Prevalence data are based on different diagnostic procedures. While the prevalence of sensitization (sensitivity) can be estimated by SPT, RAST, and immunoblot, a clinical relevant sensitization (allergy) is evaluated by convincing history (anamnesis) or food challenge tests (ideally by DBPCFC).
1.1 Subjects with Atopic or Other Diseases
| Country / Subjects | Allergy / Sensitivity | References |
| France, Nancy and Toulouse
544 food allergic children |
shrimp 2.2% (labial food challenge) | Rance et al. 1999 |
| France, Pierre Benite
580 patients with adverse reactions to food (study period 1984-92) |
shrimp 14% (RAST) | Andre et al. 1994 |
| France, Toulouse
142 food allergic children |
shrimp 2.8% (labial food challenge) | Rance & Dutau 1997 |
| Japan, Okinawa
127 atopic patients (with bronchial asthma, allergic rhinitis and/or atopic dermatitis) |
shrimp 14% (MAST) | Kosugi et al. 1992 |
| Malaysia, Kuala Lumpur
148 adults with symptoms of nasal congestion and rhinorrhea |
shrimp 48% (SPT) | Gendeh et al. 2000 |
| Spain, Gran Canaria
120 food allergic adults |
shrimp 40% (case history, SPT, RAST) | Castillo et al. 1996 |
| Switzerland, Bern
22 patients with severe food-induced anaphylaxis (study period 1994-96) |
shrimp 14% (case history) | Rohrer et al. 1998 |
| Thailand
100 asthmatic children |
shrimp 14% (SPT) | Kongpanichkul et al. 1997 |
| USA, Denver, CO
food allergic children (DBPCFC) a) 74 age of <3 years b) 111 age of 3-19 years |
a) shrimp 0%
b) shrimp 1.8% (DBPCFC) |
Bock & Atkins 1990 |
| USA, Durham, NC
113 food allergic children with atopic dermatitis |
16% (SPT) | Sampson & McCaskill 1985 |
| USA, Little Rock, AR
165 patients with atopic dermatitis |
shrimp 0.6% (SPT, DBPCFC) | Burks et al. 1998 |
| USA, Memphis, TN
89 patients with food-induced anaphylaxis (age of 12-75 years, study period 1978-92) |
crustaceae (shrimp, scallop, crab) 29%
(case history) |
Kemp et al. 1995 |
1.2 Prevalence of Associated Allergies
| Country / Subjects | Allergy / Sensitivity | References | ||||||||||||||||||||||||||||||
| Canada, Montreal, Quebec
57 food processing workers exposed to clam and shrimp as inhalant allergens |
|
Desjardins et al. 1995 | ||||||||||||||||||||||||||||||
| Japan, Tokyo
161 asthmatic children |
Cluster group: shrimp and crab
(20 inhalants and 15 foods allergens, MAST, cluster analysis) |
Iwasaki & Baba 1992 | ||||||||||||||||||||||||||||||
| USA, New Orleans, LA
36 patients with history of shrimp allergy a) atopic individuals with and b) non-atopic individuals without respiratory atopic symptoms |
|
Morgan et al. 1989a |
| Symptoms & Case Reports | References | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
| systemic reactions
anaphylaxis (1, 4, 5, 8, 9, 10), hypotension (9) symptoms on skin and mucous membranes
gastrointestinal symptoms
respiratory symptoms
other symptoms
|
(1) Hoffman et al. 1981
(2) Nagano et al. 1984 (3) Carino et al. 1985 (4) Stricker et al. 1986 (5) Sorensen et al. 1989 (6) Daul et al. 1990 (7) Desjardins et al. 1995 (8) Kemp et al. 1995 (9) Hess Schmid & Wüthrich 1997 (10) Rohrer et al. 1998 (11) Goetz & Whisman 2000 |
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Percentage of Reactions
(2) reported symptoms in shrimp allergic individuals *anaphylaxis occurred in atopic patients only (atopic = personal or family history of allergy and positive SPT to common inhalant allergens) (3) shrimp allergic individuals, symptoms after DBPCFC (n=6) or open challenge (n=3) (4) reported symptoms in shrimp allergic individuals |
(1) Waring et al. 1985
(2) Daul et al. 1987 (3) Daul et al. 1988 (4) Morgan et al. 1989a |
