Clinical, anamnestic and serological features of peach allergy in portugal.
BACKGROUND
Peach is a common food allergen source throughout Europe. The aim of this study was to characterize peach allergy in a Portuguese patient population.


METHODS
Thirty peach-allergic patients confirmed by double-blind placebo-controlled food challenges and 29 controls were included. All subjects completed a standardized questionnaire regarding symptoms and epidemiologic characteristics, skin prick tests with inhalant allergens and foods as well as specific IgE antibodies to peach, recombinant peach allergens rPru p 1, rPru p 3, rPru p 4 and cross-reactive carbohydrate determinants.


RESULTS
Thirty-seven percent of patients reported only oral allergy syndrome, while 37% reported generalized urticaria and/or angioedema, 17% localized contact urticaria and 10% anaphylaxis with peach. Sensitization to other Rosaceae fruits and tree nuts was present in 90 and 77% of the patients, respectively. Respiratory allergy history was associated with less severe symptoms (oral allergy syndrome or contact urticaria; p < 0.01) and positive skin prick test to peach peel or plum with more severe symptoms (urticaria and/or angioedema or anaphylaxis; p < 0.05). Ninety-seven percent were sensitized to Pru p 3, 13% to Pru p 4, 3% to Pru p 1 and 10% to cross-reactive carbohydrate determinants. Pru p 3 specific IgE was associated with Artemisia vulgaris sensitization and tree nut allergy (p < 0.05) but not with clinical severity.


CONCLUSIONS
Half the patients reported systemic reactions to peach. Peach allergy appeared predominantly mediated by Pru p 3 but some patients were sensitized to Pru p 4. Applying a 0.10 kU(A)/l cutoff level, the diagnostic value of combining the 3 recombinant allergens was noteworthy, with 100% sensitivity and 90% specificity.
Rodrigues-Alves
Rodrigo
R
Serviço de Imunoalergologia, Centro Hospitalar de Lisboa Norte, Portugal. rodrigosralves@gmail.com
Lopez
Anabela
A
Pereira-Santos
Maria Conceição
MC
Lopes-Silva
Susana
S
Spínola-Santos
Amélia
A
Costa
Célia
C
Branco-Ferreira
Manuel
M
Lidholm
Jonas
J
Pereira-Barbosa
Manuel
M
D000328:Adult; D000485:Allergens / Q000276:immunology*; D052179:Antigens, Plant; D016022:Case-Control Studies; D003429:Cross Reactions / Q000276:immunology; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010940:Plant Proteins; D011174:Portugal / Q000453:epidemiology; D027861:Prunus / Q000276:immunology*; D012882:Skin Tests; D011795:Surveys and Questionnaires
D000485:Allergens; D052179:Antigens, Plant; D010940:Plant Proteins; C463181:Pru p 3 allergen; D007073:Immunoglobulin E