Anisakis Allergy

Background and Aim : Anisakis simplex (A. simplex) infection, in humans, causes a series ofclinical manifestations affecting the gastrointestinal tract known as Anisakiasis/Anisakidosis.Patients may also present allergic manifestations such as hives and/or angioedema and evenanaphylactic shock. The aim of this study was to investigate whether aquacultured fish could beconsidered A. simplex-free food and constitute a safe, alternative, wild-capture fish food forGastro-Allergic Anisakiasis (GAA) sensitized subjects. The diagnosis of Anisakiasis isdocumented by the occasional finding of L۳ larvae in the infected gastro-intestinal tract. Currently,about ۱۴ allergens have been described, among which Ani s۱ and Ani s۴, both highly heatresistant,appear central in Anisakiasis anaphylaxis and necessary to cause allergic reactions. Foodhas to be considered Anisakis-free only when heat-resistant Anisakis allergens are not present.Methods : Protein extracts from A. simplex larvae in the third stage (L۳) and from the edible partof heavily infected horse mackerel (Trachurus trachurus) and aquacultured sea bream, have beentested for A. simplex allergens presence by immunological analysis. Western blot analysis using,as a source of specific Anisakis allergens antibodies, serum samples from subjects referringallergic symptoms after raw fish ingestion, was performed. These subjects showed high levels ofspecific IgE anti A. simplex allergens determined by clinical laboratory tests (ISAC test).Results : Our data demonstrate the presence of Ani s۴ allergen in both infected and aquaculturedfish extracts, providing a possible interpretation for the allergic manifestations reported bysubjects, already sensitized to A. simplex, who ate frozen or well-cooked or, even, aquaculturedfish.Conclusion : The present data stimulate more accurate prophylaxis suggestions for Anisakisallergy and more specific controls of fishmeal used in aquaculture.