Gastro-allergic
anisakiasis has been reported as an entity in which an acute parasitism by Anisakis simplex is accompanied by an
immunoglobulin (Ig)E-mediated systemic
allergic reaction. Serum samples were obtained from 24 patients within 24 h after the onset of symptoms (day 0) and after 1 month (day 30) and in 13 patients after 6 months. Total
IgE was assessed by the Imx method. Specific
IgE was assessed by CAP-FEIA. Specific
IgM,
IgG,
IgG4 and
IgA antibodies were assessed by
enzyme-linked
immunosorbent assay against
crude extract (CE) and excretory-secretory products (ESP).
IgE immunoblotting (IB) was directed against CE or ESP (day 0 and day 30). We found a rise of total
IgE, specific
IgE, number of bands in
IgE-IB,
IgG and
IgG4 between day 0 and day 30 with a fall to near basal levels after 6 months.
IgM levels were highest at day 0, falling over the next 6 months and
IgA levels remained almost unchanged. Correlation studies revealed a parallel stimulation of nearly all
Ig isotypes, except
IgM anti-ESP, whose antibody levels correlated negatively with specific
IgG levels. We found an extension of the
IgE antibody repertoire in IB. We conclude that the allergic
IgE-mediated reaction in the course of gastro-allergic
anisakiasis involves a parallel secondary Th2 type memory response and a primary immunologic stimulation of both Th2 and Th1 lymphocyte subsets against previously unrecognized
antigens.