Tomato allergy: detection of IgE-binding lipid transfer proteins in tomato derivatives and in fresh tomato peel, pulp, and seeds

Effects of variety, maturity and storage conditions on the allergic potential of kiwifruit and its relationship with antioxidant activity

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Allergenicity of kiwifruit strongly associated with its physiological attributes.

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10-day storage of kiwifruit at 20 °C increased the Act d 2 content by 50 %.

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Act d 2 content in the seeds was 4-fold higher than that of peel.

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Act d 2 content showed a negative relationship with antioxidant activity.

This work aimed to study the influences of physiological characteristics (variety, maturity, and fruit components) and storage conditions on the allergenic potential of kiwifruit. The results found kiwifruit allergen (Act d 2) is only measured in the green kiwifruit rather than golden kiwifruit. The Act d 2 content of seed is 2-fold and 4-fold higher than that of pulp and peel, respectively. The highest Act d 2 allergen content was determined in ripe kiwifruit, followed by overripe fruit and unripe fruit. A 50 % of enhancement in Act d 2 content was observed after 10-day storage at 20 °C. Further, the Act d 2 content showed a negative relationship with the ascorbic acid content and total antioxidant activity at various conditions. Thus, antioxidants as important factors may involve the regulation of Act d 2 in kiwifruit. These findings could provide a deep understanding in the distribution of Act d 2.

Tomato (Solanum lycopersicum L.) accumulation and allergenicity in response to nickel stress

Vegetables represent a major source of Ni exposure. Environmental contamination and cultural practices can increase Ni amount in tomato posing significant risk for human health. This work assesses the tomato (Solanum lycopersicum L.) response to Ni on the agronomic yield of fruits and the related production of allergens. Two cultivars were grown in pots amended with Ni 0, 30, 60, 120, and 300 mg kg⁻¹, respectively. XRF and ICP-MS analyses highlighted the direct increase of fruit Ni content compared to soil Ni, maintaining a stable biomass. Leaf water content increased at Ni 300 mg kg⁻¹. Total protein content and individual allergenic components were investigated using biochemical (RP-HPLC and N-terminal amino acid sequencing) and immunological (inhibition tests of IgE binding by SPHIAa assay on the FABER testing system) methodologies. Ni affected the fruit tissue concentration of pathogenesis-related proteins and relevant allergens (LTP, profilin, Bet v 1-like protein and TLP). This study elucidates for the first time that tomato reacts to exogenous Ni, uptaking the metal while changing its allergenic profiles, with potential double increasing of exposure risks for consumers. This evidence highlighted the importance of adequate choice of low-Ni tomato cultivars and practices to reduce Ni uptake by potentially contaminated matrices.

Tomato Allergy: The Characterization of the Selected Allergens and Antioxidants of Tomato (Solanum lycopersicum)-A Review

Tomatoes are one of the most broadly produced and consumed crop plants. They are the source of health-promoting nutrients such as antioxidants, including ascorbic acid, polyphenols, or carotenoids. Despite the beneficial role of tomatoes in the daily diet, they have been confirmed as one of the most prevalent allergenic vegetables. Food allergies can cause many clinical symptoms, e.g., in the gastrointestinal tract, skin, and lungs, as well as anaphylactic shock. A huge amount of clinical research has been carried out to improve the understanding of the immunological mechanisms that lead to the lack of tolerance of food antigens, which can result in either immunoglobulin E (IgE)-mediated reactions or non-IgE-mediated reactions. Lifestyle and diet play an important role in triggering food allergies. Allergy to tomatoes is also linked to other allergies, such as grass pollen and latex allergy. Numerous attempts have been made to identify and characterize tomato allergens; however, the data available on the subject are not sufficient.

