Afliações:
1- Hospital Dona Estefânia, Centro Hospitalar Lisboa Central, EPE, Lisbon, Portugal
Divulgação:
- Reunião internacional
- Apresentação sob a forma de poster
- Publicação sob forma de resumo
- 1º prémio Melhor Poster
Resumo:
Introduction: The protein Pru p 3, the major allergen from peach, is a 9-kDa allergen highly resistant to proteolytic digestion belonging to the family of lipid-transfer proteins (LTPs). The LTPs are the most relevant plant food allergens in the Mediterranean European countries and are associated with severe clinical symptoms. The diagnostic value of Pru p 3 for predicting Rosaceae fruit allergy has been extensively studied.
Aim:To describe the clinical manifestations of a sample of patients sensitized to peach Pru p 3 allergen attending an outpatient allergy department and to study the association of specific IgE (sIgE) levels of Pru p 3 and the severity of the reactions to peach.
Methods: The clinical records of the patients sensitized to Pru p 3 assessed by ImmunoCAP fluorenzyme immunoassay test were retrospectively analyzed. The patients were selected through informatical filter set for search for allergen Pru p 3 positivity (IgE > 0,35 kUA/l) from the period of January of 2010 to May of 2015.
Results: The study sample comprised 36 patients who were sensitized to Pru p 3, with a median age of onset of the peach allergic reaction of 13 years old (P25-75: 6.5-27.5). 51% of the patients were females. The clinical manifestations observed with peach ingestion were mainly mucocutaneous (13/34), anaphylaxis (one of them exercise-induced anaphylaxis) (10/34) and gastrointestinal (6/34). The gastrointestinal reactions were mainly oral allergy syndrome and, in two patients, eosinophilic esophagitis. Four patients were tolerant to the peach pulp, and one tolerated unpeeled peach. Twenty-one patients were sensitized to other Rosaceae, namely apple, plum, grape and strawberry. Sensitization to tree nuts and peanut was observed in 22 patients, with the peanut, the walnut and the hazelnut and most frequently foods involved. Patients with anaphylaxis to peach had higher levels of Pru p 3 sIgE compared to those with less severe reactions (p= 0.036)
Conclusions: Although sensitization to the recombinant allergen Pru p 3 is usually associated with systemic reactions, in this study the reported manifestations were predominantly mucocutaneous. There is an association between higher levels of sIgE to Pru p 3 and more severe reactions to peach.
Palavras Chave: (max. 5) Peach, lipid-transfer proteins, Rosaceae