{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:32:58Z","timestamp":1790807578668,"version":"4.1.0"},"reference-count":138,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,6,11]],"date-time":"2023-06-11T00:00:00Z","timestamp":1686441600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Shellfish, including various species of mollusks (e.g., mussels, clams, and oysters) and crustaceans (e.g., shrimp, prawn, lobster, and crab), have been a keystone of healthy dietary recommendations due to their valuable protein content. In parallel with their consumption, allergic reactions related to shellfish may be increasing. Adverse reactions to shellfish are classified into different groups: (1) Immunological reactions, including IgE and non-IgE allergic reactions; (2) non-immunological reactions, including toxic reactions and food intolerance. The IgE-mediated reactions occur within about two hours after ingestion of the shellfish and range from urticaria, angioedema, nausea, and vomiting to respiratory signs and symptoms such as bronchospasm, laryngeal oedema, and anaphylaxis. The most common allergenic proteins involved in IgE-mediated allergic reactions to shellfish include tropomyosin, arginine kinase, myosin light chain, sarcoplasmic calcium-binding protein, troponin c, and triosephosphate isomerase. Over the past decades, the knowledge gained on the identification of the molecular features of different shellfish allergens improved the diagnosis and the potential design of allergen immunotherapy for shellfish allergy. Unfortunately, immunotherapeutic studies and some diagnostic tools are still restricted in a research context and need to be validated before being implemented into clinical practice. However, they seem promising for improving management strategies for shellfish allergy. In this review, epidemiology, pathogenesis, clinical features, diagnosis, and management of shellfish allergies in children are presented. The cross-reactivity among different forms of shellfish and immunotherapeutic approaches, including unmodified allergens, hypoallergens, peptide-based, and DNA-based vaccines, are also addressed.<\/jats:p>","DOI":"10.3390\/nu15122714","type":"journal-article","created":{"date-parts":[[2023,6,12]],"date-time":"2023-06-12T01:59:07Z","timestamp":1686535147000},"page":"2714","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["IgE-Mediated Shellfish Allergy in Children"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9568-6882","authenticated-orcid":false,"given":"Mattia","family":"Giovannini","sequence":"first","affiliation":[{"name":"Allergy Unit, Meyer Children\u2019s Hospital IRCCS, 50139 Florence, Italy"},{"name":"Department of Health Sciences, University of Florence, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7677-7690","authenticated-orcid":false,"given":"Burcin","family":"Beken","sequence":"additional","affiliation":[{"name":"Department of Pediatric Allergy & Immunology, School of Medicine, Acibadem University, 34303 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1206-969X","authenticated-orcid":false,"given":"Betul","family":"Buyuktiryaki","sequence":"additional","affiliation":[{"name":"Division of Pediatric Allergy, Department of Pediatrics, School of Medicine, Koc University, 34450 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5598-2740","authenticated-orcid":false,"given":"Simona","family":"Barni","sequence":"additional","affiliation":[{"name":"Allergy Unit, Meyer Children\u2019s Hospital IRCCS, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Liccioli","sequence":"additional","affiliation":[{"name":"Allergy Unit, Meyer Children\u2019s Hospital IRCCS, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucrezia","family":"Sarti","sequence":"additional","affiliation":[{"name":"Allergy Unit, Meyer Children\u2019s Hospital IRCCS, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6902-544X","authenticated-orcid":false,"given":"Lorenzo","family":"Lodi","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Florence, 50139 Florence, Italy"},{"name":"Immunology Unit, Meyer Children\u2019s Hospital IRCCS, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9408-2773","authenticated-orcid":false,"given":"Matteo","family":"Pontone","sequence":"additional","affiliation":[{"name":"Allergy Unit, Meyer Children\u2019s Hospital IRCCS, 50139 Florence, Italy"},{"name":"Department of Health Sciences, University of Florence, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Bartha","sequence":"additional","affiliation":[{"name":"Pediatric Allergy Group, Department of Women and Children\u2019s Health, School of Life Course Sciences, King\u2019s College London, London SE1 9RT, UK"},{"name":"Children\u2019s Allergy Service, Evelina London Children\u2019s Hospital, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London SE1 7EH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Mori","sequence":"additional","affiliation":[{"name":"Allergy Unit, Meyer Children\u2019s Hospital IRCCS, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cansin","family":"Sackesen","sequence":"additional","affiliation":[{"name":"Division of Pediatric Allergy, Department of Pediatrics, School of Medicine, Koc University, 34450 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"du Toit","sequence":"additional","affiliation":[{"name":"Pediatric Allergy Group, Department of Women and Children\u2019s Health, School of Life Course Sciences, King\u2019s College London, London SE1 9RT, UK"},{"name":"Children\u2019s Allergy Service, Evelina London Children\u2019s Hospital, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London SE1 7EH, UK"},{"name":"Peter Gorer Department of Immunobiology, School of Immunology & Microbial Sciences, King\u2019s College London, London SE5 9NU, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2940-9235","authenticated-orcid":false,"given":"Andreas L.","family":"Lopata","sequence":"additional","affiliation":[{"name":"Molecular Allergy Research Laboratory, College of Public Health, Medical and Veterinary Sciences, Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia"},{"name":"Tropical Futures Institute, James Cook University, Singapore 387380, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Muraro","sequence":"additional","affiliation":[{"name":"Food Allergy Referral Centre, Department of Mother and Child Health, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Adams, S., Lopata, A.L., Smuts, 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