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Vol. 44. Issue 4.
Pages 351-358 (July - August 2016)
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Vol. 44. Issue 4.
Pages 351-358 (July - August 2016)
Original Article
DOI: 10.1016/j.aller.2015.10.003
Asymptomatic LTP sensitisation is common in plant-food allergic children from the Northeast of Spain
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151
M. Pascala,
Corresponding author
mpascal@clinic.ub.es

Corresponding author.
, M. Vazquez-Ortizb, M.M. Folqueb, R. Jimenez-Feijoob, J. Lozanob, O. Dominguezb, M. Piquer-Gibertb, M.T. Ginerb, M. Alvarob, M. Dias da Costab, B. García-Pabab, A. Machinenab, L. Alsinab, J. Yagüea, A.M. Plaza-Martinb
a Immunology Department, CDB, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Spain
b Pediatric Allergy and Clinical Immunology Section, Hospital Sant Joan de Déu, Universitat de Barcelona, Spain
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Tables (3)
Table 1. Characteristics subjects recruited.
Table 2. Main plant-foods involved and associated clinical symptoms.
Table 3. Specific IgE levels and sensitisation rates to LTPs and storage proteins.
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Abstract
Background

The sensitisation profile at molecular level in plant-food allergy is complex. Several allergens may be involved, with different potential for severe reactions. lipid transfer proteins (LTP) are considered the most relevant plant-food allergens in adults in Mediterranean countries, but less is known in children.

Aim

To describe the clinical pattern and sensitisation profile of children with plant-food allergy and LTP sensitisation from Northeast Spain.

Methods

Children with history of immediate reaction to plant-food(s), positive skin-prick-test to the culprit plant-food(s) and specific-IgE to plant-food LTPs were analysed.

Results

130 children were included. 69.2% (90/130) had reacted to ≥2 taxonomically unrelated plant-foods. Peach, walnut, hazelnut and peanut were most frequently involved. Reactions severity ranged from anaphylaxis (45.4%, 59/130) to oral symptoms only. Sensitisation to a particular plant-food LTP not always caused clinical symptoms with that plant-food; 69% (40/58) and 63% (17/27) of peach- and walnut-tolerant subjects had positive rPru p 3 and nJug r 3 specific IgE, respectively. 65.4% (85/130) of children were also sensitised to storage proteins, which was associated to anaphylaxis and nut allergy. However, 60% of patients without nuts/seeds allergy were sensitised to storage proteins. Specific-IgE levels to LTPs and/or storage proteins were not useful to predict allergy (vs. tolerance) to peach, walnut, peanut or hazelnut.

Conclusions

Sensitisation to LTP and/or storage proteins without clear clinical significance is relatively common. Prospective longitudinal studies are required to evaluate the relevance of these silent sensitisations over time. Caution is required when interpreting the results of molecular-based diagnostic tools in clinical practice.

Keywords:
Lipid transfer protein
Component resolved diagnosis
Asymptomatic sensitisation
Storage proteins
Children
Plant-food allergy
Northeast Spain
Abbreviations:
ISU
SPT
sIgE
LTP
U/AE
OS
SD
ROC
r
n

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