Similar IgE binding patterns in Gulf of Mexico and Southeast Asian shrimp species in US shrimp allergic patients

[Extract] Shellfish allergy (SA) is a leading cause of food-induced anaphylaxis1 and one of the most common causes of adult-onset food allergy worldwide, with 1%–3% of the United States (US) population affected.2-4 Nearly half (45%) of US adults with SA report utilizing emergency services for SA symptoms over their lifetime,2 remaining at-risk for lethal allergic reactions. Several allergenic proteins have been identified across shellfish species, including tropomyosin (TM), arginine kinase (AK), myosin light chain (MLC), sarcoplasmic calcium-binding protein (SCP), hemocyanin, troponin C, and triosephosphate isomerase.5 (Table 1.) However, there are a large number of shrimp allergens that have been detected, but not yet characterized.6 The allergens of major importance in SA are the muscle proteins TM and AK. TM, the major allergen with specific-IgE antibodies in ≤90% of SA patients, is associated with severe clinical reactivity. AK is a pan-allergen with cross-reactivity with crustaceans and cephalopods.