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Nonspecific lipid transfer proteins (LTPs) are present in several plant foods. LTPs are highly stable during thermal processing and digestion [1,2]. Reactivity of IgE to LTPs is often associated with severe systemic symptoms [3]. LTPs are the most important family of plant food allergens in Spain [4]. Pru p 3 is the predominant LTP in terms of recognition of IgE by a patient [5]. Owing to structural homology, LTPs from various allergen sources are generally cross-reactive to various types of IgE. However, sensitization profiles vary widely between allergic patients [6]. The aims of this study were to describe the clinical and sensitization profile of patients with LTP syndrome and to determine a clinical pattern of severity. The study sample comprised consecutive patients referred to the Allergy Unit of Hospital Universitari Germans Trias i Pujol, Badalona, Spain during 2016 (a total of 560 patients with food allergy were screened). Selection was based on a clear history of plant food allergy and IgE-mediated sensitization to Pru p 3 in a skin prick test. A control group was selected based on IgE-mediated sensitization to Pru p 3 without associated food allergy. Patients—or their representatives in the case of children—provided their informed consent, and the study was approved by the local ethics committee (PI-17-074). The clinical evaluation comprised an exhaustive medical history, skin prick tests with a common panel of aeroallergens, plant food allergens, and purified and enriched peach LTP components (Bial-Aristegui). Specific IgE to Pru p 3 and total IgE were determined using ImmunoCAP (Thermo Fisher), and IgE to the allergen components were determined using the microarray-based IgE detection chip ImmunoCAP ISAC (Thermo Fisher). ImmunoCAP and ISAC results higher than 0.35 kU/L and 0.3 ISU/E, respectively, were considered positive. The c2 or Fisher exact test was used to compare categorical variables; an analysis of variance or the Kruskal-Wallis test was used to compare quantitative variables. Statistical significance was set at P<.05. References

Clinical Profile of Lipid Transfer Protein Syndrome in a Mediterranean Area