Pru p 7 sensitization is a predominant cause of severe, cypress pollen‐associated peach allergy

Abstract

Background: Peach is a common elicitor of food allergic reactions. Peach-induced immediate reactions may occur as benign pollen-food syndromes, usually due to birch pollen-related PR-10 cross-reactivity in temperate climates, and as potentially severe primary food allergies, predominantly related to nsLTP Pru p 3 in Mediterranean regions. The newly described peach allergen Pru p 7 has gained recent attention as a potential peach allergy severity marker. Sensitization to Pru p 7 and its allergenic homologues of the gibberellin-regulated protein family occurs in areas with high Cupressaceae tree pollen exposure. Objective:We sought to investigate the distribution, clinical characteristics and molecular associations of Pru p 7 sensitization among subjects with suspected peach allergy in different regions of France. Methods: Subjects with suspected peach allergy (n = 316) were included. Diagnostic work-up was performed according to current guidelines, including open food challenge when required. IgE antibody measurements and competition experiments were performed using the ImmunoCAP assay platform. Results: Sensitization to Pru p 7 was present in 171 (54%) of all subjects in the study and in 123 of 198 (62%) diagnosed as peach allergic, more than half of whom were sensitized to no other peach allergen. Frequency and magnitude of Pru p 7 sensitization were associated with the presence of peach allergy, the clinical severity of peach-induced allergic reactions and the level of cypress pollen exposure. Cypress pollen extract completely outcompeted IgE binding to Pru p 7. Pru p 7 was extremely potent in basophil activation tests. Conclusion and Clinical Relevance: A subtype of Cupressaceae pollinosis, characterized by Pru p 7 sensitization, can be an underlying cause of severe peach allergy. K E Y W O R D S allergens and epitopes, anaphylaxis, basophil, cypress pollinosis, food allergy, IgE, immunological tests, peamaclein, Pru p 7

Cypress Pollen Allergy in a Mediterranean Area

“…An important association was recently reported between cypress pollinosis, levels of pollen exposure, and peach allergy due to sensitization to peamaclein (Pru p 7) in a French population. The authors reported that cypress pollen extract completely outcompeted IgE binding to Pru p 7 [6]. In accordance with previous studies, monosensitization to cypress pollen was exceptional in our population [7].…”

Sensitization to Gibberellin-Regulated Protein (Peamaclein) Among Italian Cypress Pollen–Sensitized Patients

“…Participating centers were left free to employ the commercial SPT preparations that they used in their routine activity; producers included Allergopharma (Reinbeck, Germany), ALK (Horsholm, Denmark), and Lofarma (Milano, Italy). Skin tests were carried out following established methods [16]; readings were taken after 15 1© 2020 Esmon Publicidad doi: 10.18176/jiaci.0542 activity. The ALK extract is known to lack labile allergens (such as PR-10 and profilin) and to contain stable allergens such as LTP [17] and peamaclein [3].…”

“…Other foods have been reported to be potential inducers of allergic reactions in patients hypersensitive to this family of allergens, including Japanese apricot [12], orange [13], and pomegranate [14], the names of these allergens being Pru m 7, Cit s 7, and Pun g 7, respectively. Further, clinical reactivity against apple, melon, watermelon, and strawberry [2], as well as to exotic fruits, kiwi, tomato, fig, carrot, grapes, coconut, and celeriac [15] has been reported in Pru p 7-hypersensitive patients making GRP a potential novel plant-food panallergen.…”

A WAO — ARIA — GA2LEN consensus document on molecular-based allergy diagnosis (PAMD@): Update 2020

“…BP14 from cypress pollen, Pru p 7 from peach, and Pun g 7 from pomegranate are some representative GRP molecules. [214][215][216][217] Kiwi Among 59 people in Sweden with peanut allergy, 39% also reported symptoms to kiwi, likely elicited by cross-reactivity between the 11S and 7S globulins present in both kiwi and peanut, and cosensitization to the kiwi 2S albumin Act d 13. 218 Additional reactivities to nuts and legumes other than peanuts were also reported.…”