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

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          Abstract

          Background

          Although pollen‐related food allergy occurs in all European populations, lipid transfer protein ( LTP) allergy is considered to manifest mainly in Mediterranean countries. We aimed to characterize adults presenting with LTP allergy in a northern European country.

          Method

          The clinical history and sensitization patterns of subjects born and residing in the United Kingdom ( UK), with a prior diagnosis of LTP allergy and sensitization to the peach LTP allergen Pru p 3, were compared to UK subjects with pollen food syndrome ( PFS). The sensitization patterns were also evaluated against a matched cohort of Italian subjects diagnosed with LTP allergy.

          Results

          None of the 15 UK PFS subjects had a positive SPT to LTP‐enriched peach reagent, compared to 91% of the 35 UK LTP subjects. The UK LTP cohort were also more likely to have positive skin prick tests to cabbage, lettuce and mustard and sensitization to the LTP allergens in peach, walnut, mugwort and plane tree These sensitization patterns to individual allergens were not significantly different to those obtained from the Italian LTP subjects, with significant correlations between Pru p 3 and the LTP allergens in peanuts, walnuts, plane tree and mugwort in both groups.

          Conclusion

          Native UK subjects with LTP allergy are not dissimilar to those with LTP allergy in southern Europe. Testing to LTP‐enriched peach SPT reagent and/or LTP allergens in peach, walnut, mugwort and plane tree may enhance diagnostic accuracy.

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          Peanut allergy: Clinical and immunologic differences among patients from 3 different geographic regions.

          Staffan Ahlstedt, Maria Ibañez, Jenny van Odijk … (2011)
          Peanut allergy affects persons from various geographic regions where populations are exposed to different dietary habits and environmental pollens. We sought to describe the clinical and immunologic characteristics of patients with peanut allergy from 3 countries (Spain, the United States, and Sweden) using a molecular component diagnostic approach. Patients with peanut allergy from Madrid (Spain, n = 50), New York (United States, n = 30), Gothenburg, and Stockholm (both Sweden, n = 35) were enrolled. Clinical data were obtained either from a specific questionnaire or gathered from chart reviews. IgE antibodies to peanut extract and the peanut allergens rAra h 1, 2, 3, 8 and 9, as well as to cross-reactive birch (rBet v 1) and grass (rPhl p 1, 5, 7, and 12) pollen allergens, were analyzed. American patients frequently had IgE antibodies to rAra h 1 to 3 (56.7% to 90.0%) and often presented with severe symptoms. Spanish patients recognized these 3 recombinant peanut allergens less frequently (16.0% to 42.0%), were more often sensitized to the lipid transfer protein rAra h 9 (60.0%), and typically had peanut allergy after becoming allergic to other plant-derived foods. Swedish patients detected rAra h 1 to 3 more frequently than Spanish patients (37.1% to 74.3%) and had the highest sensitization rate to the Bet v 1 homologue rAra h 8 (65.7%), as well as to rBet v 1 (82.9%). Spanish and Swedish patients became allergic to peanut at 2 years or later, whereas the American children became allergic around 1 year of age. Peanut allergy has different clinical and immunologic patterns in different areas of the world. Allergen component diagnostics might help us to better understand this complex entity. Copyright © 2010 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.
          Article 0 comments Cited 75 times – based on 0 reviews     Review now
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            Apple allergy across Europe: how allergen sensitization profiles determine the clinical expression of allergies to plant foods.

            Ronald Van Ree, Riccardo Asero, Laurian Zuidmeer-Jongejan … (2006)
            Allergy to a plant food can either result from direct sensitization to that food or from primary sensitization to pollen, latex, or another food. We sought to investigate the primary sensitizers in apple allergy across Europe, the individual allergens involved, and whether these differences determine the clinical presentation. Patients (n = 389) with positive case histories and skin prick test responses to fresh apple were selected in the Netherlands, Austria, Italy, and Spain. Skin prick tests and RASTs to a panel of pollens and plant foods were performed, as well as RASTs to Bet v 1 and the apple allergens Mal d 1, 2, 3, and 4. In the Netherlands, Austria, and Italy apple allergy is mild (>90% isolated oral symptoms) and related to birch pollinosis and sensitization to Bet v 1 and its apple homologue, Mal d 1, which has an odds ratio of local reactions of 2.85 (95% CI, 1.47-5.55). In Spain apple allergy is severe (>35% systemic reactions) and related to peach allergy and sensitization to Mal d 3 (nonspecific lipid transfer protein), which has an odds ratio of systemic reactions of 7.76 (95% CI, 3.87-15.56). The analysis of individual apple allergens in a clinical context has provided insight into the sensitization pathway and into the intrinsic risk an allergen bears to induce mild or severe food allergy. Information on the sensitization pathway is essential to develop preventive strategies in food allergy. The application of individual food allergens with a known intrinsic risk will improve the prognostic value of diagnostic tests.
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              Current understanding of cross-reactivity of food allergens and pollen.