Treatment of Benign Prostatic Hyperplasia by Natural Drugs

Benign prostatic hyperplasia (BPH) is one of the most common urinary diseases affecting men, generally after the age of 50. The prevalence of this multifactorial disease increases with age. With aging, the plasma level of testosterone decreases, as well as the testosterone/estrogen ratio, resulting in increased estrogen activity, which may facilitate the hyperplasia of the prostate cells. Another theory focuses on dihydrotestosterone (DHT) and the activity of the enzyme 5α-reductase, which converts testosterone to DHT. In older men, the activity of this enzyme increases, leading to a decreased testosterone/DHT ratio. DHT may promote prostate cell growth, resulting in hyperplasia. Some medicinal plants and their compounds act by modulating this enzyme, and have the above-mentioned targets. This review focuses on herbal drugs that are most widely used in the treatment of BPH, including pumpkin seed, willow herb, tomato, maritime pine bark, Pygeum africanum bark, rye pollen, saw palmetto fruit, and nettle root, highlighting the latest results of preclinical and clinical studies, as well as safety issues. In addition, the pharmaceutical care and other therapeutic options of BPH, including pharmacotherapy and surgical options, are discussed, summarizing and comparing the advantages and disadvantages of each therapy.

The diagnosis and management of allergic reactions in patients sensitized to non-specific lipid transfer proteins

Sensitization to one or more non-specific lipid transfer proteins (nsLTPs), initially thought to exist mainly in southern Europe, is becoming accepted as a cause of allergic reactions to plant foods across Europe and beyond. The peach nsLTP allergen Pru p 3 is a dominant sensitizing allergen and peaches a common food trigger, although multiple foods can be involved. A frequent feature of reactions is the requirement for a cofactor (exercise, alcohol, non-steroidal anti-inflammatory drugs, Cannabis sativa) to be present for a food to elicit a reaction. The variability in the food and cofactor triggers makes it essential to include an allergy-focused diet and clinical history in the diagnostic workup. Testing on suspected food triggers should also establish whether sensitization to nsLTP is present, using purified or recombinant nsLTP allergens such as Pru p 3. The avoidance of known trigger foods and advice on cofactors is currently the main management for this condition. Studies on immunotherapy are promising, but it is unknown whether such treatments will be useful in populations where Pru p 3 is not the primary sensitizing allergen. Future research should focus on the mechanisms of cofactors, improving diagnostic accuracy and establishing the efficacy of immunotherapy.

A Snapshot on Food Allergies: A Case Study on Edible Flowers

This perspective study addresses the main causes of adverse reactions to foods in humans, by taking into account the main allergic reactions that may occur as a result of food ingestion, as well the main allergens present in food and how their allergenicity change as a result of food preparation. In addition, European legislation on food labeling and novel foods was taken into account. The case study of this perspective is on the potential allergenicity of edible flowers as well as evidence of phytochemistry and toxic compounds and the risk associated with their ingestion. Regarding edible flowers, a key issue to address is if they are safe to consume or not. In the framework of the project “Innovative activities for the development of the cross-border supply chain of the edible flower” (ANTEA), we considered 62 different species and varieties of edible flowers. The results obtained by consulting two databases on allergens, COMPRISE and Allergen Nomenclature, marked two alerts for two species of edible flowers selected in the project. Moreover, based on edible flower consumption, about ten grams per serving, and on their protein content, we can also state that the risk of allergic reactions due to edible flower ingestion is very low.

Lipid Transfer Protein allergy in the United Kingdom: Characterization and comparison with a matched Italian cohort

BACKGROUND

Although pollen-related food allergy occurs in all European populations, lipid transfer protein (LTP) allergy is considered to manifest mainly in Mediterranean countries. We aimed to characterize adults presenting with LTP allergy in a northern European country.

METHOD

The clinical history and sensitization patterns of subjects born and residing in the United Kingdom (UK), with a prior diagnosis of LTP allergy and sensitization to the peach LTP allergen Pru p 3, were compared to UK subjects with pollen food syndrome (PFS). The sensitization patterns were also evaluated against a matched cohort of Italian subjects diagnosed with LTP allergy.

