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Allergy to lipid transfer proteins (LTP) in a pediatric population

J Barradas Lopes1, C Santa1, C Valente1

  • 1Department of Allergy and Clinical Immunology, Centro Hospitalar Vila Nova de Gaia/Espinho, EPE, Vila Nova de Gaia, Portugal.

European Annals of Allergy and Clinical Immunology
|July 23, 2021
PubMed

Insights

Lipid transfer protein (LTP) allergy is common in children, often causing severe reactions like anaphylaxis. Current diagnostic tests cannot predict tolerance or reaction severity in pediatric LTP allergy.

Area of Science:

  • Pediatric Allergy and Immunology
  • Food Hypersensitivity
  • Clinical Medicine

Background:

  • Lipid transfer proteins (LTPs) are significant food allergens, particularly in the Mediterranean region.
  • LTP allergy in pediatric populations remains under-characterized.
  • Understanding LTP allergy in children is crucial due to potential severity.

Purpose of the Study:

  • To characterize the clinical presentation and diagnostic features of LTP allergy in children.
  • To investigate associations between clinical symptoms, diagnostic markers, and reaction severity.
  • To evaluate the predictive value of current diagnostic tools for food tolerance and reaction severity.

Main Methods:

  • Retrospective review of clinical data from pediatric patients diagnosed with LTP allergy.
  • Analysis of demographic data, symptom profiles (urticaria, anaphylaxis, oral allergy syndrome), and cofactors.
  • Evaluation of skin prick tests (SPT) and specific IgE (sIgE) levels to LTPs (Pru p 3, Cor a 8) and various food extracts.

Main Results:

  • 26 children (50% female, median age 10) were included, presenting with urticaria (58%), anaphylaxis (46%), and oral allergy syndrome (42%).
  • Multiple food reactions occurred in 69% of patients; cofactors were reported in 27%.
  • No significant association was found between severe reactions and sIgE to Pru p 3 or Cor a 8, SPT to peach LTP, or the number of positive SPTs to fruits/tree nuts.

Conclusions:

  • LTP allergy is prevalent in children and can manifest with severe symptoms, including anaphylaxis.
  • Cofactors play a role in enhancing the severity of LTP allergy reactions.
  • Current diagnostic tests (SPT, sIgE) are insufficient for predicting food tolerance or reaction severity in pediatric LTP allergy.
Abstract

Keywords:
LTPchildrenfood allergyfruittree nuts

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