Article available at http://www.parasite-journal.org or http://dx.doi.org/10.1051/parasite/2004112219 CROSS-REACTIVITY BETWEEN ANTIGENS OF ANISAKIS SIMPLEX S.L. AND OTHER ASCARID NEMATODES LOZANO MALDONADO J.*, MARTIN HITA L.*, DIAZ SÂEZ V.*, MANAS ALMENDROS I.*, VALERO LOPEZ A.* & CAMPOS BUENO M.* Summary: R é s u m é : RÉACTION CROISÉE D E S ANTIGÈNES D'ANISAKIS A study of the cross-reactivity among somatic and excretory- D'AUTRES NÉMATODES ASCARIDÉS secretory antigens of the third stage larvae of Anisakis simplex s.l. SIMPLEX S.L. E T Dans ce travail nous étudions les réactions croisées des antigènes and somatic antigens of other ascarid nematodes (Ascaris du troisième stade larvaire d'Anisakis simplex s.l. et des antigènes lumbricoides, somatiques d'autres nématodes ascarides par la technique A. suum, Toxocara canis, Anisakis Hysterothylacium physeteris, aduncum and H. fabri) was carried out by immunoblotting. It was revealed a high degree of cross-reactivity among ascarids in the 3 0 and > 2 1 2 kDa range by using sera against somatic and excretory-secretory antigens of A. simplex s.l. It has been revealed also specific components of the Anisakis genus (< 7.2, 9, 19 and 25 kDa) that will be interesting in diagnosis. d'immunoblot (Ascaris lumbricoides, A. suum, Toxocara canis, Anisakis physeteris, Hysterothylacium aduncum et H. fabri). On a ainsi révélé une très importante réactivité croisée parmi des ascarides 212 (antigènes somatiques et antigènes excrétés-sécrétés ou métaboliques). spécifiques KEY W O R D S : ascarids, antigen, immunoblotting, cross-reacton dans les bandes de 30 et dans celles supérieures à kDa en employant des immunsérums anti-A. simplex s.l. De même, nous avons révélé des fractions (< 7.2, 9, 19 et 25 kDa) dans le genre Anisakis qui seront intéressantes dans le diagnostic. MOTS CLÉS : ascaridés, antigène, immunoblotting, réaction croisée. O n e o f the main d r a w b a c k s o f immunological diagnosis o f parasite infection is caused b y the complexity o f the parasite antigens, especially the existence o f antigens shared b e t w e e n species with varying degrees o f phylogenetic relationship and betw e e n the parasite a n d host (Capron et al, 1 9 6 8 ; Pascual et al., 1997; Favre et al., 1 9 9 8 ) . Immunological cross-reactions a m o n g ascarid n e m a t o d e s are widespread and infection b y a species could potentially affect on the nature o f the immune response by a n o ther species and produce false positives in the diagnosis (Kennedy et al., 1988; Kennedy et al, 1989; Iglesias et al., 1996; Nunes et al., 1997; Fernandez et al., 1998; Lorenzo et al, 1999; Kennedy, 2 0 0 0 ) . Anisakiasis o f the human alimentary tract is frequently caused by the ingestion o f raw or u n d e r c o o k e d fish infected b y Anisakis simplex larvae (L3) (Van Thiel et al, 1 9 6 0 ; Ishikura et al., 1 9 9 2 ) . O n the other hand, recently several human infections d u e to A. simplex larvae have b e e n reported in Spain (Domínguez Ortega et al., 2 0 0 0 ; D a s c h n e r et al., 2000; Castan et al., 2 0 0 2 ) . For this reason, in the present work, w e have studied the cross-reactivity b e t w e e n somatic (SA) or excretorysecretory (ES) antigens o f the third stage larvae o f A. simplex s.l., a n d other ascarid nematodes ( A s c a r i s lumbricoides, A. suum, Toxocara canis, Anisakis physeteris, Hysterothylacium aduncum and H. fabri) using immunoblotting to detect specific antigens that could b e applied to serologic diagnosis in human anisakiasis. MATERIALS AND METHODS BIOLOGICAL MATERIAL L 3 larvae o f the following nematodes w e r e isolated: A. simplex sensu lato (s.l.), (blue whiting, Micromesistius poutassou), H. aduncum (horse mackerel, Trachurus trachurus), A. physeteris (hake, Merluccius merluccius), H. fabri (striped mullet, Mullus barbatus and striped red mullet, M. surmuletus). The hosts are given in parentheses. Adults o f T. canis, A. suum and A. lumbricoides were obtained from dogs, pigs a n d humans, respectively. * Departamento de Parasitología, Facultad de Farmacia, Universidad de Granada. Campus Universitario Cartuja. 