Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2026
No demonstrated superiority of tropomyosin (Pen a 1) sIgE over crude shrimp sIgE in children.
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Yanagida Noriyuki, Yoshimoto Hironaga, Ogura Kanako, Nagakura Ken-Ichi, Takahashi Kyohei, Ogura Kiyotake, Sato Sakura, Ebisawa Motohiro
Аннотация
BACKGROUND: Tropomyosin (Pen a 1)-specific IgE (sIgE) is a proposed diagnostic marker for shrimp allergy; however, its superiority over crude shrimp sIgE is unclear. This study aimed to determine whether Pen a 1 sIgE is superior to crude shrimp sIgE for predicting oral food challenge (OFC) outcomes in children.
METHODS: We retrospectively analyzed children who underwent OFCs using ≥40 g heated shrimp and had both shrimp sIgE and Pen a 1 sIgE data. Areas under the receiver operating characteristic curves (AUCs) were compared using the DeLong test, and the paired AUC difference with its 95% confidence interval (CI) was estimated.
RESULTS: Of 204 patients (median age 6.2 years; 70% male), 33 (16%) had a positive OFC. The AUCs for shrimp sIgE (0.629; 95% CI, 0.535-0.723) and Pen a 1 sIgE (0.622; 95% CI, 0.524-0.718) did not differ significantly (difference, 0.007; 95% CI, -0.069 to 0.083; DeLong p = .850). Pen a 1 sIgE correlated strongly with shrimp sIgE (r = .767, p < .001). Among 190 patients with Dermatophagoides pteronyssinus (Der p) sIgE data, Der p sIgE correlated weakly with both markers (r= .321 and .217) and did not differ by OFC outcome (p = .612).
CONCLUSION: Superiority of Pen a 1 sIgE over crude shrimp sIgE was not demonstrated. The strong correlation suggests that tropomyosin is a major IgE-binding component of the crude extract. OFC remains essential.
METHODS: We retrospectively analyzed children who underwent OFCs using ≥40 g heated shrimp and had both shrimp sIgE and Pen a 1 sIgE data. Areas under the receiver operating characteristic curves (AUCs) were compared using the DeLong test, and the paired AUC difference with its 95% confidence interval (CI) was estimated.
RESULTS: Of 204 patients (median age 6.2 years; 70% male), 33 (16%) had a positive OFC. The AUCs for shrimp sIgE (0.629; 95% CI, 0.535-0.723) and Pen a 1 sIgE (0.622; 95% CI, 0.524-0.718) did not differ significantly (difference, 0.007; 95% CI, -0.069 to 0.083; DeLong p = .850). Pen a 1 sIgE correlated strongly with shrimp sIgE (r = .767, p < .001). Among 190 patients with Dermatophagoides pteronyssinus (Der p) sIgE data, Der p sIgE correlated weakly with both markers (r= .321 and .217) and did not differ by OFC outcome (p = .612).
CONCLUSION: Superiority of Pen a 1 sIgE over crude shrimp sIgE was not demonstrated. The strong correlation suggests that tropomyosin is a major IgE-binding component of the crude extract. OFC remains essential.