RESULTS

None of the 15 UK PFS subjects had a positive SPT to LTP-enriched peach reagent, compared to 91% of the 35 UK LTP subjects. The UK LTP cohort were also more likely to have positive skin prick tests to cabbage, lettuce and mustard and sensitization to the LTP allergens in peach, walnut, mugwort and plane tree These sensitization patterns to individual allergens were not significantly different to those obtained from the Italian LTP subjects, with significant correlations between Pru p 3 and the LTP allergens in peanuts, walnuts, plane tree and mugwort in both groups.

CONCLUSION

Native UK subjects with LTP allergy are not dissimilar to those with LTP allergy in southern Europe. Testing to LTP-enriched peach SPT reagent and/or LTP allergens in peach, walnut, mugwort and plane tree may enhance diagnostic accuracy.

Identification of non-specific Lipid Transfer Protein gene family members in Solanum lycopersicum and insights into the features of Sola l 3 protein

Non-specific lipid transfer proteins (nsLTPs) are characterized by an eight-cysteine motif backbone that is stabilized by four disulphide bonds. The strong interest towards this protein family is mainly due to the fact that nsLTPs are involved in many biological processes and have been identified as major human allergens. Since tomato (Solanum lycopersicum L.) is one of the most consumed and allergenic vegetables, a full characterization of this family is needed. In this study, hidden Markov model profiles were used to identify nsLTPs within the tomato protein complement. Following manual curation, 64 nsLTP genes were classified into six sub-families. Furthermore, nsLTP gene structure, distribution and arrangement along tomato chromosomes were investigated. Available RNA-seq expression profile data and Real-Time PCR analyses were used to derive expression patterns of tomato nsLTPs in different tissues/organs. Non-specific LTP genes with high level of expression in tomato fruits were filtered out since they could play a key role in tomato allergenicity. Among these genes was Solyc10g075090 that encodes the allergen Sola l 3. Finally, cloning, heterologous expression, purification and biochemical characterization of the recombinant protein Sola l 3 was performed.

Effect of tomato variety, cultivation, climate and processing on Sola l 4, an allergen from Solanum lycopersicum

Tomatoes (Solanum lycopersicum) are one of the most consumed vegetables worldwide. However, tomato allergies in patients suffering from birch pollen allergy occur frequently. Due to highly similar protein structures of the tomato allergen Sola l 4 and the major birch pollen allergen Bet v 1, patients cross-react with allergenic proteins from tomato as well as other fruits or vegetables. The aim of this study was to quantify Sola l 4 in various tomatoes differing in color, size and shape for identification of varieties with a reduced allergen level. Therefore, an indirect competitive ELISA using a specific polyclonal Sola l 4 antibody was developed. In addition, two varieties, both cultivated either conventionally or organically and furthermore dried with different methods, were analyzed to investigate the influence of the cultivation method and processing techniques on Sola l 4 level. Within 23 varieties, Sola l 4 content varied significantly between 0.24 and 1.71 μg Sola l 4/g FW. The tomato cultivars Rugantino and Rhianna showed the significantly lowest level, whereas in cultivars Farbini and Bambello the significantly highest concentration was determined. Drying of tomatoes in the oven and by sun resulted in a significant decrease. The thermal instability was verified for the recombinant Sola l 4 emphasizing the results for the native protein in dried tomato samples. Overall, the Sola l 4 content is cultivar-dependent and no correlation between color and Sola l 4 amount was found. During the drying process of tomatoes Sola l 4 level was significantly reduced due to thermal instability. Growing conditions have a minor effect whereas seasonal effects show a more pronounced impact. These findings could extend the knowledge about the allergen level of different tomato varieties and may help to improve food safety to potentially increase the life quality of patients suffering from birch pollen allergy.

