The clinical and immunological effects of Pru p 3 sublingual immunotherapy on peach and peanut allergy in patients with systemic reactions.
BACKGROUND
The peach non-specific lipid transfer protein, Pru p 3, is the primary sensitizer in fruits and responsible for severe reactions in the Mediterranean area. Peach allergy is frequently associated with other allergies such as peanut. Therefore, it is important to assess how specific immunotherapy to Pru p 3 could affect both peach and peanut tolerance.


OBJECTIVE
To evaluate peach and peanut desensitization and immunological changes after 1 year of Pru p 3 sublingual immunotherapy (SLIT) in patients with systemic allergic reactions to peach and/or peanut.


METHODS
Forty-eight peach allergic patients, 36 treated with SLIT and 12 non-treated, were monitored for 12 months. Treated patients were subclassified as peanut allergic (Group A), sensitized (Group B) or tolerant (Group C). SLIT effect was evaluated by skin prick test (SPT) reactivity and food challenge. Immunological changes were evaluated by monitoring sIgE and sIgG4 levels and basophil reactivity.


RESULTS
After 1 year of SLIT, the weal area in SPT significantly decreased and a significant increase in peach threshold in treated patients was observed (P < 0.001). Patients in Group A showed a significant decrease in peanut SPT weal area and an increase in peanut threshold (P < 0.001). Immunological changes were observed in treated patients only, with a significant decrease in sIgE and a parallel increase in sIgG4, sIgG4/sIgE and basophil reactivity for both Pru p 3 and Ara h 9.


CONCLUSIONS
After 1 year, Pru p 3 SLIT induces both desensitization and immunological changes not only for peach but also for other food allergens relevant in the induction of severe reactions such as peanut.
Allergy Unit, IBIMA-Regional University Hospital of Malaga, UMA, Spain.
F
http://orcid.org/0000-0003-1607-6686
F
Gomez
Allergy Unit, IBIMA-Regional University Hospital of Malaga, UMA, Spain.
G
G
Bogas
Research Laboratory, IBIMA-Regional University Hospital of Malaga, UMA, Malaga, Spain.
M
M
Gonzalez
Allergy Unit, IBIMA-Regional University Hospital of Malaga, UMA, Spain.
P
P
Campo
Allergy Unit, IBIMA-Regional University Hospital of Malaga, UMA, Spain.
M
M
Salas
Centre for Plant Biotechnology and Genomics (UPM-INIA), Pozuelo de Alarcón, Madrid, Spain.
A
A
Diaz-Perales
Research Laboratory, IBIMA-Regional University Hospital of Malaga, UMA, Malaga, Spain.
M J
MJ
Rodriguez
Pediatric Unit,-Regional University Hospital of Malaga, UMA, Malaga, Spain.
A
A
Prieto
Institute for Applied Molecular Medicine (IMMA), School of Medicine, Universidad CEU San Pablo, Madrid, Spain.
D
D
Barber
Allergy Unit, IBIMA-Regional University Hospital of Malaga, UMA, Spain.
M
M
Blanca
Allergy Unit, IBIMA-Regional University Hospital of Malaga, UMA, Spain.
M J
MJ
Torres
Allergy Unit, IBIMA-Regional University Hospital of Malaga, UMA, Spain.|Research Laboratory, IBIMA-Regional University Hospital of Malaga, UMA, Malaga, Spain.
C
C
Mayorga
D000328:Adult; D000485:Allergens / Q000276:immunology*; D052179:Antigens, Plant / Q000008:administration & dosage / Q000276:immunology*; D010367:Arachis / Q000009:adverse effects*; D001491:Basophils / Q000276:immunology / Q000378:metabolism; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy*; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D008297:Male; D021183:Peanut Hypersensitivity / Q000175:diagnosis / Q000276:immunology / Q000628:therapy; D010940:Plant Proteins / Q000008:administration & dosage / Q000276:immunology*; D000068239:Prunus persica / Q000009:adverse effects*; D012882:Skin Tests; D063729:Sublingual Immunotherapy; D063189:Symptom Assessment; D055815:Young Adult
D000485:Allergens; D052179:Antigens, Plant; D010940:Plant Proteins; C463181:Pru p 3 allergen; D007073:Immunoglobulin E
anaphylaxis; basophil; food allergy; immunotherapy; tolerance induction