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Lipid transfer proteins: the most frequent sensitizer in I talian subjects with food‐dependent exercise‐induced anaphylaxis
Author(s) -
Romano A.,
Scala E.,
Rumi G.,
Gaeta F.,
Caruso C.,
Alonzi C.,
Maggioletti M.,
Ferrara R.,
Palazzo P.,
Palmieri V.,
Zeppilli P.,
Mari A.
Publication year - 2012
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1111/cea.12011
Subject(s) - food allergy , anaphylaxis , medicine , allergen , allergy , plant lipid transfer proteins , meal , immunoglobulin e , food allergens , culprit , immunology , food science , biology , biochemistry , antibody , gene , myocardial infarction
Summary Background Specific food‐dependent exercise‐induced anaphylaxis ( S ‐ FDEIA n) is a distinct form of food allergy in which symptoms are elicited by exercise performed after ingesting food to which the patient has become sensitised. Non‐specific FDEIA n ( NS ‐ FDEIA n) is a syndrome provoked by exercise performed after ingesting any food. Objective We sought to identify the culprit allergenic molecules in patients with FDEIA n, combining ‘classic’ allergy testing with an allergenic molecule‐based microarray approach for I g E detection. Methods All subjects were evaluated who reported at least one episode of anaphylaxis in association with physical exercise performed within 4 h after a meal. We performed skin prick tests ( SPT ) with commercial food extracts, prick plus prick tests ( P + P ) with fresh foods ( P + P ), and serum specific I g E assays by means of both the I mmuno CAP ( CAP ) and the ISAC 89 microarray system ( ISAC ). Results Among our 82 FDEIA n patients, the most frequent suspected foods were tomato, cereals, and peanut. SPT , P + P , and CAP displayed different degrees of sensitivity. Each test disclosed some positivities not discovered by others. Seventy‐nine subjects were positive to at least one food (49 to more than 20), whereas three were negative. All suspected foods were positive to at least one of SPT , P + P , and CAP . When tested using the ISAC , 64 (78%) subjects were positive to P ru p 3 [peach lipid transfer protein ( LTP )], 13 were positive to other food allergen molecules, and five displayed negative results to all food allergenic molecules. Overall, 79 patients probably had S ‐ FDEIA n and the other 3 NS ‐ FDEIA n. Conclusions Multiple food hypersensitivity represents a clinical hallmark of a large percentage of FDEIA n patients. The very high prevalence of I g E to the LTP suggests a role of this allergen group in causing S ‐ FDEIA n.