Phenotypes and Endotypes of Peach Allergy: What Is New?

Abstract

Peach allergy is emerging as a common type of fresh-fruit allergy in Europe, especially in the Mediterranean area. The clinical manifestations of peach allergy tend to have a peculiar geographical distribution and can range from mild oral symptoms to anaphylaxis, depending on the allergic sensitization profile. The peach allergen Pru p 7, also known as peamaclein, has recently been identified as a marker of peach allergy severity and as being responsible for peculiar clinical features in areas with high exposure to cypress pollen. This review addresses the latest findings on molecular allergens for the diagnosis of peach allergy, the clinical phenotypes and endotypes of peach allergy in adults and children, and management strategies, including immunotherapy, for peach allergy.

Peach extract induces systemic and local immune responses in an experimental food allergy model

“…The sensitization to nsLTPs is dominated by the major peach allergen Pru p 3, considering peach as the primary sensitizer for nsLTP-driven clinical cross-reactivity in the Mediterranean area 6,9 . The highest amount of Pru p 3 can be found in the peach peel with a content seven times higher than in the pulp 10,11 . In line with this, peach allergy itself is described as common cause of fresh-fruit allergy 10 .Currently, the main treatment options for peach allergy and food allergies in general are allergen avoidance or symptomatic treatment including anti-histamines as to date no cure or preventive treatment is available [12][13][14] .…”

“…The highest amount of Pru p 3 can be found in the peach peel with a content seven times higher than in the pulp 10,11 . In line with this, peach allergy itself is described as common cause of fresh-fruit allergy 10 .Currently, the main treatment options for peach allergy and food allergies in general are allergen avoidance or symptomatic treatment including anti-histamines as to date no cure or preventive treatment is available [12][13][14] . Due to this lack of treatment options, oral immunotherapy (OIT) might be considered an attractive option to induce immunological tolerance by administration of increasing dosages of allergen.…”

“…The sensitization to nsLTPs is dominated by the major peach allergen Pru p 3, considering peach as the primary sensitizer for nsLTP-driven clinical cross-reactivity in the Mediterranean area 6,9 . The highest amount of Pru p 3 can be found in the peach peel with a content seven times higher than in the pulp 10,11 . In line with this, peach allergy itself is described as common cause of fresh-fruit allergy 10 .…”

“…The highest amount of Pru p 3 can be found in the peach peel with a content seven times higher than in the pulp 10,11 . In line with this, peach allergy itself is described as common cause of fresh-fruit allergy 10 .…”

Sensitisation to peach allergen Pru p 7 is associated with severe clinical symptoms in a Spanish population

“…2 Nevertheless, there are cases in which, despite a consistent history of peach allergy and a positive prick test with fresh peach, sensitisation to Pru p 1 (PR-10), Pru p 3 (nsLTP), or Pru p 4 (profilin) cannot be found. 2 To date, 7 peach allergens have been described 3,4 : Pru p 1 (PR-10 protein), Pru p 2 (thaumatin-like protein), Pru p 3 (LTP), Pru p 4 (profilin), Pru p 7 (gibberellin-regulated protein [GRP]), Pru p 9 (PR-1 protein), and Pru p 10 (polygalacturonidase); the latter 2 with an airborne sensitisation pathway. Pru p 7 was described as a new peach allergen in 2013 5 and has been reported as a major allergen associated with severe clinical symptoms and strong immunoglobulin (Ig)E sensitisation to cypress pollen in patients with peach allergy from Italy, Japan, and southern France.…”