Why is cross-reactivity extremely common specifically within the crustacean group, but not automatically guaranteed between crustaceans and mollusks?
Answer
Crustaceans share the primary sensitizing agent, tropomyosin.
Cross-reactivity is extremely common among crustaceans (shrimp, crab, lobster) because they share a major, common, heat-stable muscle protein allergen called tropomyosin. Since this specific protein is present in the muscle tissue of nearly all members of this group, sensitization to one typically means sensitization to all others in the crustacean category. In contrast, while mollusks might contain tropomyosin, their overall protein profile differs significantly enough that sensitivity is not automatically transferred from the crustacean group to the mollusk group, leading to two officially recognized, distinct categories of shellfish allergies.
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