Anisakis Allergy: Is Aquacultured Fish a Safe and Alternative Food to Wild-Capture Fisheries for Anisakis simplex-Sensitized Patients?

Lorenzo Polimeno,Luigi Santacroce,Skender Topi,Margherita Rossini,Edoardo Giacovazzo,Andrea Ballini,Lucantonio Debellis,Maria Teresa Lisanti,Lucrezia Polimeno

doi:10.3390/biology10020106

Abstract

Simple SummaryThe diagnosis of Anisakiasis is documented by the occasional finding of L3 larvae in the infected gastro-intestinal tract. Currently, about 14 allergens have been described, among which Ani s1 and Ani s4, both highly heat-resistant, appear central in Anisakiasis anaphylaxis and necessary to cause allergic reactions. Food has to be considered Anisakis-free only when heat-resistant Anisakis allergens are not present. Background: Anisakis simplex (A. simplex) infection, in humans, causes a series of clinical manifestations affecting the gastro-intestinal tract known as Anisakiasis/Anisakidosis. Patients may also present allergic manifestations such as hives and/or angioedema and even anaphylactic shock. The aim of this study was to investigate whether aquacultured fish could be considered A. simplex-free food and constitute a safe, alternative, wild-capture fish food for Gastro-Allergic Anisakiasis (GAA)-sensitized subjects. Methods: Protein extracts from A. simplex larvae in the third stage (L3) and from edible part of heavily infected horse mackerel (Trachurus trachurus) and aquacultured sea bream, have been tested for A. simplex allergens presence by immunological analysis. Western blot analysis using, as source of specific Anisakis allergens antibodies, serum samples from subjects referring allergic symptoms after raw fish ingestion, was performed. These subjects showed high levels of specific IgE anti A. simplex allergens determined by clinical laboratory tests (ISAC test). Results: Our data demonstrate the presence of Ani s4 allergen in both infected and aquacultured fish extracts, providing a possible interpretation for the allergic manifestations reported by subjects, already sensitized to A. simplex, who ate frozen or well-cooked or, even, aquacultured fish. Conclusions: The present data stimulate more accurate prophylaxis suggestions for Anisakis allergy and more specific controls of fishmeal used in aquaculture.

Highlights

There are numerous zoonotic diseases in humans that can be transmitted by ingestion of parasite-infected foods
The aim of the present study was to evaluate the presence of heatresistant allergens in aquacultured fish, fed with a standard fishmeal-based diet
Serum samples for Abs anti-A. simplex allergens were obtained from patients with allergic and/or gastrointestinal symptoms within 12 hrs after ingestion of fish

Summary

Introduction

There are numerous zoonotic diseases in humans that can be transmitted by ingestion of parasite-infected foods. Reports are increasingly numerous claiming the appearance of allergic symptoms, after ingestion of fish, such as canned fish, in subjects previously A. simplex-infected [5,6] This indicates that the prophylaxis currently suggested, fish cooked at 60 ◦C for 10 or frozen at −20 ◦C, for at least 24 hr, might not be sufficient to avoid the allergic effects caused by infested fish ingestion, probably due to the thermal-resistance of A. simplex allergens [5]. As source of specific Anisakis allergens antibodies, serum samples from subjects referring allergic symptoms after raw fish ingestion, was performed. These subjects showed high levels of specific IgE anti A. simplex allergens determined by clinical laboratory tests (ISAC test). Conclusions: The present data stimulate more accurate prophylaxis suggestions for Anisakis allergy and more specific controls of fishmeal used in aquaculture

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