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| Onset of Symptoms
Onset of symptoms after ingestion of shrimps: <60 min in 75% (group a) and 83% (group b) of 14 shrimp allergic individuals, and within 60-120 min in 25% (group a) and 17% (group b) (group a = atopic, group b = non-atopic) |
(1) Waring et al. 1985 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Threshold for Elicitation of Symptoms
Amounts of boiled shrimp inducing symptoms ranged from 16 to 64 g (4 to 16 shrimps) (DBPCFC, 6 shrimp allergic adults) (1) |
(1) Daul et al. 1988 |
3 Diagnostic Features of Shrimp Allergy
| Parameters / Subjects | Outcome | References | |||||||||
| Gender and Age
36 patients with history of shrimp allergy a) atopic individuals with and b) non-atopic individuals without respiratory atopic symptoms |
|
Morgan et al. 1989a | |||||||||
| SPT, IgE and Clinical Relevance
33 patients with history of shrimp allergy a) atopic individuals with and b) non-atopic individuals without history and skin test reactivity to common inhalant allergens |
Positive skin test to shrimp in 85%
Elevated shrimp specific RAST in a) 81% and b) 41% of shrimp allergic individuals |
Daul et al. 1987 | |||||||||
| SPT, IgE and Clinical Relevance
30 patients with history of shrimp allergy |
Positive immediate response to challenges with shrimps
in 30% (6 DBPCFC + 3 open challenge), generalized pruritus in 40% after
challenges and remaining 30% challenge negative;
positive SPT strongly associated with challenge symptoms (p <0.001), shrimp specific RAST significantly higher in positive challenge group (p <0.02); combination of a positive SPT and elevated specific IgE demonstrated a correct predictive value of 87% |
Daul et al. 1988 | |||||||||
| SPT and Pulmonary Symptoms
36 patients with history of shrimp allergy (39% reported pulmonary symptoms) |
Higher incidence of SPT reactivity to shrimp extract in patients who reported pulmonary symptoms (86% vs. 55% in patients without pulmonary symptoms) | Morgan et al. 1989a | |||||||||
| Ig-Classes
11 patients with history of shrimp allergy (follow-up of 24 months) |
Shrimp-specific IgE and IgG, but not IgM and IgA, significantly higher in shrimp allergic individuals as compared to controls; DBPCFC positive subjects had higher levels of both shrimp-specific IgE and IgG, levels of IgG correlated with IgE | Daul et al. 1990 | |||||||||
| IgG-Subclasses
31 patients with history of shrimp allergy |
Shrimp-specific IgG2 and IgG4 significantly higher in shrimp allergic individuals as compared to shrimp-tolerant individuals; none of the subclasses were significantly predictive of a positive response to DBPCFC | Morgan et al. 1990 |
| Proteins / Glycoproteins | Allergen Nomenclature | References |
| Tropomyosins [34-39 kDa] | a) Met e 1 (Metapenaeus ensis)
b) Pen a 1 (Penaeus aztecus) c) Pen i 1 (Penaeus indicus) d) Pen o 1* (Penaeus orientalis) |
a) Leung et al. 1994
b) Daul et al. 1994 c) Shanti et al. 1993 d) Miyazawa et al. 1996 |
| 39 kDa Allergen | Par f 1* (Parapenaeus fissurus) | Lin et al. 1993 |
| Allergens: 21** and 38 kDa*** | Hoffman et al. 1981 | |
| 7 Allergens | Lehrer et al. 1985 | |
| 13 Allergens (<16 to 166 kDa) | Daul et al. 1994 |
| Other Allergens | References |
| tRNA from boiled whole shrimp (Peneaus indicus)* | Nagpal et al. 1987 |
5.1 Sensitization to Shrimp Allergens
| Country / Subjects | Sensitivity to | References | ||||||||||||||||||||||||||||
| Taiwan, Tapei
10 shrimp allergic patients |
|
Lin et al. 1993 | ||||||||||||||||||||||||||||
| USA, New Orleans, LA