18071 Granada, Spain. Correspondence: Dr. Josefa Lozano Maldonado. Tel.: +34 958 24 38 61- Fax: +34 958 24 38 62. E-mail: jlozano@ugr.es ANTIGENS Somatic antigens (SA) o f the larvae and adults helminths: all the helminths w e r e w a s h e d several times 219 with phosphate saline buffer ( P B S ) pH 7.2, and h o m o genized in PBS supplemented with protease inhibitors: 5 mM ethylenediaminetetraacetic acid, 1 mM phenylmethylsulphonyl fluoride and 0.1 trypsin inhibitor unit/ ml aprotinin (Sigma). T h e h o m o g e n a t e s w e r e applied to several cycles o f ultrasound sonicator and centrifuged! at 2 0 , 0 0 0 r/min for 30 min at 4 ° C . T h e supernatant was harvested and conserved at - 70° C until use. Excretory-secretory antigens o f A. simplex s.l. (ES): viable L3 larvae o f A. simplex s.l. w e r e p l a c e d in an antibiotic-antifungal solution and axenized (Iglesias et al., 1 9 9 7 ) . T h e n , 2 0 0 - 2 5 0 larvae/2,5 ml w e r e placed in culture flask containing sterile saline solution at 0.9 %, and maintained at 37° C and 5 % C O , (Valero et al., 2 0 0 3 ) . T h e w o r m s were o b s e r v e d daily for mobility, moulting and survival; after 7-9 days of culture, the larvae w e r e separated and the supernatant was filtered and centrifuged at 1,900 g for 30 min at 4 ° C and stored at - 70° C until use. T h e protein concentration o f the antigens was determined by the m e t h o d of Lowry (Lowry et al.. 1 9 5 1 ) . A N T I - S A AND ANTI-ES IMMUNE SERA T o obtain anti-SA and anti-ES sera, N e w Zeeland rabbits weighing about 2 kg were immunized intramuscularly with doses o f 1 ml/rabbit o f a 1:1 (v/v) mixture of c o m p l e t e F r e u n d ' s adjuvant and a solution containing 6 mg of antigen. Both at 21 and 31 days the s a m e antigen d o s e e x c e p t adjuvant was injected. After o n e month from the last immunization, they w e r e administered a b o o s t e r dose and the animals w e r e bled at seven days. For each antiserum, a pool with immune sera (from three rabbits) obtained from successive bleedings was d o n e . Before the first inoculation, the rabbits w e r e bled via incision into the marginal vein of the ear, using this serum as a negative control. IMMUNOBLOTTING T h e protein electrophoresis w a s carried out in gels of polyacrylamide with reduced condition and in the presence o f SDS (sodium dodecylsulphate) (Laemli, 1970). T h e gels w e r e discontinous with a first stacking gel (4 % o f acrylamide) and a s e c o n d with 10 % of acrylamide. T h e samples loaded w a s mixed with equal amounts o f the antigenic solution and sample buffer, and then heated in a bath o f boiling water for 4 min. T h e e l e c trophoresis was carried out at 4° C and 200 V for 45 min and the separated proteins w e r e transferred to nitrocellulose m e m b r a n e s ( B i o - R a d ) of 0.22 pm ( T o w b i n et al., 1 9 7 9 ) . T h e transfer lasted 12 h at 4 ° C and 30 V, in a buffer o f 20 % methanol, 25 mM o f Tris, and 192 mM o f glycine, pH 8.3. 220 T h e nitrocellulose m e m b r a n e w a s b l o c k e d for o n e hour at room temperature, with skimmed p o w d e r e d milk at 5 % in PBS, and then w a s h e d for five minutes in PBS-Tween at 0.3 % (PBS-T). T h e membranes placed on a Mini Protean II Multiscan ( B i o Rad., Richmond, CA, USA) w e r e incubated with a 1:200 dilution of antiSA or anti-ES o f A. simplex s.l. sera (primary antibodies). After w a s h e d for three times with PBS-T, the m e m b r a n e s w e r e incubated with a 1:30,000 dilution o f alkaline phosphatase conjugated goat anti-rabbit IgG (Sigma) (secondary antibody) for o n e hour at r o o m temperature