              STEFAN VIETHS, STEPHAN SCHEURER, BARBARA BALLMER-WEBER (2002)
              Pollen-allergic patients frequently present allergic symptoms after ingestion of several kinds of plant-derived foods. The majority of these reactions is caused by four distinct cross-reactive structures that are present in birch pollen. Proteins that share common epitopes with Bet v 1, the major birch pollen allergen, occur in pollens of several tree species: apples, stone fruits, celery, carrot, nuts, and soybeans. Approximately 70% of our patients who are allergic to birch pollen may experience symptoms after consumption of foods from these groups. In contrast, two minor allergenic structures-profilins and cross-reactive carbohydrate determinants (CCD)-that sensitize approximately 10-20% of all pollen-allergic patients are also present in grass pollen and weed pollen. Moreover, IgE-binding proteins related to the birch pollen minor allergen Bet v 6 have been found in many vegetable foods such as apple, peach, orange, lychee fruit, strawberry, persimmon, zucchini, and carrot. Frequently, the occurrence of cross-reactive IgE antibodies is not correlated with the development of clinical food allergy. In particular, the clinical relevance of sensitization to CCD is doubtful. Generally, pollen-related allergens tend to be more labile during heating procedures and in the digestive tract compared to allergens from classical allergenic foods such as peanut. However, recent DBPCFC studies have shown that both cooked celery and roasted hazelnuts still pose an allergenic risk for pollen-sensitized subjects. Since pathogenesis-related proteins share several common features with allergens and both the Bet v 1 and the Bet v 6-related food allergens are defense-related proteins, approaches to introduce such proteins as a measure to protect plants against diseases should be performed with caution as they may increase the allergenicity of these crops.
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                Author and article information

                Contributors
                Isabel J. Skypala:
                ORCID: https://orcid.org/0000-0003-3629-4293
                I.Skypala@rbht.nhs.uk
                Journal
                Journal ID (nlm-ta): Allergy
                Journal ID (iso-abbrev): Allergy
                Journal ID (doi): 10.1111/(ISSN)1398-9995
                Journal ID (publisher-id): ALL
                Title: Allergy
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Print): 0105-4538
                ISSN (Electronic): 1398-9995
                Publication date (Electronic): 14 March 2019
                Publication date (Print): July 2019
                Volume: 74
                Issue: 7 ( doiID: 10.1111/all.2019.74.issue-7 )
                Pages: 1340-1351
                Affiliations
                [ 1 ] Royal Brompton & Harefield NHS Foundation Trust London UK
                [ 2 ] Imperial College London London UK
                [ 3 ] SOS Allergy and Immunology USL Toscana Centro Prato Italy
                [ 4 ] Istituto Dermopatico dell'Immacolata IDI‐IRCCS Roma Italy
                [ 5 ] Guy's & St Thomas’ NHS Foundation Trust London UK
                [ 6 ] King's College London London UK
                Author notes
                [*] [* ] Correspondence

                Isabel J. Skypala, Department of Allergy & Clinical Immunology, Royal Brompton Hospital, London, UK.

                Email: I.Skypala@ 123456rbht.nhs.uk

                Author information
                https://orcid.org/0000-0003-3629-4293
                https://orcid.org/0000-0002-0658-2449
                https://orcid.org/0000-0003-3425-3463
                https://orcid.org/0000-0002-9391-9168
                https://orcid.org/0000-0003-4518-3093
                Article
                Publisher ID: ALL13747
                DOI: 10.1111/all.13747
                PMC ID: 6767535
                PubMed ID: 30762886
                SO-VID: 0527a77b-f2cd-4c9e-9fc3-4efedb297294
                Copyright © © 2019 The Authors. Allergy Published by John Wiley & Sons Ltd.
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                Date received : 15 October 2018
                Date revision received : 13 December 2018
                Date accepted : 06 January 2019
                Page count
                Figures: 2, Tables: 4, Pages: 12, Words: 10825
                Categories
                Subject: Original Article
                Subject: ORIGINAL ARTICLES
                Subject: Food Allergy and Gastrointestinal Diseases
                Custom metadata
                source-schema-version-number 2.0
                component-id all13747
                cover-date July 2019
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.9 mode:remove_FC converted:30.09.2019

                ScienceOpen disciplines: Immunology
                Keywords: allergy,food,lipid transfer protein
                Data availability:
                ScienceOpen disciplines: Immunology
                Keywords: allergy, food, lipid transfer protein

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