34 shrimp allergic patients |
|
Daul et al. 1994 | ||||||||||||||||||||||||||||
| USA, NC
11 shrimp allergic patients |
38 kDa allergen in 100%
21 kDa allergen in 64% (RAST) |
Hoffman et al. 1981 |
5.2 Properties of Tropomyosins
5.3 Properties of 39 kDa Allergen (Par f 1)
| Extract / Purified Allergens | Methods | References |
| Protein Extract | Meat from boiled shrimp homogenized in PBS (pH 7.2), mixing overnight at 4°C, centrifuged, supernatant concentrated by membrane filtration, centrifuged, and dialyzed | Lehrer 1986 |
| Protein Extract | Whole shrimp cooked in distilled water for 10 min, supernatant decanted, cooled, and centrifuged, followed by ammonium sulfate precipitation, precipitate redissolved in Tris-HCl buffer (pH 8) and dialyzed | Nagpal et al. 1987 |
| Protein Extract | Meat from boiled shrimp homogenized in PBS (pH 7.2), mixing overnight with agitation, centrifuged, supernatant dialyzed, and freeze-dried | Crespo et al. 1995 |
| Muscle Protein Fractions | Shrimp meat homogenized with cold PBS (pH 7.2), centrifuged, and supernatant filtered (filtrate = sarcoplasmic protein solution); precipitate washed, redissolved in high-salt buffer, centrifuged and filtered (filtrate = myofibrillar protein solution) | Byun et al. 2000 |
| 21 and 38-kDa Allergens | 38 kDa allergen isolated from fresh extract of boiled shrimp by gel filtration and from raw shrimp by gel filtration and agarose electrophoresis; 21 kDa allergen isolated from raw shrimp | Hoffman et al. 1981 |
| 34 kDa Allergen (Pen i 1) | Isolation from boiled shrimp protein extract by successive ion exchange chromatography (DEAE-sephacel) and gelfiltration (BioGel, Sepharose columns) | Nagpal et al. 1989 |
| Pen a 1 | Isolation of 36 kDa band from SDS-PAGE gels by electroelution | Daul et al. 1994 |
| Pen a 1 | Isolation of Pen a 1 by preparative SDS-PAGE / fraction collection | Reese et al. 1995 |
| Tropomyosin | Cut shrimp meat boiled in distilled water for 10 min, followed by ammonium sulfate precipitation, centrifugation, precipitate redissolved in Tris-HCl buffer (pH 8.0) and dialyzed; major shrimp allergen isolated by column chromatography (DEAE-Sepharose, hydroxylapatite, and Sephacryl S-300) | Miyazawa et al. 1996 |
| Major Heat Stable Protein (36 kDa) | Boiled shrimp peeled and deveined, meat homogenized, extracted with PBS (pH 7.2) at 4°C overnight and centrifuged; supernatant filtered and followed by ammonium sulfate precipitation; precipitate redissolved in PBS, dialyzed, followed by isoelectric precipitation at pH 4.5 (repeated 3 times) | Byun et al. 2000 |
| Cross-Reacting Allergens | Subjects / Methods | References |
| Shrimp (Species)
Penaeus setifecus (white shrimp) and Penaeus aztecus (brown shrimp) |
Positive SPT to both in 77% of 30 patients with shrimp
allergy, 1 individual reacted to brown shrimp extract only; elevated RAST
values to both extracts in 52%, 1 subject reacted only to white shrimp
and 2 subjects to brown shrimp alone;
2 sera recognized qualitatively different allergens in brown and white shrimp extracts by RAST inhibition |
Morgan et al. 1989b |
| Shrimp (Crustaceae)
crab, crawfish, and lobster * |
18 precipitating antigens in shrimp extract by CIE; 5 cross-reacted with crawfish, 3 with lobster and 1 with crab extract in CLIE; 7 shrimp allergens identified by CRIE with 6 sera from shrimp allergic patients, 3 allergens reacted with most of 6 sera, 2 precipitins present in shrimp, crawfish, lobster, and crab, while 1 precipitin were present only in shrimp | Lehrer et al. 1985 |
| Shrimp (Crustaceae)
crab, crawfish, and lobster |
