Skip to main content
NIHPA Author Manuscripts logoLink to NIHPA Author Manuscripts
. Author manuscript; available in PMC: 2016 Apr 22.
Published in final edited form as: EuPA Open Proteom. 2014 Sep;4:140–155. doi: 10.1016/j.euprot.2014.06.006

Characterisation of potential novel allergens in the fish parasite Anisakis simplex

Christiane Kruse Fæste a,*, Karen R Jonscher b, Maaike MWB Dooper a, Wolfgang Egge-Jacobsen c, Anders Moen c, Alvaro Daschner d, Eliann Egaas a, Uwe Christians b
PMCID: PMC4840464  NIHMSID: NIHMS777320  PMID: 27110489

Abstract

The parasitic nematode Anisakis simplex occurs in fish stocks in temperate seas. A. simplex contamination of fish products is unsavoury and a health concern considering human infection with live larvae (anisakiasis) and allergic reactions to anisakid proteins in seafood. Protein extracts of A. simplex produce complex band patterns in gel electrophoresis and IgE-immunostaining. In the present study potential allergens have been characterised using sera from A. simplex-sensitised patients and proteome data obtained by mass spectrometry. A. simplex proteins were homologous to allergens in other nematodes, insects, and shellfish indicating cross-reactivity. Characteristic marker peptides for relevant A. simplex proteins were described.

Keywords: Allergenicity, Anisakis simplex, Cross-reactivity, Immunoblotting, Mass spectrometry, Proteomic analysis

1. Introduction

Anisakis simplex (herring or whale worm) is the only known fishery product-contaminating parasite eliciting clinical allergic responses [1]. In gastro-allergic anisakiasis allergic symptoms can arise as secondary immune response after a previous infestation by live larvae [2]. There is, however, an on-going discussion regarding whether primary sensitisation by antigens from dead larvae can also occur [36]. Four clinical allergic manifestations, i.e. gastric, intestinal, ectopic, and systemic, have been associated with A. simplex, and responses might depend on the route of sensitisation [7]. More than 90% of the anisakiasis cases resulted from infection with a single larva [2]. The seafood-transmitted zoonotic disease is caused by the accidental ingestion of third-stage larvae lying encapsulated in the edible tissues of infected fish that is eaten raw or under-cooked [8]. Allergic incidents can, however, also be elicited by hidden allergens in processed fish and products thereof [9], by A. simplex protein transmission through the food chain [7], and by occupational exposure to aerosols [4,10]. Recently, the European Food Safety Authority has concluded that A. simplex larvae have a considerable allergic potential, emphasising the need for routine testing of fishery products [6].

The occurrence of anisakid nematodes has been reported from all major oceans and seas [11]. The A. simplex life cycle is complex involving planktonic crustaceans, fish and marine mammals. In fish, the larvae are mainly situated in the visceral cavity; however, a minor proportion may migrate deeply into the fillets [12]. In recent years, an increasing number of anisakiasis cases have been observed [13], and this development has been connected to the increase of marine mammal populations, a more globalised cuisine, faster cooking practices (e.g. microwaving), the trend to avoid overcooked food for vitamin preservation, and a generally higher consumption of fish for health reasons [1]. Over 90% of the anisakiasis cases world-wide are reported from Japan, and most others occur in Spain, Italy, the USA (Hawaii), the Netherlands, and Germany in regions, where traditionally raw or undercooked fish dishes such as sushi and sashimi, pickled anchovies, lomi-lomi, and salted herring are consumed [5].

In Norway, a country with proportionally high per-capita fish consumption, the number of anisakiasis incidents is low, possibly because mainly cooked or fried fish products are eaten [14]. The demographic IgE sensitisation to A. simplex proteins is less than 2%, a relatively low value as compared to about 12% in Japan and Spain. Immunoblot analyses using crude A. simplex extracts have shown very heterogeneous and individually different IgE compositions between patients and populations [1517], and genetic predisposition is thought to be a possible cause for the observed differences in disease susceptibility [18]. The prevalence of anti-A. simplex IgE in a population may also result from subclinical and undiagnosed anisakiasis, cross-reactivity with other nematodes or insects due to homologous allergens, or cross-reactions with carbohydrate- and phosphorylcholine-groups on post-translationally modified proteins [19].

Since positive IgE values are not a reliable marker for allergic reactivity, the discrimination between symptomatic and asymptomatic individuals by other than serodiagnostic analyses is important for the determination of A. simplex allergy [15]. Established methods include skin prick testing (SPT), basophil activation (BAT) measurement, and oral challenge. However, even the outcome of double-blind placebo-controlled food challenges (DBPCFC) is influenced by patient recruitment and choice of the A. simplex challenge material [5,20]. Whereas some studies reported that sensitised patients tolerated deep-frozen or well-cooked fish with anisakid larvae, others have described patients getting allergic symptoms from heat-processed contaminated fish.

In addition to the great variability in responsiveness between individuals, differences may also result from the complexity of the A. simplex proteome and specific protein characteristics. Several anisakid allergens have been shown to be relatively resistant to digestion or heat treatment and may even renature under cooling [20,21]. Furthermore, allergenicity appeared to be allocated to sequential epitopes and independent from glycosylation [22].

Three different groups of potential allergenic proteins originate from A. simplex. Excretory/secretory (ES) proteins are expressed by the larvae in high amounts during host infestation, somatic proteins are constituents of the larvae body, and cuticular proteins on the larvae's surface serve as protection from digestion [1]. Together with the different routes of sensitisation (ingestion, inhalation, mucosal, or cutaneous contact) this diverse immunogenic composition is likely a major cause for the development of differential clinical responses.

A. simplex protein extracts produce complex band patterns in gel electrophoresis [23,24]. A number of proteins have been recognised as allergens and are registered in the Aller-gome database [25]. Among these are known proteins such as secreted proteinase inhibitors (Ani s1, Ani s 4) and somatic paramyosin (Ani s 2) and tropomyosin (Ani s 3), but also a number of un-characterised proteins, whose functions have not yet been established (Ani s 7, Ani s 10–12, Ani s 24) (Table 1).

Table 1.

A. simplex allergens described in literature (retrieved from the Allergome database (www.allergome.org) [25].

Allergen Accession no. Protein name MW (kDa) Protein family AllFam/Pfam
Ani s 1.0101 Q7Z1K3 Animal Kunitz serine protease inhibitor 21.2 AF003/PF00014
Ani s 2.0101 Q9NJA9 Paramyosin 100 AF100/PF01576
Ani s 3.0101Ani s 3.0102 Q9NAS5G4XTD3 Tropomyosin 33.3 33.2 AF054/PF00261
Ani s 4.0101 P83885 Cystatin Fragmenta AF005/PF00031
Ani s 5.0101 A1IKL2 SXP/RAL-2 proteins 16.6 AF137/PF02520
Ani s 6.0101 A1IKL3 Serine protease inhibitor 9.7 AF027/PF01826 & PF08742
Ani s 7.0101 A9XBJ8 Unknown 119 Unknown
Ani s 8.0101 A7M606 SXP/RAL-2 proteins 16.1 AF137/PF02520
Ani s 9.0101 B2XCP1 SXP/RAL-2 proteins 15.5 AF137/PF02520
Ani s 10.0101 D2K835 Unknown 23.3 Unknown
Ani s 11.0101 E9RFF3 Unknown 30.0 Unknown
Ani s 12.0101 E9RFF6 Unknown 32.9 Unknown
Ani s 24 kDa G1FMP3 Unknown 23.5 Unknown
Ani s CCOS3 Q1X6K9 Cytochrome C oxidase subunit 3 29.0 –/PF00510
Ani s cytochrome B Q1X6L0 Cytochrome B 42.2 –/PF00032
Ani s FBPP Fructose 1,6-bisphosphatase ∼40 –/PF00316b
Ani s NADHDS4L Q1X6K2 NADH dehydrogenase subunit 4L 9.2 –/PF00420
Ani s NARaS Nicotinic acetylcholine receptor alpha subunit ∼60 –/PF02931b
Ani s PEPB Phosphatidylethanolamine-binding protein ∼24 –/PF01161b
Ani s troponin Q9U3U5 Troponin C 18.5 AF007/PF00036 & PF01036
a

Cystatin in Caenorhabditis elegans 15.6 kDa.

b

By comparison with Ascaris suum proteins.

The complex binding pattern of A. simplex proteins observed in IgE immunoblots suggests that the description of allergens is incomplete. Indeed, several new allergens have been detected by using high-resolution protein purification methods and immunoscreening of protein-expressing cDNA libraries or phage display systems constructed from A. simplex larvae [26].

In the present study a different approach using mass spectrometry-based proteomic analysis was attempted to characterise A. simplex proteins and to identify potential novel allergens.

2. Materials and methods

2.1. Patients

Sera from two different patient populations were obtained including 14 Norwegian and 13 Spanish patients with IgE against A. simplex and positive skin prick tests (Table 2). The Norwegian patients were originally recruited by newspaper advertisements for a study on shellfish allergy; however, they were also tested for cross-reactivity to A. simplex and mite. Skin prick testing (SPT) was performed with total PBS extract of A. simplex 3rd stage larvae retrieved from contaminated Blue Withing (Micromesistius poutassou) caught in the Norwegian Sea. Positive responders were studied further using a basophile activation test, ImmunoCap™ (Phadia, Uppsala, Sweden) analyses, and immunoblotting. Specific IgE levels to A. simplex (p4, Anisakis spp.), shrimp (f24, Pandalus borealis, Penaeus monodon, Metapenaeopsis barbata, Metapenaus joyneri), and mite (d1, Dermatophagoides pteronyssinus) were measured. The sera were stored in conformity with Norwegian law in a registered diagnostic bio-bank.

Table 2.

Patient groups from Norway and Spain. Results of total serum IgE analysis and analysis of individual IgE to Anisakis spp., shrimp (Pandalus borealis, etc.), and house dust mite (Dermatophagoides pteronyssimus). Several patients were positive in skin prick testing with A. simplex extract.

