Sublingual immunotherapy in peach allergy: monitoring molecular sensitizations and reactivity to apple fruit and Platanus pollen.
BACKGROUND
Peach allergy is prevalent, persistent, and potentially severe and as such is a target for immunotherapy. Our aims were to evaluate the profile of sensitization to Rosaceae allergens and the effects of sublingual peach immunotherapy on immunoglobulin (Ig) E levels to these allergens, to monitor for neosensitizations, and to check if this treatment modified other Rosaceae fruit and pollen-related sensitizations.


METHODS
A double-blind placebo-controlled trial was conducted on 56 peach-allergic patients who received, sublingually, a standardized peach extract quantified in mass units of Pru p 3, or placebo for 6 months. IgE to recombinant (r) Mal d 1, rMal d 4, rPru p 3, and natural (n) Art v 3 and skin prick test (SPT) reactivity to Platanus pollen and apple extracts evaluated before treatment (T0), after 1 month (T1) and after and 6 months (T6) were recorded.


RESULTS
In total, 18.5% of patients recognized rMal d 1, 83.3%, rPru p 3, 24.1%, rMal d 4, and 25.9% nArt v 3. IgE to Pru p 3 rose from T0 to T1 in both the active group (P = .003) and the placebo group (P = .022), and remained elevated at T6 in the active group (P = .001). IgE to other purified allergens did not change significantly and no relevant neosensitizations were detected. SPT reactions to peach decreased from T0 to T6 in the active group (P < 0.05). Reactivity to peach (T1 and T6) and apple (T6) was lower in the active group than in the control group.


CONCLUSIONS
The main allergen was Pru p 3. Changes in rPru p 3 IgE levels and in peach and apple extract SPT were induced by sublingual immunotherapy.
Servicio de Alergia, Hospital Virgen del Camino, Pamplona, Spain. bgarciaf@cfnavarra.es
B E
BE
García
E
E
González-Mancebo
D
D
Barber
S
S
Martín
A I
AI
Tabar
Alonso Ma D
AM
Díaz de Durana
S
S
Garrido-Fernández
G
G
Salcedo
P
P
Rico
M
M
Fernández-Rivas
D000286:Administration, Sublingual; D000293:Adolescent; D000328:Adult; D000368:Aged; D003888:Desensitization, Immunologic; D004311:Double-Blind Method; D005512:Food Hypersensitivity / Q000276:immunology / Q000628:therapy*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D027845:Malus / Q000276:immunology*; D008875:Middle Aged; D010936:Plant Extracts / Q000276:immunology; D011058:Pollen / Q000276:immunology*; D027861:Prunus / Q000276:immunology*; D012882:Skin Tests
D010936:Plant Extracts; D007073:Immunoglobulin E