Different Fish-Eating Habits and Cytokine Production in Chronic Urticaria with and without Sensitization against the Fish-Parasite Anisakis simplex

作者：Daschner Alvaro^*; Fernandez Figares Virginia; Valls Ana; de Frutos Consolacion; Rodero Marta; Ubeira Florencio M; Cuellar Carmen

来源：Allergology International, 2013, 62(2): 191-201.

DOI：10.2332/allergolint.12-OA-0504

• Anisakis simplex
• chronic urticaria
• cytokines
• diet
• phenotype

Background: Anisakis simplex sensitization has been associated with acute, but also with chronic urticaria. The objective of this study is to characterize chronic urticaria with (CU+) and without sensitization (CU-) against the ubiquitous fish parasite A. simplex in a transversal and longitudinal evaluation. %26lt;br%26gt;Methods: 16 CU+ and 22 CU- patients were included and assessed for Urticaria activity score (UAS), fish-eating habits by standardized questionnaire and cytokine production (assessed by flow cytometric bead-based array) of peripheral blood mononuclear cells after stimulation with A. simplex extract or Concanavalin A (Con A). Patients were randomly put on a fish-free diet for three months and UAS, as well as cytokine production were again assessed. A difference of in UAS was defined as improvement. %26lt;br%26gt;Results: There was no difference in UAS in both groups. Anisakis induced IL-2, IL-4 and IFN-gamma production was higher in CU+. Con A induced IL-6 and IL-10 production was higher in CU+. CU+ was associated with higher total fish intake, whereas CU-was associated with oily fish intake. The correlation of UAS was positive with oily fish, but negative with total fish intake. %26lt;br%26gt;There was a better UAS-based prognosis in CU+ without diet. Improvement was associated with higher Con A induced IL-10/IFN-gamma as well as IL-10/1L-6 ratios. Further, previous higher oily fish intake was associated with improvement. %26lt;br%26gt;Conclusions: Our data confirm the different clinical and immunological phenotype of CU+. Our results show a complex relationship between fish-eating habits, cytokine production and prognosis, which could have important consequences in dietary advice in patients with CU. When encountering A. simplex sensitization, patients should not be automatically put on a diet without fish in order to reduce contact with A. simplex products.

• 出版日期2013-6