ID Age Sex Total IgE (kU/l) A. simplex Shrimp Mite SPTb



Classa IgE (kU/l) Classa IgE (kU/l) Classa IgE (kU/l)
Norwegian group
N1 38 F 51 0 <0.35 0 <0.35 1 0.6 +
N2 37 F 780 2 1.5 3 6.3 2 2.2 ++
N3 33 M 124 2 3.5 4 24.5 3 4.4 +++
N4 49 M 71 2 0.8 3 5.5 2 2.3 +++
N5 43 M 268 0 <0.35 0 <0.35 3 7.7
N6 55 M 2308 0 <0.35 3 10.7 3 12.9
N7 21 M 3287 3 3.6 3 12.1 3 8.2
N8 59 M 610 0 <0.35 1 0.6 3 7.0
N9 65 M 491 0 <0.35 2 2.5 2 1.9
N10 27 M 328 3 8.5 4 43.1 4 39.9 +++
N11 37 M 242 3 5.6 5 56.3 5 58.5 ++
N12 45 F 4569 2 1.0 2 1.6 4 39.0
N13 50 M 1237 1 0.4 2 2.6 2 1.5
N14 42 F 467 0 <0.35 3 4.2 3 3.7 +++
Spanish group
S1 37 F 106 2 2.4 3 8.0 3 8.0 pos.
S2 32 F 271 3 14.7 5 70.0 3 10.5 pos.
S3 33 F 92 2 2.8 2 0.8 0 <0.35 pos.
S4 58 F 57 1 0.8 2 1.6 2 1.2 pos.
S5 24 F 27 1 0.5 2 2.4 ≥1 ≥0.35 pos.
S6 40 F 229 3 9.4 2 2.5 n.m. n.m. pos.
S7 48 F 199 2 0.9 2 2.9 ≥1 ≥0.35 pos.
S8c 41 M 434 3 7.2 2 2.3 ≥1 ≥0.35 pos.
S9c 39 M 87 3 8.0 2 1.3 ≥1 ≥0.35 pos.
S10c 49 F 441 3 12.3 1 0.4 1 0.4 pos.
S11c 65 M 141 3 10.2 0 <0.35 n.m. n.m. pos.
S12c 68 M 75 3 14.2 0 <0.35 n.m. n.m. pos.
S13c 60 M 166 4 18.1 0 <0.35 n.m. n.m. pos.
a

IgE classes by ImmunoCap according to IgE levels (kU/L): class 0: <0.35; class 1: 0.35–0.7; class 2: 0.8–3.5; class 3: 3.6–17.5; class 4: 17.6–50; class 5: 51–100; class 6: >100.

b

Skin prick testing: −: no reaction; +: <20% of positive control; ++: <50%; +++: ≤80%; pos.: positive; n.m.: not measured.

c

Patients with gastro-allergic anisakiasis.

The Spanish patients were admitted to clinical treatment either because of anisakiasis or allergy to A. simplex proteins. Skin prick tests were performed with A. simplex antigen (Lab IPI, Madrid, Spain), and SPT responses were considered positive when they had a mean diameter of at least 3 mm × 3 mm. Histamine (1%) and isotonic saline solution (0.9% NaCl) were the positive and negative controls, respectively. Measurements of total and specific IgE were performed using ImmunoCap™. The studies were approved by the study centre's institutional review board and all patients gave their written informed consent.

2.2. A. simplex protein extracts

The protein was extracted from 3rd stage A. simplex larvae that were freed from host tissue as described earlier [24]. Proteins were extracted with phosphate-buffered saline (PBS) (pH 7.4) for 1 h at room temperature. Total protein contents were determined using the Lowry Protein Assay (BioRad Laboratories, Hercules, CA). Aliquots were stored at −20 °C until use.

2.3. Gel electrophoresis and immunoblot

The NuPage Gel System (Invitrogen, Carlsbad, CA) was used for electrophoretic separation of protein samples by SDS-PAGE, in accordance with the manufacturer's instructions as previously described [24]. Samples contained 10 μg and 30 μg A. simplex protein for the immunoblotting and mass spectrometry experiments, respectively. Proteins were either stained with SimplyBlue™ Safe Stain (Invitrogen) and used for in-gel digestion and MS experiments, or transferred electrophoretically onto nitrocellulose membrane (Bio-Rad) in an XCell II Blot Module (Invitrogen) and used for immunostaining.

Immunoblots were developed as described before using Tris-buffered saline containing 0.1% Tween 20 (TBS-T, pH 7.6) as washing buffer and TBS-T containing 3% BSA as blocking and assay buffer [27]. After incubating at 4°C overnight with 1:20 diluted patient sera the blots were washed (3 × 15 min) and incubated subsequently with rabbit anti-human IgE antibody (1:1000; Dako, Glostrup, Denmark) and HRP-conjugated goat anti-rabbit antibody (1:5000; Zymed, San Francisco, CA) for 2h each with intermediate washing. After washing (3 × 10 min), the membrane was developed with 3,3′,5,5′-tetramethylbenzidine (TMB) substrate solution (Zymed) until bands of satisfactory intensity appeared (2–10 min). All washing and incubation steps were performed under gentle shaking at RT.

2.4. GelPro Analyzer® image analysis

Immunoblots were scanned and processed using GelPro Analyzer® Version 6.3 (MediaCybernetics, Bethesda, MD). IgE-binding signal intensities were determined by applying Standard Optical Density Fitting (second order polynomial) correlating the number of pixels measured to the optical density (OD). The relative protein amount in an individual band was approximated in proportion to the protein quantity loaded in each lane (10 μg). All lanes were processed individually so that potential lane-to-lane intensity differences were compensated.

2.5. Sample preparation for MS experiments

Protein bands of interest were excised from the SDS-page gels, destained, alkylated, digested and extracted as described previously [27]. Briefly, the gel slices were destained with acetonitrile/50 mM NH4HCO3 (50/50) at room temperature (RT), dried, reduced with dithiothreitol (Sigma Chemicals, St. Louis, MD) at 56 °C, alkylated with iodoacetamide at RT in the dark, washed and dried. Proteins were digested in gel with 0.1 μg/ml trypsin (Trypsin Gold mass spectrometry grade, Promega, Madison, WI) at 37 °C overnight. Tryptic peptides were extracted from the gel, acidified with formic acid, and analysed by mass spectrometry.

2.6. Protein identification by nanoLC/quadrupole ion trap MS/MS

Tryptic A. simplex peptides were analysed by reversed-phase nano-liquid chromatography electrospray quadrupole-iontrap mass spectrometry (nanoLC ESI-MS/MS) using an Agilent 1100 HPLC-system equipped with a nanopump coupled to an Agilent LC/MSD Trap XCT Plus (Agilent Technologies, Palo Alto, CA) mass spectrometer. Peptides were loaded onto a Zorbax C18 column (75 μm ID × 10 cm, 300 Å porosity, 5 μm particles) (Agilent Technologies) for 2 min using a micro-well plate autosampler and a capillary pump delivering a flow of 5 μl/min without split. Peptides were eluted by a gradient of solvent A (0.1% formic acid) and solvent B (90% acetonitrile, 0.1% formic acid) at a flow rate of 300nl/min. The gradient was ramped from 3% to 8% B in 1 min, from 8% to 45% B in 85 min, and finally to 90% B in 5 min, until the mobile phase was returned to the initial conditions after 10 min. Spray was established using 8 μm ID emitters (New Objective, Woburn, MA) and a capillary voltage of 1600 V. Spectra were collected over 350–1800 m/z. Three fragmentation spectra were collected for the three most abundant m/z values. Subsequently, those m/z were excluded from analysis for 1 min and the next three most abundant m/z values were selected for fragmentation to enable analysis of lower abundance peptide ions.

The Spectrum Mill database search algorithm (Agilent Technologies, Santa Clara, CA) was used to search the NCBInr and UniProt databases, employing the taxonomy filter for nematodes. Parameters used for the search included the monoisotopic mass, a peptide mass tolerance of 1.2 Da and a fragment ion mass tolerance of 0.6 Da. Furthermore, tryptic peptides were only allowed two missed cleavages, and carbamidomethylation of cysteine was chosen as a fixed modification. Post-translational modifications (glycosylations and/or phosphorylations) as possible variable peptide modifications were not included in the search parameters. Database matches were validated by reverse database scoring using SpectrumMill software. Proteins with SpectrumMill scores above 13, peptide scores above 10 and scored percent intensity (SPI) of 70% were used as a cutoff for initial “hit” validation. Additionally, search result using MASCOT were included when protein scores were above the significance threshold (p<0.05) and peptide expectation values below 10−5.

2.7. High resolution proteomics by nanoLC-ESI-orbitrap-MSMS

The tryptic A. simplex peptides were further analysed using high-resolution reversed-phase nano-liquid chromatographic ESI-Orbitrap-MSMS. The system consisted of two Agilent 1200 HPLC binary pumps (nano and capillary) with autosampler, column heater and integrated switching valve (Agilent, Waldbronn, Germany) coupled to a nanoelectrospray LTQ-Orbitrap XL mass spectrometer (Thermo Fisher Scientific, Bremen, Germany). Peptide solutions (4μL) were extracted on 5-mm × 0.3-mm Zorbax 300 SB-C18 5 μm columns (Agilent) by washing with 97% 0.1% formic acid/3% acetonitrile at a flow rate of 4μL/min provided by the capillary pump. After 7 min, the integrated switching valve was activated, and peptides were eluted onto a 150-mm × 0.075-mm C18, 3-μm resin column (GlycproSIL C18-80 Å, Glycpromass, Stove, Germany). Chromatographic separation was achieved using an acetonitrile/water (0.1% formic acid) binary gradient from 5% to 55% acetonitrile in 70 min and a flow rate of 0.2 μL min−1 provided by the nanoflow pump.

Mass spectra were acquired in the positive ion mode applying a data-dependent automatic switch between survey scan and tandem mass spectra (MS/MS) acquisition. Peptide samples were analysed with a high-energy collisional dissociation (HCD) fragmentation method, acquiring one Orbitrap survey scan in the mass range of m/z 300–2000 followed by MS/MS of the three most intense ions in the Orbitrap. The target value in the LTQ-Orbitrap was 1,000,000 for survey scans at a resolution of 30,000 for m/z 400 using lock masses for recalibration to improve the mass accuracy of precursor ions. Collision-induced fragmentation was performed with a target value of 5000 ions. The ion selection threshold was 500 counts. Selected sequenced ions were dynamically excluded for 180 s.

