Abstract
AbstractIntroductionFood allergy is an increasing problem with limited therapeutic approaches apart from to the eviction diet.Case presentationA 40-year-old female patient with food allergy symptoms was polysensitized to almost all vegetable food since the age of 36; the onset of symptoms was during pregnancy. The allergological study demonstrated positive skin prick tests (SPT) to nuts, legumes, cereals, spices, several fresh fruits including peach, and other groups of vegetable foods however, it was negative to common aeroallergens. Serum specific IgE levels were negative (<0.35 kU/L) to profilin and carbohydrate determinants, but positive to Pru p 3 (3.5 kU/L). Positive double-blind placebo-controlled food challenge to peach confirmed the allergic disease. She received specific sublingual immunotherapy with native Pru p 3 at a concentration of 40 μg/ml with 5 administrations per week and a cumulative dose of 200 μg of nPru p 3 per month. After an ultra-rush build-up phase concluded in one day she continued therapy during a year with 5 administrations per week. The clinical evolution and laboratory studies demonstrated an early reduction on SPT reactions with no relevant changes on serum specific IgE, IgG, IgG1and IgG4to Pru p 3 during the immunotherapy period. The challenge test was negative 4 months after the beginning of the SLIT. Regarding clinical response she markedly improved after the first month of treatment, and by the 3th month she had no major vegetable dietary restrictions, except for nuts and pepper.ConclusionThese results demonstrate the excellent efficacy and safety of sublingual specific protein immunotherapy developed according to the patient specific sensitivity profile to Pru p3.
Highlights
Food allergy is an increasing problem with limited therapeutic approaches apart from to the eviction diet.Case presentation: A 40-year-old female patient with food allergy symptoms was polysensitized to almost all vegetable food since the age of 36; the onset of symptoms was during pregnancy
The challenge test was negative 4 months after the beginning of the sublingual immunotherapy (SLIT). Regarding clinical response she markedly improved after the first month of treatment, and by the 3th month she had no major vegetable dietary restrictions, except for nuts and pepper. These results demonstrate the excellent efficacy and safety of sublingual specific protein immunotherapy developed according to the patient specific sensitivity profile to Pru p3
Peach Lipid transfer proteins (LTP) purificaction Peach peel was homogenated into Björksten [11] buffer and after centrifugation the supernatant was dialysed against 20 mM phosphate, pH 6), filtered (0.22 mm) and applied onto a 5 mL Capto S cationic column using an Akta prime system
Summary
Food allergy is an increasing problem with limited therapeutic approaches apart from to the eviction diet.Case presentation: A 40-year-old female patient with food allergy symptoms was polysensitized to almost all vegetable food since the age of 36; the onset of symptoms was during pregnancy. Lipid transfer proteins (LTP) form a broad and widespread group of proteins, of plant origin [4] They represent a class of ubiquitous allergens specific for foods such as fresh fruits and cereals, and responsible for allergy reactions favours because of its stable and resistant structure to harsh physicochemical conditions with several well-conserved domains which may condition a high degree of cross-reactivity among botanically unrelated foods [3,4]. In addition to these proteins commonly involved in food allergy, profilins from pollens and plant foods as well as carbohydrate determinants (CCDs) can induce IgE cross-reactive responses in pollen-allergic patients [5,6]
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