Heidari, Sahel, Ruethers, Thimo, Karnaneedi, Shaymaviswanathan, Yin, Lydia Wong Su, and Lopata, Andreas (2025) Advances in Shellfish Allergy Therapy: From Current Approaches to Future Strategies. Clinical Reviews in Allergy & Immunology, 68. 65.

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Abstract

Shellfish allergy, triggered by immune reactions to crustacean and mollusk proteins upon consumption/inhalation, is one of the most severe and persistent food allergies, affecting approximately 1%–3% of the general population worldwide. Shellfish is among the “big nine” food allergens responsible for over 90% of food allergy cases worldwide. Its diagnosis poses major challenges due to regional species diversity and a lack of reliable diagnostic tools. Management strategies generally emphasize strict avoidance and provision of emergency adrenaline autoinjectors; however, these approaches are inconvenient and insufficient for both patients and healthcare providers. Given the rising prevalence of shellfish allergy, there is an urgent need for targeted therapies that focus on key allergens, particularly tropomyosin—a major pan-allergen. As the primary target in current immunotherapy approaches, tropomyosin plays a central role in driving shellfish-induced immune responses. Recent advancements in immunotherapy are exploring alternatives beyond avoidance, aiming for long-term desensitization. This review discusses progress with allergen-specific immunotherapy, hypoallergenic allergen variants, DNA-based vaccines, and innovative approaches involving immunoregulatory peptides and probiotics. These strategies collectively strive to desensitize patients, reduce allergic symptoms, and enhance quality of life. Although some therapies are in active trials, most are in the investigational stages and offer promising directions for effective, patient-centered long-term management of shellfish allergy.

Item ID:	86990
Item Type:	Article (Research - C1)
ISSN:	1559-0267
Copyright Information:	This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Date Deposited:	25 Aug 2025 23:39
FoR Codes:	32 BIOMEDICAL AND CLINICAL SCIENCES > 3204 Immunology > 320401 Allergy @ 50% 32 BIOMEDICAL AND CLINICAL SCIENCES > 3204 Immunology > 320499 Immunology not elsewhere classified @ 30% 42 HEALTH SCIENCES > 4206 Public health > 420699 Public health not elsewhere classified @ 20%
SEO Codes:	20 HEALTH > 2099 Other health > 209999 Other health not elsewhere classified @ 20% 28 EXPANDING KNOWLEDGE > 2801 Expanding knowledge > 280112 Expanding knowledge in the health sciences @ 30% 28 EXPANDING KNOWLEDGE > 2801 Expanding knowledge > 280103 Expanding knowledge in the biomedical and clinical sciences @ 50%
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