Non‐specific lipid‐transfer proteins: Allergen structure and function, cross‐reactivity, sensitization, and epidemiology

Skypala, Isabel; Asero, Riccardo; Barber, Domingo; Cecchi, Lorenzo; Díaz-Perales, Araceli; Hoffmann‐Sommergruber, Karin; Pastorello, Elide A.; Swoboda, Ines; Bartra, Joan; Ebo, Didier G.; Faber, Margaretha A.; Fernández‐Rivas, Montserrat; Gómez, Francisco Alvarado; Konstantinopoulos, Anastasios P; Luengo, Olga; Ree, Ronald van; Scala, Enrico; Till, Stephen J.

doi:10.1002/clt2.12010

Cited by 94 publications

(96 citation statements)

References 125 publications

(282 reference statements)

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“…Non‐specific lipid transfer proteins (LTPs) represent the most frequent cause of primary food allergy in adults living in Mediterranean countries and are the main cause of food‐induced anaphylaxis in these areas as well 1–3 …”

Section: Introductionmentioning

confidence: 99%

“…At the beginning of the new century, it became clear that LTPs were not specific to Rosaceae fruits, but could be detected also in various pollen sources 11 and botanically unrelated plant‐derived foods, and was heat‐ and pepsin‐resistant 12,13 . The list of foods found to contain LTP has increased over the years (summarized in references 3 and, 14 ) up to the point that this protein is now considered one of the most typical examples of panallergen (Figure 1).…”

Section: Introductionmentioning

confidence: 99%

“…However, this phenomenon is not constant, and offending allergen sources may show much variability from one geographical area to another. A pair of excellent and comprehensive review articles about LTP endorsed by the European Academy of Allergy and Clinical Immunology and co‐authored by the world‐leading experts in this field have been very recently published 3,4 . Thus, we decided to focus the present paper on the several controversial aspects and unanswered questions that surround this particular type of food allergy, including its peculiar geographical prevalence, the cross‐reactivity between homologous allergens, and the risk factors associated with sensitization to LTP.…”

Section: Introductionmentioning

confidence: 99%

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Lipid transfer protein allergy: A review of current controversies

Asero

Pravettoni

Scala

et al. 2021

Clin Experimental Allergy

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Sensitization to lipid transfer protein (LTP), the most frequent cause of food allergy in southern Europe, still shows several controversial, but also intriguing, aspects. Some of these include the degree of cross‐reactivity between LTPs from botanically distant sources, the definition of risk factors, the role of some cofactors, clinical outcomes, geographical differences and the identification of the primary sensitizer in different areas. This review article tries to analyse and comment on these aspects point by point suggesting some explanatory hypotheses with the final scope to stimulate critical thoughts and elicit the scientific discussion about this issue in the readership.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Lipid transfer protein allergy: A review of current controversies

Asero

Pravettoni

Scala

et al. 2021

Clin Experimental Allergy

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“…Cross-reactivity between pollens and plant food has been widely described [1][2][3]. It has been reported to cause the onset of allergic reactions in subjects who develop sensitization to both pollens, developing respiratory allergies and allergies to plant food and causing food allergy clinical manifestations which can vary from oral allergic syndrome (OAS) to anaphylaxis [4].Various advanced therapeutic approaches are under evaluation and include biological agents such as anti-IgE, anti-IL-5 and anti IL-4/IL-13 treatments, as these molecules are important in food-induced allergic inflammatory pathogenesis [5,6].…”

Section: Introductionmentioning

confidence: 99%

Plant Food Allergy Improvement after Grass Pollen Sublingual Immunotherapy: A Case Series

Furci

Ricciardi

2021

Pathogens

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Background: Cross-reactivity between pollens and plant food has been widely described. Pollen extract subcutaneous immunotherapy in patients with pollens and plant food allergy has been shown to improve tolerance not only to inhalant allergens but also to reduce symptoms in patients with various food allergies. Methods: We retrospectively report our experience with 15 female patients with a positive history for moderate, persistent allergic rhinitis due to grass pollen and oropharyngeal symptoms after ingestion of different plant food. These patients followed a five-grass pollen sublingual tablet immunotherapy for three years in a discontinuous pre-co-seasonal scheme. Results: All 15 patients treated with the 5-grass pollen sublingual tablet immunotherapy, taken once daily for 3 years on a 7-month course, showed improved ocular/nasal symptoms, with a reduction in the use of symptomatic drugs (e.g., nasal corticosteroids and H1 antihistamines). After the first seven-month course of immunotherapy, all patients declared a good tolerance to the intake of fruits and vegetables, and in particular, good tolerance to the offending foods. Conclusions: In conclusion, we have observed improvement of both respiratory and plant food allergies after sublingual immunotherapy (SLIT) with a five-grass pollen tablet.

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“…These small, heat-stable, structurally highly conserved proteins belong to the major fruit allergens [ 25 ]. nsLTPs are the most frequent cause of food allergies in adults in the Mediterranean area [ 26 , 27 ] and are known as panallergens, as patients often present IgE binding to several different nsLTPs due to cross-reactivity, leading to a phenomenon also known as the LTP-syndrome [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

Does the Food Ingredient Pectin Provide a Risk for Patients Allergic to Non-Specific Lipid-Transfer Proteins?

Steigerwald

Blanco-Pérez

Albrecht

et al. 2021

Foods

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Pectin, a dietary fiber, is a polysaccharide that is widely used in food industry as a gelling agent. In addition, prebiotic and beneficial immunomodulatory effects of pectin have been demonstrated, leading to increased importance as food supplement. However, as cases of anaphylactic reactions after consumption of pectin-supplemented foods have been reported, the present study aims to evaluate the allergy risk of pectin. This is of particular importance since most of the pectin used in the food industry is extracted from citrus or apple pomace. Both contain several allergens such as non-specific lipid transfer proteins (nsLTPs), known to induce severe allergic reactions, which could impair the use of pectins in nsLTP allergic patients. Therefore, the present study for the first time was performed to analyze residual nsLTP content in two commercial pectins using different detection methods. Results showed the analytical sensitivity was diminished by the pectin structure. Finally, spiking of pectin with allergenic peach nsLTP Pru p 3 led to the conclusion that the potential residual allergen content in both pectins is below the threshold to induce anaphylactic reactions in nsLTP-allergic patients. This data suggests that consumption of the investigated commercial pectin products provides no risk for inducing severe reactions in nsLTP-allergic patients.

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Non‐specific lipid‐transfer proteins: Allergen structure and function, cross‐reactivity, sensitization, and epidemiology

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Cited by 94 publications

References 125 publications

Lipid transfer protein allergy: A review of current controversies

Lipid transfer protein allergy: A review of current controversies

Plant Food Allergy Improvement after Grass Pollen Sublingual Immunotherapy: A Case Series

Does the Food Ingredient Pectin Provide a Risk for Patients Allergic to Non-Specific Lipid-Transfer Proteins?

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