Gummy shark is tolerated by children with IgE-mediated fish allergy
Journal Publication ResearchOnline@JCUAbstract
Background: Fish is a leading trigger of food anaphylaxis. Co-sensitisation to various bony fish species is common due to similar beta-parvalbumin allergens, leading many fish-allergic individuals avoiding all types of fish. Cartilaginous fish, like sharks and rays, predominantly contain alpha-parvalbumin as the major allergen. This unique allergen profile suggests that cartilaginous fish could be a safe alternative for bony fish allergic individuals. Objective: To determine the rate of oral tolerance to gummy shark (Mustelus antarcticus) among children with IgE-mediated bony fish allergy and evaluate the predictive value of raw gummy shark skin prick testing (SPT). Methods: Children aged 1-18 years with an IgE-mediated bony fish allergic reaction within the past 3 years underwent medical evaluation and SPTs to cartilaginous and bony fish species. All participants underwent an open challenge with 100g cooked gummy shark. Follow-up at 2 weeks and 6 months assessed ongoing tolerance and dietary incorporation. Results: All 21 children with bony fish allergy tolerated gummy shark during the challenge, despite seven (33%) children having a positive SPT (3mm) to gummy shark (median 5mm). Six months post-challenge, 7 out of the 21 children (33%) did not incorporate gummy shark in their diet, citing taste aversion and difficulties finding a reliable source. There was one reported allergic reaction in the community to gummy shark following the OFC. Conclusion: Bony-fish allergic children demonstrated tolerance to gummy shark. SPT to gummy shark showed limited predictive value in this cohort. Gummy shark may be a safe alternative in children with bony fish allergy.
Journal
Journal Of Allergy And Clinical Immunology: In Practice
Publication Name
Journal Of Allergy And Clinical Immunology: In Practice
Volume
13
ISBN/ISSN
2213-2201
Edition
N/A
Issue
8
Pages Count
3
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Publisher
Elsevier
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EISSN
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DOI
10.1016/j.jaip.2025.05.011