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PubMed2002

[Anisakis simplex and immediate hypersensitivity reactions].

BACKGROUND: Anisakis simplex is one of the nematode worms that parasitize sea mammals. When its larvae are accidentally ingested by humans, they can infect the host, resulting in anisakiasis manifested by digestive symptoms, or they may cause an allergic reaction, which in some cases may be severe. CASE REPORTS: We report three cases of acute urticaria associated with abdominal pain, and hypotension in two of them, starting two to six hours after ingestion of raw fish. The diagnosis of an allergic reaction caused by Anisakis simplex was based on the clinical histories and positive tests for anisakis-specific IgE. DISCUSSION: In patients with acute urticaria associated with abdominal symptoms, a history of ingestion of raw fish in the preceeding hours is evocative of gastro-allergic anisakiasis. In association with symptomatic treatment, gastrointestinal endoscopy allows the larvae to be visualized and removed, which may relieve the symptoms and provide a diagnosis before the results of skin testing and serological assay are known.

Adult↗
PubMed1992

[Significance of detection of specific IgE in Anisakis-related diseases].

Anisakis larvae which parasitize sea fishes sometimes cause not only anisakiasis but also such allergic reactions as mackerel-induced urticaria. We prepared AlaSTAT by using excretory/secretory antigens from Anisakis larvae to detect specific IgE in various patients groups. The AlaSTAT positive rate was 87.5% in gastric anisakiasis patients who were endoscopically diagnosed, while it was 66.7% in patients who had acute abdominal pain but no larva detected. Ascariasis in the common bile duct was 0%. The positive rate in mackerel-induced urticaria patients was 75.0%, while it was 8.3% and 10.0% in patients with urticaria of unknown origin and normal controls, respectively. Based on these data, the detection of specific IgE using AlaSTAT is useful in elucidating the cause of urticaria or acute abdominal pain, such as Anisakis.

Animals↗
PubMed1991

[Detection of antibodies against the larva of Anisakis simplex in the pollock Pollachius virens using ELISA].

From the fact that older saithes (more than 5 years old) are showing significantly lower prevalence of attack by Anisakis larvae in lateral muscle than younger saithes (3-4 years old), the question arises if this phenomenon is based on a specific immune response. Therefore we have investigated serum samples from saithes of different ages by using an indirect ELISA to estimate the antibody-titer against excretory-secretory Anisakis antigen. Results showing a moderate correlation (r = 0.66) between the height of titer and the age of underfeeding saithes (post spawning) and a close correlation (r = 0.93) of saithes in an optimal condition (pre spawning). It may be concluded that the migration-distance and the lifetime of Anisakis larvae in lateral-muscle is influenced by a specific immune response which increases with the age of the saithes.

Age Factors↗
PubMed1989

Electrophoretic identification of Anisakis sp. larvae (Ascaridida: Anisakidae) from Clupea harengus L. in Baltic Sea.

On the basis of electrophoretic studies carried out on 15 gene-enzyme systems, 80 Anisakis sp. larvae from the herring Clupea harengus, fished in South Baltic Sea and Gdanisk Bay, were identified as Anisakis simplex B. This is the first record of Anisakis simplex B in the Baltic Sea. The spawning migration of the herrings from the North Sea to the Baltic Sea and the distribution of A. simplex B are briefly discussed.

Animals↗
PubMed2004

Anisakis simplex only provokes allergic symptoms when the worm parasitises the gastrointestinal tract.

We analysed patients with allergic or digestive symptoms after seafood ingestion in order to assess a correct diet in Anisakis simplex sensitised individuals. A total of 120 patients who suffered allergic and/or digestive symptoms after marine food ingestion were studied. We performed skin prick tests for A. simplex and seafood, total serum and specific serum immunoglobulin E to A. simplex in the acute stage and 1 month later. A gastroscopy was carried out to find larvae in those patients with persistent abdominal pain. A challenge with non-infective larvae was performed to assess a correct diet. Some 96 patients were sensitised to A. simplex. Gastroscopy was performed in 47 and we detected larvae in 24. We compared symptoms, skin tests, total and specific IgE and the latency of appearance of symptoms in patients positive for Anisakis larvae, patients without larvae at gastroscopy and patients without digestive symptoms. There was no difference among the groups. We challenged 22 patients with frozen A. simplex larvae. After allowing deep-frozen seafood in the diet for more than 2 years, no patient suffered a reaction. At this time, we allowed all our patients well-frozen seafood without any allergic reaction occurring. Allergic symptoms are the most frequent manifestation of A. simplex parasitism. We could not find any patient allergic to the thermostable proteins of parasite.

