Detection of Some Safe Plant-Derived Foods for LTP-Allergic Patients

Abstract

Background: Lipid transfer protein (LTP) is a widely cross-reacting plant pan-allergen. Adverse reactions to Rosaceae, tree nuts, peanut, beer, maize, mustard, asparagus, grapes, mulberry, cabbage, dates, orange, fig, kiwi, lupine, fennel, celery, tomato, eggplant, lettuce, chestnut and pineapple have been recorded. Objective: To detect vegetable foods to be regarded as safe for LTP-allergic patients. Methods: Tolerance/intolerance to a large spectrum of vegetable foods other than Rosaceae, tree nuts and peanut was assessed by interview in 49 subjects monosensitized to LTP and in three distinct groups of controls monosensitized to Bet v 1 (n = 24) or Bet v 2 (n = 18), or sensitized to both LTP and birch pollen (n = 16), all with a history of vegetable food allergy. Patients and controls underwent skin prick test (SPT) with a large spectrum of vegetable foods. The absence of IgE reactivity to foods that were negative in both clinical history and SPT was confirmed by immunoblot analysis and their clinical tolerance was finally assessed by open oral challenge (50 g per food). Results: All patients reported tolerance and showed negative SPT to carrot, potato, banana and melon; these foods scored positive in SPT and elicited clinical symptoms in a significant proportion of patients from all three control groups. All patients tolerated these four foods on oral challenge. Immunoblot analysis confirmed the lack of IgE reactivity to these foods by LTP-allergic patients. Conclusion: Carrot, potato, banana and melon seem safe for LTP-allergic patients. This finding may be helpful for a better management of allergy to LTP.

Lipid Transfer Protein Syndrome in a Non-Mediterranean Area

“…Despite the fact that the study was carried out on adult patients, we must note that these were mainly young patients with an average age of 34 years, which is very similar to that of the patients involved in other studies (patients between the ages of 29 and 37 years) [8,22,23] and with a high incidence of atopy (43% with rhinitis and 21% with asthma), as is also mentioned in the referenced literature [24]. …”

“…We are well aware of the fact that our study does not include the gold standard for the diagnosis of food allergies, the DBPCFC. However, the prospective inclusion of patients with an unequivocal clinical history of an IgE-mediated process is similar to that of other studies involving LTP-sensitized patients [8,9,19,20,22,23]. Additionally, the frequency with which the patients developed systemic symptoms, as well as the large number of foods that triggered the onset of allergic symptoms in each patient, constitute a major constraint for a DBPCFC-type study design.…”

Recurrent anaphylaxis in patient allergic to eggplant – a case study

“…He came to the conclusion that carrot, potato, banana and melon seem safe. 24 The future for LTP syndrome patients definitely involves a specific immunotherapy developed according to the patient -specific sensitivity profile. There are some interesting cases showing the efficiency of this treatment, but there are no commercially available immunotherapies for these patients.…”

New Food Allergies in a European Non-Mediterranean Region: Is <b><i>Cannabis sativa</i></b> to Blame?

“…Furthermore, several patients demonstrated allergic reactions towards fruits and vegetables such as banana, tomato, citrus and grape fruits that are rarely involved in a well-known Bet v 1-associated food syndrome [2,39]. Alternatively, unlike in southern European surveys [14,15,40,41], allergy to peach was not predominant and some patients reacted to banana, which was previously described to be safe in peach-allergic patients [42]. Finally, most patients did not easily recognize their drug allergy and also suffered from a birch pollen allergy, they were generally unable to recollect the exact sequence of appearance of cannabis and food-related symptoms.…”