Department of Allergy, Institute for Health Research (IdiPAZ), La Paz University Hospital, Madrid, Spain.
Department of Preventive Medicine, La Paz University Hospital, Madrid, Spain.
Pediatr Allergy Immunol. 2023 Sep;34(9):e14030. doi: 10.1111/pai.14030.
Pru p 7 has been reported as a major allergen in peach allergy, associated with severe clinical symptoms and related to IgE sensitisation to cypress pollen. The main objective of this study was to prospectively evaluate the frequency of sensitisation to Pru p 7 and its clinical relevance amongst pediatric patients with peach allergy in Madrid (Spain).
Patients with a history of IgE-mediated symptoms (oral allergy syndrome, urticaria/angioedema, rhinoconjunctivitis/asthma, gastrointestinal symptoms, or anaphylaxis) occurring within 2 h after peach intake or contact were prospectively recruited from February 2020 to September 2021. Skin tests, sIgE by ImmunoCAP® (Pru p 1, Pru p 3, Pru p 4, Pru p 7, and Cupressus arizonica) and oral food challenge (OFC) were performed. The study was approved by the local Ethics Committee (PI-4513).
Ninety-two patients were included (53.3% male); median age, 10 (IQR 6.0-14.75) years. Seventy-four (80.4%) patients had a reaction after ingestion of fresh peach (25.0% from peel, 23.9% from pulp, and 44.6% from both). Fifteen (16.3%) patients were sensitised to Pru p 7. Upper airway symptoms, anaphylaxis, and grade 2 reactions were statistically more frequent in patients sensitised to Pru p 7. Seven (7.9%) patients presented with exercise as a cofactor, four of whom were sensitised to Pru p 7 (p = .001). Patients sensitised to Pru p 7 were significantly more likely to have a positive OFC result than patients who were not (p = .008). Four patients who reacted to peach at OFC were sensitised to Pru p 7. Specific IgE against Cupressus arizonica pollen was positive in 25 (62.5%) patients.
Pru p 7 sensitisation was observed in 16.3% of our population and was related to severe reactions, upper airway symptoms, anaphylaxis, and the presence of an eliciting cofactor.
普鲁 7 已被报道为桃过敏的主要过敏原，与严重的临床症状相关，并与侧柏花粉 IgE 致敏有关。本研究的主要目的是前瞻性评估普鲁 7 致敏的频率及其在马德里（西班牙）患有桃过敏的儿科患者中的临床相关性。
从 2020 年 2 月至 2021 年 9 月，前瞻性招募了 92 例有 IgE 介导症状（口腔过敏综合征、荨麻疹/血管性水肿、鼻结膜炎/哮喘、胃肠道症状或过敏反应）史的患者，这些症状在桃摄入或接触后 2 小时内发生。进行皮肤测试、ImmunoCAP® 的 sIgE（Pru p 1、Pru p 3、Pru p 4、Pru p 7 和 Cupressus arizonica）和口服食物挑战（OFC）。该研究获得了当地伦理委员会的批准（PI-4513）。
92 例患者纳入（53.3%为男性）；中位年龄为 10（IQR 6.0-14.75）岁。74 例（80.4%）患者在食用新鲜桃后有反应（25.0%来自果皮，23.9%来自果肉，44.6%来自两者）。15 例（16.3%）患者对普鲁 7 过敏。在普鲁 7 致敏的患者中，上呼吸道症状、过敏反应和 2 级反应更为常见。7 例（7.9%）患者出现运动作为协同因子，其中 4 例对普鲁 7 过敏（p=0.001）。对 OFC 中桃有反应的患者比未对其有反应的患者更有可能有阳性的 OFC 结果（p=0.008）。4 例在 OFC 中对桃有反应的患者对普鲁 7 过敏。25 例（62.5%）患者对侧柏花粉的特异性 IgE 呈阳性。
在我们的人群中，16.3%的患者对普鲁 7 过敏，与严重反应、上呼吸道症状、过敏反应和存在诱发协同因子有关。
