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Allergy to peanut lipid transfer protein (LTP): frequency and cross-reactivity between peanut and peach LTP.
Eur Ann Allergy Clin Immunol 2009; 41(4):106-11EA

Abstract

BACKGROUND

Lipid transfer protein (LTP) is a widely cross-reacting plant pan-allergen, and sensitized patients may react to many foods. Although peanut allergy is frequently reported by LTP-allergic patients, the evidence of the presence of an allergen homologous to LTP in peanuts is limited.

OBJECTIVE

To assess the prevalence of peanut allergy in patients sensitized to LTP, detect any allergen homologous to LTP in peanuts, and assess its cross-reactivity with peach LTP.

METHODS

Spanish and Italian adults monosensitized to LTP were interviewed for possible peanut allergy and underwent skin prick tests (SPTs) with peanut extract. Sera from 32 peanut-allergic patients were assayed for peanut-specific IgE by direct ELISA and the Real Test; the serum showing the strongest reactivity was used in immunoblot analysis.

RESULTS

74/114 (65%) patients were sensitized to peanuts, and 37 (32% of the whole population; 50% of those sensitized) were clinically allergic. Positive histories were validated by open oral food challenges in 13/13 cases. No SPT-negative patients reported clinical allergy to peanuts. Thus, in this selected population, sensitivity and negative predictive value of peanut SPTs were 100%, whereas specificity and positive predictive value were poor (52% and 32%, respectively). Only 2/32 sera scored positive in both in vitro assays and 4 reacted in the Real Test alone. In immunoblot, the serum studied reacted at about 10 kDa against the peanut extract; pre-adsorption with purified peach LTP totally inhibited such reactivity.

CONCLUSIONS

Peanut sensitization is frequent among LTP-allergic patients and is clinically significant in about 50% of cases. Peanut tolerance should be assessed in LTP-allergic patients positive on peanut SPTs. Peanut LTP seemingly shares all allergenic determinants with peach LTP.

Authors+Show Affiliations

Department of Internal Medicine and Geriatrics, UCSC-Allergy Unit, Complesso Integrato Columbus, Rome, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19877562

Citation

Romano, A, et al. "Allergy to Peanut Lipid Transfer Protein (LTP): Frequency and Cross-reactivity Between Peanut and Peach LTP." European Annals of Allergy and Clinical Immunology, vol. 41, no. 4, 2009, pp. 106-11.
Romano A, Fernandez-Rivas M, Caringi M, et al. Allergy to peanut lipid transfer protein (LTP): frequency and cross-reactivity between peanut and peach LTP. Eur Ann Allergy Clin Immunol. 2009;41(4):106-11.
Romano, A., Fernandez-Rivas, M., Caringi, M., Amato, S., Mistrello, G., & Asero, R. (2009). Allergy to peanut lipid transfer protein (LTP): frequency and cross-reactivity between peanut and peach LTP. European Annals of Allergy and Clinical Immunology, 41(4), pp. 106-11.
Romano A, et al. Allergy to Peanut Lipid Transfer Protein (LTP): Frequency and Cross-reactivity Between Peanut and Peach LTP. Eur Ann Allergy Clin Immunol. 2009;41(4):106-11. PubMed PMID: 19877562.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Allergy to peanut lipid transfer protein (LTP): frequency and cross-reactivity between peanut and peach LTP. AU - Romano,A, AU - Fernandez-Rivas,M, AU - Caringi,M, AU - Amato,S, AU - Mistrello,G, AU - Asero,R, PY - 2009/11/3/entrez PY - 2009/11/3/pubmed PY - 2009/12/16/medline SP - 106 EP - 11 JF - European annals of allergy and clinical immunology JO - Eur Ann Allergy Clin Immunol VL - 41 IS - 4 N2 - BACKGROUND: Lipid transfer protein (LTP) is a widely cross-reacting plant pan-allergen, and sensitized patients may react to many foods. Although peanut allergy is frequently reported by LTP-allergic patients, the evidence of the presence of an allergen homologous to LTP in peanuts is limited. OBJECTIVE: To assess the prevalence of peanut allergy in patients sensitized to LTP, detect any allergen homologous to LTP in peanuts, and assess its cross-reactivity with peach LTP. METHODS: Spanish and Italian adults monosensitized to LTP were interviewed for possible peanut allergy and underwent skin prick tests (SPTs) with peanut extract. Sera from 32 peanut-allergic patients were assayed for peanut-specific IgE by direct ELISA and the Real Test; the serum showing the strongest reactivity was used in immunoblot analysis. RESULTS: 74/114 (65%) patients were sensitized to peanuts, and 37 (32% of the whole population; 50% of those sensitized) were clinically allergic. Positive histories were validated by open oral food challenges in 13/13 cases. No SPT-negative patients reported clinical allergy to peanuts. Thus, in this selected population, sensitivity and negative predictive value of peanut SPTs were 100%, whereas specificity and positive predictive value were poor (52% and 32%, respectively). Only 2/32 sera scored positive in both in vitro assays and 4 reacted in the Real Test alone. In immunoblot, the serum studied reacted at about 10 kDa against the peanut extract; pre-adsorption with purified peach LTP totally inhibited such reactivity. CONCLUSIONS: Peanut sensitization is frequent among LTP-allergic patients and is clinically significant in about 50% of cases. Peanut tolerance should be assessed in LTP-allergic patients positive on peanut SPTs. Peanut LTP seemingly shares all allergenic determinants with peach LTP. SN - 1764-1489 UR - https://www.unboundmedicine.com/medline/citation/19877562/Allergy_to_peanut_lipid_transfer_protein__LTP_:_frequency_and_cross_reactivity_between_peanut_and_peach_LTP_ DB - PRIME DP - Unbound Medicine ER -