Mass spectrometric data were first analysed by generating msf-files from raw MS and MS/MS spectra using the Proteome Discoverer 1.0 software (Thermo Fisher Scientific). Database searches were performed by using the NCBI-database applying the taxonomy filter for nematodes. Both the SEQUEST search engine (La Jolla CA, USA) involving the criteria enzyme name (trypsin), missed cleavage sites (2), precursor mass tolerance (10 ppm), fragment mass tolerance (0.6 Da), fixed modifications (carbamidomethyl), variable modification (oxidation), and the MASCOT search engine (Matrix Science Inc., Boston, MA) with the criteria enzyme name (trypsin), fixed modifications (carbamidomethyl), variable modifications (oxidation), mass values (monoisotopic), protein mass (unrestricted), peptide mass tolerance (±7 ppm), fragment mass tolerance (±0.6 Da), and maximum missed cleavages (1) were used. Proteins were considered as significant hits if the XCorr was higher than 1.5 (SEQUEST) or if the score was higher than 30 (MASCOT).

3. Results

3.1. Norwegian patients included in the study

The 14 Norwegian patients (Table 2) had serous total IgE levels ranging from 51 to 4569 kU/L and specific IgE levels of classes 0–4 (<0.35–8.5 kU/L) for Anisakis ssp, classes 0–5 (<0.35–56.3 kU/l) for shrimp, and classes 1–5 (0.6–58.5 kU/l) for mite. Skin prick testing (SPT) with total A. simplex extract resulted in strong reactions in four patients, medium reactions in two patients and a slight reaction in one patient whereas there was no reaction in seven patients. Reactivity in SPT and specific IgE serum levels appeared not to be directly correlated. Patient N14 had no measurable anti-Anisakis IgE, but experienced one of the strongest reactions in SPT. Patient N7 had class 3 anti-Anisakis IgE, but was negative in SPT, and N10 had both high anti-Anisakis IgE and a strong SPT reaction.

All patients were additionally sensitised to house dust mite, and several were also sensitised to shrimp. Patients N3, N4, N10, and N11 had IgE classes of 2–5 for all three allergens, and strong SPT reactions. N1 and N14 were sensitised to mite and not to Anisakis; however, they were positive in SPT. Four patients, N5, N6, N8, and N9, hadnoanti-Anisakis IgE, and were negative in SPT, but were included in the study because of their elevated anti-mite IgE levels with the aim to study potential cross-reactivity.

3.2. Spanish patients included in the study

The 13 Spanish patients (Table 2) could be divided into two subgroups: Patients S1–S7 were allergic to A. simplex, whereas patients S8–S13 had been diagnosed with gastro-allergic (GA) anisakiasis. All patients were positive in SPT with A. simplex and had at least class 1 serum IgE again Anisakis ssp. proteins, although in average the GA-patients had higher levels. S13 had the highest anti-Anisakis IgE serum level of all patients included in this study. Patients S1–S7 were also sensitised to shrimp, and partly also to mite, whereas S8–S13 had little or none IgE to shrimp and mite.

3.3. Determination of allergenic A. simplex proteins using patient sera

Sera from 14 Norwegian and 13 Spanish patients (Table 2) were used to detect allergenic A. simplex proteins using immunoblot. The individual sera bound to multiple protein bands, creating patient-specific binding patterns. The signal intensities of 39 individual protein bands ranging from 5 to 200 kDa were determined using image analysing software (Fig. 1a). The respective molecular weights of the signal bands (presented with a decimal for better differentiation) were determined by the software in relation to the pre-stained molecular weight marker. For each band, the approximated relative protein amounts were summed up for all patients (Fig. 1b). A. simplex proteins ranging from 25 to 80 kDa showed particularly strong IgE-binding. Several proteins were detected by all sera, and IgE-binding to the band at 55.5 kDa was the strongest, followed by bands at 37.7 and 73.3 kDa. Second to this triplet were four protein bands at 40.8, 47.5, 63.7, and 68.0 kDa, followed by a group of eight bands at 25.3, 34.4, 35.9, 39.3, 43.2, 50.3, 58.6, and 204.6 kDa. In contrast, some proteins were recognised with considerable strength only by a few patient sera such as 18.2 kDa by N1, N4, N7, S4, and S6 and 13.7 kDa by N12, S11, S12, and S13. Only S11 bound to a protein band at 5.5 kDa.

Fig. 1.

Fig. 1

(a) IgE-immunoblot with total A. simplex extract using sera from14 Norwegian (N1–N14) and 13 Spanish (S1–S13) patients with sensitivity to A. simplex (s. Table 2). Relevant lanes were extracted from the scanned individual patient immunoblots and presented as a composite gel. M: SeeBluePlus2 molecular weight marker; relative protein molecular weights (kDa) are indicated on the right. (b) Bar Chart showing summarised binding intensities of 27 patients for 22 IgE-binding signals on immunoblot (Fig. 1a). Protein molecular weights (kDa) as determined by GelPro Analyzer® are given on the ordinate, protein amounts (ng), calculated as described in Section 2, are on the abscissa. The contributions of individual patients to the combined results are marked by different patterns as shown in the legend.

Evaluating the two patient groups separately (figures not shown) showed very similar binding patterns for the Norwegian and Spanish sera. There were, however, slight differences for five protein bands. Whereas the combined Norwegian sera appeared to bind stronger to the protein at 68.0 kDa, the Spanish sera showed stronger binding to bands at 13.7, 25.3, 47.5, and 63.7 kDa.

3.4. Characterisation of A. simplex proteins using MS-based proteomics

Total protein extract from A. simplex was separated by one-dimensional gradient electrophoresis under denaturing conditions (Fig. 2). At least 22 protein bands in the range from 3 to 200 kDa were visible after gel staining, forming a multi-band pattern. Protein bands at about 40, 48, 56 and 73 kDa were particularly intense, but many other bands in the upper molecular range were also clearly visible.

Fig. 2.

Fig. 2

Coomassie-stained SDS-PAGE of total A. simplex protein extract. Gel bands (No. 1–16) were excised, digested with trypsin, and subjected to mass spectrometric analysis. SeeBlue Plus2 molecular weight marker; relative protein sizes (kDa) are given on the left side of the gel.

Tryptic peptides of 16 A. simplex protein bands (Fig. 2) were analysed with LC/MSMS. The resulting peptide masses, patterns and sequences were compared to the database entries for nematodes. A. simplex proteins were identified by peptide homologies to known nematode proteins (Table 3). The numbers of detected matching peptides varied from only 1 to 56, resulting in uncertainties for proteins with low hit rates. However, among the 10 proteins described by one peptide (Table 3) were two known A. simplex proteins.

Table 3.

Anisakis simplex proteins identified by proteomic analysis using ESI-Iontrap or ESI-Orbitrap mass spectrometry and database search (UniProt).