Abdominal Pain↗
PubMed2001

Anisakis infestation in marine fish and cephalopods from Galician waters: an updated perspective.

A total of 2,673 fresh specimens of cephalopod and fish representing 35 species were obtained from commercial local fisheries in Galician waters (NW Spain). They were examined for anisakid nematodes by digestion of the muscle and elution of the viscera and whole body cavity. All larval nematodes recovered were identified by light microscopy and multilocus electrophoresis as belonging to the species Anisakis simplex sensu stricto and A. pegreffii. Encysted larvae mostly occurred in the viscera but were also found in the flesh of squid and fish. Demographic values for larval nematodes are discussed in relation to host preferences and the ecological niche of both anisakid species at the sampling area. Primary recommendations are also expressed concerning the effects of current fishing and aquaculture practices on the Anisakis problem.

Animals↗
PubMed1996

Evidence for arylamine N-acetyltransferase in the nematode Anisakis simplex.

N-Acetyltransferase activities with p-aminobenzoic acid and 2-aminofluorene were determined in Anisakis simplex, a nematode found in the intestine of the salt water fish Trichiurus lepturus. The N-acetyltransferase activity was determined using an acetyl CoA recycling assay and high pressure liquid chromatography. The N-acetyltransferase activity from a number of Anisakis simplex whole tissue homogenizations was found to be 2.89 +/- 0.52 nmol/min per mg for 2-aminofluorene and 2.54 +/- 0.45 nmol/min per mg for p-aminobenzoic acid. The K(m) and Vmax values obtained were 1.06 +/- 0.69 mM and 9.34 +/- 1.94 nmol/min per mg for 2-aminofluorene, and 2.25 +/- 0.10 mM and 14.44 +/- 0.7 nmol/min per mg for p-aminobenzoic acid. The optimal pH value for the enzyme activity was pH 8.0 for both substrates tested. The optimal temperature for enzyme activity was 37 degrees C for both substrates. The N-acetyltransferase activity was inhibited by iodoacetamide: at 0.25 mM iodoacetamide, activity was reduced 50% and 1.0 mM iodoacetamide inhibits activity more than 90%. Among a series of divalent cations and salts, Cu2+ and Zn2+ were demonstrated to be the most potent inhibitors. This is the first demonstration of acetyl CoA/arylamine N-acetyltransferase activity in a nematode and extends the number of phyla in which this activity has been found.

4-Aminobenzoic Acid↗
PubMed1999

Immunopathogenesis of human gastrointestinal infection by Anisakis simplex.

BACKGROUND: Anisakis simplex is a parasite of fish, and in the case of human infestation, it should be considered as a possible cause of gastrointestinal disease, especially in countries where raw or undercooked fish is a frequent food. Clinical features of anisakiasis may simulate acute abdominal pain, such as that found in patients with gastric ulcers, appendicitis, and Crohn's disease. Furthermore, many cases of anisakiasis are diagnosed as eosinophilic gastroenteritis, which is a broad term for a specific disease. OBJECTIVE: The purpose of this study was to investigate the immunopathogenesis of human gastrointestinal infestation by A simplex. METHODS: Thirteen intestinal biopsy specimens from patients with anisakiasis were analyzed for the presence of messenger (m)RNA for different cytokines and inflammatory mediators by RT-PCR. Specific IgE, eosinophil cationic protein, eosinophil protein X, and tryptase levels were measured in each patient's serum. Also, cell cultures were set up with lymphocytes from some patients and stimulated in vitro with Anisakis and Ascaris antigens. RESULTS: We performed immunologic phenotyping in 13 patients. All patients underwent biopsy after emergency surgery caused by episodes of acute abdominal pain. In all cases inflammatory infiltrate composed of eosinophils and lymphocytes was found in the intestinal wall. We demonstrated that after infestation, a T(H2)-type immune response occurred. Also, major basic protein, nitric oxide, and eotaxin were found in the tissue, and eosinophil cationic protein and eosinophil protein X levels were elevated in sera. CONCLUSION: These data and in vitro lymphocyte cultures indicate that a T(H2) mechanism plays an important role in the inflammatory infiltrate produced by the anchorage of parasites in the gastrointestinal wall.

