Five-year follow-up after peach sublingual immunotherapy for lipid transfer protein (LTP) syndrome

Lipid transfer protein (LTP) syndrome is a major cause of severe food allergy in Mediterranean populations and is associated with a substantial psychosocial burden and dietary restrictions. Although sublingual immunotherapy with a Pru p 3-enriched peach extract (SLIT-peach; ALK-Abelló, Hørsholm, Denmark) is available, data on its long-term impact on quality of life (QOL) remain limited.

To evaluate long-term changes in food allergy-related QOL in patients with LTP syndrome treated with SLIT-peach, compared with untreated controls.

This ambispective case-control study included 75 patients with LTP syndrome who were followed at a tertiary allergy center. A total of 61 patients received SLIT-peach for 1 to 3 years, and 14 served as untreated controls after declining immunotherapy. QOL was assessed using the Food Allergy Quality of Life Questionnaire-Adult Form at baseline, after treatment, and annually for up to 5 years. Analyses included the global score and 4 domains: Allergen Avoidance, Emotional Impact, Risk of Accidental Exposure, and Food Allergy-Related Health.

The active group showed sustained improvement in Food Allergy Quality of Life Questionnaire-Adult Form scores from baseline through all follow-up assessments (all P < .001 vs baseline), with the greatest reduction observed after treatment and maintained up to 5 years. Improvements were most pronounced in the Emotional Impact and Allergen Avoidance domains. In contrast, no clinically relevant changes were observed in the controls. The Risk of Accidental Exposure domain improved but remained a residual concern.

The SLIT-peach was associated with significant and durable improvement in food allergy-related QOL in patients with LTP syndrome. Benefits persisted for up to 5 years after treatment and were particularly evident in emotional burden and allergen avoidance, supporting SLIT-peach as a disease-modifying strategy in LTP syndrome.