No.a Protein name Protein family AllFam/Pfam Access. no. MW (kDa)a Peptide matchb Mascot score Sequence coverage (%)c
1 Myosin-4 AF007/PF00063& PF0273 F1KQ88 200 45 1323 27 (Asc s)
Filamin-A –/PF00630 F1KPN0 6 146 3 (Asc s)
Apolipophorin AF092/PF01347 & PF09172 F1KPM2 3 45 1 (Asc s)
Carbonic anhydrase AF139/PF00194 E0VS50 1 44 <1 (Ped h)
2 RAS GTPase-activating protein –/PF03836 F1KR99 170 3 89 2 (Asc s)
Clathrin heavy chain –/PF00637 F1KQ49 2 36 1 (Asc s)
ATP-dependent RNA-helicase –/PF00270 & PF04408 Q7QCW2 23 32 20 (Ano g)
Coiled-coiled protein –/PF03915 Q7PQ25 13 32 17 (Ano g)
3 Pyruvate carboxylase 1 –/PF02786 & PF02436 F1KRV7 100 10 84 8 (Asc s)
Kinesin light chain –/PF09311 & PF00515 Q05090 18 33 25 (Str p)
Calponin-like protein AF164/PF00307 & PF00402 F1KPY3 56 34 26 (Asc s)
4 Elongation factor 2 –/PF00009 & PF00679 F1KWZ4 91 25 772 33 (Asc s)
α-Actinin AF164/PF00307 & PF00435 F1KR95 21 486 25 (Asc s)
Glycogen phosphorylase –/PF00343 F1KSK3 17 413 20 (Asc s)
Tetrahydrofolate synthase –/PF01268 F1KRW4 8 342 11 (Asc s)
Transitional endoplasmic reticulum ATPase 1 –/PF02359 & PF2933 F1LCZ2 8 376 26 (Asc s)
10-Formyltetrahydrofolate dehydrogenase AF040/PF00551 & PF00171 F1KT06 14 279 13 (Asc s)
Paramyosin (Ani s 2) AF100/PF01576 Q9NJA9 12 251 17 (Ani s)
Nuclease-domain containing protein 1 –/PF00565 & PF00567 F1KT77 8 195 10 (Asc s)
26S proteasome subunit 2 –/PF01851 F1KV05 5 164 5 (Asc s)
Aminopeptidase –/PF01433 & PF11838 F1KUM7 6 138 9 (Asc s)
Glycine dehydrogenase –/PF02347 F1KTS9 4 72 5 (Asc s)
5 Propionyl-CoA carboxylase α –/PF00289 & PF00364 F1KUZ6 83 20 1123 30 (Asc s)
Methylmalonyl-CoA mutase –/PF01642 F1KWB3 20 836 35 (Asc s)
Heat shock protein 90 AF042/PF00183 C1KG49 20 495 29 (Asc s)
6-Phosphofructokinase –/PF00365 F1KSL6 8 326 13 (Asc s)
Aconitate hydratase AF186/PF00330 & PF00694 F1KYA7 7 268 10 (Asc s)
6 Heat shock protein 70 AF002/PF00012 A8Q5Z6 70 21 946 35 (Bru m)
Phosphoenolpyruvate carboxykinase –/PF00821 Q05893 21 617 35 (Asc s)
1,4-α-Glucan-branching enzyme (α-amylase) AF033/PF00128 & PF02806 F1KTZ0 9 283 15 (Asc s)
Transketolase-1 –/PF00456 A8WUX5 6 281 8 (Cae b)
Moesin –/PF00769 &PF03979 F1KX42 9 193 20 (Asc s)
Glycogen synthase –/PF05693 F1KYL5 9 147 14 (Asc s)
ATP synthase subunit A AF048/PF00006 F1KW99 8 131 13 (Asc s)
Intermediate filament protein B AF008/PF00038 P23731 2 114 4 (Asc s)
Succinate dehydrogenase –/PF00890 & PF02910 Q8WSR3 3 64 6 (Asc s)
Endochitinase AF077/PF00704 F1L1F6 1 42 3 (Asc s)
7 Glutamate dehydrogenase –/PF00208 & PF02812 F1L1D2 56 11 780 23 (Asc s)
Glucose-6-P-isomerase –/PF00342 F1KUW6 9 570 17 (Asc s)
Heat shock protein 60 –/PF00118 F1KVK8 13 287 20 (Asc s)
Phosphoglucomutase-1 –/PF02878 & PF00408 F1L0Y5 8 230 15 (Asc s)
Disulphide isomerase AF023/PF00085 B2REF9 7 145 17 (Asc s)
Protein phosphatase PP2A –/PF02985 F1KVC0 4 83 8 (Asc s)
Plastin-2 –/PF00307 F1KY27 2 63 3 (Asc s)
Myophilin AF164/PF00307 Q24799 1 59 9 (Ech g)
Translation initiation factor 3 –/PF10255 F1KUY0 2 55 2 (Asc s)
Calrecticulin AF055/PF00262 Q0VJ74 2 52 7 (Hel p)
Aldehyde dehydrogenase AF040/PF00171 F1KZ18 1 37 1 (Asc s)
8 Tubulin α AF025/PF00091 & PF03953 F1L649 52 15 695 43 (Asc s)
Tubulin β AF025/PF00091 & PF03953 F1L7U3 15 649 43 (Asc s)
ATP-synthase subunit B AF048/PF00006 F1L006 7 311 15 (Asc s)
Dihydrolipoyl dehydrogenase –/PF00070 & PF02852 F1L686 7 263 22 (Asc s)
Propionyl-CoA carboxylase β –/PF01039 F1L4Y2 6 255 14 (Asc s)
UTP-G-1-P-uridylyltransferase –/PF01704 F1KYX7 9 240 21 (Asc s)
Fumarase –/PF00206 & PF10415 E1FRT7 6 228 21 (Lol l)
Cytosolic dipeptidase –/PF01546 & PF07687 F1L670 5 184 15 (Asc s)
6-Phosphogluconate dehydrogenase –/PF00393 &PF03446 F1L0I1 6 147 15 (Asc s)
26S protease subunit 4 –/PF00004 F1L7Q7 4 108 9 (Asc s)
Importin α –/PF00514 F1L5L6 2 43 5 (Asc s)
Glycine/serine hydroxymethyltransferase –/PF00464 B7PG87 1 42 1 (Ixo s)
9 Enolase AF031/PF00113 & PF03952 Q8MU59 49 30 4392 80 (Ani s)
Rab GDP dissociation inhibitor α –/PF00996 F1KV11 12 596 40 (Ani s)
Elongation factor 1 α AF011/PF00009 Q9U600 10 534 36 (Ani s)
Phosphoglycerate kinase AF145/PF00162 F1L2P3 10 235 25 (Asc s)
Adenosylhomocysteinase –/PF05221 & PF00670 E1FVC1 4 201 11 (Lol l)
Hexokinase –/PF00349 & PF03727 F1KVA2 5 174 17 (Asc s)
Isocitrate dehydrogenase –/PF00180 F1L8D7 5 157 13 (Asc s)
Initiation factor 4A –/PF00270 & PF00271 F1KY60 8 131 18 (Asc s)
4-Hydroxybutyrate-CoA transferase –/PF02550 F1KWR3 1 83 4 (Asc s)
CAMP-dependent protein kinase regulatory subunit –/PF00027 & PF02197 F1LA32 2 63 9 (Asc s)
Serpin serine proteinase inhibitor AF018/PF00079 F4MST7 5 45 12 (Ani s)
Imidazolone propionase –/PF13147 F1L4M6 2 43 4 (Asc s)
Nucleosome assembly protein –/PF000956 Q9U602 1 36 8 (Ani s)
10 Actin –/PF00022 Q25010 42 20 521 58 (Hel a)
Pyruvate dehydrogenase –/PF00676 P26268 9 44 30 (Asc s)
11 Glyceraldehyde-3-P-dehydrogenase AF184/PF00044 & PF02800 P48812 40 12 424 37 (Bru m)
Tropomyosin (Ani s 3) AF054/PF00261 Q9NAS5 11 299 37 (Ani s)
Fructose-1,6-bisphosphatase (Ani s FBPP) –/PF00316 E3MYI5 3 233 15 (Cae r)
Fructose-bisphosphate aldolase 1 –/PF00274 A8P3E5 3 230 15 (Bru m)
Haemoglobin AF009/PF00042 P26914 3 149 5 (Pse d)
Malate dehydrogenase AF014/PF00056 & PF02866 F1L7C0 3 102 5 (Asc s)
Arginine kinase AF049/PF00217 & PF02807 E1GBI0 3 53 10 (Lol l)
60S acidic ribosomal protein AF070/PF00428 & PF00466 A8PQF5 1 42 3 (Bru m)
Antigenic IgI-domain –/PF07679 Q8MY16 7 34 20 (Asc s)
12 14-3-3 Protein –/PF00244 F1KXW6 34 13 880 42 (Asc s)
Proteasome subunit α 1 AF149/PF00227 F1L3M2 7 226 33 (Asc s)
40S ribosomal protein S3 AF185/PF00189 & PF07650 F1L5X2 7 200 34 (Asc s)
60S ribosomal protein L5 –/PF00861 & PF14204 F1L6Y6 2 111 23 (Bru m)
Glucosamine-6-phosphate deaminase –/PF01182 F1KZ94 2 92 10 (Sac k)
ADP/ATP translocase –/PF00153 F1LB38 5 71 15 (Asc s)
3-Oxoacyl-reductase AF028/PF00106 O17915 2 64 9 (Asc s)
GTP-binding nuclear protein ran-1 –/PF00071 F1KXW6 3 48 14 (Cae e)
13 Triosephosphate isomerase AF032/PF00121 P91919 27 4 166 20 (Cul p)
14 Thioredoxin peroxidase 2 AF167/PF10417&PF00578 Q17172 22 4 107 29 (Bru m)
60S ribosomal protein L11 –/PF00281 & PF00673 Q94793 4 74 30 (Tox c)
40S ribosomal protein S7 –/PF01251 P33514 8 62 32 (Ano g)
Glutathione-S-transferase AF010/PF00043 & PF02798 P46436 5 50 15 (Asc s)
15 SXP/RAL-2 protein (Ani s 8) AF137/PF02520 A7M6Q6 15 4 40 28 (Ani s)
Calmodulin AF007/PF00036 & PF01036 O16305 1 (20) 11 (Cae e)
Troponin-like protein (Ani s troponin) AF007/PF00036 & PF01036 Q9U3U5 1 (10) 14 (Ani s)
16 Histone 4 –/PF00047 Q6WV72 12 14 38 83 (Myt t)
a

Protein band number and molecular weight from SDS-PAGE gel (Fig. 1).

b

Proteins characterised by only one peptide match are uncertain.

c

Sequence coverages as found to homologous protein species in other ecdysozoan species including Anisakis simplex (Ani s), Anopheles gambiae (Ano g), Ascaris suum (Asc s), Brugia malayi (Bru m), Caenorhabditis briggsae (Cae b), Caenorhabditis elegans (Cae e), Caenorhabditis remanei (Cae r), Culex pipiens (Cul p), Echinococcus granulosus (Ech g), Helicoverpa armigera (Hel a), Heligmosomoides polygyrus (Hel p), Ixodes scapularis (Ixo s), Loa loa (Lol l), Mytilus trossulus (Myt t), Pediculus humanus corporis (Ped h), Pseudoterranova decipiens (Pse d), Saccoglossus kowalevski (Sac k), Strongylocentrotus purpuratus (Str p), Toxocara canis (Tox c).

103 A. simplex proteins were characterised in this study, of which 94 had not been described before. Currently, both the Universal Protein Knowledgebase (UniProtKB) and the NCBI database contain data for 44 unique A. simplex proteins, some of them listed with many protein species and fragments so that the total numbers of entries are 153 and 536, respectively.

The proteins characterised in the present study (Tables 3 and S1) included many structural proteins and locomotoric muscle proteins. Furthermore, proteins associated with transcription or translation processes, the cellular energy supply, or the nuclear DNA repair system, and protein synthesis-associated proteins such as ribosomal subunits, translation initiation factors, and elongation factors were identified. In addition, regulatory proteins as well as transport-related proteins were discovered in the A. simplex extract, but catabolic enzymes accounted for the biggest part of the characterised proteins (Table 3). Many of the enzymes achieving the best Mascot scores were involved in sugar metabolism processes (glycogenolysis, citric acid cycle, glycolysis, pyruvate dehydrogenase, pentose phosphate pathway). Several key enzymes of other metabolic pathways could also be characterised (Table 3) such as enzymes involved in amino acid metabolism. Finally, proteins associated with detoxification reactions as well as invertebrate haemoglobin were found.

3.5. Allocation of A. simplex proteins to allergen families

A considerable number of the detected A. simplex proteins could be classified into 33 allergen families (Table 4) as defined in the AllFam database (http://www.meduniwien.ac.at/allergens/allfam) [28]. The classification is only made with respect to specific peptide sequence motifs and domains and is without prejudice to the actual allergenicity of the respective proteins. Nevertheless, each AllFam class contains known allergens originating from different species. Many of the 16 analysed gel bands (Fig. 2) contained potentially allergenic proteins.

Table 4.