Inhibition of IgE binding to shrimp extract by crab (42%), crawfish (67%), and lobster extracts (82%), inhibition of IgE binding to crab (85%), crawfish (90%), and lobster extracts (78%) by shrimp extract (RAST inhibition) | Lehrer 1986 |
| Shrimp (Crustaceae)
crab, crawfish, and lobster and Pen a 1 |
Strong inhibition of IgE binding to Pen a 1 by crab, crawfish, and lobster protein extracts, similar inhibition potency to shrimp extract (RAST inhibition, serum pool from shrimp sensitive individuals) | Daul et al. 1994 |
| Shrimp (Crustaceae)
crab and rMet e 1 |
Complete inhibition of IgE binding to
recombinant crab tropomyosin by recombinant shrimp tropomyosin (rMet e1) (SDS-PAGE immunoblot, 10 patients with crustaceae allergy) |
Leung et al. 1998a |
| Shrimp (Crustaceae)
lobster and rMet e 1 |
Complete inhibition of IgE binding to lobster muscle extracts by recombinant shrimp tropomyosin (rMet e 1) (SDS-PAGE immunoblot, 10 patients with crustaceae allergy) | Leung et al. 1998b |
| Shrimp (Mollusca)
oyster |
52-88% inhibition of IgE binding to oyster extracts by shrimp extracts (RAST inhibition, serum pool from 4 oyster sensitive individuals) | Lehrer & McCants 1987 |
| Shrimp (Mollusca)
clam |
Inhibition of IgE binding to shrimp extract by clam extract, similar inhibitory potency as shrimp (RAST inhibition, serum pool from 3 patients with clam and shrimp specific IgE) | Desjardins et al. 1995 |
| Shrimp (Mollusca)
squid (Todarodes pacificus) and shrimp (Penaeus orientalis) tropomyosins |
Significant cross-reactivity between squid tropomyosin (Tod p 1, 38 kDa) and shrimp tropomyosin (RAST inhibition) | Miyazawa et al. 1996 |
| Shrimp (Mollusca)
scallop |
17% inhibition of IgE-binding to
shrimp by scallop and 28% to scallop by shrimp extracts;
Significant inhibition of 35 to 39 kDa bands of shrimp by scallop extract and vice versa (ELISA inhibition, SDS-PAGE immunoblot, 1 shrimp and scallop allergic individual) |
Goetz & Whisman 2000 |
| Shrimp (Caddis Fly)
caddis fly |
IgE reactivity of sera of 1 patient: cross-reacting homologous 13 kDa proteins in extracts of shrimp and caddis fly (RAST inhibition, SDS-PAGE immunoblot inhibition, caddis fly sensitvie patients) | Koshte et al. 1989 |
| Shrimp (Mite)
boiled shrimp (Crangon crangon) and mite (Dermatophagoides pteronyssinus) |
100-fold higher inhibition of IgE binding to mite extract by shrimp extract as compared to tropomyosin depleted shrimp extract (RAST inhibition, 3 sera from mite sensitive and shrimp allergic patients) | Witteman et al. 1994 |
| Shrimp (Cockroach)
boiled Atlantic shrimp (Pandalus borealis) and German cockroach (Blattella germanica) |
Inhibition of IgE binding by shrimp extract to cockroach extract, and vice versa (RAST inhibition); strongest IgE binding for both at 30 to 43 kDa, binding capacity of cockroach was totally abolished by shrimp extract, while cockroach extract only partially inhibited IgE binding to shrimp (SDS-PAGE immunoblot inhibition) (sera from 89 shrimp and/or cockroach sensitive patients) | Crespo et al. 1995 |
8 Stability of Shrimp Allergens
| Treatment | Effects | References |
| Shrimps (Heat)
boiled and raw shrimp extracts from white shrimp (Penaeus setifecus) |
Similar reactivity of boiled and raw shrimp in SPT, higher specific IgE to boiled shrimp as compared to raw shrimp in 9 from 14 shrimp allergic individuals (RAST) | Waring et al. 1985 |
| Shrimps (Heat)
boiled and raw shrimp extracts from white shrimp (Penaeus setifecus) |
