A European‐Japanese study on peach allergy: IgE to Pru p 7 associates with severity

Background Pru p 3 and Pru p 7 have been implicated as risk factors for severe peach allergy. This study aimed to establish sensitization patterns to five peach components across Europe and in Japan, to explore their relation to pollen and foods and to predict symptom severity. Methods In twelve Eur...

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Published in:Allergy (Copenhagen) 2023-09, Vol.78 (9), p.2497-2509
Main Authors: Kallen, E. J. J., Revers, A., Fernández‐Rivas, M., Asero, R., Ballmer‐Weber, B., Barreales, L., Belohlavkova, S., Blay, F., Clausen, M., Dubakiene, R., Ebisawa, M., Fernández‐Perez, C., Fritsche, P., Fukutomi, Y., Gislason, D., Hoffmann‐Sommergruber, K., Jedrzejczak‐Czechowicz, M., Knulst, A. C., Kowalski, M. L., Kralimarkova, T., Lidholm, J., Metzler, C., Mills, E. N. C., Papadopoulos, N. G., Popov, T. A., Purohit, A., Reig, I., Seneviratne, S. L., Sinaniotis, A., Takei, M., Versteeg, S. A., Vassilopoulou, A. E., Vieths, S., Welsing, P. M. J., Zwinderman, A. H., Le, T. M., Van Ree, R.
Format: Article
Language:English
Subjects:
Allergies
Epidemiology
Food allergies
Immunoglobulin E
Peach allergy
Pollen
prediction
Pru p 3
Pru p 7
Risk factors
Serology
severity
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Summary:Background Pru p 3 and Pru p 7 have been implicated as risk factors for severe peach allergy. This study aimed to establish sensitization patterns to five peach components across Europe and in Japan, to explore their relation to pollen and foods and to predict symptom severity. Methods In twelve European (EuroPrevall project) and one Japanese outpatient clinic, a standardized clinical evaluation was conducted in 1231 patients who reported symptoms to peach and/or were sensitized to peach. Specific IgE against Pru p 1, 2, 3, 4 and 7 and against Cup s 7 was measured in 474 of them. Univariable and multivariable Lasso regression was applied to identify combinations of parameters predicting severity. Results Sensitization to Pru p 3 dominated in Southern Europe but was also quite common in Northern and Central Europe. Sensitization to Pru p 7 was low and variable in the European centers but very dominant in Japan. Severity could be predicted by a model combining age of onset of peach allergy, probable mugwort, Parietaria pollen and latex allergy, and sensitization to Japanese cedar pollen, Pru p 4 and Pru p 7 which resulted in an AUC of 0.73 (95% CI 0.73–0.74). Pru p 3 tended to be a risk factor in South Europe only. Conclusions Pru p 7 was confirmed as a significant risk factor for severe peach allergy in Europe and Japan. Combining outcomes from clinical and demographic background with serology resulted in a model that could better predict severity than CRD alone. This study analyzed sensitization patterns to five peach components across Europe and in Japan, to explore their relation to pollen and foods and to predict symptom severity. A severity prediction model combining clinical and demographic outcomes with component‐resolved diagnostic (CRD) performs better than CRD alone. Geographic differences were identified, confirming and extending earlier reports: PR‐10 (Pru p 1) dominant in Northern/Central Europe, lipid transfer protein (LTP) (Pru p 3) in Southern Europe and GRP (Pru p 7) in Japan. Pru p 7 is associated with severe reactions.Abbreviations: CRD, component‐resolved diagnostic; IgE, immunoglobulin E; kUA/L, kilounits of allergen‐specific IgE per liter; LTP, lipid transfer protein
ISSN:0105-4538
1398-9995
DOI:10.1111/all.15783