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Query: UMLS:C0042109 (urticaria)
 6,569 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Anisakis simplex is a fish parasite that is a public health risk to those consuming raw or poorly cooked marine fish and cephalopods because of the possibility of becoming infested with live larvae. In humans, penetration of the larvae into the gastrointestinal track can cause acute and chronic symptoms and allergic anisakiasis. Excretion and secretion products released by the larvae are thought to play a role in migration through the tissues and induce an immunoglobulin E-mediated immune response. The aim of this preliminary study was to detect parasite antigens and allergens in fish tissues surrounding the migrating larvae. Hake and anchovy fillets were artificially parasitized with Anisakis larvae and stored in chilled conditions for 5 days. Larvae were evaluated for fluorescence, fish muscle tissue was examined with transmission electron microscopy, and immunohistochemical reactions of two rabbit polyclonal antisera against a parasite crude extract and the allergen Ani s 4 were recorded. Larvae immediately migrated into the fish muscle, and no emission of bluish fluorescence was observed. Fish muscle areas in contact with the parasite showed disruptions in the structure and inclusion of granules within sarcomeres. Both parasite antigens and the Ani s 4 allergen were located in areas close to the larvae and where sarcomere structure was preserved. These findings indicate that parasite antigens and allergens are dispersed into the muscle and might cause allergic symptoms such as dyspnea, vomiting, diarrhea, urticaria, angioedema, or anaphylaxis in some individuals sensitive to A. simplex.
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PMID:Anisakis antigens detected in fish muscle infested with Anisakis simplex L3. 1859 60

Anisakidae larvae can cause anisakiasis when ingested by humans. Although several groups have reported a gastrointestinal Anisakis allergy among people in Spain and Japan, our report is the first to summarize the clinical features of 10 Anisakis allergy cases in Korea. We enrolled 10 Korean patients (6 men and 4 women) who complained of aggravated allergic symptoms after ingesting raw fish or seafood. Sensitization to Anisakis was confirmed by detecting serum specific IgE to Anisakis simplex. The most common manifestation of anisakiasis was urticaria (100%), followed by abdominal pain (30%) and anaphylaxis (30%). All patients presenting with these symptoms also exhibited high serum specific IgE (0.45 to 100 kU/L) to A. simplex. Nine patients (90%) exhibited atopy and increased total serum IgE levels. The fish species suspected of carrying the Anisakis parasite were flatfish (40%), congers (40%), squid (30%), whelk (10%), and tuna (10%). Anisakis simplex should be considered as a possible causative food allergen in adult patients presenting with urticaria, angioedema, and anaphylaxis following the consumption of raw fish or seafood.
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PMID:The clinical characteristics of Anisakis allergy in Korea. 1954 98

Background The link between various chronic skin disorders and toxocariasis was previously demonstrated by case reports and several case-control studies. However, these previous studies were based only on the Toxocara canis excretory-secretory-enzyme-linked immunosorbent assay (TES-ELISA) serological technique, which is not specific due to cross-reactivity with parasites of the genera Anisakis or Ascaris. Immunoblot analysis is highly specific and can detect very low levels of Toxocara antibodies. Therefore, this technique may be useful in the identification of Toxocara infection in patients with chronic skin disorders. Objectives Because urticaria and pruritus/prurigo are skin conditions previously associated with toxocariasis, we carried out a prospective study using both TES-ELISA and Toxocara Western blot on 113 patients with either chronic urticaria (n = 84) or chronic pruritus (n = 29). Methods Patients were matched with controls according to gender, age and residence location (rural or urban area). Data were analysed using a Mantel-Haenszel chi(2) test. Results The proportion of positive TES-ELISA results was not significantly different for patients with chronic skin disorders (urticaria or pruritus/prurigo) from that of control subjects. However, the proportion of positive immunoblot results was significantly higher for patients with chronic urticaria than for control subjects (P = 0.009). Conclusions Our study demonstrates the need to perform Western blotting immunodiagnosis, whatever the TES-ELISA result, to improve diagnosis of human toxocariasis in patients with chronic urticaria caused by Toxocara infection.
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PMID:Comparative assessment of enzyme-linked immunosorbent assay and Western blot for the diagnosis of toxocariasis in patients with skin disorders. 1978 12

