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Researchers at the Chinese University of Hong Kong (CUHK) identified a "fish allergenicity ladder" system, promoting evidence-based, personalized seafood avoidance for children with fish allergies.
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Based on findings that show some fish-allergic children are more tolerant to less allergenic fish, doctors can suggest young patients build up tolerance based on a ladder system similar to patients who have milk and egg allergies.
Patients can gradually take food of higher allergen quantities based on how allergic they are to certain types of fish.
The fish allergy system is based on a clinical tolerance pattern corresponding to amounts of β-parvalbumin, a protein commonly found in the fish's flesh but levels vary depending on the species.
Based on the fish ladder, fish-allergic individuals have decreased tolerance of catfish and grass harps due to their high levels of parvalbumin, while parents should be careful giving groupers and herrings to allergic children given they contain a medium amount of the protein.
Study findings also show there is an increase in tolerance among allergic patients towards salmon and tuna, which have the lowest degrees of parvalbumin.
Assistant professor Agnes Leung Sze-yin from the Department of Paediatrics, noted the importance of introducing the ladder system when speaking to The Standard.
"This is the first time the concept of fish allergen ladders was introduced, and gives allergists a significant reference in diagnosis."
CUHK Paediatrics research assistant professor Christine Wai Yee-yan expressed their willingness to expand the ladder to include more kinds of fish.
"This round of research mostly targets fish species that can be widely found in local markets. We hope to work with experts from around the world to perfect our system."
Even though fish is full of nutrients like protein and Omega 3 that are important to a child's development, fish allergies have an early onset during the first two to three years of life and persist to their teenage years. Allergic reactions can range from mild rashes to breathing difficulties.
Ms. Wong, who has a fish-allergic daughter, shared how the ladder had helped her family.
"Based on the ladder's information, I carefully tried giving my daughter tuna and salmon after the results showed she is tolerant to both kinds of fish," she said.
"Although she is still hesitant to try more allergic types of fish, the system helps us safely determine how to treat our child."
(Wisley Lau)