Classification of detected A. simplex proteins to known allergen families.

AllFam Protein family No.a Taxonomy A. simplexb
AF002 Heat shock protein (HSP) 70 6 Fungi, plants, animals HSP70
AF007 EF hand domain allergens 63 Plants, animals Myosin-4, Ani s troponin, calmodulin
AF008 Intermediate filament protein 1 Animal Intermediate filament protein B
AF009 Globin 11 Animals Haemoglobin
AF010 Glutathione S-transferase 8 Fungi, plants, animals Glutathione S-transferase
AF011 Eukaryotic elongation factor 1 1 Fungus Elongation factor 1α
AF014 Lactate/malate dehydrogenase 3 Fungi, plants Malate dehydrogenase
AF018 Serpin serine protease inhibitor 4 Plants, animals Serine protease inhibitor
AF023 Thioreduxin 11 Fungi, plants, animals Disulphide isomerase
AF025 Tubulin/FtsZ family 2 Animals Tubulin α, tubulin β
AF028 Short-chain dehydrogenase 3 Fungi 3-Oxoacyl-reductase
AF031 Enolase 12 Fungi, plants, animals Enolase
AF032 Triosephosphate isomerase 4 Plants, animals Triosephosphate isomerase
AF033 Alpha-amylase 10 Bacteria, fungi, plants, animals α-Amylase
AF040 Aldehyde dehydrogenase 3 Fungi 10-Formyltetrahydro-folate dehydrogenase, aldehydedehydrogenase
AF042 Heat shock protein (HSP) 90 2 Fungi, plants HSP90
AF048 ATP synthase 1 Animal ATP synthase subunit A, ATP synthase subunit B
AF049 ATP:guanido phosphotransferase 11 Animals Arginine kinase
AF054 Tropomyosin 47 Animals Tropomyosin
AF055 Calreticulin family 1 Fungus Calrecticulin
AF070 60S acidic ribosomal protein 11 Fungi, plants, animals 60S acidic ribosomal protein
AF077 Glycoside hydrolase family 9 Plants, animals Endochitinase
AF092 Lipoprotein 6 Animals Apolipophorin
AF100 Myosin tail 5 Animals Paramyosin (Ani s 2)
AF137 SXP/RAL-2 family 3 Animals SXP/RAL-2 protein (Ani s 8)
AF139 Eukaryotic-type carbonic anhydrase 1 Plant Carbonic anhydrase
AF145 Phosphoglycerate kinase 1 Fungus Phosphoglycerate kinase
AF149 Proteasome subunit 1 Plant Proteasome subunit α 1
AF164 EB1 family 1 Animal Calponin-like protein, α-actinin, myophilin
AF167 Peroxiredoxin 1 Plant Thioredoxin peroxidase 2
AF184 Glyceraldehyde 3-phosphate dehydrogenase 2 Fungus, animal Glyceraldehyde 3-phosphate dehydrogenase
AF185 Ribosomal protein S3 1 Fungus 40S ribosomal protein S3
AF186 Aconitase 1 Fungus Aconitase
a

Number of known allergens in this AllFam protein family [28].

b

Extracted from Table 3.

Several known allergens from A. simplex (Table 1) were detected in the present analysis, including paramyosin (Ani s 2) containing myosin tail (AF100), tropomyosin (Ani s 3) (AF054), Ani s troponin including an EF-hand domain (AF007), SXP/RAL-2 protein Ani s 8 (AF137), and fructose 1,6-bisphosphatase Ani s FBPP (without AllFam number). However, the majority of the newly characterised A. simplex proteins, which could be allocated to an allergen family, had not been described before (Table 4).

3.6. Comparison of potential A. simplex allergens to known nematode, insect, and shellfish allergens

Focussing on AllFam families containing homologous allergenic proteins from potentially cross-reacting species such as other nematodes, insects, or shellfish, 17 allergen candidates from A. simplex have been identified in this study (Table 5).

Table 5.

Potential novel allergens in A. simplex and homologues in nematodes, insects, and crustaceans.

Protein MWa (kDa) AllFamb Homologous allergensc
Apolipophorin 353.6 AF092 Cockroach (Bla g vitellogenin)
Mite (Der p 14, Der f 14, Eur m 14)
Calponin-like protein 256.1 AF164 Roundworm (Asc s calponin)
Carbonic anhydrase 233.7 AF139 Louse (Ped h carbonic anhydrase)
Myosin-4 218.6 AF007 Cockroach (Bla g 8)
Midge (For t myosin)
Shrimp (Lit v 3)
α-Amylase 84.4 AF033 Mite (Blo t 4, Der p 4, Eur m 4, Tyr p 4)
Mosquito (Aed a 4)
Midge (Cul n 8)
Heat shock protein 70 70.5 AF002 Mite (Der f HSP, Blo t HSP)
Cockroach (Bla g HSP)
Midge (Cul n HSP)
Fly (Sim vi 70 kDa)
Myophilin 21.2 AF164 tapeworm (Ech g myophilin)
Disulphide isomerase 55.6 AF023 Moth (Plo i 2)
Shrimp (Lit v TRX)
Tubulin α/β 55.6/51.3 AF025 Mite (Lep d alpha tubulin, Tyr p alpha tubulin)
Enolase 47.7 AF031 Cockroach (Bla g enolase)
Arginine kinase 41.8 AF049 Cockroach (Bla g 9, Per a 9)
Mite (Der p 20)
Moth (Plo i 1)
Shrimp (Lit v 2, Cra c 2, Met e 2, Pen m 2)
Crab (Chi o 2, Scy s 2)
Lobster (Hom g 2)
Endochitinase 40.0 AF077 Mite (Der f 15, Der f 18, Der p 15, Der p 18, Blo t 15)
Haemoglobin 39.5 AF009 Midge (Chi k 1, Pol n 1, Chi t 1-9)
Fructose-1,6-bisphosphate aldolase 1 39.5 Cockroach (Bla g FPA)
Midge (For t FPA)
60S acidic ribosomal protein 34.9 AF070 Midge (Cul n 1)
Triosephosphate isomerase 26.3 AF032 Cockroach (Bla g TPI)
Midge (For t TPI)
Crayfish (Arc s 8)
Shrimp (Cra c 8)
Glutathione-S-transferase 23.6 AF010 Cockroach (Bla g 5, Per a 5)
Mite (Aca s 8, Ale o 8 Blo t 8, Der f 8, Der p 8, Gly d 8, Lep d 8, Sui m 8, Tyr p 8, Sar s GST)
Nematode (Asc s GST, Bru m GST, Loa lo GST, Onc v GST, Sch j GST, Wuc ba GST)
a

Molecular weight according to peptide sequence (UniProt database).

b

AllFam [28].

c

Homologous allergens in other ecdysozoan species: Aedes aeqypti (Aed a), Aleuroglyphus ovatus (Ale o), Archaeopotamobius sibiriensis (Arc s), Ascaris suum (Asc s), Blatella germanica (Bla g), Blomia tropicalis (Blo t), Brugia malayi (Bru m), Chironomus kiiensis (Chi k), Chionoecetes opillo (Chi o), Chironomus thummi thummi (Chi t), Crangon crangon (Cra c), Culicoides nubeculosus (Cul n), Dermatophagoides farinae (Der f), Dermatophagoides pteronyssinus (Der p), Echinococcus granulosus (Ech g), Euroglyphus maynei (Eur m), Forcipomyia taiwana (For t), Glycyphagus domesticus (Gly d), Homarus gammarus (Hom g), Lepidoglyphus destructor (Lep d), Litopenaeus vannamei (Lit v), Loa loa (Lol lo), Metapenaeus ensis (Met e), Onchocerca volvulus (Onc v), Pediculus humanus corporis (Ped h), Penaeus mondon (Pen m), Periplaneta americana (Per a), Plodia interpunctella (Plo i), Polypedilum nubiferum (Pol n), Sarcoptes scabiei (Sar s), Schistosoma japonicum (Sch j), Scylla serrata (Scy s), Simulia vittata (Sim vi), Suidasia medanensis (Sui m), Tyrophagus putrescentiae (Tyr p), Wuchereria bancrofti (Wuc ba).

Myosin-4 contains the well-conserved EF-hand motif of structural proteins, and some of the major allergens of animal origin belong to this protein class. Myosin light chain from German cockroach is an inhalant allergen [29], myosin heavy chain from biting midge is allergenic by bite [30], and European white shrimp myosin is a known food allergen [31]. Carbonic anhydrase is a major antigen in human body louse and the sanyak plant [32]. Lipid transport proteins including apolipophorin, and vitellogenin have been determined as allergens in German cockroach and three species of house dust mites [33]. Calponin-like protein, belonging to the EB1 family, is as a major allergen in pig roundworm [34]. Myophilin, from the same protein family, is recognised as a muscle-specific antigenin dog tapeworm [35]. Alpha-amylase has homologues in yellowfever mosquito, mites, and midge, which all have been shown to elicit allergenic reactions by sting, bite, or inhalation [33]. Heat shock protein 70 (HSP70) is a known allergenic inhalant in house dust mite [36], storage mite, biting midge, black fly, and cockroach [29]. Endochitinase, a glycoside hydrolase from the chitinase class III group, was detected a 70 kDa. The weight of the nematode aglycone from A. suum is 40 kDa but chitinases are generally highly glycosylated. The enzyme has been identified as a major mite allergen for cats, dogs, and humans [33,37]. Disulphide isomerase contains a thioredoxin domain. Thioredoxins (TRX) with IgE-binding potential have been determined in Indian meal moth and white shrimp. Tubulin α has been found to cause asthma and allergy after inhalation of dust containing fodder mite or dust mite. Enolase is a major cross-reacting allergen in plants, fungi, and fish, and has also been recognised as an allergen in cockroach [29]. Arginine kinase (ATP-guanido phosphotransferase) is an important cross-reactive pan-allergen in invertebrates. So far, IgE-binding arginine kinases have been identified in 11 insect and shellfish species, including cockroaches, mite, moth, shrimps, crabs, and lobster. Haemoglobin is a known allergen in midges. Fructose-bisphosphate aldolase I (FPA) has not been assigned an AllFam-number yet, although it has shown allergenicity in cockroach and biting midge [30]. The 60S ribosomal protein (AF070) is allergenic in horses by sting or bite from midge [38]. Moreover, the protein is an inhalant or ingestion allergen in many fungi and some plants. Triosephosphate isomerase (TPI) has been characterised as an allergen in several invertebrates and plants. The enzyme can elicit allergic reactions in humans by inhalation of dust containing cockroach debris [29], by midge bite or sting [30], or by ingestion of crayfish and shrimp. Glutathione-S-transferase (GST) has been identified as an important allergen in German and American cockroaches [39,40]. The enzyme is also termed Group 8 mite allergen [33]. Furthermore, GST has shown allergenic potential in several parasitic nematodes.