with light stirring. With washings as the above, antigen bands w e r e visualized with 5 - b r o m o 4 - c h l o r o - 3 - i n d o l y l p h o s p h a t e / n i t r o b l u e tetrazolium ( B I C P - N B T ) (Bio-Rad). RESULTS R abbit anti-SA and anti-ES sera o f A. simplex s.l. had similar antigen recognition patterns and numerous bands against the somatic antigens of A. lumbricoides, A. suum. T. canis, A. simplex s.l., A. physeteris, H. aduncum and H. fabri and against the excretory-secretory antigens o f A. simplex s.l. w e r e detected. T h e s e results are s h o w n in the Table I. ASSAYS WITH ANTI-SA SERUM OF A. SIMPLEX S.L. Most o f the shared bands w e r e found b e t w e e n 30 and > 212 k D a (Fig. 1A). Bands o f approximately 60, 75, 110 kDa and two b a n d s greater than 212 kDa w e r e observed in the majority of the antigens. However, the anti-SA serum recognised a 25 kDa band only in SA of A. simplex s.l. and low Mw b a n d s ( 1 9 and 22 k D a ) in both antigens o f A. simplex s.l. and in the somatic antigens of A. physeteris. ASSAYS WITH ANTI-ES SERUM OF A. SIMPLEX S.L. T h e results obtained with the different antigens are presented in Fig. I B . This i m m u n e serum r e c o g n i s e s c o m m o n bands o f 7.2, 36, 75, 110, 212 and > 212 kDa, A n t i AS A. simplex Anti ES s.l. A. simplex serum serum A. simplex s.l. ( A S ) 20 23 A. simplex s.l. ( E S ) 19 12 26 A. lumbricoides 19 A. suum 13 20 T. cuius 10 15 18 18 1 1 14 12 14 A. physeteris H. aduncum H. fabri s.l. T a b l e I. - C o m m o n b a n d s , b e t w e e n n e m a t o d e s p e c i e s , o b t a i n e d b y immunoblot. Fig. 1. - Cross-reactivity r e v e a l e d b y i m m u n o b l o t t i n g b e t w e e n Anisakis w i t h anti-SA s e r u m o f A. simplex simplex s.l a n d o t h e r n e m a t o d e s . A ) I m m u n o b l o t o f h e l m i n t h e x t r a c t s s.l. B ) I m m u n o b l o t o f h e l m i n t h e x t r a c t s with anti-ES s e r u m o f A. simplex s.l. -SA-; ( l a n e e ) A. simplex s.l. -ES-; ( l a n e f) A. physeteris; suum; ( l a n e c ) Toxocara canis; terothylacium ( l a n e h ) H. fabri. A r r o w s s h o w s p e c i e - s p e c i f i c a n d g e n u s - s p e c i f i c b a n d s . T h e m o l e c u l a r w e i g h t m a r k e r s are indi- aduncum; ( l a n e d ) A. simplex s.l.: ( l a n e a ) Ascaris ( l a n e b ) A. lumbricoides: ( l a n e g ) Hys- c a t e d o n t h e left. in the different species of n e m a t o d e s studied. Also it revealed a band o f low Mw ( 1 4 k D a ) in A. simplex s.l., A. physeteris and Hysterothylacium antigens, two bands of < 7.2 and 19 kDa in both antigens of A. simplex s.l. and a band o f 9 kDa only in the ES antigen o f A. simplex s.l. DISCUSSION T he studies of cross-reactivity by different methods confirm the large antigenic homology among the nematodes. In this work, somatic and excretorysecretory antigens of the third stage larvae o f A. simplex s.l. and the somatic antigens of the n e m a t o d e s : A. physeteris, H. aduncum. H. fabri. A. lumbricoides. A. suum and T. canis, have b e e n studied by immunoblotting, using rabbit anti-SA and anti-ES sera of A. simplex s.l.. A study o f this kind had not b e e n d o n e with A. physeteris and H. fabri. Although this study has b e e n carried out with immunized rabbits sera only, w e believe that the results obtained can apply to a natural infection. Thus, sera from m i c e infected with live larvae and immunized with dead larvae recognized a similar pattern o f bands in immunoblots of ES and SA antigen preparations (Iglesias et al., 1993); also, Pascual et al., 1999, demonstrated high, medium and low molecular weigh bands in the sera o f 12 patients with gastric anisakiasis. Otherwise, the larvae L3 were maintained o f 7-9 days in vitro cultivation to obtain a greater concentration o f excretion-secretion antigens and w e should admit that