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Biomedical subjects

J J Musmand

Publications and source records attributed to J J Musmand.

4 recordsLinked to original sources

Fish allergy: is cross-reactivity among fish species relevant? Double-blind placebo-controlled food challenge studies of fish allergic adults.

BACKGROUND: Allergic reactions to fish are a common cause of food allergy in many areas of the world where fish is a major source of protein. Although different species of fish may be consumed, possible cross-reactivity has received limited investigation. OBJECTIVE: The aim of this study was to assess potential cross-reactivity to different species of fish species using double-blind, placebo-controlled food challenges (DBPCFC) in fish-allergic adults and to compare skin test and RAST reactivity with the challenge response. METHODS: Nine skin prick test and/or RAST-positive adult individuals with histories of an immediate-type reaction following fish ingestion were challenged with different fish species using double-blind, placebo-controlled food challenge. RESULTS: Of a total of 19 double-blind, placebo-controlled fish challenges performed, 14 challenges (74%) resulted in the induction of objective signs that were consistent with an IgE-mediated response. The most common sign observed was emesis (37%); the most prevalent subjective symptoms reported were compatible with the oral allergy syndrome (84%). Three subjects reacted to at least three fish species and one subject reacted to two fish species tested. In regard to the positive challenges, predictive accuracy of skin prick test and RAST was 84% and 78%, respectively. CONCLUSION: Our results indicate that clinically relevant cross-reactivity among various species of fish may exist. Advising fish-allergic subjects to avoid all fish species should be emphasized until a species can be proven safe to eat by provocative challenge.

Adult

Immunopathogenesis of fish allergy: identification of fish-allergic adults by skin test and radioallergosorbent test.

BACKGROUND: As the consumption of fish increases in the United States, the importance of allergic reactions to fish has become clear. Since most previous studies on fish allergy have focused on children reacting mainly to codfish, there is a need to investigate allergic reactions to other fish in adults. OBJECTIVE: To identify fish-allergic adults, and to assess cross-reactivity among different species of fish by RAST inhibition. METHODS: Thirty-nine individuals who reported fish allergy were selected for study; 32 (82%) were atopic as defined by two or more positive skin tests to common inhalant allergens and a history of allergic reactions and 33 (85%) experienced allergic symptoms within 30 minutes after ingesting fish. The most frequently reported symptoms were hives (69%), itching (69%), and wheezing/chest tightness (54%). Study subjects were skin tested with fish extracts and their sera assayed for IgE antibodies to different fish species. RESULTS: Thirty-six (92%) of the subjects tested had a positive skin test to at least one of 17 fish extracts tested; 9/35 (26%) reacted to all 17 extracts. Of the atopic (two or more positive skin tests to common inhalant allergens plus a personal and/or family history of allergy) and nonatopic fish-tolerant controls, 20/26 (77%) reacted by skin test to one or more fish extracts tested; the most prevalent positive reaction was to anchovy (73%). A significant correlation (P < .01) was observed between skin test reactivity of fish-allergic subjects to most fish extracts and fish RAST reactions. Radioallergosorbent inhibition testing demonstrated significant cross-reactivity among pollack, salmon, trout, and tuna; and between mackerel and anchovy. CONCLUSION: These results suggest that fish-allergic subjects may be clinically sensitive to more than one species of fish. Skin test reactivity to fish by itself is not an adequate criterion for the confirmation of clinically relevant fish allergy; consequently, fish-allergic subjects with positive skin tests to several fish species should exercise caution when eating fish until tolerance can be demonstrated by double-blind, placebo-controlled food challenge, at the patient's earliest convenience.

Adult

Identification of important allergens in German cockroach extracts by sodium dodecylsulfate-polyacrylamide gel electrophoresis and western blot analysis.

BACKGROUND: Despite recent advances in the purification and characterization of cockroach allergens, identification of clinically important allergens and their source have not been completely elucidated. This study investigated the allergen content of German cockroach (Blattella germanica) whole body (GWBE) and fecal (GFE) extracts. METHODS: Sera from 37 subjects with asthma, with positive skin test results to cockroach, were used for RAST and Western blot (after sodium dodecyl sulfate-polyacrylamide gel electrophoresis [SDS-PAGE] under reducing conditions); this serum panel is the largest used to date for cockroach allergen analysis. RESULTS: RAST reactivity to GWBE and GFE were highly correlated (r = 0.882, p < 0.001). SDS-PAGE and Western blotting showed that GWBE and GFE had similar patterns of IgE binding. Furthermore, Western blot inhibition investigations revealed that either GWBE or GFE could almost completely inhibit the reactivity of the other extract, SDS-PAGE and Western blotting demonstrated in both extracts numerous bands that displayed a high prevalence of IgE binding. Protein bands at 67, 50, 45, and 36 kd bound more than 50%, and the band at 60 kd bound approximately 80% of the sera tested. CONCLUSIONS: In summary, this investigation identified German cockroach allergens, established their relative importance by prevalence of reactivity to a large serum panel, and demonstrated that cockroach feces possess significant allergenic activity. Five allergens identified demonstrated reactivity with up to 50% to 80% of the 37 subjects' sera tested.

Allergens