Fish Allergy Management: From Component-Resolved Diagnosis to Unmet Diagnostic Needs

Julia Klueber, Denise Schrama, Pedro Rodrigues, Heinrich Dickel, Annette Kuehn*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

23 Citations (Scopus)


Purpose of review: Fish is a common elicitor of IgE-mediated food allergy. Fish includes a large variety of foods, in terms of species and food processing, with marked distinction in local diets around the globe. Fish-allergic patients present with phenotypic diversity and major differences in levels of clinical cross-reactivity, features that pose an important challenge for the clinical diagnosis and management. Recent findings: Parvalbumin is the major fish allergen. However, a single molecule is not sufficient but several homologs, allergens different from parvalbumin and allergen extracts, are needed for IgE-based diagnosis. Summary: Parvalbumin-specific IgE are markers for clinical cross-reactions. Added value is provided by IgE typing to parvalbumin homologs from distantly related fish. IgE co-sensitization profiles (parvalbumin, enolase, aldolase) are referred as severity markers. The allergen panel seems to be not yet complete why fish extracts still play a crucial role in serum IgE analysis. Further clinical validation of a multiplex approach in molecular fish allergy diagnosis is needed for striving to avoid unnecessary food restrictions and in a further sense, improved patient care.

Original languageEnglish
Pages (from-to)322-337
Number of pages16
JournalCurrent Treatment Options in Allergy
Issue number4
Publication statusPublished - Dec 2019


  • Allergen
  • Component-resolved diagnosis
  • Fish allergy
  • Food
  • Parvalbumin


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