Dawes, Kathryn, Smart, Joanne, Ruethers, Thimo, Lopata, Andreas, Alhucema, Paulina, Campbell, Dianne E., Ainsworth, John, Simpson, Bridget, Baldwin, Samara, Mahoney, Gabby, Baumgratner, JoJo, and Mehr, Sam (2025) Gummy shark is tolerated by children with IgE-mediated fish allergy. Journal Of Allergy And Clinical Immunology: In Practice, 13 (8). pp. 2186-2188.

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Abstract

Background: Fish is a leading trigger of food anaphylaxis. Co-sensitisation to various bony fish species is common due to similar beta-parvalbumin allergens, leading many fish-allergic individuals avoiding all types of fish. Cartilaginous fish, like sharks and rays, predominantly contain alpha-parvalbumin as the major allergen. This unique allergen profile suggests that cartilaginous fish could be a safe alternative for bony fish allergic individuals.

Objective: To determine the rate of oral tolerance to gummy shark (Mustelus antarcticus) among children with IgE-mediated bony fish allergy and evaluate the predictive value of raw gummy shark skin prick testing (SPT). Methods: Children aged 1-18 years with an IgE-mediated bony fish allergic reaction within the past 3 years underwent medical evaluation and SPTs to cartilaginous and bony fish species. All participants underwent an open challenge with 100g cooked gummy shark. Follow-up at 2 weeks and 6 months assessed ongoing tolerance and dietary incorporation.

Results: All 21 children with bony fish allergy tolerated gummy shark during the challenge, despite seven (33%) children having a positive SPT (3mm) to gummy shark (median 5mm). Six months post-challenge, 7 out of the 21 children (33%) did not incorporate gummy shark in their diet, citing taste aversion and difficulties finding a reliable source. There was one reported allergic reaction in the community to gummy shark following the OFC.

Conclusion: Bony-fish allergic children demonstrated tolerance to gummy shark. SPT to gummy shark showed limited predictive value in this cohort. Gummy shark may be a safe alternative in children with bony fish allergy.

Item ID:	86991
Item Type:	Article (Short Note)
ISSN:	2213-2201
Copyright Information:	Published Version: © 2025 American Academy of Allergy, Asthma & Immunology. AAM may be made open access in an Institutional Repository under a CC BY-NC-ND license after a 12 month embargo.
Funders:	Australian Research Council (ARC)
Projects and Grants:	ARC GNT1086656
Date Deposited:	26 Aug 2025 00:01
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 @ 40% 28 EXPANDING KNOWLEDGE > 2801 Expanding knowledge > 280103 Expanding knowledge in the biomedical and clinical sciences @ 60%
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