Phenotyping peach-allergic patients sensitised to LTP and analysing severity biomarkers.

Background Patients with peach allergy due to nsLTP sensitisation constitute a heterogeneous group in terms of sensitisation profile and severity. This could be due to the presence of additional allergies to pollens. The aim of this study was to analyse the clinical characteristics, sensitisation profile, and severity of reactions in peach-allergic patients sensitised to nsLTP from two Mediterranean areas with different pollen exposure. Methods Patients with diagnosis of LTP allergy from the Allergy Unit of Hospital Regional Universitario de Malaga (HRUM) and Hospital Clinic de Barcelona (HCB) were prospectively included and classified into two groups; (a) LTP-monoallergic: those that presented reaction only with peach, and (b) LTP-Allergy: those that presented reaction with peach and at least another plant-food containing LTP. Results 252 patients were included, 235 (93.2%) had LTP-syndrome and 17 (6.8%) were LTP-monoallergic. We found a higher percentage of anaphylaxis and delayed onset of symptoms in the LTP-monoallergic group (p=0.02 and p=0.04, respectively). Moreover, anaphylaxis was less frequent in patients with profilin sensitisation (p=0.03). The comparison of patients' data from HRUM with data from HCB showed differences in sensitisation to olive tree pollen and profilin (p=0.01 and p=0.001, respectively). Conclusion This study was undertaken to characterize two large group of subjects from to two regions with differing exposures to pollen. We found that more than 90% of peach-allergic patients in both populations evolved to LTP-Allergy and showed an early onset. Profilin sensitisation could be more useful as a severity biomarker than the number of nsLTP, aeroallergen sensitisations, or sIgE levels. This could provide clues regarding sensitisation and severity patterns that might be relevant in other geographical areas.