소아 갈치알레르기: 대구 특이 IgE 검사 활용성 및 대구와의 교차반응

Abstract

Purpose Fish allergy is the ninth common food allergy, and cutlassfish is one of the common allergenic fishes in Korean children. However, there is no commercial diagnostic tool for testing cutlassfish allergy in the world. We evaluated the usefulness of serum cod specific IgE (cod-sIgE) to diagnose cutlassfish allergy and cross-reaction between cutlassfish and cod.

Methods Nineteen children who experienced immediate type reactions after consumption of cutlassfish were enrolled. Cod-sIgE was measured by ImmunoCAP, and serum samples were obtained from 11 allergic patients and 11 controls. Using our own homemade crude extracts, sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), anti-parvalbumin (PV) immunoglobulin G immunoblot, enzyme-linked immunosorbent assay (ELISA), and ELISA inhibition were performed.

Results Thirteen patients were clinically allergic to both cutlassfish and cod, and 6 were allergic to cutlassfish alone. The median age and cod-sIgE concentrations were not significantly different between the 2 groups. The clear fish protein bands and PVs were identified on SDS-PAGE and immunoblotting. Serum cod-sIgE was positive in 4 out of 6 cutlassfish mono-allergic patients, however, there was no significant correlation between cod-sIgE by ImmunoCAP and cutlassfish-specific IgE by ELISA. The cutlassfish IgE ELISA was profoundly inhibited by cutlassfish, while the cod IgE ELISA was profoundly inhibited by cod but partially inhibited by cutlassfish.

Conclusion We found a potential diagnostic value of cod-sIgE to diagnose cutlassfish allergy and the asymmetric cross-reaction between cutlassfish and cod. These results could help diagnose and provide a dietary guidance in cutlassfish allergic children.