052*	0.3333	0.0749	0.7007
Clu h 1 +	3	2
Clu h 1 −	6	89	0.00472*	0.3333	0.0749	0.7007
Cra c 6 +	3	4
Cra c 6 −	6	87	0.01501	0.3333	0.0749	0.7007
Cyp c 1 +	4	2
Cyp c 1 −	5	89	0.00044*	0.4444	0.1370	0.7880
Gad m +	3	1
Gad m −	6	90	0.00198*	0.3333	0.0749	0.7007
Gad m 1 +	3	0
Gad m 1 −	6	91	0.00052*	0.3333	0.0749	0.7007
Gad m 2 +3 +	1	2
Gad m 2 +3 −	8	89	0.24870	0.1111	0.0028	0.4825
Hom g +	4	11
Hom g −	5	80	0.02701*	0.4444	0.1370	0.7880
Chispp +	2	7
Chispp −	7	84	0.18588	0.2222	0.0281	0.6001
Lit s+	2	4
Lit s −	7	87	0.08972	0.2222	0.0281	0.6001
Lolspp +	3	9
Lolspp −	6	82	0.07390	0.3333	0.0749	0.7007
Myt e +	1	3
Myt e −	8	88	0.31841	0.1111	0.0028	0.4825
Ost e +	1	3
Ost e −	8	88	0.31841	0.1111	0.0028	0.4825
Pan b +	4	8
Pan b −	5	83	0.01122*	0.4444	0.1370	0.7880
Pecs +	3	8
Pecs −	6	83	0.05823	0.3333	0.0749	0.7007
Pen m 1+	1	4
Pen m 1 −	8	87	0.38231	0.1111	0.0028	0.4825
Pen m 2 +	7	11
Pen m 2 −	2	80	0.00006*	0.7778	0.3999	0.9719
Pen m 3 +	1	0
Pen m 3 −	8	91	0.09000	0.1111	0.0028	0.4825
Pen m 4 +	0	2
Pen m 4 −	9	89	1.00000	0.0000	0.0000	0.3363
Raj c +	0	0	Tests cannot be computed for 1×2 tables.
Raj c −	9	91
Rud ssp +	1	7
Rud ssp −	8	84	0.54330	0.1111	0.0028	0.4825
Sal s +	2	0
Sal s −	7	91	0.00727*	0.2222	0.0281	0.6001
Sal s 1 +	4	3
Sal s 1 −	5	88	0.00099*	0.4444	0.1370	0.7880
Sco s +	3	3
Sco s −	6	88	0.00900*	0.3333	0.0749	0.7007
Sco s 1 +	3	3
Sco s 1 −	6	88	0.00900*	0.3333	0.0749	0.7007
Thu a +	0	5
Thu a −	9	86	1.00000	0.0000	0.0000	0.3363
Thu a 1+	4	3
Thu a 1 −	5	88	0.00099*	0.4444	0.1370	0.7880
Xip g +	4	2
Xip g −	5	89	0.00044*	0.4444	0.1370	0.7880
Der p 10 +	1	3
Der p 10 −	8	88	0.31841	0.1111	0.0028	0.4825

Allergen reagents (molecular components) of fish are marked extra bold. Fisher's Exact is used for the calculation of the sensitivity of examination (Rates and Confidence Intervals 95% C. I., value, lower, upper); the significant relationship between results of ALEX2 Allergy explorer test and the results of the open exposure test/history are marked with* extra bold.

Explanation: Specific IgE to allergen reagents (molecular components) + positive, − negative

We confirmed significant relation between the results of specific IgE to allergen reagents (molecular components) of fish and the results open exposure test/history. The sensitivity allergen reagents (molecular components of fish is 33.3%–44.4%.

We did not confirm the significant relation between the results of sIgE to Gad m 2+3 and the open exposure test/history to fish. On the other hand, we confirmed the significant relationship between the results of specific IgE to molecular components and allergen extracts of shrimp (Hom g, Pan b, Pen m 2, Cra c 6) and the open exposure test/history to fish.

Table 7. Results of specific IgE to allergen reagents (molecular components) in atopic dermatitis patients with the clinical reaction to shrimps and in patients without clinical reaction to shrimps. Results of specific IgE to allergen reagents (molecular components) are evaluated as positive (classes of specific IgE 1−4) and negative (Class 0).

