Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano, Italy.
J Investig Allergol Clin Immunol. 2013;23(1):37-42.
Tomato contains many allergens but their clinical relevance is poorly defined and the usefulness of available diagnostic methods is unknown.
To assess the clinical usefulness of current diagnostic methods for tomato allergy.
Ninety-six adults with plant food allergy were grouped based on their reactivity to PR-10, profilin, and lipid transfer protein (LTP). Tomato allergy was ascertained by history and a positive skin prick test (SPT) to fresh tomato. SPT with a commercial extract and immunoglobulin (Ig) E measurements were carried out.
In total, 36%, 8%, 28%, 18%, 8%, and 1% of patients were sensitized to PR-10, profilin, both PR-10 and profilin, LTP alone, LTP plus PR-10 or profilin, and genuine tomato allergens, respectively. Tomato allergy was detected in 32 (33%) of the 96 patients and was significantly associated with profilin hypersensitivity (P < .001). The sensitivity of SPT was good in all subgroups, but specificity was poor in many cases. ImmunoCAP sensitivity was acceptable in profilin reactors, but very poor in PR-10 reactors. IgE levels were not associated with tomato allergy in any of the subgroups. Similarly, birch and peach-specific IgE levels were not associated with tomato allergy in PR-10/profilin or in LTP reactors, respectively. Both SPT and ImmunoCAP worked well in the only patients with true tomato allergy. Birch- and tomato-specific IgE levels were not associated in patients monosensitized to PR-10, but they were correlated in profilin groups (P < .005). Peach- and tomato-specific IgE levels were correlated (P < .001) in LTP-allergic patients.
Tomato allergy occurs via sensitization towards different proteins. Component-resolved diagnosis helps to define clinical subgroups with different risk levels.
番茄含有许多过敏原，但它们的临床相关性尚未明确，且现有诊断方法的实用性也不明确。
评估用于诊断番茄过敏的现有诊断方法的临床实用性。
根据对 PR-10、丝氨酸蛋白酶抑制剂和脂质转移蛋白（LTP）的反应性，将 96 例植物性食物过敏成人分为不同组。通过病史和对新鲜番茄的皮肤点刺试验（SPT）阳性来确定番茄过敏。进行 SPT 与商业提取物和免疫球蛋白（Ig）E 测量。
共有 36%、8%、28%、18%、8%和 1%的患者分别对 PR-10、丝氨酸蛋白酶抑制剂、PR-10 和丝氨酸蛋白酶抑制剂、LTP 单独、LTP 加 PR-10 或丝氨酸蛋白酶抑制剂和真正的番茄过敏原过敏。在 96 例患者中，有 32 例（33%）检测到番茄过敏，且与丝氨酸蛋白酶抑制剂过敏显著相关（P <.001）。SPT 的敏感性在所有亚组中均良好，但特异性在许多情况下较差。免疫 CAP 在丝氨酸蛋白酶抑制剂反应者中的敏感性可接受，但在 PR-10 反应者中非常差。在任何亚组中，IgE 水平均与番茄过敏无关。类似地，在 PR-10/丝氨酸蛋白酶抑制剂或 LTP 反应者中，桦树和桃特异性 IgE 水平与番茄过敏均无关。在仅对真正的番茄过敏的患者中，SPT 和免疫 CAP 均效果良好。在仅对 PR-10 过敏的患者中，桦树和番茄特异性 IgE 水平无关，但在丝氨酸蛋白酶抑制剂组中相关（P <.005）。在 LTP 过敏患者中，桃和番茄特异性 IgE 水平相关（P <.001）。
番茄过敏是通过对不同蛋白的致敏引起的。基于成分的诊断有助于确定具有不同风险水平的临床亚组。