The clinical relevance of lipid transfer protein

Despite a huge number of studies, many aspects of the lipid transfer protein (LTP) syndrome, the most frequent primary food allergy in Mediterranean countries, remain unclear. Its peculiar geographical distribution, along with the extreme variability of its clinical expression, makes this type of food allergy something unique in the panorama of IgE-mediated food-induced allergic reactions. This review article tried to summarize the current knowledge about the most important aspects of LTP sensitization and allergy, along with the importance of positive and negative co-factors in the clinical expression of the syndrome as well as the issues regarding the cross-reactivity between LTPs present in botanically related and unrelated foods. Further, the possible absence of the protein from some plant foods is discussed.

Impact of Wild Loci on the Allergenic Potential of Cultivated Tomato Fruits

Tomato (Solanum lycopersicum) is one of the most extensively consumed vegetables but, unfortunately, it is also able to induce allergic reactions. In the past, it has been shown that the choice of tomato cultivar significantly influenced the allergic reaction of tomato allergic subjects. In this study we investigated the allergenic potential of the cultivated tomato line M82 and of two selected lines carrying small chromosome regions from the wild species Solanum pennellii (i.e. IL7-3 and IL12-4). We evaluated the positive interactions of IgEs of allergic subjects in order to investigate the different allergenic potential of the lines under investigation. We used proteomic analyses in order to identify putative tomato allergens. In addition, bioinformatic and transcriptomic approaches were applied in order to analyse the structure and the expression profiles of the identified allergen-encoding genes. These analyses demonstrated that fruits harvested from the two selected introgression lines harbour a different allergenic potential as those from the cultivated genotype M82. The different allergenicity found within the three lines was mostly due to differences in the IgE recognition of a polygalacturonase enzyme (46 kDa), one of the major tomato allergens, and of a pectin methylesterase (34 kDa); both the proteins were more immunoreactive in IL7-3 compared to IL12-4 and M82. The observed differences in the allergenic potential were mostly due to line-dependent translational control or post-translational modifications of the allergens. We demonstrated, for the first time, that the introgression from a wild species (S. pennellii) in the genomic background of a cultivated tomato line influences the allergenic properties of the fruits. Our findings could support the isolation of favorable wild loci promoting low allergenic potential in tomato.

Allergenic Potential of Tomatoes Cultivated in Organic and Conventional Systems

Tomatoes (Lycopersicon esculentum Mill.) are a widely consumed vegetables and contain many health beneficial micronutrients. Unfortunately, they may also cause adverse allergic reactions in sensitized people. Many studies, conducted in recent years, indicate that organically produced vegetables have higher nutritional value, improved sensory quality and contain more health-enhancing bioactive compounds than vegetables grown under the conventional system. However, the relation between organic methods of cultivation and allergenic potential of tomatoes has received little scientific attention. This study analyzed samples of five tomato cultivars taken from organic and conventional systems over three consecutive years. The content of profilin, Bet v 1 and lipid transfer protein (LTP) analogues in tomato samples was determined using an indirect ELISA assay. Substantial quantities of these proteins were found in certain cultivars across all three years of cultivation. On the basis of these findings, organically grown tomatoes appear to offer little advantage over conventionally cultivated plants in terms of reduced allergenic potential.

Expression and characterization of a new isoform of the 9 kDa allergenic lipid transfer protein from tomato (variety San Marzano)

Lipid transfer proteins (LTPs) are food allergens found first in fruits of the Rosaceae family and later identified in other food plants. Their high structural stability causes them to behave as allergens in cooked and processed foods. Allergenic LTPs have been identified in tomato fruits as well, but studies of their thermal stability and structural characteristics are limited. In this article we report the identification of the coding region for a novel 9 kDa LTP isoform in the tomato variety San Marzano, together with the expression of the recombinant mature protein. The purified recombinant protein was further characterized for its thermal stability and was found to bind 1-palmitoil-2-lysophosphatidylcholine (Lyso-C16) after thermal treatments up to 105 °C. Analysis of a modeling derived structure of the protein allowed the identification of possible epitope regions on the molecular surface.