Abdominal Pain↗
PubMed2005

Anisakis simplex-induced small bowel obstruction after fish ingestion: preliminary evidence for response to parenteral corticosteroids.

BACKGROUND & AIMS: Gastrointestinal anisakiasis, a fish-borne zoonoses, may be acquired by humans after the ingestion of raw marine fish infested with larvae of the nematode Anisakis simplex. Because of the invasive nature of the parasite, inflammatory obstruction or perforation of the gut wall may result. Although rare, Anisakis-induced intestinal obstruction is becoming a growing public health problem in Mediterranean areas, such as Spain, with a high fish-intake-based diet. Unawareness of this entity and nonspecific clinical symptoms, along with the lack of alternative therapeutic options other than conservative measures, may explain why half of these patients require abdominal laparotomy for diagnostic and therapeutic purposes. METHODS: We describe a series of 8 patients with acute intestinal anisakiasis treated in our center from July 2001 to January 2004. RESULTS: The first 3 patients underwent segmental ileal resection for imminent peritonitis. The remaining 5 patients were treated with intravenous 6-methylprednisolone (1 mg/kg/24 h) for 5 days with fast clinical and radiologic resolution in all 5 patients with no adverse reactions. CONCLUSIONS: Although preliminary, our data may suggest that parenteral corticosteroids could be a reasonable, inexpensive, and safe alternative in these patients to prevent intestinal resection.

Adult↗
PubMed1996

Enzyme-linked immunosorbent assay, immunoblot analysis and RAST fluoroimmunoassay analysis of serum responses against crude larval antigens of Anisakis simplex in a Spanish random population.

The results obtained in a study of seroprevalence by means of ELISA and immunoblot with crude larval extracts of Anisakis simplex using 1008 human sera from Spanish people showing no clinical suspicion of anisakidosis are given. For the evaluation of the results obtained by ELISA the Diagnostic Index (DI) was used, as the ratio between the optical density resulting from the test serum and the optical density of the negative control. Forty-seven sera showed DIs between 1.5 and 2, and 14 sera were greater than 2. After comparison of the immunoblot analysis with the immunorecognition pattern of a human anisakidosis reference serum, a diagnostic criterion could be established for those sera that, at a 1/100 dilution, showed a DI by ELISA greater than 1.5. Seven of 14 selected sera with DIs in ELISA higher than 1.3 showed anti-Anisakis specific IgE antibodies by RAST fluoroimmunoassay.

Adult↗
PubMed2003

The occurrence and infection dynamics of Anisakis larvae in the black-scabbard fish, Aphanopus carbo, chub mackerel, Scomber japonicus, and oceanic horse mackerel, Trachurus picturatus from Madeira, Portugal.

Larval stages of Anisakis spp. (Nematoda: Anisakidae) were found encapsulated or free in the viscera and abdominal cavity of the black-scabbard fish, Aphanopus carbo, chub mackerel, Scomber japonicus and oceanic horse mackerel, Trachurus picturatus in Madeiran waters. The prevalence of infection reached 97.2% for A. carbo, 69.5% for S. japonicus and 62.5% for T. picturatus. Considerable differences in parasite intensities between A. carbo and both S. japonicus and T. picturatus were found, with mean intensities up to 69.6 in A. carbo, while in the other two fish hosts the intensity reached only a maximum of 2.6. These differences were probably due to different feeding behaviours of the hosts. Intensities of Anisakis sp. in A. carbo were high irrespective of sex and season. No relationship between host length and prevalence of infection was observed for A. carbo, while for S. japonicus a weak positive significant relationship was found.

Animals↗
PubMed2000

Specific and total IgE in patients with recurrent, acute urticaria caused by Anisakis simplex.

