Sensitization to one or more non-specific lipid transfer proteins(nsLTP), initially thought to exist mainly in southern Europe,is becoming accepted as a cause of allergic reactions to plant foods across Europe and beyond.The peach nsLTP allergen Pru p 3 is a dominant sensitizing allergen, and peaches a common food trigger, although multiple foods can be involved. A frequent feature of reactions is the requirement for a co-factor (exercise, alcohol, non-steroidal anti-inflammatory drugs, Cannabis sativa)to be present for a food to elicit a reaction. The variability in the food and co-factor triggers make it essential to include an allergy focused diet and clinical history in the diagnostic work-up. Testing on suspected food triggers, should also establish whether sensitization to nsLTP is present, usingpurified or recombinant nsLTP allergens such as Pru p 3. Theavoidance of known trigger foods and advice on co-factors is currently the main management for this condition. Studies on immunotherapy are promising, but it is unknown whether such treatments will be useful in populations where Pru p 3 is not the primary sensitizing allergen. Future research should focus on the mechanisms of co-factors, improving diagnostic accuracy and establishing the efficacy of immunotherapy.

The diagnosis and management of allergic reactions in patients sensitized to non-specific Lipid Transfer Proteins / I.J. Skypala, J. Bartra, D.G. Ebo, M.A. Faber, M. Fernández-Rivas, F. Gomez, O. Luengo, S.J. Till, R. Asero, D. Barber, L. Cecchi, A. Diaz Perales, K. Hoffmann-Sommergruber, E.A. Pastorello, I. Swoboda, A.P. Konstantinopoulos, R. van Ree, E. Scala. - In: ALLERGY. - ISSN 1398-9995. - (2021). [Epub ahead of print] [10.1111/all.14797]

The diagnosis and management of allergic reactions in patients sensitized to non-specific Lipid Transfer Proteins

E.A. Pastorello;
2021

Abstract

Sensitization to one or more non-specific lipid transfer proteins(nsLTP), initially thought to exist mainly in southern Europe,is becoming accepted as a cause of allergic reactions to plant foods across Europe and beyond.The peach nsLTP allergen Pru p 3 is a dominant sensitizing allergen, and peaches a common food trigger, although multiple foods can be involved. A frequent feature of reactions is the requirement for a co-factor (exercise, alcohol, non-steroidal anti-inflammatory drugs, Cannabis sativa)to be present for a food to elicit a reaction. The variability in the food and co-factor triggers make it essential to include an allergy focused diet and clinical history in the diagnostic work-up. Testing on suspected food triggers, should also establish whether sensitization to nsLTP is present, usingpurified or recombinant nsLTP allergens such as Pru p 3. Theavoidance of known trigger foods and advice on co-factors is currently the main management for this condition. Studies on immunotherapy are promising, but it is unknown whether such treatments will be useful in populations where Pru p 3 is not the primary sensitizing allergen. Future research should focus on the mechanisms of co-factors, improving diagnostic accuracy and establishing the efficacy of immunotherapy.
Lipid Transfer Protein; co-factors; diagnosis; management;
Settore MED/09 - Medicina Interna
2-mar-2021
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/822745
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