Pru p 7 sensitisation is a predominant cause of severe, cypress pollen‐associated peach allergy

Abstract

Background

Peach is a common elicitor of food allergic reactions. Peach‐induced immediate reactions may occur as benign pollen‐food syndromes, usually due to birch pollen related PR‐10 cross‐reactivity in temperate climates, and as potentially severe primary food allergies, predominantly related to nsLTP Pru p 3 in Mediterranean regions. The newly described peach allergen Pru p 7 has has gained recent attention as a potential peach allergy severity marker. Sensitisation to Pru p 7 and its allergenic homologues of the gibberellin‐related protein family occurs in areas with high Cupressaceae tree pollen exposure.

Objective

We sought to investigate the distribution, clinical characteristics and molecular associations of Pru p 7 sensitisation among subjects with suspected peach allergy in different regions of France.

Methods

Subjects with suspected peach allergy (n=316) were included. Diagnostic workup was performed according to current guidelines, including open food challenge when required. IgE antibody measurements and competition experiments were performed using the ImmunoCAP assay platform.

Results

Sensitisation to Pru p 7 was present in 171 (54%) of all subjects in the study and in 123 of 198 (62%) diagnosed as peach allergic, more than half of whom were sensitised to no other peach allergen. Frequency and magnitude of Pru p 7 sensitisation were associated with the presence of peach allergy, the clinical severity of peach‐induced allergic reactions, and the level of cypress pollen exposure. Cypress pollen extract completely outcompeted IgE binding to Pru p 7. Pru p 7 was extremely potent in basophil activation tests.

Conclusion and Clinical relevance

A subtype of Cupressaceae pollinosis, characterised by Pru p 7 sensitisation, can be an underlying cause of severe peach allergy.

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