The biochemical basis and clinical evidence of food allergy due to lipid transfer proteins: a comprehensive review

Plant lipid transfer proteins (LTPs) are ubiquitous proteins that are found in divergent plant species. Although the exact function of LTPs is not fully understood, LTPs are conserved across a broad range of plant species. Because LTPs share structural features, there is an increased probability for significant allergic cross-reactivity. The molecular features of LTPs also decrease the probability of degradation due to cooking or digestion, thereby increasing the probability of systemic absorption and severe allergic reactions. LTP allergy, unlike other forms of anaphylaxis, tends to occur more frequently in areas of lower latitude. The geographic distribution of LTP allergy, along with evidence of increased sensitization after respiratory exposure, has led to the hypothesis that LTP-related food allergy may be secondary to sensitization via the respiratory route. Clinical reactions associated with LTPs have broad clinical phenotypes and can be severe in nature. Life-threatening clinical reactions have been associated with ingestion of a multitude of plant products. Component-resolved diagnosis has played a significant role in research applications for LTP allergy. In the future, component-resolved diagnosis may play a significant role in day-to-day clinical care. Also, quantitative analysis of LTPs in foodstuffs may allow for the identification and/or production of low-LTP foods, thereby decreasing the risk to patients with LTP allergy. Furthermore, sublingual immunotherapy may provide a therapeutic option for patients with LTP allergy.

Electrospray MS and MALDI imaging show that non-specific lipid-transfer proteins (LTPs) in tomato are present as several isoforms and are concentrated in seeds

Non-specific lipid-transfer proteins (nsLTPs) are major human allergens in many plant species, albeit their role in plant biochemistry is still undefined. They are found in many plant species, either as one or several isoforms according to the species, and usually they are found to concentrate in the outer part of the fruits. In this work, the characterization of tomato nsLTP isoforms was performed on the three main fractions of Piccadilly tomato fruit (peel, pulp and seeds) by using ultracentrifuge devices with molecular cut-off able to retain proteins with molecular weight typical of plant LTPs. The isolated proteins were further analysed by LC-MS, in order to investigate the occurrence and the localization of tomato LTP isoforms. The chromatographic retention times, the molecular masses, the presence of eight cysteine residues in their tertiary structures and the sequence information obtained by MS, although not complete yet, allowed us to identify four different LTP isoforms, not yet reported in the literature, which were found to be concentrated in the seed fractions. None of the molecular masses of these potential LTPs was already present in the UniProtKB/SwissProt database. MALDI imaging experiments confirmed their presence and main localization in seeds, although the actual data hinted at their presence around seeds, rather than exactly in them. These data hint to a complicated scenario concerning LTP proteins in tomato.

A survey of plants responsible for causing irritant contact dermatitis in the Amathole district, Eastern Cape, South Africa

ETHNOPHARMACOLOGICAL RELEVANCE

Potentially harmful plants grow almost everywhere, hence, it is not practical to eradicate them all. However, a basic understanding of adverse cutaneous reactions and the common plants that cause each type can enable vulnerable individuals to discover the source of their dermatitis and thus prevent re-exposure. The aim of this study therefore, was to document the plants responsible for irritant contact dermatitis (ICD) in the Eastern Cape, along with their respective irritants and clinical presentations.

MATERIALS AND METHODS

Study participants (161) in 12 locations were selected by convenient sampling with particular focus on local people who regularly interact with plants or plant products. Interview questions were focused on the local names of plants that contain irritating chemicals and physical characteristics that cause ICD.

