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Ask The Expert

July 30, 2013

Relationship of Dust Mites and Crustaceans

Question

While it has been reported that up to 15% of patients highly sensitized to dust mites are also sensitized to crustaceans, e.g. shrimp and snails, due largely to the cross-reacting anti-tropomyosin IgE, is there risk of inducing clinically significant allergic reactions to the crustaceans while treating patients with dust mite immunotherapy? Should patients highly allergic to dust mites be advised to avoid eating crustaceans?

Answer

By Dr. Susanne Vrtala

It has been shown that house dust mite immunotherapy can induce IgE-antibodies to shrimps and snails (1), whereas other studies showed that house dust mite immunotherapy with mite extracts did not induce shrimp allergy (2). The discrepancy of the results might be caused by the house dust mite extracts used for immunotherapy, since it has been shown recently that several commercial house dust mite extracts lack tropomyosin (Der p 10), whereas others contain large amounts of this allergen (3).

Only 10-20% of mite allergic patients are sensitized to tropomyosin (4). House dust mite allergic patients should thus be tested for IgE-reactivity to Der p 10, in order to assess the risk of allergic reactions to crustaceans.

  1. van Ree, R., L. Antonicelli, J. H. Akkerdaas, M. S. Garritani, R. C. Aalberse, and F. Bonifazi. 1996. Possible induction of food allergy during mite immunotherapy. Allergy 51: 108-113.
  2. Asero, R. 2005. Lack of de novo sensitization to tropomyosin in a group of mite-allergic patients treated by house dust mite-specific immunotherapy. Int Arch Allergy Immunol137: 62-65.
  3. Casset, A., A. Mari, A. Purohit, Y. Resch, M. Weghofer, R. Ferrara, W. R. Thomas, C. Alessandri, K. W. Chen, F. de Blay, R. Valenta, and S. Vrtala. 2012. Varying allergen composition and content affects the in vivo allergenic activity of commercial Dermatophagoides pteronyssinus extracts. Int Arch Allergy Immunol 159: 253-262.
  4. Resch, Y., M. Weghofer, S. Seiberler, F. Horak, S. Scheiblhofer, B. Linhart, I. Swoboda, W. R. Thomas, J. Thalhamer, R. Valenta, and S. Vrtala. Molecular characterization of Der p 10: a diagnostic marker for broad sensitization in house dust mite allergy. Clin Exp Allergy 41: 1468-1477.

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