3.7. Combination of immunoblot and proteomics data

Several A. simplex proteins of particular interest emerged when the immunoblot analysis and the proteomics data were considered together. The alignment of blot and gel gave an indication of which proteins could be responsible for IgE-binding. Several strong signals (Fig. 1a and b) coincided with known A. simplex allergens (Table 1) or proteins that are known allergens in other invertebrate species (Table 5). Due to this approximation, the high-molecular weight proteins myosin-4, apolipoprotein, and carbonic anhydrase might have caused binding at about 200 kDa. In the range from 82 to 185 kDa, the combined total IgE-binding was rather low, although individual patients reacted strongly to some proteins (Fig. 1b). The proteomics data suggested the presence of calponin-like protein and paramyosin (Ani s 2) at this molecular weight. Comparably, it could be assumed that the immunoblot signal at 85 kDa might be associated with the presence of heat shock protein 90 or aconitate hydratase (Table 4) and that the signal triplet at 73, 68, and 64 kDa was associated with α-amylase, heat shock protein 60, and endochitinase (Table 5). The strongest observed IgE-binding signal for all patients at 56 kDa might be correlated to disulphide isomerase and myophilin (Table 5). The tubulins α and β could be associated to the signal duplet at 59 and 50 kDa and enolase could have produced the signal at 48 kDa. The four signals from 43 to 38 kDa are potentially related to the presence of arginine kinase, haemoglobin, fructose-1,6-bisphosphate aldolase 1, and 60S acidic ribosomal protein in the same molecular range on the gel. The IgE-binding at about 35 kDa could result from tropomyosin (Ani s 3) (Table 1). Triosephosphate isomerase or gluthatione-S-transferase was candidates to have caused the relatively strong signal at 25 kDa. Troponin C (Ani s troponin) and the SXP/RAL-2 proteins (Ani s 5, Ani s 8, Ani s 9) were potentially responsible for some of the scattered immunoblot signals at lower molecular weights (Fig. 1a).

3.8. Marker peptides of potential novel A. simplex allergens

Unique allergen peptides could be suitable for the screening of potentially contaminated food products. Several of the newly discovered allergen candidates from A. simplex were therefore studied in more detail using high-resolution MS/MS for the identification of possible biomarkers. Considering the qualities of the individual data, peptides from eleven A. simplex proteins were selected (Table S2).

Enolase (Fig. S1a) showed the best results under the chosen measurement conditions. Comparison to the A. simplex enolase protein sequence in the UniProt database revealed no mismatches in the 30 peptides that had been determined by MS/MS-analysis. Enolase was the only of the potential novel allergens, for which A. simplex sequence information was available in the NCBI and UniProt protein databases. One in many species highly conserved enolase peptide and two A. simplex-specific peptides were identified as good marker peptide candidates (Table S1, Fig. S1b and c). Additionally, an A. simplex-specific peptide was found in myosin-4 (Fig. S2), with identity in 13 or 14 of the 15 amino acids, respectively, to homologous myosin-4 in the nematodes A. suum and Caenorhabditis elegans. The marker peptides detected in α-amylase, HSP70, disulphide isomerase, tubulin α, arginine kinase, 60S acidic ribosomal protein, triosephosphate isomerase, and glutathione-S-transferase are all highly conserved in nematodes (Table S2, Fig. S2). In contrast, nematode haemoglobins are less homologous. The proteins from cod worm (Pseudoterranova decipiens), pig roundworm (Ascaris suum), and canine roundworm (Toxocara canis) share only 60 to 65% homology. However, a C-terminal peptide of A. simplex haemoglobin had 100% sequence identity to the homologous peptide in the closely related Anisakis peregreffi (Table S2, Fig. S2).

4. Discussion

Allergy to A. simplex and gastro-allergic anisakiasis caused by contaminated fishery products have been recognised as a food safety concern [6]. At the same time, there is a lack of data regarding the allergenic potential of anisakid proteins. The A. simplex genome is not completely identified and only a relatively small number of A. simplex proteins have been entered into protein databases to date. However, the observed complex patterns in immunoblots using patient sera have led to the entry of 21 A. simplex proteins into the Allergome database [25] reflecting the ambiguous situation. The respective importance of the listed allergens is under discussion because a high frequency of false-positive results in immunoblots with sera from sensitised patients without clinical manifestations and even in healthy control individuals has been observed [1,14,16,41]. Additionally, the allergenic potentials of several of the listed A. simplex proteins designated as allergens, including Ani s 5, Ani s 6, Ani s 7, Ani s 10, Ani s 11, and Ani s 12, have been determined only by immunoscreening of an expression cDNA or phage display library with serum from a single patient [26].

In order to characterise the allergenic potential of A. simplex proteins further we have performed immunostaining with sera from sensitised Spanish and Norwegian patients and proteomic analysis.

4.1. Sensitisation to A. simplex proteins in the patient groups

Compared to the high incidence of infestation of wild-caught marine edible fish by A. simplex larvae, cases of anisakiasis and clinically manifested allergy to anisakid proteins are surprisingly uncommon. The occurrence of anisakiasis is directly connected to special dietary habits such as the consumption of raw and undercooked fish in certain geographical regions. In contrast the ratio of anti-A. simplex IgE seropositive persons in a population is considerably higher, but again, sensitisation appears to be geographically dependent [1].

There is apparently a connection between the frequency of anisakid infections and the rate of sensitisation in specific populations. It has been suggested that infection with parasitic worms may modulate the immune reactivity of the host [42]. The nematode presumably blocks the mechanisms that trigger allergic incidents resulting in an overall systemic anti-allergic effect although the nematode allergens stimulate the generation of specific IgE. In this context, invertebrate tropomyosin, a conserved muscle protein present in high amounts in all nematodes, is regarded as a promising candidate for a vaccine against allergy to nematodes [42]. On the other hand it has been argued that acute or sporadic forms of parasitism, such as gastro-allergic anisakiasis, are associated with an elevated risk of allergy [43,44].

The IgE-immunoblots performed in our study showed little variability between Norwegian and Spanish patients. Reactivity in SPT and specific IgE serum levels did not appear to be directly correlated, and IgE classes were not recognisably connected to binding patterns and intensities. The observed binding patterns showed more inter-individual than inter-group differences, as previously noted [45]. Three regions on the immunoblots, depicting IgE-binding to proteins with molecular weights of 80–150 kDa, 30–40 kDa, and <20 kDa, demonstrated the most diversity between patients.

The greatest difference with regard to the two patient groups was the consistent co-sensitisation to mite in the Norwegian patients. More than 90% of the study subjects had anti-mite IgE of class 2 or more, whereas the Spanish patients were not, or to a lesser degree, sensitised to mite. This difference might explain the observed small variations in immunoblot binding intensities to five protein bands when comparing the combined results of each group. Although the results could only be considered as indicative due to the uncertainties connected to some variances in the background noise of the blots and the image processing performed, they allowed the observation of some trends: The Norwegian sera appeared to bind notably stronger to a protein band at 68 kDa, which according to the proteomic analysis could contain A. simplex heat shock protein 70, a known mite allergen [36]. Furthermore, α-amylase, another insect allergen, was presumably recognised at 73 kDa. The potential importance of cross-reactivity of anti-insect IgE with anisakid proteins was further confirmed by the results for the four patients who were sensitised to mite but not to A. simplex. Cross-sensitisation and allergenic cross-reactivity to mite had also been observed in Norwegians with anti-A. simplex IgE in previous studies [14,46].

The Spanish sera bound rather intensely to a protein band at 14 kDa, tentatively characterised as an SXP/RAL2-protein (Ani s 8). Excretory/secretory (ES) proteins such as Ani s 8 are up-regulated following host infection. Not surprisingly, the sera of the anisakiasis patients S10–S13 showed the strongest binding to this allergen. In total somatic extracts from A. simplex larvae, as used in the present study, the secretory proteins originate from the excretory glands and are generally underrepresented [23]. Consequently, we found only a few ES proteins by proteomic analysis. Three other signals that appeared to be preferentially represented in the immunoblot from the Spanish sera were provisionally aligned with triosephosphate isomerase (25 kDa), enolase (48 kDa), and endochitinase (64 kDa). A 48 kDa protein, presumably enolase, was also well recognised in another study involving Spanish patients [16,45].

In general, the IgE-binding patterns to A. simplex proteins found in the present experiment were comparable to those in previous published studies describing complex patterns with multiple bands in the range from 14 to 190 kDa [15,16,20,23,47,48]. Sera of anisakiasis patients bound preferentially to ES allergens and their carbohydrated forms [17,47], with dominant bands at 14, 56, and 72 kDa [41]. In somatic extracts, the strongest binding occurred at 43, 48, and 56 kDa [23,45], which could be related to the allergen candidates arginine kinase, enolase, disulfide isomerase, and myophilin determined in the present study. Based on our results, the designated pan-allergens paramyosin (Ani s 2) and tropomyosin (Ani s 3) were of lesser importance confirming previous findings that have questioned the clinical relevance of these anisakid proteins [43].

4.2. Analysis of the A. simplex proteome

The proteomic analysis of the somatic A. simplex extract resulted in the identification of numerous proteins by comparison to homologous peptides from database-listed nematode proteins. Since entries for nematodes of the Anisakidae family (including A. simplex and Pseudoterranova decipiens) are scarce, we used data of the phylogenetically closely related Ascaris suum of the Ascaridae family as the best fit. Both families belong to the same Ascaridoidea superfamily and Ascaridida order [49], whereas the “model” nematode Caenorhabditis elegans, the genome of which has been totally sequenced, belongs to the Rhabditida order and is more distantly related.

