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Dissecting the Sensitization Profiles to Parvalbumins From 12 Freshwater Fish Species to Improve Diagnosis of Fish Allergy

Kalic Kamath T1,2, Djukic T3, Kamath SD2,4, Lengger N2, Ottersbach S2, Uranowska-Kostrubala K1, Mladenovic Stokanic M5, Park KH6, Forstenlechner P4, Aumayr M4, Lamorte G2,4, Velickovic Cirkovic T5, Hemmer W7, Breiteneder H2, Hafner C1

1Department of Dermatology, University Hospital St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
2Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
3Institute of Medical Chemistry, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
4MacroArray Diagnostics, Vienna, Austria
5Centre of Excellence for Molecular Food Sciences, Department of Biochemistry, Faculty of Chemistry, University of Belgrade, Belgrade, Serbia
6Division of Allergy and Immunology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
7Floridsdorf Allergy Center, Vienna, Austria

J Investig Allergol Clin Immunol 2025; Vol. 35(6)
doi: 10.18176/jiaci.1069

Background: Many fish-allergic patients only react to certain fish species and may tolerate others, mostly because of IgE-mediated recognition of specific epitopes on the major allergen parvalbumin. However, the considerable number of fish species consumed makes it challenging to identify which species are allergenic and which are tolerated by individual patients.
Objective: In order to improve the diagnosis of fish allergy, we investigated IgE-mediated reactivity to parvalbumins from 12 freshwater fish species that are largely underrepresented in diagnostic tests.
Methods: Parvalbumins were purified from 12 freshwater fish species belonging to 8 families, and their isoform composition was analyzed using mass spectrometry. IgE specific for each parvalbumin was quantified in serum samples from 66 fish allergic individuals, and basophil activation tests were performed for 5 patients. Crosswise inhibition assays were carried out for all parvalbumins for 7 patients to investigate cross-reactivity between the parvalbumins from the different species.
Results: IgE binding and cross-linking potency of the parvalbumins differed, with the strongest reactivities observed for 4 parvalbumins from the salmonid family (results positive for 89%-95% of patients) and the weakest for parvalbumins from Wels catfish, European eel, and tench (results negative for ≥50% of patients). Ninety percent of the patients with negative results for Wels catfish parvalbumin also had negative results for additional parvalbumins from multiple species. Inhibition assays revealed variable recognition of epitopes by several patients, with the primary sensitizers most frequently being parvalbumins from salmonids and percids.
Conclusion: Including freshwater salmonids in the diagnostic work-up for fish allergy may help to identify most fish-allergic patients. IgE to Wels catfish could help distinguish between polysensitized and oligosensitized patients.

Key words: Parvalbumin, Fish allergy, Freshwater fish, Salmonids, IgE, Wels catfish, Fish tolerance, Oligosensitization