Patients Allergic to Fish Tolerate Ray Based on the Low Allergenicity of Its Parvalbumin
Abstract
BACKGROUND: Clinical reactions to bony fish species are common in patients with allergy to fish and are caused by parvalbumins of the β-lineage. Cartilaginous fish such as rays and sharks contain mainly α-parvalbumins and their allergenicity is not well understood. OBJECTIVE: To investigate the allergenicity of cartilaginous fish and their α-parvalbumins in individuals allergic to bony fish. METHODS: Sensitization to cod, salmon, and ray among patients allergic to cod, salmon, or both (n = 18) was explored by prick-to-prick testing. Clinical reactivity to ray was assessed in 11 patients by food challenges or clinical workup. IgE-binding to β-parvalbumins (cod, carp, salmon, barramundi, tilapia) and α-parvalbumins (ray, shark) was determined by IgE-ELISA. Basophil activation tests and skin prick tests were performed with β-parvalbumins from cod, carp, and salmon and α-parvalbumins from ray and shark. RESULTS: Tolerance of ray was observed in 10 of 11 patients. Prick-to-prick test reactions to ray were markedly lower than to bony fish (median wheal diameter 2 mm with ray vs 11 mm with cod and salmon). IgE to α-parvalbumins was lower (median, 0.1 kU/L for ray and shark) than to β-parvalbumins (median, ≥1.65 kU/L). Furthermore, α-parvalbumins demonstrated a significantly reduced basophil activation capacity compared with β-parvalbumins (eg, ray vs cod, P < .001; n = 18). Skin prick test further demonstrated lower reactivity to α-parvalbumins compared with β-parvalbumins. CONCLUSIONS: Most patients allergic to bony fish tolerated ray, a cartilaginous fish, because of low allergenicity of its α-parvalbumin. A careful clinical workup and in vitro IgE-testing for cartilaginous fish will improve patient management and may introduce an alternative to bony fish into patients' diet.
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BibTeX
@article{kalic2026patients,
title = {{Patients Allergic to Fish Tolerate Ray Based on the Low Allergenicity of Its Parvalbumin}},
author = {Tanja Kalic and Francoise Morel-Codreanu and Christian Radauer and Thimo Ruethers and Aya Taki and Ines Swoboda and Christiane Hilger and Karin Hoffmann-Sommergruber and Markus Ollert and Christine Hafner and Andreas Lopata and Martine Morisset and Heimo Breiteneder and Annette Kuehn},
journal = {Journal of Allergy and Clinical Immunology: In Practice},
year = {2026},
month = oct,
doi = {10.1016/j.jaip.2018.11.011},
url = {https://hal.science/hal-05779966v1},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Patients Allergic to Fish Tolerate Ray Based on the Low Allergenicity of Its Parvalbumin
AU - Tanja Kalic
AU - Francoise Morel-Codreanu
AU - Christian Radauer
AU - Thimo Ruethers
AU - Aya Taki
AU - Ines Swoboda
AU - Christiane Hilger
AU - Karin Hoffmann-Sommergruber
AU - Markus Ollert
AU - Christine Hafner
AU - Andreas Lopata
AU - Martine Morisset
AU - Heimo Breiteneder
AU - Annette Kuehn
PY - 2026
DA - 2026/10/06
JO - Journal of Allergy and Clinical Immunology: In Practice
DO - 10.1016/j.jaip.2018.11.011
UR - https://hal.science/hal-05779966v1
AB - BACKGROUND: Clinical reactions to bony fish species are common in patients with allergy to fish and are caused by parvalbumins of the β-lineage. Cartilaginous fish such as rays and sharks contain mainly α-parvalbumins and their allergenicity is not well understood. OBJECTIVE: To investigate the allergenicity of cartilaginous fish and their α-parvalbumins in individuals allergic to bony fish. METHODS: Sensitization to cod, salmon, and ray among patients allergic to cod, salmon, or both (n = 18) was explored by prick-to-prick testing. Clinical reactivity to ray was assessed in 11 patients by food challenges or clinical workup. IgE-binding to β-parvalbumins (cod, carp, salmon, barramundi, tilapia) and α-parvalbumins (ray, shark) was determined by IgE-ELISA. Basophil activation tests and skin prick tests were performed with β-parvalbumins from cod, carp, and salmon and α-parvalbumins from ray and shark. RESULTS: Tolerance of ray was observed in 10 of 11 patients. Prick-to-prick test reactions to ray were markedly lower than to bony fish (median wheal diameter 2 mm with ray vs 11 mm with cod and salmon). IgE to α-parvalbumins was lower (median, 0.1 kU/L for ray and shark) than to β-parvalbumins (median, ≥1.65 kU/L). Furthermore, α-parvalbumins demonstrated a significantly reduced basophil activation capacity compared with β-parvalbumins (eg, ray vs cod, P < .001; n = 18). Skin prick test further demonstrated lower reactivity to α-parvalbumins compared with β-parvalbumins. CONCLUSIONS: Most patients allergic to bony fish tolerated ray, a cartilaginous fish, because of low allergenicity of its α-parvalbumin. A careful clinical workup and in vitro IgE-testing for cartilaginous fish will improve patient management and may introduce an alternative to bony fish into patients' diet.
SN - 2213-2198
SN - 2213-2201
ER -