Many of the characterised A. simplex proteins were enzymes involved in carbohydrate metabolism. Parasitic nematodes use glucose from the host environment at a high rate, and glycogen has been shown to be their main endogenous carbohydrate [50]. Structural and muscle proteins were likewise present in considerable abundance in the somatic extract. They account for an essential part of the nematode's total body weight and are easily detected. Generally, when using a mass spectrometry-based proteomics approach without targeted enrichment, the more abundant proteins in an organism achieve the highest sequence coverage and best peptide Mascot scores, as observed here.

4.3. Novel A. simplex allergen candidates

Recently, the determination of new allergens has preferably been based on methods of molecular allergology such as the immunoscreening of cDNA libraries rather than the previously applied immunoblots [26]. However, this approach is somewhat limited in that allergen detection is based on a single patient serum, and protein expression in culture is not necessarily the same as in a live organism. In contrast, immunoblot analysis uses representative protein extracts and often multiple patient sera, but allergen detection is restricted to molecular weight comparisons or confirmation by monoclonal antibodies.

In the present study we combined the advantages of IgE-based immunoscreening with mass spectrometry-based proteomics, allowing for the direct identification of protein bands of interest and description of a number of new allergen candidates extracted from A. simplex. Somatic protein extracts contain a large variety of proteins and the sensitivity and reactivity of patients are highly variable as multi-band immunoblot patterns confirm [16,48]. Nevertheless, proteins have to be fairly abundant to elicit IgE-sensitisation and are therefore well-suited for MS-based strategies, so that both techniques are mutually supportive.

Considering the observed cross-reactivity among ecdysozoan species [46] we were particularly interested in potentially allergenic A. simplex proteins that were homologous to known allergens in related phyla such as other nematodes, insects, or shellfish. According to our findings, myosin, heat shock protein 70, α-amylase, disulphide isomerase, myophilin, enolase, arginine kinase, haemoglobin, fructose-1,6-biphosphate aldolase 1, 60S acidic ribosomal protein, triosephosphate isomerise, and glutathione-S-transferase are all candidates for causing insect-nematode cross-allergies.

4.4. Marker peptides for A. simplex

Peptide sequence analyses of selected A. simplex proteins resulted in the determination of a number of marker peptides for the specific detection of this nematode, underlining the great potential of MS-based proteomic analysis. This technique may allow the differentiation between homologous proteins from related nematode species and could therefore be used for the classification of food and feed contaminants. In a next step, it will be advantageous to verify our findings by using fractionated or recombinant proteins for the immunoblotting experiments or to perform two-dimensional electrophoresis, and to study the allergenicity of selected allergen candidates in more detail.

In conclusion, A. simplex is known for its diversity of antigens that are responsible for the development of differential clinical responses [1]. By comparing serum analyses and proteome data we have characterised a number of potential novel allergens of this fish parasite. They will facilitate further studies on the mechanisms leading to A. simplex sensitisation and on the risk characterisation with regard to its allergic potential.

Supplementary Material

01
02
03
04
05
06

Acknowledgments

The authors would like to thank Dr. Arne Levsen from the National Institute of Nutrition and Seafood in Bergen, Norway, for the sourcing and characterisation of Anisakis simplex 3rd stage larvae. We greatly appreciate Marianne Werner from the Norwegian Veterinary Institute for preparing the protein extracts. Furthermore, we are very grateful to Agnieszka A. Kendrick from the University of Colorado at Denver for technical assistance with the ESI-IT-MSMS and to Christian Köhler from the University of Oslo for help with the protein database searching. Additional funding for the activities at the University of Colorado was received by NIH/NIDDK P30 DK48520.

Funding: This study was funded by the Orkla Foundation, Norway.

Abbreviations

A. simplex

Anisakis simplex

m/z

mass-to-charge ratio

NanoLC ESI-MS/MS

nano-liquid chromatography electrospray ionisation tandem mass spectrometry

OD

optical density

Footnotes

Conflict of interest statement: The authors declare that they have no conflict of interest.

Transparency document: The Transparency document associated with this article can be found in the online version.

Appendix A. Supplementary data: Supplementary data associated with this article can be found, in the online version, at doi:10.1016/j.euprot.2014.06.006.