RESULTS

Forty four plant species distributed in 24 families and 34 genera were reported as causative agents of irritant contact dermatitis. Herbs constituted 67.35%, trees 24.49% and shrubs 8.16%. Mechanical ICD was reported to be caused by 23 species, closely followed by chemical ICD (20 species) and mechanico-chemical ICD (6 species). Species with the highest frequency of citations were Allium cepa, Acacia karroo, Capsicum annuum, Citrus limon and Zea mays. The most representative families were Euphorbiaceae (for chemical ICD), Urticaceae (for mechanico-chemical ICD), Fabaceae and Rutaceae for mechanical ICD. Most of the classes of chemical compounds identified as being responsible for chemical ICD were restricted to plants of specific genera such as the diterpenes in Euphorbia spp., disulphides in Allium spp., terpenes in Citrus spp. and isothiocyanates in Brassica spp. Thorns and hairs were reported for causing Mechanical ICD in 6 plant species each, including widely cultivated plants such as Acacia karoo and Citrus reticulata.

CONCLUSION

Irritant contact dermatitis is a common cutaneous disorder in individuals exposed to plants in the Eastern Cape, especially among workers of the food and flower industries. Health practitioners should therefore consider the possible work-related causes of dermatitis, especially in cases associated with a clear history of symptoms.

Food hypersensitivity in patients over 14 years of age suffering from atopic dermatitis

BACKGROUND

Patients suffering from atopic dermatitis often describe food hypersensitivity. Rising prevalence of food hypersensitivity and severe allergic reactions to foods have been reported, but the data are scarce.

AIMS AND OBJECTIVES

Evaluation of food hypersensitivity reactions in patients suffering from atopic dermatitis.

MATERIALS AND METHODS

The dermatological examination was performed in patients of age 14 years and above and the detailed history was taken concerning the food hypersensitivity.

RESULTS

A total of 228 patients were examined-72 men, 156 women, average age 26.2 (SD 9.5) years. The food hypersensitivity reactions were recorded in 196 patients from 228 (86%), no reactions were recorded in 32 patients (24%). Foods with the most often recorded reactions are: Nuts (in 35% of patients), tomatoes (in 20%), and kiwi (in 17, 5%), apples and spices (in 16%), tangerines and oranges (in 15%), capsicum (in 13%), fishes (in 12%), celery (in 9%), and chocolate (in 7%).

CONCLUSION

Food hypersensitivity reactions are recorded in 86% of patients suffering from atopic dermatitis. Nuts, tomatoes, and pollen-associated foods play a role in the majority of patients suffering from atopic dermatitis.

Anaphylaxis to plant-foods and pollen allergens in patients with lipid transfer protein syndrome

PURPOSE OF REVIEW

Nonspecific lipid transfer protein (LTP) is the main cause of primary food allergy in adults living in the Mediterranean area. The way allergic patients get sensitized to this protein is all but established, and the clinical expression of sensitization is extremely variable, ranging from long-lasting symptomless sensitization to severe anaphylaxis. Such variability is seemingly due to the presence/absence of a number of cofactors.

RECENT FINDINGS

The possibility that LTP sensitization occurs via the inhalation of LTP-containing pollen particles seems unlikely; in contrast, peach particles containing the protein seem able to sensitize both via the airways and the skin. Cosensitization to pollen allergens as well as to labile plant food allergens makes LTP allergy syndrome less severe. In some LTP sensitized subjects clinical food allergy occurs only in the presence of cofactors such as exercise, NSAIDs, or chronic urticaria.

SUMMARY

Lipid transfer protein allergy syndrome shows some peculiarities that are unique in the primary food allergy panorama: geographical distribution, frequent asymptomatic sensitization, frequent need for cofactors, and reduced severity when pollen allergy is present. Future studies will have to address these points as the results may have favorable effects on other, more severe, types of food allergy.

Allergenic relevance of nonspecific lipid transfer proteins 2: Identification and characterization of Api g 6 from celery tuber as representative of a novel IgE-binding protein family

SCOPE

Apium graveolens represents a relevant food allergen source linked with severe systemic reactions. We sought to identify an IgE-binding nonspecific lipid transfer protein (nsLTP) in celery tuber.

