The clinical and immunological effects of Pru p 3 SLIT on peach and peanut allergy in patients with systemic reactions

Abstract

Background

The peach non-specific lipid transfer protein (nsLTP), Pru p 3, is the primary sensitizer in fruits and responsible for severe reactions in the Mediterranean area. Peach allergy is frequently associated with other allergies such as peanut. Therefore, it is important to assess how specific immunotherapy to Pru p 3 could affect both peach and peanut tolerance.

Objectives

To evaluate peach and peanut desensitization and immunological changes after one year of Pru p 3 sublingual immunotherapy (SLIT) in patients with systemic allergic reactions to peach and/or peanut.

Methods

Forty-eight peach allergic patients, 36 treated with SLIT and 12 non-treated, were monitored for 12 months. Treated patients were sub-classified as peanut allergic (Group A), sensitized (Group B) or tolerant (Group C). SLIT effect was evaluated by skin prick test (SPT) reactivity and food challenge. Immunological changes were evaluated by monitoring sIgE and sIgG4 levels and basophil reactivity.

Results

After one year of SLIT, the wheal area in SPT significantly decreased and a significant increase in peach threshold in treated patients was observed(p<0.001). Patients in Group A showed a significant decrease in peanut SPT wheal area and an increase in peanut threshold (p<0.001). Immunological changes were observed in treated patients only, with a significant decrease of sIgE and a parallel increase of sIgG4, sIgG4/sIgE and basophil reactivity for both Pru p 3 and Ara h 9.

Conclusion

After one year, Pru p 3 SLIT induces both desensitization and immunological changes not only for peach but also for other food allergens relevant in the induction of severe reactions such as peanut.

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