D1.64 - Distinct and Overlapping Sensitization Patterns to Crustacean and House Dust Mite Allergens in Tropical Allergy

Crustacean allergy is a prevalent food allergy that arises from immune responses to specific proteins in shrimp, lobster, and crab, the most consumed food groups. More than ten allergenic proteins have been identified in crustaceans to date, several of which can trigger severe reactions, including anaphylaxis. Individuals allergic to shellfish frequently exhibit co-sensitization to house dust mites (HDM), yet the molecular association between these ingestion- and inhalation-related sensitizations remains insufficiently defined.

In this study, 93 seafood-allergic individuals were examined, and 54 subjects with positive skin prick tests and/or ImmunoCAP specific IgE to crustaceans were included for further analysis. Allergy Explorer 2 (ALEX2) testing was performed to profile IgE reactivity to both crustacean and mite allergens. 

Anaphylaxis occurred in 11 subjects and was strongly associated with sensitization to tropomyosin (63.6%) as well as to Lep d 2 and Der p 23 (both 54.5%). Over 81% of subjects showed IgE reactivity to at least one mite allergen, most commonly Der p 1, Der p 2, Der p 23, Der f 1, Der f 2, Gly d 2, and Lep d 2. Der p 23 alone was recognized by more than 61% of crustacean-allergic individuals. 

These results illustrate the complex and overlapping sensitization profiles among crustacean-mite allergic individuals in tropical regions, highlighting the contribution of both tropomyosin and non-tropomyosin allergens to cross- and co-reactivity.