Titres of parasite-specific IgE were investigated in 19 patients thought to have recurrent, acute urticaria caused by sensitization to Anisakis simplex (Dujardin, 1845), before and after they were placed on a fish-free diet. Patients with other allergic disease and those being treated with corticosteroids or antihistaminics were excluded. Skin-prick tests were carried out with A. simplex extract, and blue- and white-fish extracts. The CAP system (Pharmacia), a commercial test kit developed for the assay of food-specific IgE, was used to monitor serum concentrations of total IgE and antigen-specific IgE against Anisakis, Ascaris, Echinococcus, Toxocara, tuna, salmon, shrimp, mussel and cod. Before going on a fish-free diet, the 19 patients had CAP scores against A. simplex of 5 (three cases), 3 (seven) or 2 (nine). After a mean of 120 days on the diet, the scores against A. simplex were unchanged in 15 of the cases, reduced in three [from 5 to 4 (one case) or from 2 to 0 (two cases)] and increased in one (from 2 to 3). Most (16) of the patients no longer had any urticaria and the others reported significant reductions in the intensity and frequency of their symptoms.

Acute Disease↗
PubMed2005

Anisakis simplex allergy: a murine model of anaphylaxis induced by parasitic proteins displays a mixed Th1/Th2 pattern.

The study of the singular hypersensitivity reactions to Anisakis simplex (A.s) proteins, may help us to undestand many of the unknown immune interactions between helmiths infections and allergy. We have developed a murine model of allergy to A. simplex, that mimics human A. simplex allergy to study the specific aspects of anaphylaxis induced by parasites. Male C3H/HeJ mice were intraperitoneally sensitized to A. simplex. Mice were then intravenous or orally challenged with A. simplex. Antigen-specific immunoglobulins, polyclonal IgE, anaphylactic symptoms, plasma histamine levels and cytokine profiles were determined. Comparative IgE immunoblot analyses were also performed. Specific IgE, IgG(1) and IgG(2a) were detected in sensitized mice since week 3. Polyclonal IgE raised and peaked with different kinetics. Intravenous A. simplex challenge produced anaphylaxis in mice, accompanied by plasma histamine release. Oral A. simplex challenge in similarly sensitized mice did not caused symptoms nor histamine release. Numerous A. simplex allergens were recognized by sensitized mouse sera, some of them similar to human serum. The A. simplex stimulated splenocytes released IL-10, IFN-gamma, IL-4, IL-13 and IL-5. We describe a new animal model of anaphylaxis. It exhibits characteristics of type I hypersensitivity reactions to Anisakis simplex similar to those observed in allergic humans. Different responses to i.v. or oral A. simplex challenges emerged, which did not reflect a window tolerization period. The cytokine profile developed (mixed Th(1)/Th(2) pattern) differed from the observed in classical models of anaphylaxis or allergy to food antigens. This model may permit to investigate the peculiar allergic reactions to parasitic proteins.

Allergens↗
PubMed1999

Anti-anisakis antibodies in the clinical course of Crohn's disease.

BACKGROUND: Human anisakidosis is a parasitic disease whose intestinal form shares several characterictics with Crohn's disease (CD), like the ileocolonic location predominantly and the presence of granuloma. METHODS: 73 CD patients diagnosed according to Lennard-Jones' criteria were studied. The disease activity was measured by means of Harvey-Bradshaw Index. Different clinical variables were analyzed. Antigenic extract of Anisakis simplex larvae extracted from blue whiting was prepared. Determination of IgG, IgM, IgA and total specific immunoglobulin against A. simplex were carried out in sera by enzyme-linked immunosorbent assay. Immunorecognition patterns of these sera were realized by immunoblotting analysis. Results were compared with prevalence of antibodies anti-Anisakis in 251 healthy controls. RESULTS: 29% of CD patients showed detectable specific total Ig (G+M+A) against A. simplex (95% CI, 19-41). For IgG, IgM and IgA the percentages were 44, 18 and 53% (95% CI, 32-56, 10-26, and 41-65) respectively. In positive specific total Ig cases CD was localized mainly in ileum. In IgG-, IgM- and IgA-positive cases the location was predominantly ileocolonic. CD activity index was higher for groups with positive IgA (2.86 vs. 5.55; p < 0.05). CONCLUSION: Patients with CD have high prevalence of specific immunoglobulin against A. simplex. Specific IgA are associated to higher activity index of CD.