References

  • 1.Audicana MT, Kennedy MW. Anisakis simplex: from obscure infectious worm to inducer of immune hypersensitivity. Clin Microbiol Rev. 2008;21:360–79. doi: 10.1128/CMR.00012-07. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2.Daschner A, Alonso-Gómez A, Cabañas R, Suarez-de-Parga JM, López-Serrano MC. Gastroallergic anisakiasis: borderline between food allergy and parasitic disease-clinical and allergologic evaluation of 20 patients with confirmed acute parasitism by Anisakis simplex. J Allergy Clin Immunol. 2000;105:176–81. doi: 10.1016/s0091-6749(00)90194-5. [DOI] [PubMed] [Google Scholar]
  • 3.Audicana MT, Fernández de Corres L, Muñoz D, Fernández E, Navarro JA, del Pozo MD. Recurrent anaphylaxis caused by Anisakis simplex parasitizing fish. J Allergy Clin Immunol. 1995;96:558–60. doi: 10.1016/s0091-6749(95)70301-2. [DOI] [PubMed] [Google Scholar]
  • 4.Nieuwenhuizen N, Lopata AL, Jeebhay MF, Herbert DR, Robins TG, Brombacher F. Exposure to the fish parasite Anisakis causes allergic airway hyperreactivity and dermatitis. J Allergy Clin Immunol. 2006;117:1098–105. doi: 10.1016/j.jaci.2005.12.1357. [DOI] [PubMed] [Google Scholar]
  • 5.Pravettoni V, Primavesi L, Piantanida M. Anisakis simplex: current knowledge. Eur Ann Allergy Clin Immunol. 2012;44:150–6. [PubMed] [Google Scholar]
  • 6.EFSA Panel on Biological Hazards (BIOHAZ) Scientific opinion on risk assessment of parasites in fishery products. EFSA J. 2010;8:1543–634. [Google Scholar]
  • 7.Armentia A, Martin-Gil FJ, Pascual C, Martín-Esteban M, Callejo A, Martínez C. Anisakis simplex allergy after eating chicken meat. J Investig Allergol Clin Immunol. 2006;16:258–63. [PubMed] [Google Scholar]
  • 8.Deardorff TL, Kayes SG, Fukumura T. Human anisakias is transmitted by marine food products. Hawaii Med J. 1991;50:9–16. [PubMed] [Google Scholar]
  • 9.Añíbarro B, Seoane FJ, Múgica MV. Involvement of hidden allergens in food allergic reactions. J Investig Allergol Clin Immunol. 2007;17:168–72. [PubMed] [Google Scholar]
  • 10.Mazzucco W, Lacca G, Cusimano R, Provenzani A, Costa A, Di Noto AM, et al. Prevalence of sensitisation to Anisakis simplex among professionally exposed populations in Sicily. Arch Environ Occup Health. 2012;67:91–7. doi: 10.1080/19338244.2011.578683. [DOI] [PubMed] [Google Scholar]
  • 11.Sakanari JA, McKerrow JH. Anisakiasis. Clin Microbiol Rev. 1989;2:278–84. doi: 10.1128/cmr.2.3.278. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 12.Levsen A, Lunestad BT. Anisakis simplex third stage larvae in Norwegian spring spawning herring (Clupea harengus L.), with emphasis on larval distribution in the flesh. Vet Parasitol. 2010;171:247–53. doi: 10.1016/j.vetpar.2010.03.039. [DOI] [PubMed] [Google Scholar]
  • 13.Klimpel S, Palm HW. Anisakid nematode (Ascaridoidea) life cycles and distribution: increasing potential in the time of climate change? In: Melhorn H, editor. Progress in parasitology. 1st. Berlin, Heidelberg, Germany: Springer-Verlag; 2011. pp. 201–22. [Google Scholar]
  • 14.Lin AH, Florvaag E, Van Do T, Johansson SG, Levsen A, Vaali K. IgE sensitisation to the fish parasite Anisakis simplex in a Norwegian population: a pilot study. Scand J Immunol. 2012;75:431–5. doi: 10.1111/j.1365-3083.2012.02670.x. [DOI] [PubMed] [Google Scholar]
  • 15.Del Pozo MD, Moneo I, de Corres LF, Audicana MT, Muñoz D, Fernandez E, et al. Laboratory determinations in Anisakis simplex allergy. J Allergy Clin Immunol. 1996;97:977–84. doi: 10.1016/s0091-6749(96)80073-x. [DOI] [PubMed] [Google Scholar]
  • 16.García M, Moneo I, Audicana MT, del Pozo MD, Muñoz D, Fernández E, et al. The use of IgE immunoblotting as a diagnostic tool in Anisakis simplex allergy. J Allergy Clin Immunol. 1997;99:497–501. doi: 10.1016/s0091-6749(97)70076-9. [DOI] [PubMed] [Google Scholar]
  • 17.Hwang YK, Kim JS, Lee JB, Song TJ, Joo KW, Lee JS, et al. Human anisakiasis: diversity in antibody response profiles to the changing antigens in larval excretions/secretions. Parasite Immunol. 2003;25:1–7. doi: 10.1046/j.1365-3024.2003.00493.x. [DOI] [PubMed] [Google Scholar]
  • 18.Sánchez-Velasco P, Mendizábal L, Antón EM, Ocejo-Vinyals G, Jerez J, Leyva-Cobián F. Association of hypersensitivity to the nematode Anisakis simplex with HLA class II DRB1*1502-DQB1*0601 haplotype. Hum Immunol. 2000;61:314–9. doi: 10.1016/s0198-8859(99)00167-6. [DOI] [PubMed] [Google Scholar]
  • 19.Lorenzo S, Romarís F, Iglesias R, Audícana MT, Alonso JM, Leiro J, et al. O-glycans as a source of cross-reactivity in determinations of human serum antibodies to Anisakis simplex antigens. Clin Exp Allergy. 2000;30:551–9. doi: 10.1046/j.1365-2222.2000.00758.x. [DOI] [PubMed] [Google Scholar]
  • 20.Moneo I, Caballero ML, González-Muñoz M, Rodríguez-Mahillo AI, Rodríguez-Perez R, Silva A. Isolation of a heat-resistant allergen from the fish parasite Anisakis simplex. Parasitol Res. 2005;96:285–9. doi: 10.1007/s00436-005-1362-2. [DOI] [PubMed] [Google Scholar]
  • 21.Caballero ML, Moneo I. Several allergens from Anisakis simplex are highly resistant to heat and pepsin treatments. Parasitol Res. 2004;93:248–51. doi: 10.1007/s00436-004-1099-3. [DOI] [PubMed] [Google Scholar]
  • 22.Moneo I, Audicana MT, Alday E, Curiel G, del Pozo MD, García M. Periodate treatment of Anisakis simplex allergens. Allergy. 1997;52:565–9. doi: 10.1111/j.1398-9995.1997.tb02601.x. [DOI] [PubMed] [Google Scholar]
  • 23.Moneo I, Caballero ML, Gómez F, Ortega E, Alonso MJ. Isolation and characterization of a major allergen from the fish parasite Anisakis simplex. J Allergy Clin Immunol. 2000;106:177–82. doi: 10.1067/mai.2000.106732. [DOI] [PubMed] [Google Scholar]
  • 24.Werner MT, Fæste CK, Levsen A, Egaas E. A quantitative sandwich ELISA for the detection of Anisakis simplex in seafood. Eur Food Res Technol. 2011;232:157–66. [Google Scholar]
  • 25.Mari A, Rasi C, Palazzo P, Scala E. Allergen databases: current status and perspectives. Curr Allergy Asthma Rep. 2009;9:376–83. doi: 10.1007/s11882-009-0055-9. [DOI] [PubMed] [Google Scholar]
  • 26.López I, Pardo MA. A phage display system for the identification of novel Anisakis simplex antigens. J Immunol Methods. 2011;373:247–51. doi: 10.1016/j.jim.2011.08.009. [DOI] [PubMed] [Google Scholar]
  • 27.Faeste CK, Christians U, Egaas E, Jonscher KR. Characterization of potential allergens in fenugreek (Trigonella foenum-graecum) using patient sera and MS-based proteomic analysis. J Proteomics. 2010;73:1321–33. doi: 10.1016/j.jprot.2010.02.011. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 28.Radauer C, Bublin M, Wagner S, Mari A, Breiteneder H. Allergens are distributed into few protein families and possess a restricted number of biochemical functions. J Allergy Clin Immunol. 2008;21:847–52. doi: 10.1016/j.jaci.2008.01.025. [DOI] [PubMed] [Google Scholar]
  • 29.Chuang JG, Su SN, Chiang BL, Lee HJ, Chow LP. Proteome mining for novel IgE-binding proteins from the German cockroach (Blattella germanica) and allergen profiling of patients. Proteomics. 2010;10:3854–67. doi: 10.1002/pmic.201000348. [DOI] [PubMed] [Google Scholar]
  • 30.Chen YH, Lee MF, Lan JL, Chen CS, Wang HL, Hwang GY, et al. Hypersensitivity to Forcipomyia taiwana (biting midge): clinical analysis and identification of major For t 1, For t 2 and For t 3 allergens. Allergy. 2005;60:1518–23. doi: 10.1111/j.1398-9995.2005.00918.x. [DOI] [PubMed] [Google Scholar]
  • 31.Ayuso R, Grishina G, Bardina L, Carrillo T, Blanco C, Ibáñ ez MD, et al. Myosin light chain is a novel shrimp allergen, Lit v 3. J Allergy Clin Immunol. 2008;122:795–802. doi: 10.1016/j.jaci.2008.07.023. [DOI] [PubMed] [Google Scholar]
  • 32.Hur GY, Park HJ, Kim HA, Ye YM, Park HS. Identification of Dioscorea batatas (sanyak) allergen as an inhalant and oral allergen. J Korean Med Sci. 2008;23:72–6. doi: 10.3346/jkms.2008.23.1.72. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 33.Thomas WR, Smith WA, Hales BJ, Mills KL, O'Brien RM. Characterization and immunobiology of house dust mite allergens. Int Arch Allergy Immunol. 2002;129:1–18. doi: 10.1159/000065179. [DOI] [PubMed] [Google Scholar]
  • 34.Wang J, Czech B, Crunk A, Wallace A, Mitreva M, Hannon GJ, et al. Deep small RNA sequencing from the nematode Ascaris reveals conservation, functional diversification, and novel developmental profiles. Genome Res. 2011;21:1462–77. doi: 10.1101/gr.121426.111. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 35.Virginio VG, Hernández A, Rott MB, Monteiro KM, Zandonai AF, Nieto A, et al. A set of recombinant antigens from Echinococcus granulosus with potential for use in the immunodiagnosis of human cystic hydatid disease. Clin Exp Immunol. 2003;132:309–15. doi: 10.1046/j.1365-2249.2003.02123.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 36.Aki T, Fujikawa A, Wada T, Jyo T, Shigeta S, Murooka Y, et al. Cloning and expression of cDNA coding for a new allergen from the house dust mite, Dermatophagoides farinae: homology with human heat shock cognate proteins in the heat shock protein 70 family. J Biochem. 1994;115:435–40. doi: 10.1093/oxfordjournals.jbchem.a124356. [DOI] [PubMed] [Google Scholar]
  • 37.O'Neil SE, Heinrich TK, Hales BJ, Hazell LA, Holt DC, Fischer K, et al. The chitinase allergens Der p 15 and Der p 18 from Dermatophagoides pteronyssinus. Clin Exp Allergy. 2006;36:831–9. doi: 10.1111/j.1365-2222.2006.02497.x. [DOI] [PubMed] [Google Scholar]
  • 38.Althaus H, Müller N, Busato A, Mellor PS, Torsteinsdottir S, Marti E. Cloning and sequencing of a cDNA expressing a ribosomal P0 peptide from Culicoides nubeculosus Diptera) Vet Immunol Immunopathol. 2004;99:99–111. doi: 10.1016/j.vetimm.2004.01.011. [DOI] [PubMed] [Google Scholar]
  • 39.Arruda LK, Vailes LD, Ferriani VP, Santos AB, Pomés A, Chapman MD. Cockroach allergens and asthma. J Allergy Clin Immunol. 2001;107:419–28. doi: 10.1067/mai.2001.112854. [DOI] [PubMed] [Google Scholar]
  • 40.Jeong KY, Lee H, Shin KH, Yi MH, Jeong KJ, Hong CS, et al. Sequence polymorphisms of major German cockroach allergens Bla g 1, Bla g 2, Bla g 4, and Bla g 5. Int Arch Allergy Immunol. 2008;145:1–8. doi: 10.1159/000107460. [DOI] [PubMed] [Google Scholar]
  • 41.Del Rey Moreno A, Valero A, Mayorga C, Gómez B, Torres MJ, Hernández J, et al. Sensitisation to Anisakis simplex s.l. in a healthy population. Acta Trop. 2006;97:265–9. doi: 10.1016/j.actatropica.2005.11.007. [DOI] [PubMed] [Google Scholar]
  • 42.Sereda MJ, Hartmann S, Lucius R. Helminths and allergy: the example of tropomyosin. Trends Parasitol. 2008;24:272–8. doi: 10.1016/j.pt.2008.03.006. [DOI] [PubMed] [Google Scholar]
  • 43.Daschner A, Cuéllar C, Rodero M. The Anisakis allergy debate: does an evolutionary approach help? Trends Parasitol. 2012;28:9–15. doi: 10.1016/j.pt.2011.10.001. [DOI] [PubMed] [Google Scholar]
  • 44.Yazdanbakhsh M, Kremsner PG, van Ree R. Allergy, parasites, and the hygiene hypothesis. Science. 2002;296:490–4. doi: 10.1126/science.296.5567.490. [DOI] [PubMed] [Google Scholar]
  • 45.Baeza ML, Rodríguez A, Matheu V, Rubio M, Tornero P, de Barrio M, et al. Characterization of allergens secreted by Anisakis simplex parasite: clinical relevance in comparison with somatic allergens. Clin Exp Allergy. 2004;34:296–302. doi: 10.1111/j.1365-2222.2004.01883.x. [DOI] [PubMed] [Google Scholar]
  • 46.Johansson E, Aponno M, Lundberg M, van Hage-Hamsten M. Allergenic cross-reactivity between the nematode Anisakis simplex and the dust mites Acarus siro, Lepidoglypus destrucor, Tyrophagus putrescentiae, and Dermatophagoides pteronyssinus. Allergy. 2001;56:660–6. doi: 10.1034/j.1398-9995.2001.00798.x. [DOI] [PubMed] [Google Scholar]
  • 47.Akao N, Ohyama T, Kondo K. Immunoblot analysis of serum IgG, IgA and IgE responses against larval excretory-secretory antigens of Anisakis simplex in patients with gastric anisakiasis. J Helminthol. 1990;64:310–8. doi: 10.1017/s0022149x00012359. [DOI] [PubMed] [Google Scholar]
  • 48.Rodero M, Cuéllar C, Chivato T, Mateos JM, Laguna R. Western blot antibody determination in sera from patients diagnosed with Anisakis sensitisation with different antigenic fractions of Anisakis simplex purified by affinity chromatography. J Helminthol. 2007;81:307–10. doi: 10.1017/s0022149x07820220. [DOI] [PubMed] [Google Scholar]
  • 49.Kim KH, Eom KS, Park JK. The complete mitochondrial genome of Anisakis simplex (Ascaridida: Nematoda) and phylogenetic implications. Int J Parasitol. 2006;36:319–28. doi: 10.1016/j.ijpara.2005.10.004. [DOI] [PubMed] [Google Scholar]
  • 50.Mansour TE. The pharmacology and biochemistry of parasitic helminths. In: Garattini S, Shore PA, editors. Advances in pharmacology. 3rd. New York, USA: Academic Press; 1964. pp. 129–65. [DOI] [PubMed] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

01
02
03
04
05
06

RESOURCES