Tolerance induction to LTP in patients with anaphylaxis: Serological response markers

Allergy to lipid transfer proteins (LTP) is one of the leading causes of anaphylaxis in the Mediterranean region. Oral immunotherapy, sublingual immunotherapy (SLIT), with peach extract has emerged as a strategy to induce tolerance.

This study aimed to evaluate the efficacy of SLIT with peach extract and the usefulness of serological biomarkers as predictors of clinical response in patients with LTP-related anaphylaxis.

Observational study involving 80 patients diagnosed with LTP syndrome. Total IgE levels, specific IgE, and IgG4 specific to Pru p 3 were measured before and after 1 year of treatment. Patients were classified based on tolerance at the end of therapy.

Sixty-one patients (76.3%) tolerated the final oral challenge. Baseline levels of total IgE, specific IgE, and IgG4 specific to Pru p 3 were significantly higher in the tolerance group. IgG4 levels increased significantly in both groups after treatment. Specific IgE levels increased only in the nontolerance group.

SLIT with peach extract may induce tolerance in the majority of patients with LTP allergy. Elevated baseline levels of total IgE, specific IgE, and IgG4 specific to Pru p 3 could serve as markers of clinical response.