Lettuce Allergy Is a Lipid Transfer Syndrome-Related Food Allergy With a High Risk of Severe Reactions.
OBJECTIVE
Lipid transfer protein (LTP) sensitization is the most common cause of food allergy in the Mediterranean area, with peach allergy acting as the primary sensitizer in most cases. Lettuce has been described as a common offending food in patients with LTP syndrome. The aim of the study was to investigate the frequency and clinical expression of LTP syndrome in a sample of lettuceallergic patients.


METHODS
We determined specific IgE to Pru p 3 and lettuce in a sample of 30 patients with a diagnosis of lettuce allergy. Symptoms elicited by other LTP-containing plant-derived foods and the presence of cofactors were assessed.


RESULTS
The clinical symptoms of lettuce allergy were frequently severe, with 18 of the 30 patients experiencing anaphylaxis. All the patients had allergic reactions to other plant foods. Cofactors were involved in the clinical reactions of 13 of the 30 patients. Sensitization to pollens was found in 90% of patients.


CONCLUSIONS
Lettuce allergy is found not as an isolated condition but in the context of LTP syndrome and it is characterized by severe reactions and frequent cofactor association.
Allergy Section, Department of Internal Medicine, Hospital Vall d´Hebron, Barcelona, Spain.|Department of Immunology, IIS- Fundación Jimenez Diaz, UAM, Madrid, Spain.|Hospital Universitario de Getafe, Madrid, Spain.
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Muñoz-García
Allergy Section, Department of Internal Medicine, Hospital Vall d´Hebron, Barcelona, Spain.|Allergy Research Unit, Institut de Recerca Vall d'Hebron, Barcelona, Spain.
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Luengo-Sánchez
Allergy Section, Department of Internal Medicine, Hospital Vall d´Hebron, Barcelona, Spain.|Allergy Research Unit, Institut de Recerca Vall d'Hebron, Barcelona, Spain.
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Moreno-Pérez
Department of Allergy, Fundación Jiménez Díaz, Madrid, Spain.
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Cuesta-Herranz
Department of Immunology, IIS- Fundación Jimenez Diaz, UAM, Madrid, Spain.|These authors contributed equally to this work.
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Pastor-Vargas
Allergy Section, Department of Internal Medicine, Hospital Vall d´Hebron, Barcelona, Spain.|These authors contributed equally to this work.
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Cardona
D000293:Adolescent; D000328:Adult; D000707:Anaphylaxis / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D052179:Antigens, Plant / Q000008:administration & dosage / Q000009:adverse effects* / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D002352:Carrier Proteins / Q000009:adverse effects* / Q000276:immunology; D005260:Female; D005512:Food Hypersensitivity / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D005638:Fruit / Q000009:adverse effects / Q000276:immunology; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007159:Immunologic Tests; D018545:Lactuca / Q000009:adverse effects* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D018515:Plant Leaves / Q000009:adverse effects* / Q000276:immunology; D010940:Plant Proteins / Q000008:administration & dosage / Q000009:adverse effects* / Q000276:immunology; D011237:Predictive Value of Tests; D000068239:Prunus persica / Q000009:adverse effects / Q000276:immunology; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis / Q000276:immunology; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult
D052179:Antigens, Plant; D015415:Biomarkers; D002352:Carrier Proteins; D010940:Plant Proteins; C463181:Pru p 3 allergen; C511920:lipid transfer proteins, plant; D007073:Immunoglobulin E
Anaphylaxis; Cofactor; Food allergy; LTP syndrome; Lettuce allergy; Lipid transfer protein