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Lipid transfer protein cross-reactivity assessed in vivo and in vitro in the office: pros and cons.

Abstract

BACKGROUND

Few studies analyze cross-reactivity between lipid transfer proteins (LTP) from a large spectrum of botanically unrelated plant-derived foods using routine diagnostic tests.

OBJECTIVE

To assess the clinical usefulness of currently available in vivo and in vitro tests in LTP-hypersensitive patients.

METHODS

An in vitro and in vivo study was performed of 15 peach-allergic adults monosensitized to LTP in order to analyze their allergy and hypersensitivity to apple, hazelnut, walnut, peanut, soybean, lentil, maize, celery, carrot, banana, melon, tomato, kiwi, buckwheat, and sunflower, poppy, mustard, and sesame seeds.

RESULTS

The study revealed that 8, 7, 10, 5, 3, 2, 1, 1, and 1 patients were allergic to apple, hazelnut, walnut, peanut, tomato, kiwi, melon, lentil, and maize, respectively. Immunoglobulin (Ig) E levels for peach were strongly associated with the total number of offending foods other than peach and with levels of IgE specific for all the study foods except carrot. Both in vivo and in vitro tests showed excellent sensitivity and negative predictive value, but poor specificity and positive predictive value. Sensitized but tolerant patients showed lower IgE levels than those with a history of local or systemic symptoms, although the difference between the 3 subsets was not statistically significant.

CONCLUSION

This study confirms that peach is the primary sensitizer to LTP and that the level of IgE to peach LTP is the main factor associated with cross-reactivity (and clinical allergy) to non-Rosaceae foods. Clinically irrelevant sensitization is common in LTP-hypersensitive patients, and positive in vivo and/or in vitro test results are of little help in detecting potential clinical reactors.

Authors+Show Affiliations

Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Italy. r.asero@libero.it

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21462803

Citation

Asero, R. "Lipid Transfer Protein Cross-reactivity Assessed in Vivo and in Vitro in the Office: Pros and Cons." Journal of Investigational Allergology & Clinical Immunology, vol. 21, no. 2, 2011, pp. 129-36.
Asero R. Lipid transfer protein cross-reactivity assessed in vivo and in vitro in the office: pros and cons. J Investig Allergol Clin Immunol. 2011;21(2):129-36.
Asero, R. (2011). Lipid transfer protein cross-reactivity assessed in vivo and in vitro in the office: pros and cons. Journal of Investigational Allergology & Clinical Immunology, 21(2), pp. 129-36.
Asero R. Lipid Transfer Protein Cross-reactivity Assessed in Vivo and in Vitro in the Office: Pros and Cons. J Investig Allergol Clin Immunol. 2011;21(2):129-36. PubMed PMID: 21462803.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lipid transfer protein cross-reactivity assessed in vivo and in vitro in the office: pros and cons. A1 - Asero,R, PY - 2011/4/6/entrez PY - 2011/4/6/pubmed PY - 2011/11/9/medline SP - 129 EP - 36 JF - Journal of investigational allergology & clinical immunology JO - J Investig Allergol Clin Immunol VL - 21 IS - 2 N2 - BACKGROUND: Few studies analyze cross-reactivity between lipid transfer proteins (LTP) from a large spectrum of botanically unrelated plant-derived foods using routine diagnostic tests. OBJECTIVE: To assess the clinical usefulness of currently available in vivo and in vitro tests in LTP-hypersensitive patients. METHODS: An in vitro and in vivo study was performed of 15 peach-allergic adults monosensitized to LTP in order to analyze their allergy and hypersensitivity to apple, hazelnut, walnut, peanut, soybean, lentil, maize, celery, carrot, banana, melon, tomato, kiwi, buckwheat, and sunflower, poppy, mustard, and sesame seeds. RESULTS: The study revealed that 8, 7, 10, 5, 3, 2, 1, 1, and 1 patients were allergic to apple, hazelnut, walnut, peanut, tomato, kiwi, melon, lentil, and maize, respectively. Immunoglobulin (Ig) E levels for peach were strongly associated with the total number of offending foods other than peach and with levels of IgE specific for all the study foods except carrot. Both in vivo and in vitro tests showed excellent sensitivity and negative predictive value, but poor specificity and positive predictive value. Sensitized but tolerant patients showed lower IgE levels than those with a history of local or systemic symptoms, although the difference between the 3 subsets was not statistically significant. CONCLUSION: This study confirms that peach is the primary sensitizer to LTP and that the level of IgE to peach LTP is the main factor associated with cross-reactivity (and clinical allergy) to non-Rosaceae foods. Clinically irrelevant sensitization is common in LTP-hypersensitive patients, and positive in vivo and/or in vitro test results are of little help in detecting potential clinical reactors. SN - 1018-9068 UR - https://www.unboundmedicine.com/medline/citation/21462803/Lipid_transfer_protein_cross_reactivity_assessed_in_vivo_and_in_vitro_in_the_office:_pros_and_cons_ L2 - http://www.jiaci.org/issues/vol21issue2/vol21issue02-7.htm DB - PRIME DP - Unbound Medicine ER -