title: High prevalence of lipid transfer protein sensitization in apple allergic patients with systemic symptoms.
abstract: BACKGROUND
  Apple allergy manifests as two main groups of clinical entities reflecting different patterns of allergen sensitization: oral allergy syndrome (OAS) and generalized symptoms (GS).
  
  
  OBJECTIVE
  We analysed the sensitization profile to a wide panel of different components of food allergens (rMal d 1, Mal d 2, rMal d 3, rMal d 4, rPru p 3, rBet v 1 and Pho d 2) for a population of Mediterranean patients with OAS and GS to apple.
  
  
  METHODS
  Patients (N = 81) with a history of apple allergy that could be confirmed by positive prick-prick test and/or double-blind-placebo-controlled food challenge (DBPCFC), were included. Skin prick test (SPT) and ELISA were performed using a panel of inhalant, fruit and nut allergens. ELISA and ELISA inhibition studies were performed in order to analyse the sensitization patterns.
  
  
  RESULTS
  Thirty-five cases (43.2%) had OAS and 46 (56.8%) GS. SPT showed a significantly higher number of positive results with peach, cherry and hazelnut in those with GS. ELISA showed a significantly high percentage of positive cases to rMal d 3, rMal d 4, rPru p 3 and Pho d 2 in patients with OAS and GS compared to controls, and to rBet v 1 in patients with OAS vs controls and between OAS and GS patients. Three different patterns of recognition were detected: positive to LTP (rMal d 3 or rPru p 3), positive to profilin (rMal d 4 and Pho d 2), or positive to both. There were also patients with rMal d 1 recognition who showed cross-reactivity to rBet v 1.
  
  
  CONCLUSIONS
  In an apple allergy population with a high incidence of pollinosis different patterns of sensitization may occur. LTP is most often involved in those with GS. Profilin, though more prevalent in patients with OAS, has been shown to sensitise patients with both types of symptoms.
authors.affiliation: Allergy Service, IBIMA, Regional University Hospital of Malaga, UMA, Malaga, Spain.
authors.forename: Francisca
authors.initials: F
authors.lastname: Gomez
authors.affiliation: Research Laboratory, IBIMA, Regional University Hospital of Malaga, UMA, Malaga, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Aranda
authors.affiliation: Allergy Service, IBIMA, Regional University Hospital of Malaga, UMA, Malaga, Spain.
authors.forename: Paloma
authors.initials: P
authors.lastname: Campo
authors.affiliation: Biotechnology Department, Center for Plant Biotechnology and Genomics, Pozuelo de Alarcon, Madrid, Spain.
authors.forename: Araceli
authors.initials: A
authors.lastname: Diaz-Perales
authors.affiliation: Allergy Service, Infanta Leonor Hospital, Madrid, Spain.
authors.forename: Natalia
authors.initials: N
authors.lastname: Blanca-Lopez
authors.affiliation: Research Laboratory, IBIMA, Regional University Hospital of Malaga, UMA, Malaga, Spain.
authors.forename: James
authors.initials: J
authors.lastname: Perkins
authors.affiliation: Biotechnology Department, Center for Plant Biotechnology and Genomics, Pozuelo de Alarcon, Madrid, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Garrido
authors.affiliation: Allergy Service, IBIMA, Regional University Hospital of Malaga, UMA, Malaga, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Blanca
authors.affiliation: Allergy Service, IBIMA, Regional University Hospital of Malaga, UMA, Malaga, Spain; Research Laboratory, IBIMA, Regional University Hospital of Malaga, UMA, Malaga, Spain.
authors.forename: Cristobalina
authors.initials: C
authors.lastname: Mayorga
authors.affiliation: Allergy Service, IBIMA, Regional University Hospital of Malaga, UMA, Malaga, Spain.
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Torres
mesh_terms: D000328:Adult; D000485:Allergens / Q000276:immunology; D002352:Carrier Proteins / Q000276:immunology*; D005260:Female; D005512:Food Hypersensitivity / Q000097:blood / Q000453:epidemiology / Q000276:immunology*; D005638:Fruit / Q000009:adverse effects*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D027845:Malus / Q000009:adverse effects*; D010940:Plant Proteins / Q000276:immunology*; D015995:Prevalence; D055815:Young Adult
chemical_list: D000485:Allergens; D002352:Carrier Proteins; D010940:Plant Proteins; C030363:lipid transfer protein; D007073:Immunoglobulin E