title: Pru p 3-sensitised Italian peach-allergic patients are less likely to develop severe symptoms when also presenting IgE antibodies to Pru p 1 and Pru p 4.
abstract: BACKGROUND
  The roles played by different peach allergens with respect to symptom severity have not been completely ascertained. We have evaluated the diagnostic efficacy of peach recombinant allergens ImmunoCAP compared to peach in the identification of subjects at an increased risk for severe reactions to peaches.
  
  
  METHODS
  148 peach-allergic patients were divided based on their symptom severity into 2 groups: mild oral allergy syndrome (OAS) and severe OAS. Anti-rPru p 1, 3 and 4 IgE levels were measured. Statistical analyses were carried out using parametric and non-parametric tests.
  
  
  RESULTS
  anti-rPru p 1 and anti-rPru p 4 IgE levels were significantly higher in patients with mild OAS than in patients with severe OAS (p = 0.0001); in contrast, anti-rPru p 3 IgE levels were significantly higher in patients with severe OAS than in patients with mild OAS (p < 0.00005). Moreover, we found that any unitary increase in anti-rPru p 1 IgE values corresponded to a 2.48% reduction in the odds of having severe OAS (p = 0.048), whereas any unitary increase in anti-rPru p 3 IgE values corresponded to a 9.02% increase in the probability of having severe OAS (p = 0.001). Unexpectedly, we found that patients positive to rPru p 3 as well as rPru p 1 and 4 demonstrated a significant reduction of the odds of developing severe symptoms than those positive to rPru p 3 alone. Anti-rPru p 3 IgE levels were a significantly better indicator than anti-peach IgE values (p = 0.016) of patients with the highest risk for severe OAS. A cutoff of 2.69 kUA/l for anti-rPru p 3 IgE values better discriminated peach-allergic patients at a higher risk for symptoms.
  
  
  CONCLUSIONS
  Italian patients with positive anti-rPru p 1, 4 and 3 IgE levels seemed less likely to experience the clinical effects of high anti-rPru p 3 IgE values.
authors.affiliation: Unit of Allergology and Immunology, Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Elide A
authors.initials: EA
authors.lastname: Pastorello
authors.forename: Laura
authors.initials: L
authors.lastname: Farioli
authors.forename: Valerio
authors.initials: V
authors.lastname: Pravettoni
authors.forename: Joseph
authors.initials: J
authors.lastname: Scibilia
authors.forename: Ambra
authors.initials: A
authors.lastname: Mascheri
authors.forename: Linda
authors.initials: L
authors.lastname: Borgonovo
authors.forename: Marta
authors.initials: M
authors.lastname: Piantanida
authors.forename: Laura
authors.initials: L
authors.lastname: Primavesi
authors.forename: Chrysi
authors.initials: C
authors.lastname: Stafylaraki
authors.forename: Sara
authors.initials: S
authors.lastname: Pasqualetti
authors.forename: Jan
authors.initials: J
authors.lastname: Schroeder
authors.forename: Michele
authors.initials: M
authors.lastname: Nichelatti
authors.forename: Alessandro
authors.initials: A
authors.lastname: Marocchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000276:immunology*; D052179:Antigens, Plant / Q000276:immunology*; D003429:Cross Reactions / Q000276:immunology; D003430:Cross-Sectional Studies; D005260:Female; D005512:Food Hypersensitivity / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology*; D007558:Italy; D008297:Male; D008875:Middle Aged; D010940:Plant Proteins; D027861:Prunus / Q000276:immunology*; D012016:Reference Values; D012680:Sensitivity and Specificity; D012882:Skin Tests; D055815:Young Adult
chemical_list: D000485:Allergens; D052179:Antigens, Plant; D010940:Plant Proteins; C403252:Pru p 1 allergen; C463181:Pru p 3 allergen; D007073:Immunoglobulin E