Daschner, ÁlvaroFernández Fígares, VirginiaValls, AnaFrutos, Consolación deRodero, MartaMartínez Ubeira, Florencio CésarCuéllar, Carmen2020-04-272020-04-272013Daschner, A., Fernández Figares, V., Valls, A., de Frutos, C., Roder, M., Ubeira, F.M., et al.(2013). Different fish-eating habits and cytokine production in chronic urticaria with and without sensitization against the fish-parasite anisakis simplex. Allergology international, vol. 62, 191-2011323-8930http://hdl.handle.net/10347/21818Background:Anisakis simplexsensitization has been associated with acute, but also with chronic urticaria.The objective of this study is to characterize chronic urticaria with (CU+) and without sensitization (CU-) againstthe ubiquitous fish parasiteA. simplexin a transversal and longitudinal evaluation.Methods:16 CU+ and 22 CU- patients were included and assessed for Urticaria activity score (UAS), fish-eating habits by standardized questionnaire and cytokine production (assessed by flow cytometric bead-basedarray) of peripheral blood mononuclear cells after stimulation withA. simplexextract or Concanavalin A (ConA). Patients were randomly put on a fish-free diet for three months and UAS, as well as cytokine productionwere again assessed. A difference of"1 in UAS was defined as improvement.Results:There was no difference in UAS in both groups.Anisakisinduced IL-2, IL-4 and IFN-γproduction washigher in CU+. Con A induced IL-6 and IL-10 production was higher in CU+. CU+ was associated with highertotal fish intake, whereas CU- was associated with oily fish intake. The correlation of UAS was positive with oilyfish, but negative with total fish intake.There was a better UAS-based prognosis in CU+ without diet. Improvement was associated with higher ConA induced IL-10!IFN-γas well as IL-10!IL-6 ratios. Further, previous higher oily fish intake was associated withimprovement.Conclusions:Our data confirm the different clinical and immunological phenotype of CU+. Our results show acomplex relationship between fish-eating habits, cytokine production and prognosis, which could have impor-tant consequences in dietary advice in patients with CU. When encounteringA. simplexsensitization, patientsshould not be automatically put on a diet without fish in order to reduce contact withA. simplexproductseng© 2013 Japanese Society of Allergology. Published by Elsevier under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)https://creativecommons.org/licenses/by-nc-nd/4.0/Anisakis simplexChronic urticariaCytokinesDietPhenotypejournal article10.2332/allergolint.12-OA-05041440-1592open access