	Number of patients – clinical reaction to shrimps			Sensitivity Rates and Confidence Intervals 95% C. I.
Specific IgE to allergen reagents (molecular components)	Yes 5 (5%)	no 95 (95%)	p- value	value	lower	upper
Ani s 1 +	0	0	Tests cannot be computed for 1×2 tables.
Ani s 1 −	5	95
Ani s 3 +	0	4
Ani s 3 +	5	91	1.0000	0.0000	0.0000	0.5218
Clu h +	0	3
Clu h +	5	92	1.0000	0.0000	0.0000	0.5218
Clu h 1+	0	5
Clu h 1−	5	90	1.0000	0.0000	0.0000	0.5218
Cra c 6+	0	7
Cra c 6−	5	88	1.0000	0.0000	0.0000	0.5218
Cyp c 1+	0	6
Cyp c 1−	5	89	1.0000	0.0000	0.0000	0.5218
Gad m+	0	5	1.0000	0.0000	0.0000	0.5218
Gad m−	5	90
Gad m 1 +	0	3	1.0000	0.0000	0.0000	0.5218
Gad m 1 −	5	92
Gad m 2 +3 +	0	3	1.0000	0.0000	0.0000	0.5218
Gad m 2 +3 −	5	92
Hom g +	1	14	0.56432	0.2000	0.0051	0.7164
Hom g −	4	81
Chispp +	2	7
Chispp −	3	88	0.06281	0.40000	0.0527	0.8534
Lit s +	0	6
Lit s −	5	89	1.0000	0.0000	0.0000	0.5218
Lolspp +	1	11	0.47965	0.2000	0.0051	0.7164
Lolspp −	4	84
Myt e +	0	4	1.0000	0.0000	0.0000	0.5218
Myt e −	5	91
Ost e +	0	4	1.0000	0.0000	0.0000	0.5218
Ost e −	5	91
Pan b +	1	11	0.47965	0.2000	0.0051	0.7164
Pan b −	4	84
Pecs +	1	10	0.44868	0.2000	0.0051	0.7164
Pecs −	4	85
Pen m 1 +	0	5	1.0000	0.0000	0.0000	0.5218
Pen m 1 −	5	90
Pen m 2 +	2	16	0.21941	0.40000	0.0527	0.8534
Pen m 2 −	3	79
Pen m 3 +	0	1	1.0000	0.0000	0.0000	0.5218
Pen m 3 −	5	94
Pen m 4 +	1	1	0.09798	0.2000	0.0051	0.7164
Pen m 4 −	4	94
Raj c +	0	0	Tests cannot be computed for 1×2 tables.
Raj c −	5	95
Rud ssp +	1	7	0.34681	0.2000	0.0051	0.7164
Rud ssp −	4	88
Sal s +	0	2	1.0000	0.0000	0.0000	0.5218
Sal s −	5	93
Sal s 1+	0	7	1.0000	0.0000	0.0000	0.5218
Sal s 1−	5	88
Sco s +	0	6
Sco s −	5	89	1.0000	0.0000	0.0000	0.5218
Sco s 1+	0	6
Sco s 1−	5	89	1.0000	0.0000	0.0000	0.5218
Thu a +	1	4	0.23041	0.2000	0.0051	0.7164
Thu a −	4	91
Thu a 1+	0	7
Thu a 1−	5	88	1.0000	0.0000	0.0000	0.5218
Xip g 1+	0	6
Xip g 1−	5	89	1.0000	0.0000	0.0000	0.5218
Der p 10 +	0	4
Der p 10 −	5	91	1.0000	0.0000	0.0000	0.5218

Allergen reagents (molecular components) of shrimps are marked extra bold. Fisher's Exact is used for the calculation of the sensitivity of examination (Rates and Confidence Intervals 95% C. I., value, lower, upper).

We did not confirm the significant relationship between the results of specific IgE to allergen reagents (molecular components) of shrimps and the results open exposure test/history.

Explanation: Specific IgE to allergen reagents (molecular componets) + positive, − negative.

WHO/IUIS Allergen Nomenclature Sub-Committee Allergen Nomenclature. (accessed on 16 April 2021); Available online: http://www.allergen.org/index.php.

 Google Scholar