Lipid Transfer Protein Sensitization: Risk of Anaphylaxis and Molecular Sensitization Profile in Pru p 3-Sensitized Patients

Int Arch Allergy Immunol. 2021;182(5):425-432. doi: 10.1159/000511977. Epub 2020 Dec 18.

Abstract

Background: Component-resolved diagnosis reveals the IgE response to many inhaled, food, and other allergens, improving the understanding and diagnosis of allergic diseases.

Objective: The aims of the study are to study the recognition of different lipid transfer proteins (LTPs) and other allergen families in a large group of people sensitized to Pru p 3 and to analyze the relationship between the clinical entities and the allergens.

Methods: This cross-sectional study included a large cohort of patients with positive skin tests to peach fruit and Pru p 3 specific IgE antibodies. Respiratory and food allergy symptoms were collected, and we performed prick tests with pollen, plant food, and other allergens plus the ImmunoCAP ISAC assay.

Results: Our sample consisted of 421 people with a mean age of 33.25 years (range 16-68); 54.6% were women. Clinical entities included anaphylaxis (37.1%), urticaria (67.9%), and oral allergy syndrome (59.1%). Rhinitis, rhinoconjunctivitis, and/or asthma were diagnosed in 71.8% of the participants. The most pronounced correlation existed between sensitization to Pru p 3 and to Jug r 3, Pla a 3, Ara h 9, and Cor a 8. We found a higher incidence of anaphylaxis in people with 5 or more recognized LTPs. No association was observed between inhaled and food allergies.

Conclusion: Most Pru p 3-sensitized participants were sensitized to additional allergens from the same family and, to a lesser extent, to other allergens, mainly in the profilin and PR-10 protein families. Anaphylaxis occurred in more than a third of the cases evaluated, and almost three-quarters of them had respiratory symptoms. Respiratory and food allergies involving LTPs do not seem to be associated.

Keywords: Anaphylaxis; Component-resolved diagnosis; Lipid transfer proteins; Pru p 3; Risk factors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anaphylaxis / diagnosis
  • Anaphylaxis / epidemiology*
  • Anaphylaxis / etiology*
  • Antigens, Plant / immunology*
  • Carrier Proteins / immunology*
  • Cross-Sectional Studies
  • Diagnosis, Differential
  • Female
  • Humans
  • Immunoglobulin E / blood
  • Immunoglobulin E / immunology
  • Incidence
  • Male
  • Middle Aged
  • Plant Proteins / immunology*
  • Risk Assessment
  • Risk Factors
  • Young Adult

Substances

  • Antigens, Plant
  • Carrier Proteins
  • Plant Proteins
  • Pru p 3 allergen
  • lipid transfer protein
  • Immunoglobulin E