Supplementary Material for: Cross-Reactivity between <b><i>Anisakis</i></b> spp. and Wasp Venom Allergens

<b><i>Background:</i></b> Anisakiasis is caused by the consumption of raw or undercooked fish or cephalopods parasitized by live L3 larvae of nematode <i>Anisakis </i>spp. Larvae anchor to stomach mucosa releasing excretion/secretion products which contain the main allergens. It has been described that nematode larvae release venom allergen-like proteins among their excretion/secretion products. We investigated potential cross-reactivity between <i>Anisakis </i>and wasp venom allergens. <b><i>Methods:</i></b> Two groups of 25 patients each were studied: wasp venom- and <i>Anisakis-</i>allergic patients. Sera from patients were tested by ImmunoCAP, dot-blotting with recombinant <i>Anisakis</i> allergens and ADVIA-Centaur system with Hymenoptera allergens. Cross-reactivity was assessed by IgE immunoblotting inhibition assays. Role of cross-reactive carbohydrate determinants (CCDs) was studied by inhibition with bromelain and periodate treatment. <b><i>Results:</i></b> A total of 40% of wasp venom-allergic patients had specific IgE to <i>Anisakis simplex </i>and 20% detected at least one of the <i>Anisakis</i> recombinant allergens tested. Likewise, 44% of <i>Anisakis-</i>allergic patients had specific IgE to <i>Vespula </i>spp<i>.</i> venom and 16% detected at least one of the Hymenoptera allergens tested. Wasp venom-allergic patients detected CCDs in <i>Anisakis</i> extract and peptide epitopes on <i>Anisakis </i>allergens rAni s 1 and rAni s 9, whereas <i>Anisakis-</i>allergic patients only detected CCDs on nVes v 1 allergen from <i>Vespula </i>spp. venom. The only <i>Anisakis</i> allergen inhibited by <i>Vespula </i>venom was rAni s 9. <b><i>Conclusions:</i></b> This is the first time that cross-sensitization between wasp venom and <i>Anisakis </i>is described. CCDs are involved in both cases; however, peptide epitopes are only recognized by wasp venom-allergic patients.