Anisakis simplex is a fish parasite capable of inducing inflammatory and allergic reactions in humans who eat raw or undercooked fish. The aim of this study was to characterize the T helper type 1 (Th1)/Th2 immune response to parasite crude (CE) and thermostable (TsE) extracts in A. simplex-sensitized patients. Cytokines were quantified by a multiplex flow cytometric method in short-term whole blood cultures. Higher concentrations of IL-2, IL-4 and IL-5, measured with the CE and TsE, were found in patients than in controls. Patients showing urticaria-angio-oedema or anaphylaxis (UA/A) had higher total and specific IgE levels than those with gastrointestinal symptoms (GI). The UA/A group showed high levels of IL-5 and IL-4 and low expression of IFN-gamma than the GI group. The GI group had significantly higher IFN-gamma/IL4 ratio than the UA/A group. Four patients with severe GI symptoms reporting a delayed skin test reaction had very low values of specific IgE to A. simplex and higher IFN-gamma/IL4 ratios than that observed in other patients belonging to the GI group. This short-term whole blood test can be useful for immune response characterization in Anisakis infection and showed that heated parasite antigens are still capable of inducing cellular immune response in sensitized patients.
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PMID:Different Th1/Th2 responses to Anisakis simplex are related to distinct clinical manifestations in sensitized patients. 2059 Nov 23

A 75-year-old man ingested salted fish guts made of Sagittated calamari which he caught in the daytime, with alcohol and then dozed. Five hours later, he woke up due to itching over his entire body and noticed generalized urticaria and a swollen tongue, which was too large for him to close his mouth. Serum total IgE was 456 IU/ml and ImmunoCAP was positive for anisakis, but negative for squid, shrimp, and ascaris. A skin prick test (SPT) was positive for anisakis extract (10 mg/ml) and house dust mites, but negative for squid and shrimp. He was diagnosed with IgE-mediated allergy due to Anisakis simplex after the ingestion of salted fish guts made of Sagittated calamari, which had been parasitized by Anisakis simplex. Furthermore, we performed SPT with six extracts of purified or recombinant allergens (Ani s 1, 3, 4, 5, 6, and 8) to identify the causative allergens in this case. Only Ani s 3 (tropomyosin) was positive, indicating that Ani s 3 was the causative allergen in this case. Third stage larvae of the nematode Anisakis simplex often parasitize not only marine fish but also invertebrates, including squid. It is necessary to consider Anisakis simplex allergy for urticarial reactions that develop after the ingestion of squid.
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PMID:[A case of an allergic reaction due to Anisakis simplex after the ingestion of salted fish guts made of Sagittated calamari: allergen analysis with recombinant and purified Anisakis simplex allergens]. 2013 93

Bowel anisakiasis is rare, and the incidence and clinical features of this condition remain unclear. Using the Japanese Diagnosis Procedure Combination (DPC) in-patient database, we identified 201 cases of bowel anisakiasis between the months of July and December during 2007 and 2008. More than 70% were males. The average age was 54.5 years. Overall, 102 (50.7%) cases had ileus, 16 (8.0%) had perforation or peritonitis, and 4 (2.0%) had intestinal bleeding. Allergic responses, including urticaria, were found in seven (3.5%) patients. Fourteen (7.0%) cases underwent open surgery. Three (1.5%) underwent colonoscopic removal of Anisakis larvae. The average length of stay in the hospital was 9.6 days. The annual incidence of bowel anisakiasis is estimated to be about 3.0 per 1 million people per year. It is important to continue collecting all available data to monitor the trends of this distressing condition.
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PMID:Clinical features of bowel anisakiasis in Japan. 2059 86

Acute urticaria is defined as evanescent wheals with a duration period of up to 6 weeks. Yet within acute urticaria, IgE-mediated urticaria lasts rarely more than 48 h, whereas longer duration periods are frequently unfruitful with respect to diagnostic work-up. We hypothesize the differences in immunologic features in immediate type urticaria versus prolonged acute urticaria within the model of Anisakis simplex (A. simplex) sensitization-associated urticaria. We included 57 patients with gastro-allergic Anisakiasis (GAA) and urticaria duration of less than 48 h and 17 patients with A. simplex sensitization-associated prolonged acute urticaria (PROL), defined as urticaria duration between 3 days and 6 weeks. As control group served 23 patients with A. simplex sensitization-associated chronic urticaria (CU+). We compared total IgE as well as specific IgE, IgG and IgG(4) against A. simplex. Median total IgE was higher in GAA than in PROL or CU+ [442 (interquartile range, IQR 198-995) vs. 117 (68-261) or 251 (94-382) kU/l, respectively]. Median-specific IgE was higher in GAA than in PROL or CU+ [62 (IQR 24.1-99) vs. 12.3 (6-30.9) or 14.2 (6.2-44.9) kU/l, respectively]. The differences were statistically significant at P < 0.001 for GAA against PROL and at P < 0.003 for GAA against CU+. Also, specific IgG and IgG(4) levels were higher in GAA than in PROL or CU+ at the same significance level. The levels of total IgE or specific immunoglobulin isotypes were not significantly different between PROL and CU+. In the model of A. simplex sensitization-associated urticaria, immediate-type urticaria in GAA is immunologically different from prolonged acute urticaria, which, in turn, shows features nearer to chronic urticaria than to gastro-allergic Anisakiasis. Thus, in an allergological evaluation of urticaria, we propose a possible benefit of a distinction of the duration period at 48 h, and not 6 weeks, when differentiating acute versus chronic urticaria.
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PMID:Anisakis simplex sensitization-associated urticaria: short-lived immediate type or prolonged acute urticaria. 2062 48

