The diagnosis and management of allergic reactions in patients sensitized to non‐specific lipid transfer proteins
Year: 2021
Type: article
Abstract: Sensitization to one or more non-specific lipid transfer proteins (nsLTPs), 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 cofactor (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 cofactor triggers makes it essential to include an allergy-focused diet and clinical history in the diagnostic workup. Testing on suspected food triggers should also establish whether sensitization to nsLTP is present, using purified or recombinant nsLTP allergens such as Pru p 3. The avoidance of known trigger foods and advice on cofactors 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 cofactors, improving diagnostic accuracy and establishing the efficacy of immunotherapy.
Source: Allergy
DOI: 10.1111/all.14797
Authors: Isabel J. Skypala, Joan Bartra, Didier G. Ebo, Margaretha Antje Faber, Montserrat Fernández‐Rivas, Francisca Gomez, Olga Luengo, Stephen J. Till, Riccardo Asero, Domingo Barber, Lorenzo Cecchi, Araceli Diaz Perales, Karin Hoffmann‐Sommergruber, Elide Anna Pastorello, Ines Swoboda, Anastasios. P. Konstantinopoulos, Ronald van Ree, Enrico Scala
Institutions: Royal Brompton & Harefield NHS Foundation Trust, Imperial College London, Hospital Clínic de Barcelona, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Universitat de Barcelona, University of Antwerp, Antwerp University Hospital, Universidad Complutense de Madrid, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga, Universitat Autònoma de Barcelona, Vall d'Hebron Hospital Universitari, King's College London, Guy's and St Thomas' NHS Foundation Trust, Universidad San Pablo CEU, Instituto de Salud Carlos III, Azienda Usl Toscana Centro, Centre for Plant Biotechnology and Genomics, Universidad Politécnica de Madrid, Medical University of Vienna, University of Milan, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Hochschule Campus Wien, Vienna Biocenter, National and Kapodistrian University of Athens, Amsterdam UMC Location University of Amsterdam, Amsterdam University Medical Centers, Istituto Dermopatico dell'Immacolata
Language: English
Subfield: Immunology and Allergy
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funder: Aimmune Therapeutics
OpenAlex ID: W3134498828