Art v 3 sensitization is associated with increased immunological complexity but not clinical severity in lipid...

Background. Lipid transfer protein (LTP)-mediated food allergy represents one of the most severe and heterogeneous forms of IgE-mediated food allergy in Mediterranean populations. Although Pru p 3 is the main marker of LTP sensitization, the clinical relevance of pollen-derived LTPs such as Art v 3 remains incompletely defined. Methods. We conducted a retrospective observational study including 241 adult patients with LTP-mediated food allergy and confirmed sensitization to Pru p 3. Art v 3-specific IgE was determined using component-resolved diagnostics. Clinical severity was assessed using the Food Allergy Severity Score (FASS). Profilin sensitization was analyzed when available. Correlations were evaluated using Spearman's coefficient. Results. Art v 3 sensitization was detected in 124 patients (51.5%). A higher proportion of moderate-to-severe reactions (FASS ≥ 3) was observed in Art v 3-sensitized patients compared with non-sensitized patients (64.0% vs 56.3%), although this difference did not reach statistical significance (OR = 1.38; 95% CI: 0.82-2.31). A statistically significant but low positive correlation was observed between Art v 3- and Pru p 3-specific IgE levels (Spearman's ρ = 0.46). Profilin sensitization was not associated with clinical severity (p = 0.36). Conclusions. Art v 3 sensitization is associated with a more complex immunological profile rather than acting as an independent predictor of clinical severity. Its clinical value may lie in risk stratification. Prospective studies are needed.