Evolutionary Medicine can be useful when analysing the origin of disease and symptoms. Acute urticaria or anaphylaxis is bothersome and potentially life-threatening. We analyse this symptom-complex in the context of Gastro-allergic Anisakiasis (GAA), where the human is an incidental host for the cosmopolitan fish-nematode Anisakis simplex (A. simplex). The immunological response against this nematode resembles that against other helminths, but overt expression of allergic symptoms is by far more frequent in GAA. This could be due to the missing co-evolutionary relationship between host and parasite. Features of acute gastric parasitism with and without overt allergic type 1 hypersensitivity symptoms are compared with the abdominal complications in intestinal Anisakiasis, where clinically visible IgE mediated symptoms are missing. In GAA, parasite induced chronic abdominal complications are missing. We postulate that urticaria in GAA can be considered the price for rapidly expelling the live larva of A. simplex in those subjects whose evolutionary history made them more resistant to other helminth parasites. Further, urticaria is explained as a possibly exaggerated immunopathological feature in this special type of acute parasitism, where sensitized mast-cells are not only present in the skin, but also in the gastro-intestinal mucosa. This evolutionary analysis of clinical observations is the first known report that addresses the possible beneficial feature of hypersensitivity type 1 response with overt allergic urticaria-anaphylaxis in GAA and confers an evolutionary based sense to the acute IgE-mediated reaction.
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PMID:The hidden sense of symptoms: urticaria can be beneficial. 2072 3

The relationship between atopic sensitization and chronic urticaria is still controversial. In this study, we aimed to compare the prevalence of aeroallergen sensitization in chronic urticaria patients with (CU/As+) and without (CU/As-) sensitization against Anisakis simplex. Forty-nine CU/As+ and 80 CU/As- patients were studied and skin prick tests (SPT) were performed against aeroallergens. We assessed sensitization in a subgroup of patients with allergic rhinoconjunctivitis and/or bronchial asthma (RCBA) and compared the prevalence with a control group of 522 non-urticaria patients with RCBA. Forty-five percent of CU/As- and 60.4% of CU/As+ patients displayed positive SPT to at least one aeroallergen. CU/As+ patients had a higher prevalence of sensitization against pollen, mould or dander (PMD) (52.2% vs 29.1%, P < 0.01), whereas the prevalence of house dust mite (HDM) sensitization was not statistically different (26.3% in CU/As- and 36.7% in CU/As+). However, in chronic urticaria patients with RCBA, 53.8% of CU/As- and 57.9% of CU/As+ patients differed in the prevalence of HDM sensitization compared to the control group (33.5%, P = 0.03), whereas no difference could be stated for PMD sensitization. Compared to RCBA patients, both CU/As+ and CU/As- patients have a higher clinically relevant sensitization rate against HDM, thus displaying a differential atopy phenotype.
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PMID:Chronic urticaria is associated with a differential helminth-arthropod-related atopy phenotype. 2088 61

In recent years, Anisakis simplex has been shown to be an important etiologic agent responsible for food allergy and for gastrointestinal anisakiasis. We report a 61-year-old woman presenting with generalized urticaria and subsequent anaphylaxis after ingestion of raw mackerel. She rapidly recovered with administration of epinephrine and endoscopic extraction of an A. simplex larva. Serologic testing revealed specific IgE antibody to A. simplex was positive whereas that to mackerel was negative. She was diagnosed as IgE-mediated hypersensitivity to A. simplex. Patients diagnosed as fish-related or idiopathic allergy should be examined for evidence of Anisakis-induced allergy.
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PMID:Anisakis simplex-induced anaphylaxis. 2125 54


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