Fish allergy: Fish and products thereof

Allergy to fish is a common cause of IgE-mediated food allergic reactions especially in geographic regions where fish is an important dietary component. Fish allergy is estimated to affect 0.4% of the total population in the United States. All species of fish are believed to be allergenic, but allergic reactions to fish reported in the medical literature are most commonly caused by cod and salmon. The major allergen in fish is a naturally occurring muscle protein called parvalbumin. Some evidence exists of allergic reactions to other fish proteins including collagen. This review addresses fish allergy and fish-derived ingredients, namely gelatin, isinglass, fish maws, ice-structuring protein, fish oil, and Worcestershire sauce.