Lipid Transfer Protein Syndrome in a Non-Mediterranean Area

Int Arch Allergy Immunol. 2016;169(3):181-8. doi: 10.1159/000445893. Epub 2016 May 4.

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.

MeSH terms

  • Adult
  • Allergens / immunology*
  • Antibody Specificity / immunology
  • Antigens, Plant / immunology*
  • Carrier Proteins / immunology*
  • Comorbidity
  • Cross Reactions / immunology
  • Female
  • Food Hypersensitivity / diagnosis
  • Food Hypersensitivity / epidemiology*
  • Food Hypersensitivity / immunology*
  • Food Hypersensitivity / prevention & control
  • Humans
  • Immunization
  • Immunoglobulin E / blood
  • Immunoglobulin E / immunology
  • Male
  • Phenotype
  • Pollen / immunology
  • Skin Tests
  • Spain / epidemiology
  • Syndrome
  • Young Adult

Substances

  • Allergens
  • Antigens, Plant
  • Carrier Proteins
  • lipid transfer protein
  • Immunoglobulin E