Molluscan shellfish cross-reactions

Cross-reactivity between molluscan and crustacean shellfish species also occurs rafher frequently. Since tropomyosin is the major allergen in both molluscan and crustacean shellfish, fhe frequency of cross-reactions is not surprising. Allergy to crustacean shellfish is more frequenfly diagnosed than molluscan shellfish allergy (Hefle et ah, 2007). Many of fhese individuals may be at risk of reactions fo molluscan shellfish also. Appropriately, most individuals with either molluscan or crustacean shellfish allergy are advised to avoid all shellfish. 

The tropomyosins of mite and insect species show some sequence identity (63-65%) with snail tropomyosin and share similar epitopes (EFSA, 2006 Fig. 4.1). Still, tropomyosin appears to play a minor role in the crossreactivity of dust mites and snails (Asturias et ah, 2002 Guilloux et ah, 1998 Van Ree et ah, 1996a). Other non-tropomyosin allergens are likely to be involved including Der p 4 (amylase), Der p 5, Der p 7, and hemocyanin (Martins et ah, 2005 Mistrello et ah, 1992 Van Ree et ah, 1996). While snail is the main molluscan shellfish species involved in cross-reactions with dust mites, some patients allergic to dust mites and snails are also sensitized to mussels (DeMaat-Bleeker et ah, 1995 Van Ree et ah, 1996b). In their study of 70 patients sensitized to molluscan shellfish, Wu and Williams (2004) noted that 90% were also sensitized to dust mites. However, the clinical significance of this sensitization was not documented. 

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