Características socio-demográficas y patrones clínicos de sensibilización molecular en pacientes con alergia alimentaria por sensibilización a proteínas transportadoras de lípidos (LTPs)

Resumen

Sensitization to Pru p 3 (Peach LTP) is becoming a remarkable sanitary problem in the Mediterranean Area. This allergic disease is often associated to severe clinical manifestations and leads to a significant impairment in the quality of life of the affected patients. The primary endpoint of our study was to determine the molecular sensitization profiles of patients diagnosed with Pru p 3 food allergy in the East Murcia Area (Health Area VII). The secondary endpoints were to find the main risk factors, and compare the diagnostic efficiency of several techniques commonly used in our daily clinical practice namely skin tests (Prick Tests) and determination of serum specific IgE against the most relevant allergens. The 60 patients included in the present study were divided into 3 groups according to the allergic symptoms severity: - Group 1. Anaphylaxis (30 subjects). - Group 2. Mild to moderate clinical symptoms such as urticaria, angioedema, Oral Allergy Syndrome or OAS, digestive symptoms (15 subjects). - Group 3. Sensitization to Pru p 3 but no symptoms after ingesting or contact with peach (15 subjects). A detailed medical history, Skin Prick Tests and specific IgE determination were carried out on all of them. This latter technique was performed using the ImmunoCAP¿ ISAC¿ diagnostic platform (Thermo Fisher Scientific Inc.). The outcomes revealed that patients in our study showed molecular profiles with low sensitization levels to major pollens allergens, except for Ole e 1. However, the percentage of sensitization to Food LTPs and Pollen LTPs was high and similar in the three groups. NSAIDs were the most frequently involved cofactor, and the risk of food allergy due to Pru p 3 sensitization was found to be four times higher when patients had a positive family history for Atopic diseases. Finally, the techniques routinely used in the consultation, i.e. the skin test (Prick test) and the determination of specific IgE in blood (ImmunoCAP¿ ISAC¿), were comparable in terms of diagnostic efficiency. In view of the above, we can conclude that: - Pru p 3 sensitization is a prevalent allergic disease in Our Health Area and is becoming more and more difficult to manage. - Pru p 3 hypersensitivity seems to start plant-food allergy as well as to prime and trigger the rest of the new and progressive sensitizations to different pollens and plant-foods - We have to pay attention to NSAIDs as the most frequently involved cofactor being able to enhance and worsen the clinical manifestations. - When Pru p 3 sensitization is considered Skin Prick Tests and serum Specific IgE determination are comparable in terms of diagnostic efficiency. - More epidemiological, clinical and therapeutics studies are necessary to assess the real scope of this allergic disease.