{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:43:53Z","timestamp":1787013833114,"version":"build-2736575974"},"reference-count":53,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T00:00:00Z","timestamp":1745452800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005847","name":"Health and Medical Research Fund","doi-asserted-by":"publisher","award":["08191356"],"award-info":[{"award-number":["08191356"]}],"id":[{"id":"10.13039\/501100005847","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005847","name":"Health and Medical Research Fund","doi-asserted-by":"publisher","award":["09202866"],"award-info":[{"award-number":["09202866"]}],"id":[{"id":"10.13039\/501100005847","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>IgE\u2010mediated fish allergy has long been considered an umbrella term due to the high cross\u2010reactivity of parvalbumin, the major fish allergen. Yet, clinical tolerance to certain fish highlights allergenicity differences. In this study, we sought to construct a fish allergenicity ladder and identify fish parvalbumin epitopes to improve the diagnosis of fish allergy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Reported clinical history and the serum\u2010specific IgE (sIgE) responses of 200 Chinese subjects with suspected fish allergy were collected and analyzed, while the relative parvalbumin content in different fish was measured for the construction of a fish allergenicity ladder. Double\u2010blind placebo\u2010controlled food challenge (DBPCFC) and open challenge against salmon, grass carp, and grouper were performed in 58 selected patients for validation of the ladder. Epitope mapping was performed by peptide array against parvalbumins of salmon (both \u03b2\u20101 and \u03b2\u20102), cod, grouper, and grass carp with sera from fish allergic (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200911), partial fish tolerant (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200912), and complete fish tolerant (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095) patients diagnosed based on oral food challenge outcome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The distribution pattern of reported history of fish allergy and tolerance, sIgE and molecular data, as well as their strong positive correlation led to the construction of a 3\u2010step fish allergenicity ladder comprising: step 1 of the least allergenic fishes (tuna, halibut, salmon and cod), steps 2 of moderately allergenic fishes (herring and grouper) to step 3 of highly allergenic fishes (catfish, grass carp and tilapia). Epitope mapping revealed one epitope from grouper parvalbumin (AA64\u201078) for diagnosing general fish allergy and one epitopic region from salmon parvalbumin (AA19\u201033) as a biomarker of specific fish tolerance. Only epitope\u2010specific IgE differentiated these patients but not sIgE to fish extract or parvalbumin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The fish ladder and epitopes discovery can precisely differentiate fish\u2010allergic and tolerant subjects and guide fish reintroduction by stepping up the ladder, which innovates fish allergy care in the next millennium.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/all.16562","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T03:44:53Z","timestamp":1745466293000},"page":"2810-2823","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Fish Allergenicity Ladder and Parvalbumin Epitopes for Predicting Clinical Cross\u2010Reactivity and Reintroduction in Chinese Population"],"prefix":"10.1111","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2570-7745","authenticated-orcid":false,"given":"Christine Y. Y.","family":"Wai","sequence":"first","affiliation":[{"name":"Department of Paediatrics The Chinese University of Hong Kong  Hong Kong SAR China"},{"name":"Hong Kong Hub of Paediatric Excellence The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6836-6445","authenticated-orcid":false,"given":"Nicki Y. H.","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Paediatrics The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8249-4478","authenticated-orcid":false,"given":"Agnes S. Y.","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Paediatrics The Chinese University of Hong Kong  Hong Kong SAR China"},{"name":"Hong Kong Hub of Paediatric Excellence The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3683-9217","authenticated-orcid":false,"given":"Man Fung","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Paediatrics The Chinese University of Hong Kong  Hong Kong SAR China"},{"name":"Hong Kong Hub of Paediatric Excellence The Chinese University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c5sa","family":"Marknell DeWitt","sequence":"additional","affiliation":[{"name":"Thermo Fisher Scientific ImmunoDiagnostics  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5292-5510","authenticated-orcid":false,"given":"Jaime S.","family":"Rosa Duque","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine The University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0333-0059","authenticated-orcid":false,"given":"Gilbert T.","family":"Chua","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine The University of Hong Kong  Hong Kong SAR China"},{"name":"Allergy Centre Union Hospital  Hong kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5471-9139","authenticated-orcid":false,"given":"Yat Sun","family":"Yau","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Queen Elizabeth Hospital  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9256-4799","authenticated-orcid":false,"given":"Wai Hung","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Queen Elizabeth Hospital  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7836-5243","authenticated-orcid":false,"given":"Po Ki","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Queen Elizabeth Hospital  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1476-9625","authenticated-orcid":false,"given":"Mike Y. 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