they were obtained so much antigens o f L3 as of L4, since L3 moulting at 3-5 days (Iglesias et al., 1997; Iglesias, 1999; Iglesias et al. 2001). Cross-reactivity was detected with all the heterologous antigens tested, although the greatest antigenic similarity was obtained with the somatic antigen of A. physeteris that revealed 18 c o m m o n bands (Table I). In the case of the anti-ES serum, a strong reactivity with the antigens o f A. suum and A. lumbricoides ( 2 0 and 19 bands, respectively) was also demonstrated. T h e results obtained with anti-SA and anti-ES sera demonstrate the existence of common bands in the ascarids of 60, 75, 110 and > 212 kDa. Some of these bands had b e e n also revealed by other authors (Akao et al., 1990; D e Baere et al. 1992; Garcia et al. 1997; Carretero et al, 1998; Iglesias et al, 1996; Iglesias. 1998). However, the high Mw bands (212 and > 212 kDa) observed by us in the most of the ascarids studied both b y electrophoresis (unpublished data) and by blotting, have not b e e n detected by other authors either in cross-reactivity studies or in sera of patients with invasive anisakiosis, but they have b e e n revealed with the serum o f patients allergic to Anisakis (Montoro et al., 1997; Valero et al., 2 0 0 3 ) . Specie-specific c o m p o n e n t s have also b e e n revealed: o n e < 7.2 kDa in the two A. simplex s.l. antigens, a b a n d of 9 kDa only in the ES antigen and another o n e of 25 kDa in the AS antigen (Figs 1A, 1 B ) . Anti SA and anti ES sera, detect a 19 kDa protein in A. simplex s.l. antigens and the anti SA serum also 221 revealed this c o m p o n e n t in the somatic antigen o f A. physeteris. Therefore, this protein could b e considered to b e specific o f the Anisakis genus; w e think that it will b e interesting to look deeply into the study o f these low Mw antigens in view o f possible u s e in immunodiagnostic. Other authors also demonstrated that the specificity is found in the low molecular mass proteins, s o Hwang et al., 2 0 0 3 , reported a specificantigen in L3ESP, located at less than 13 kDa and recognized b y sera from persons diagnosed with anisakiasis. Also, specific bands with low Mw were detected in somatic antigens o f Anisakis (Iglesias et a l . , 1993; Iglesias et a l . , 1996); A. suum and T. canis (Maizels et a l . , 1984; Magnaval et a l . , 1991) and in the sera o f patients allergie to A>iisakis (Del Pozo et al., 1996; Montoro et al., 1997; Carretero et ai, 1998). Anti-ES serum revealed a protein o f 14 k D a in the somatic antigens o f A. simplex s.l., A. physeteris and H. aduncum and in the excretory-secretory antigens o f A. simplex s.l (Fig. I B ) ; otherwise, t h e anti SA serum did not detect this protein in any case. T h e fact that this c o m p o n e n t was only detected in the antigens o f Anisakis and Hysterothylacium and with the ES serum, s e e m s to indicate that this is released b y the larvae, into t h e m a i n t e n a n c e m e d i u m in sufficient amounts, to produce an antibody response in immunized rabbits and that it is present, in a lower c o n c e n tration, in the somatic antigens. This protein, characteristic o f t h e Ascaridoidea, w a s not detected in the other parasitic n e m a t o d e s supporting the findings o f Kennedy el ai, 1988 and K e n n e d y et al., 1989, about the 14 k D a antigen which is produced in different quantities b y the m e m b e r s o f this superfamily and can even presents structural differences in the molecule, that would condition its immunogenicity. T N.. O H Y A M A T . & K O X D O K. Immunoblot analisis of serum IgG, IgA and IgE responses against larval excretorysecretory antigens of Anisakis simplex in patiens with gastric anisakiasis. Journal Helminthology, 1990, 64, 310318. A., BIGUET J . , VERNES A. & A F C H A I N D. Structure antigénique des helminthes. Aspects immunologiques des relations hôte-parasite. Pathology et Biology, 1968, 16. 