THE USE OF IGE IMMUNOBLOTTING AS A DIAGNOSTIC-TOOL IN ANISAKIS SIMPLEX ALLERGY

Background: The fish parasite Anisakis simplex is the etiologic agent of anisakiasis and induces IgE-mediated reactions. Skin prick tests (S PTs) and the measurement of specific IgE to A. simplex were, in our ex perience, not valid tools with which to discriminate between allergic and nonallergic patients because many control subjects also had positi ve results. Objective: The study was carried out to assess the usefuln ess of IgE immunoblotting in the diagnosis of allergy to A, simplex. M ethods: We have studied 61 patients with acute symptoms of urticaria, angioedema, or anaphylaxis and positive specific IgE to A, simplex. Ac cording to the anamnesis, time interval between ingestion of fish and clinical onset of symptoms, and exclusion of other causes of allergy, three different groups of patients were established: group A (allergic ), group NA (nonallergic), and group D (doubtful), Fifty-one healthy d onors were included as control subjects (group C). IgE immunoblotting with A. simplex whole-body extract was performed in all patients and c ontrol subjects. Results: Four patterns of immunoblotting were observe d: type 1, with a group of several bands of medium molecular weight an d others of low molecular weight; type 2, two or more bands of medium molecular weight; type 3, only one band of medium molecular weight; ty pe 4, without any band. There was a significant predominance of blotti ng type 1 in group A and type 4 in group C. Conclusion: These data sug gest that IgE immunoblotting is the most useful approach to A. simplex allergy diagnosis.