Utility of Shrimp and Der p 10 specific IgE for Shrimp Allergy Diagnosis in Non-House Dust Mite Sensitized Patients

24 Background: There are no set specific IgE (sIgE) to predict shrimp allergy as cross25 reactivity with other arthropods play a role in shrimp sensitization. 26 Objective: This study identifies the allergens associated with shrimp allergy in house 27 dust mite (HDM) and non-HDM sensitized patients. 28 Methods: Patients with shrimp sensitization (positive skin prick test [SPT] and/or sIgE) 29 with/without history of clinical reaction were recruited. Allergy was confirmed by oral 30 food challenge (OFC) except for patients with history of anaphylaxis. Shrimp allergic 31 (SA) and shrimp tolerant (ST) patients were further classified based on HDM sensitivity. 32 The sIgE to shrimp, shrimp and HDM components were performed. Fisher’s exact test, 33 Wilcoxon sum rank test and receiver operating characteristics analyses were done. 34 Results: Of 79 patients recruited, 12 SA (7 positive OFC and 5 with history of 35 anaphylaxis), 18 ST and 10 non-shrimp sensitized controls (NC) were enrolled. In non36 HDM sensitized patients, sIgE to shrimp (10.5 kUA/L, p=0.012) and Der p 10 (4.09 37 kUA/L, p=0.035) were higher in SA patients. Shrimp sIgE ≥3.55 kUA/L had 100% 38 sensitivity and 85.71% specificity (ROC=0.94[0.81, 1.0]). Der p 10 sIgE ≥3.98 kUA/L 39 had sensitivity of 80% and specificity of 100% (ROC=0.86[0.57, 1.0]). rPen a 1 ≥1.1 40 kUA/L had sensitivity of 80% and specificity of 85.7% (ROC=0.80[0.47,1.0]). 41 Conclusions: In non-HDM sensitized patients, shrimp sIgE ≥3.55 kUA/L and Der p 10 42 sIgE≥3.98 kUA/L give 100% sensitivity and specificity, respectively, to diagnose shrimp 43 allergy. HDM sensitivity can influence sIgE levels to shrimp and shrimp/HDM 44 components due to cross-reactivity. 45 46 47 peer-reviewed) is the author/funder. All rights reserved. No reuse allowed without permission. The copyright holder for this preprint (which was not . http://dx.doi.org/10.1101/199620 doi: bioRxiv preprint first posted online Oct. 17, 2017;