Lipid transfer protein syndrome: clinical pattern, cofactor effect and profile of molecular sensitization to plant‐foods and pollens

Abstract

Several plant-foods, taxonomically unrelated, independent of peach involvement, are implicated in LTP syndrome. Local symptoms should be evaluated as a risk marker for anaphylaxis because they are frequently associated with cofactor-dependent anaphylaxis. The association of these symptoms with pollinosis, especially plane tree pollinosis, could be part of this syndrome in our area.

Sublingual Immunotherapy with Quantified Peach Extract: An Alternative Treatment in Legumes Allergy

“…Consistent with published data, LTP syndrome could include a complex clinical manifestation associated with a large group of taxonomically unrelated food [7]. Our patient suffered anaphylactic reactions principally after the ingestion of legumes, but he presented positive SPT to almost all legumes and nuts.…”

Drug-Induced Anaphylaxis

“…NSAIDs, particularly aspirin, and food additives may exacerbate allergic symptoms in patients with chronic idiopathic urticaria and food-dependent exercise-induced anaphylaxis (FDEIA) [67][68][69]. In these cases, these drugs act as cofactors for triggering a response.…”

“…To make matters even more complex, anaphylaxis can occur following the intake of drugs and foods and undertaking exercise [67,69,72]. Therefore, a detailed clinical history with a precise description of the timing of drug intake, other potential factors, and appearance of symptoms is essential.…”

Lettuce Allergy Is a Lipid Transfer Syndrome-Related Food Allergy With a High Risk of Severe Reactions

“…This condition has been termed lipid transfer protein syndrome [5] and is a consequence of the high degree of IgE cross-reactivity between lipid transfer proteins (LTPs), including those that are taxonomically distant [6][7][8]. Among the peculiarities of this syndrome are its geographical distribution (limited to the Mediterranean area), the frequent need for cofactors to elicit clinical reactivity, and reduced severity when pollen allergy is present [2,4].…”

“…The main offending foods reported by patients, and confirmed by sensitization in skin prick tests (SPTs), are peach (75.6%), lettuce (48.9%), walnut (46.7%), and hazelnut (33.3%) [7].…”