121-138. CAPROX 222 F., INARRAIRAEGUI M., PASTOR G., VILA J. & J.M. D A S C H N E R A., A L O N S O - G O M F Z A., C A B A N A S R., SUAREZ D E P A R G A M.C. Gastroallergic anisakiasis: borderline between food allergy and parasitic disease. Clinical and allergology evaluation of 20 patients with confirmed acute parasitism by Anisakis simplex. Journal of Allergy and Clinical Immunology, 2000, 105, 176-181. J.M. & DE LOPEZ SERRANO BAERE I., Lu L., MOENS RICHELLEJ., TROTMAN C. L., BEEIMEN J.V., GIELENS F I N C H J . , G E R S T E I N M. ci PERITZ C, M. Polar zipper sequence in the high-affinity haemoglobin of Ascaris suum: amino acid sequence and structural interpretation. Proceedings of the National Academy of Science USA, 1992, 89, 4638-4642. DEL Pozo M.T.. M.D., MONEO M U N O Z D.. I., FERNANDEZ DE CORRES F E R N A N D E Z E., N A V A R R O J.A. L., ci AUDICANA GARCIA M. Laboratory determinations in Anisakis simplex allergy. Journal of Alleigy and Clinical Immunology. 1996, 97, 97798T. D O M I ' N G U F Z O R T E G A J . , CIMARRA M . , ZARES A., MONEO I., ROBLEDO SEVILLA M., ECHARREN ALONSO-LLAMAT. & MARTINEZ C. Anisakis simplex: una causa de pseudobstrucciôn intestinal. Revista Espaùola de Enfermedades Digestivas. 2000, 92, 132-139. CÔCERA F A V R E R., C E R M O L A M . , N U N F S C P . . H E R M A N N R., M U L L E R M . , & P. Immuno-cross-reactivity of CIJT-1 and cuticlin epitopes between Ascaris lumbricoides, Caenorhabditis elegans and Heterorbabditis. Journal of Structural Biology, 1998, 123. 1-7. BAZZICALUPO FERNANDEZ CALDAS, E., QITRCE S., MARANÔN F., DI'EZ GOMEZ M.L., G I J Ô N H. & L O P E Z R. Allergenic cross-reactivity between third stage larvae of Hysterothylacium aduncum and Anisakis simplex. Journal cf Allergy and Clinical Immunology. 1998, 101. =04-555. AUDICANA M.T.. D E L P O Z O M.D., MUNOZ DI'EZ J . , E T X E N A G U S I A M . , A N S O T E G L T I.J. & The use of IgE immunoblotting as a diagnostic tool in Anisakis simplex allergy, foumai of Allergy Clinical Immunology. 1997. 99, 497-501. L.F. DECORRES Y.K.. KIM J.S., LEE J . B . , SONG T.J.. Joo K.W.. L E E J.S. & C H O S.W. Human anisakiasis: diversity in antibody response profiles to the changing antigens in larval excretions/secretions. Parasite Immunology, 2003, 25, 1-7. AKAO RIVAS C, BORDA e Inmu- Digestive anisakiasis: clinical manifestations and diagnosis according to localization. Revista Espaùola de Enfermedades Digestivas, 2002, 94. 463-472. HWANG REFERENCES MONEO B., ZOZAYA D . , F E R N A N D E Z E., his work w a s partly funded by the Research Groups Grant from Junta d e Andalucia. T h e translation into English was b y C. C o o p e . & CASTAN G A R C I A M., M O N R O L. ACKNOWLEDGEMENTS C A R R E T E R O P., Anisakis simplex. Revista Espaùola de Alergología nología Clínica. 1998, 13. 226-228. T O D O O . , GÓMEZ B . , N U N E Z C , A L D A Y E. I. Anafilaxia tras la realización de prick test a R. La anisaquiosis y su diagnôstico. M.S. Thesis, University of Santiago de Compostela, Spain, 1998, 144 p. IGLESIAS L. Estudios biológicos sobre Anisakis simplex s.s. e Hysterothylacium aduncum. M.S. Thesis, University of Granada, Spain, 1999. 239 p. IGLESIAS IGLESIAS R., L E I R O J . , U B E I R A F . M . , SANTAMARINA M.T. & SANMARTIN M.L. Anisakis simplex: antigen recognition and antibody production in experimentally infected mice. Parasite Immunology. 1993, 15, 243-250. IGLESIAS R., RETE I. & LEIRO J., UBEIRA SANMARTÍN F.M., S A N T A M A R I N A M.T., NAVAR- M.L. Antigenic cross-reactivity in mice between third-stage larvae of Anisakis simplex and other nematodes. Parasitology Research, 1996, 82, 378-381. PASCUAL C.Y., MARTÍN-ESTEBAN L., V A L E R O A. & A D R O H E R F . J . Some factors which influence the in vitro maintenance of Anisakis simplex (Nematoda). Folia Parasitologica. 1997. 