• M Pascal, R Muñoz-Cano, Z Reina, A Palacín, R Vilella, C Picado, M Juan, J Sánchez-López, M Rueda, G Salcedo, A Valero, J Yagüe, and J Bartra.
• Servei d'Immunologia, Centre de Diagnòstic Biomèdic, Hospital Clínic, Barcelona, Spain.
• Clin. Exp. Allergy. 2012 Oct 1; 42 (10): 1529-39.

BackgroundMultiple plant-food sensitizations with a complex pattern of clinical manifestations are a common feature of lipid transfer protein (LTP)-allergic patients. Component-resolved diagnosis permits the diagnosis of the allergen sensitization profile.ObjectiveWe sought to clinically characterize and describe the plant-food and pollen molecular sensitization profile in patients with LTP syndrome.MethodsForty-five subjects were recruited, after being diagnosed with multiple plant-food allergies sensitized to LTP, but not to any other plant-food allergen, according to the molecular allergen panel tested (Pru p 3 (LTP), Pru p 1 (Bet v 1-like), Pru p 4 (profilin) and those included in a commercial microarray of 103 allergenic components). IgE-mediated food-allergy symptoms and pollinosis were collected. Patients were skin prick tested with a plant-food and pollens panel, and specific IgE to Tri a 14 was evaluated.ResultsA heterogeneous group of plant-foods was involved in local and systemic symptoms: oral allergy syndrome (75.6%), urticaria (66.7%), gastrointestinal disorders (55.6%) and anaphylaxis (75.6%), 32.4% of which were cofactor dependent (Non-Steroidal Anti-inflammatory Drugs, exercise). All tested subjects were positive to peach and Pru p 3, Tri a 14 and to some of the LTPs included in the microarray. Pollinosis was diagnosed in 75.6% of subjects, with a broad spectrum of pollen and pollen-allergen sensitization. Plane tree and mugwort were the statistically significant pollens associated with Pru p 3.Conclusions And Clinical RelevanceSeveral plant-foods, taxonomically unrelated, independent of peach involvement, are implicated in LTP syndrome. Local symptoms should be evaluated as a risk marker for anaphylaxis because they are frequently associated with cofactor-dependent anaphylaxis. The association of these symptoms with pollinosis, especially plane tree pollinosis, could be part of this syndrome in our area.© 2012 Blackwell Publishing Ltd.

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