85% and 88% inhibition of IgE binding to raw and cooked oyster extracts, respectively, by cooked shrimp extract; 56% and 52% inhibition of IgE binding to raw and cooked oyster extracts, respectively, by raw shrimp extract (RAST inhibition, serum pool from 4 oyster sensitive individuals) | Lehrer & McCants 1987 |
| Shrimps (Heat)
allergens from boiling water and extracts from boiled shrimps |
Both shrimp extracts contained acidic proteins (pI <3.5-6.0) and demonstrated similar allergenic activity (IEF-PAGE immunoblot, RAST, RAST inhibition, 14 shrimp allergic individuals) | Lehrer et al. 1990 |
| Major Allergen (Heat)
38 kDa allergen isolated from boiled and raw shrimp |
38 kDa allergen gave a correlation coefficient of 0.98 with whole cooked shrimp extract and of 0.66 with raw shrimp extract; strong inhibition of boiled and raw extracts by 38 kDa allergen (RAST, RAST inhibition, 11 shrimp allergic patients) | Hoffman et al. 1981 |
| Shrimps, Major Protein (gamma
Irradiation)
Isolated shrimp heat-stable protein (HSP) gamma irradiated at 0, 1, 3, 5, 7, or 10 kGy in solution, fresh shrimp also irradiated |
Dose-dependent reduction of IgE binding to irradiated HSP, and sarcoplasmic and myofibrillar protein extracts from irradiated shrimp ; reduction of HSP amount; in SDS-PAGE the main band (36 kDa) disappeared and traces induced from coagulation appeared at higher Mr (ELISA, SDS-PAGE, sera from 20 shrimp allergic individuals) | Byun et al. 2000 |
| Reported Adverse Reactions | References |
| Shrimp
Symptoms after ingestion of shrimp in various forms (e.g. whole shrimps, food compound, challenge test) |
see 2 Symptoms of Shrimp Allergy |
| Shrimp-Meal
Occupational asthma due to shrimp meal inhalation |
Carino et al. 1985 |
| Dust Samples
Occupational asthma in food processing workers due to exposure to dust containing corn starch, guar gum, cellulose, shrimp (1%), and traces of clam |
Desjardins et al. 1995 |
| Shrimp Boiling Steam
Occupational asthma in a seafood restaurant worker (shrimp allergy evaluated by RAST, SPT, and inhalation challenge): shrimp allergens were identified in boiling water distillates by SDS-PAGE immunoblot |
Goetz & Whisman 2000 |
| Fish Food
27-year-old patient with bronchial asthma who kept fish showed strongly positive reactions in skin tests for Chironomus and Culex larvae, as well as several kinds of Crustacea species, such as Daphnia and brine shrimps which are common ingredients in pet fish food |
Dietschi & Wüthrich 1987 |
| Allergens in Seafood Products | Content / Results | References |
| Pen a 1
in 4 commercial shrimp extracts, crab and lobster extracts |
Commercial shrimp extracts demonstrated a 40-fold difference in Pen a 1 levels (24 to 920 µg/ml); crab and lobster extracts contained detectable levels of Pen a 1-like proteins; no detection in cockroach, house dust mite, oyster, codfish, or peanut extracts (ELISA, Pen a 1 specific mAb) | (1) Jeoung et al. 1997 |
| Other Allergen Sources | References |
| House Dust Mite Immunotherapy
Sensitization to shrimp during mite immunotherapy might occasionally occur probably due to cross-reactive allergenic tropomyosins from mite and shrimp; 17 patients receiving mite immunotherapy: 2 patients with antitropomyosin IgE also had a positive SPT for shrimp, and demonstrated oral allergy syndrome (OAS) after eating shrimp |
van Ree et al. 1996 |
| Food Allergen | Labeling / Regulation Status | References |
| International Regulations
Crustaceae* and crustaceae products |
mandatory labeling of prepackaged food / advisary status (1) | (1) Codex Alimentarius Commission 1999 |
| European Regulations
Crustaceae* and crustaceae products |
labeling appropriate / recommendation (1) | (1) Bousquet et al. 1998 |