44. 297-301. TOWBIN A., B E N Í T E Z R. & A D R O H E R F . J . In vitro cultivation of Anisakis simplex: pepsin increases survival and moulting from fourth larval to adult stage. Parasitology. 2001, 123. 285-291. VALERO IGLESIAS IGLESIAS L., VALERO I S H I K U R A H.. KIKUCHI K., N A G A S A W A K., O O I W A T., TAKAMIYA H.. N. & S U G A N E K. Anisakidae and anisakidosis, in: Progress in Clinical Parasitology, Volume III. Tsieh Sun. M.D. (ed.). Springer-Verlag, New York, Inc., 1992. 42-102. SATO M . W . Immune response to Anisakis simplex other ascarid nematodes. Allergy, 2000, 55, 7-13. and KENNEDY KENNEDY M.W.. TIERNKY J.. YE P.. MCMONAGLE F.A.. MCIN- A., M C L A U G H L I N D . & S M I T H J . W . The secreted and somatic antigens of the third stage larvae of Anisakis simplex and antigenic relationship with Ascaris suit m, Ascaris lumbricoides and Toxocara canis. Molecular and Biochemical Parasitology. 1988. 31, 35-46. TOSH KENNEDY. M.W., Q U R E S H I F., FRASER E.M., HASWELL-ELKINS S A N C H E Z - P A S T O R S.. D A S C H N E R A., ALONSO-GÓMEZ A. M . Humoral immune-response in patients with gastric anisakiasis. Journal of Allergy and Clinical Immunology, 1999, 103, 148. & H., S T A E H E I . I N T . & G O R D O N J . Electrophoretic transfer of proteins from polyacrilamide gels to nitrocellulose sheets: procedure and some applications Proceeding of the National Academy of Science USA. 1979, 76. 4350-4354. A., T E R R A D O S S., D I A Z V., R E G U E R A V. & L O Z A N O J . Determination of IgE in the serum of patients with allergic reactions to four species of fish parasite anisakids. Journal of Investigation Allergology and Clinical Immunology. 2003, 13. 94-98. P.H., K U I P E R S F . C . & R O S K A M R. T . A nematode parasitic to herring causing acute abdominal syndromes in man. Tropical and Geographical Medicine, 1960, 2, 97-113. VAN THIEL Reçu le 23 juin 2003 Accepté le 20 janvier 2004 M., H.V. Antigenic relationships between the surface-exposed, secreted and somatic materials of the nematode parasites Ascaris lumbricoides. Ascaris suum and Toxocara canis. Clinical and experimental Immunology. 1989. 7 5 493-500. ELKINS D.B. & SMITH E . K . Cleavage of structural proteins during the assembly of the head of bacteriophage T4. Nature. 1970. 227. 680-685. LAEMMLI LORENZO S., I G L E S I A S R., PANIAGUA E., LEIRO J . & UBEIRA F.M. Analysis of the antigenicity in mice of biotinyl enzymes from Anisakis simp/ex and other nematodes. Parasitology Research, 1999, 85. 441-445. O.H., R O S E B R O U G H N.J., F A R R A.L. & R A N D A L L R.J. Protein measurement with the Folin Phenol reagent. Journal Biology Chemical. 1951, 193. 265-275. LOWRY MAGNAVALJ.F., F A V R E R., M A U R I E R E S P.. CHARLETJ.P. & D E LAR- Application of the western blotting procedure for the immunodiagnosis of human toxocariosis. Parasitology Research. 1991, 77. 697-702. RARD B. R . M . , S A V I G N Y D . H . & O G I L M E B . M . Characterization of surface and excretory-secretory antigens of Toxocara canis infective larvae. Parasitology Immunology, 1984. 6, 23-37. MAIZELS M O N T O R O A., P R E T E J E R M.J., C H I V A T O T.. L A C U N A R. & C U E L L A R C. Recidivous acute urticaria caused by Anisakis Allergy. 1997. 52. 985-991. NUNES C M . , T U N D I S I R.N., GARCIA J.F., simplex. HEINEMANN M.B., OGAS- Cross-reactions between Toxocara canis and Ascaris suum in the diagnosis of visceral larva migrans by western blotting technique. Revista do Instituto de Medicina Tropical Sao Paulo. 1997, 5 253-256. SAWARA S. & P A S C U A L C.Y.. CABALLERO RICHTZENHAIN CRESPO J.F., T., J. S A N M A R T I N S., O R N T A N., MUNOZ-PEREIRA M. & ORTEGA MARTIN-ESTEBAN N.. M. Cross-reactivity between IgE-binding proteins from Anisakis, German cockroach, and chironomids. Allergy, 1997, 52. 514-520. 223
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