Background and Aim: Anisakis simplex (A. simplex) infection, in humans, causes a series of clinical manifestations affecting the gastrointestinal tract known as Anisakiasis/Anisakidosis. Patients may also present allergic manifestations such as hives and/or angioedema and even anaphylactic shock. The aim of this study was to investigate whether aquacultured fish could be considered A. simplex-free food and constitute a safe, alternative, wild-capture fish food for Gastro-Allergic Anisakiasis (GAA) sensitized subjects. The diagnosis of Anisakiasis is documented by the occasional finding of L۳ larvae in the infected gastro-intestinal tract. Currently, about ۱۴ allergens have been described, among which Ani s۱ and Ani s۴, both highly heat-resistant, appear central in Anisakiasis anaphylaxis and necessary to cause allergic reactions. Food has to be considered Anisakis-free only when heat-resistant Anisakis allergens are not present.Methods: Protein extracts from A. simplex larvae in the third stage (L۳) and from the edible part of heavily infected horse mackerel (Trachurus trachurus) and aquacultured sea bream, have been tested for A. simplex allergens presence by immunological analysis. Western blot analysis using, as a source of specific Anisakis allergens antibodies, serum samples from subjects referring allergic symptoms after raw fish ingestion, was performed. These subjects showed high levels of specific IgE anti A. simplex allergens determined by clinical laboratory tests (ISAC test).Results: Our data demonstrate the presence of Ani s۴ allergen in both infected and aquacultured fish extracts, providing a possible interpretation for the allergic manifestations reported by subjects, already sensitized to A. simplex, who ate frozen or well-cooked or, even, aquacultured fish.Conclusion: The present data stimulate more accurate prophylaxis suggestions for
Anisakis allergy and more specific controls of fishmeal used in aquaculture.