Adolescent↗
PubMed2002

The nematode Anisakis simplex in American shad (Alosa sapidissima) in two Oregon rivers.

This paper represents the first report of the nematode Anisakis simplex in the American shad (Alosa sapidissima) in its introduced range in the American Pacific Northwest. All the adult shad sampled from spawning populations in the Willamette (n = 9) and Umpqua (n = 12) rivers were infected with A. simplex with intensities ranging from 6 to 89 worms per fish. This preliminary investigation contrasts sharply with previous studies in the native range of American shad and confirms that this fish may be an important intermediate host for A. simplex in the Pacific Northwest. It is suggested that this new parasite-host relationship has led to an ecological expansion into rivers and Anisakis may present an emerging health risk for wildlife and some human consumers.

Animals↗
PubMed2003

High hydrostatic pressure treatment of finfish to inactivate Anisakis simplex.

High hydrostatic pressure has been demonstrated to be a useful technique for treating food to reduce the number of pathogenic organisms and to extend shelf life. Most research in this area has focused on bacteria. However, a concern in the sashimi (raw fish) industry is that nematode worms such as Anisakis simplex occur naturally in cold-water marine fish. The objectives of this research were to perform a pilot study to determine the effect of high hydrostatic pressure on the viability of Anisakis simplex larvae, commonly found in king salmon and arrowtooth flounder, and to evaluate the effects of high hydrostatic pressure on the color and texture of the fish fillets. Pieces of fish (ca. 100 g per bag) containing 13 to 118 larvae were exposed to pressures of up to 80,000 lb/in2 (552 MPa) for up to 180 s. The times and pressures required to kill 100% of the larvae were as follows: 30 to 60 s at 60,000 lb/in2 (414 MPa), 90 to 180 s at 40,000 lb/in2 (276 MPa), and 180 s at 30,000 lb/in2 (207 MPa). For all salmon treatments that killed 100% of the larvae, a significant increase in the whiteness of the flesh was observed. Although high hydrostatic pressure was effective in killing A. simplex larvae in raw fish fillets, its significant effect on the color and overall appearance of the fillet may limit its application to the processing of fish for raw-fish markets.

Animals↗
PubMed1999

[Hypersensitivity to Anisakis simplex: apropos of 36 cases].

The authors report a group of 36 cases of hypersensitivity to Anisakis simplex, a fish parasite. They examined 11 boys and 25 girls who attended the Allergy service of the Central Hospital Marques of Valdecilla in Santander (Spain), between 12th May 1997 and 26th June 1998, for history of acute urticaria, most often after an aggravation of an allergic pathology. All were given an immunological examination that was composed of: food investigation, prick test, measurement of total and specific IgE and blood eosinophilia. In conclusion, the authors emphasize an increase in hypersensitivity to Anisakis simplex, masked by a food allergy and in spite of a nematode infection. Blood eosinophilia was normal in most cases.

Aged↗
PubMedDate not supplied

What does Anisakis simplex parasitism in gastro-allergic anisakiasis teach us about interpreting specific and total IgE values?

BACKGROUND: gastro-allergic Anisakiasis is a mostly transitory clinical entity caused by Anisakis simplex (A. simplex) and can be suspected by history and confirmed by fiberoptic gastroscopy and specific IgE. OBJECTIVE: we report a case of gastro-allergic Anisakiasis, in which the parasite induces a high specific and total IgE response, and want to follow the specific and total IgE values by a serologic follow up over 10 months. METHODS: an analysis of total IgE and specific IgE against. A. simplex was performed within 24 hours, after 1, 4, 6 and 10 months. At month 4 and month 10 specific IgE against Ascaris lumbricoides and Echinococcus granulosus was determined in order to value cross-reactivity. RESULTS: there is an important raise in specific IgE against Anisakis simplex (up to 903 kU/l) after 6 months and total IgE (up to 15,258 kU/l) after one month. Cross-reactive specific IgE against Ascaris lumbricoides and Echinococcus granulosus can be detected. CONCLUSIONS: we consider a raise of total and specific IgE as a typical feature of helminth infestation and learn that specific and total IgE values are highly variable in the months following the allergic and parasite-specific reaction. The amount of specific IgE against other cross reactive parasites depends directly on the total IgE values.

Animals↗