1. Sensitization profile in a group of Spanish patients allergic to LTP
Barbarroja-Escudero J, Antolin-Amerigo D, Sanchez-Gonzalez MJ, Alvarez-Mon M, Rodriguez-Rodriguez M
Hospital Universitario Príncipe de Asturias. Allergy Department. Alcalá de Henares. Madrid. Spain
Background
Lipid transfer protein (LTP) induces severe allergic reactions in sensitized patients, usually anaphylaxis. Vegetables are the culprit food in most cases, and subsequently, fresh fruits and nuts.
Method
We recruited 46 patients (39 women) sensitized to LTP over a six-month study period. This IgE-mediated allergy was demonstrated by anamnesis, skin-prick tests, prick-by-prick testing and/or ImmunoCAP assay.
Results
Of forty-six patients, 26 suffered from anaphylaxis (56.52%), 6 systemic urticaria/angioedema (13.04%), 5 oral allergy syndrome (OAS) (10.86%), 3 contact urticaria (CU) (6.52%), 2 anaphylaxis and OAS (4.34%), 2 anaphylaxis and CU (4.34%), 2 urticaria and OAS (4.34%), 1 rhinitis (2.17%), and 1 protein contact dermatitis (2.17%), due to LTP allergy. The mean age was 32 years old. Thirteen patients showed pollen allergy, of which 5 were allergic to profilin. The culprit foods were, in order of frequency: rosacea fruits (39 patients, 84.78%), nuts (23p, 50%), tropical fruits (5p, 10.86%), legumes (6p, 13.04%), cereals (3p, 6.52%), grape (3p, 6.52%), lettuce (2p, 4.34%), asparagus (1p, 2.17%), and pomegranate (1p, 2.17%). The mean specific IgE to LTP was 8.71 kU/L (ranging from 0.39 kU/L in an anaphylaxis by rosacea to in a OAS by nuts).
Conclusions
In our series of 46 patients allergic to LTP, the most frequent clinical picture registered was anaphylaxis, followed by systemic urticaria/angioedema.
The most recurrent culprit foods were rosacea fruits, followed by nuts.
Elevated specific IgE levels against LTP were not always correlated with the most severe reactions.
References
Asero R, Pravettoni V. Anaphylaxis to plant-foods and pollen allergens in patients with lipid transfer protein syndrome. Curr Opin Allergy Clin Immunol Feb 18.
González-Mancebo E, González-de-Olano D, Trujillo MJ, Santos S, Gandolfo-Cano M, Meléndez A, Juárez R, Morales P, Calso A, Mazuela O, Zapatero A. Prevalence of sensitization to lipid transfer proteins and profilins in a population of 430 patients in the south of Madrid. J Investig Allergol Clin Immunol. 2011;21(4):