Gamboa P M, Cáceres O, Antepara I, Sánchez-Monge R, Ahrazem O, Salcedo G, Barber D, Lombardero M, Sanz M L
Servicio de Alergia, Hospital de Basurto, Bilbao, Spain.
Allergy. 2007 Apr;62(4):408-14. doi: 10.1111/j.1398-9995.2006.01284.x.
Peach allergy has two different patterns: central Europe with oral allergy syndrome (OAS) related to a primary sensitization to birch pollen Bet v 1 and profilins and southern Europe with mostly systemic symptoms, in many cases due to sensitization to lipid-transfer proteins.
Thirty peach-allergic patients with positive skin and food challenge tests and 29 control subjects were included. Skin prick tests (SPT) with inhalant allergens, commercial peach and apple extracts and native Pru p 3 were performed. In vitro specific immunoglobulin (Ig) E to grass pollen, birch pollen, peach, apple, rBet v 1, rBet v 2 and rPhl p 12 was determined by CAP, and rBet v 1, rMal d 1, rMal d 4, rMal d 3 and rPru p 3 using the ADVIA-Centaur platform. Basophil activation test (BAT) with commercial peach extract, commercial apple extract, nPru p 3, rMal d 3, rMal d 1 and rMal d 4 was also performed.
Pru p 3 was the major allergen in the patient group from northern Spain. Sensitization to this allergen was found in 100% of the patients with systemic symptoms or contact urticaria. Only 60% of OAS patients were sensitized to Pru p 3, being all of them sensitized to profilins and 60% of them to allergens of the Bet v 1 family. Specific IgE determination and BAT using recombinant allergens (rPru p 3) show specificity and sensitivity values close to 100%.
Most peach-allergic patients coming from the north of Spain present systemic symptoms after ingestion of peach, Pru p 3 being the main allergen. Patients with OAS present profilin-Bet v 1-related sensitization. Thus, in the north of Spain our patients show a mixed central-south Europe pattern with LTP-profilin-Bet v 1 sensitization depending on the symptoms presented. The use of natural and recombinant plant allergens, allows establishing the sensitization patterns to the different allergens studied.
桃子过敏有两种不同模式：在中欧，桃子过敏与对桦树花粉Bet v 1和肌动蛋白结合蛋白的原发性致敏相关，表现为口腔过敏综合征（OAS）；而在南欧，桃子过敏大多表现为全身症状，在许多情况下是由于对脂质转移蛋白致敏所致。
纳入30例皮肤和食物激发试验阳性的桃子过敏患者以及29例对照受试者。用吸入性变应原、市售桃子和苹果提取物以及天然Pru p 3进行皮肤点刺试验（SPT）。通过CAP法测定针对草花粉、桦树花粉[、桃子、苹果、重组Bet v 1（rBet v 1）、重组Bet v 2（rBet v 2）和重组Phl p 12的体外特异性免疫球蛋白（Ig）E，并使用ADVIA-Centaur平台测定针对rBet v 1、重组Mal d 1（rMal d 1）、重组Mal d 4（rMal d 4）、重组Mal d 3（rMal d 3）和rPru p 3的IgE。还用市售桃子提取物、市售苹果提取物、天然Pru p 3、rMal d 3、rMal d 1和rMal d 4进行嗜碱性粒细胞活化试验（BAT）。
Pru p 3是西班牙北部患者组中的主要变应原。在所有出现全身症状或接触性荨麻疹的患者中均发现对该变应原致敏。只有60%的OAS患者对Pru p 3致敏，所有这些患者均对肌动蛋白结合蛋白致敏，其中60%对Bet v 1家族的变应原致敏。使用重组变应原（rPru p 3）进行特异性IgE测定和BAT，显示特异性和敏感性值接近100%。
大多数来自西班牙北部的桃子过敏患者在摄入桃子后出现全身症状，Pru p 3是主要变应原。OAS患者表现出与肌动蛋白结合蛋白 - Bet v 1相关的致敏。因此，在西班牙北部，我们的患者根据所呈现的症状表现出一种中欧 - 南欧混合模式，即对脂质转移蛋白 - 肌动蛋白结合蛋白 - Bet v 1致敏。使用天然和重组植物变应原，能够确定对所研究的不同变应原的致敏模式。
