Lipid Transfer Protein Syndrome in a Non-Mediterranean Area

Abstract

Background: Plant food allergies associated with lipid transfer protein (LTP) have been widely described in the Mediterranean Basin. Objective: The aim of this work was to describe the clinical profile and pollen sensitization of plant food- allergic patients sensitized to LTP in a non-Mediterranean area. Methods: Patients with clear IgE-mediated symptoms associated with plant foods and a positive skin prick test (SPT) to Pru p 3 were included in a prospective study in the north of Spain. Reported symptoms were analyzed together with a battery of food and pollen SPTs and specific IgE components by ISAC microarray. Cross-inhibition studies were performed by ImmunoCAP with plane tree, mugwort and rPru p 3. Results: Among the 72 patients included, the most frequent food allergy reported was to peaches (69%) followed by nuts (walnuts 55%, peanuts 54% and hazelnuts 43%). Most patients suffered from symptoms with multiple plant foods (a median of 6 foods per patient). Regarding the patients' pollen sensitization, 36% were sensitized to mugwort pollen (72% showing sIgE to Art v 3), 33% to grass pollen and 24% to plane tree pollen (94% with sIgE to Pla a 3). Inhibition studies showed that specific IgEs against mugwort and plane tree pollen are inhibited by Pru p 3 in a strong manner, whereas Pru p 3 was less inhibited by pollen extracts. Conclusions: LTP syndrome occurs in a non-Mediterranean area and is related to multiple sensitizations to foods and pollens such as plane tree and mugwort. In these pollen sensitizations, Pru p 3 seems to be the primary sensitizer.

Lipid Transfer Protein allergy in the United Kingdom: Characterization and comparison with a matched Italian cohort

“…Our data are the first to indicate that LTP allergy is manifest in UK‐born adults, with sensitization patterns to LTP allergens similar to those seen in matched Italian subjects. The geographical variation in plant food allergies is well reported, but our data add to published evidence that LTP allergy occurs in northern regions of Mediterranean countries and also other regions of Europe . Recent studies include one on Austrian subjects with severe reactions to plant foods, who have been shown to be sensitized to Pru p 3, and a large data set has demonstrated that LTP sensitization is present in subjects living in Belgium .…”

Immunoglobulin E-binding Proteins of Cooked Walnuts in Korean Children

“…In the future, these low-allergen WNs could be used for desensitization therapy of patients who are allergic to WNs. LTP allergen (Jug r 3) appears to be one of the candidate allergens causing severe reactions in patients with LTP syndrome, 16 17 but not in this study. In order to draw more definite conclusions on LTP, further studies on older participants are needed.…”

Rational Design, Structure–Activity Relationship, and Immunogenicity of Hypoallergenic Pru p 3 Variants

“…Therefore, they served as models for plant food allergy and were extensively studied during the past decades . LTPs are one of the major causes of FA in Mediterranean countries, though some recent studies also suggest LTP sensitization distinct from this geographic location . Their high structural homology gives rise to the LTP‐syndrome, characterized by clinically relevant IgE cross‐reactivity between homologs from various fruits and vegetables .…”