METHODS AND RESULTS

A low molecular weight protein exclusively present in celery tuber was purified and designated Api g 6. The entire protein sequence was obtained by MS and classified as member of the nsLTP2 family. Api g 6 is monomeric in solution with a molecular mass of 6936 Da. The alpha-helical disulfide bond-stabilized structure confers tremendous thermal stability (Tm > 90°C) and high resistance to gastrointestinal digestion. Endolysosomal degradation demonstrated low susceptibility and the presence of a dominant peptide cluster at the C-terminus. Thirty-eight percent of A. graveolens allergic patients demonstrated IgE reactivity to purified natural Api g 6 in ELISA and heat treatment did only partially reduce its allergenic activity. No correlation in IgE binding and limited cross-reactivity was observed with Api g 2 and Art v 3, nsLTP1 from celery stalks and mugwort pollen.

CONCLUSION

Api g 6, a novel nsLTP2 from celery tuber represents the first well-characterized allergen in this protein family. Despite similar structural and physicochemical features as nsLTP1, immunological properties of Api g 6 are distinct which warrants its inclusion in molecule-based diagnosis of A. graveolens allergy.

Lipid transfer proteins: the most frequent sensitizer in Italian subjects with food-dependent exercise-induced anaphylaxis

BACKGROUND

Specific food-dependent exercise-induced anaphylaxis (S-FDEIAn) is a distinct form of food allergy in which symptoms are elicited by exercise performed after ingesting food to which the patient has become sensitised. Non-specific FDEIAn (NS-FDEIAn) is a syndrome provoked by exercise performed after ingesting any food.

OBJECTIVE

We sought to identify the culprit allergenic molecules in patients with FDEIAn, combining 'classic' allergy testing with an allergenic molecule-based microarray approach for IgE detection.

METHODS

All subjects were evaluated who reported at least one episode of anaphylaxis in association with physical exercise performed within 4 h after a meal. We performed skin prick tests (SPT) with commercial food extracts, prick plus prick tests (P + P) with fresh foods (P + P), and serum specific IgE assays by means of both the ImmunoCAP (CAP) and the ISAC 89 microarray system (ISAC).

RESULTS

Among our 82 FDEIAn patients, the most frequent suspected foods were tomato, cereals, and peanut. SPT, P + P, and CAP displayed different degrees of sensitivity. Each test disclosed some positivities not discovered by others. Seventy-nine subjects were positive to at least one food (49 to more than 20), whereas three were negative. All suspected foods were positive to at least one of SPT, P + P, and CAP. When tested using the ISAC, 64 (78%) subjects were positive to Pru p 3 [peach lipid transfer protein (LTP)], 13 were positive to other food allergen molecules, and five displayed negative results to all food allergenic molecules. Overall, 79 patients probably had S-FDEIAn and the other 3 NS-FDEIAn.

CONCLUSIONS

Multiple food hypersensitivity represents a clinical hallmark of a large percentage of FDEIAn patients. The very high prevalence of IgE to the LTP suggests a role of this allergen group in causing S-FDEIAn.

Fennel allergy is a lipid-transfer protein (LTP)-related food hypersensitivity associated with peach allergy

Fennel allergy has been rarely reported, and the association with peach allergy has never been described. Our aim was to (i) study the correlation between symptom severity of peach and fennel and (ii) identify fennel allergens and the role of rPru p 3 antibodies in severe reactions to fennel. In 148 patients with peach allergy, we investigated 58 patients with symptoms and IgE antibodies positive to fennel. IgE to rPru p 1, 3, and 4 and rBet v 1, 2, and 4 were measured by immunoblotting, and the N-terminal amino acid sequences and relevant allergens were determined. We found significant association between severe reactions to fennel and peach (p = 0.0009). A major allergen was ~9 kDa lipid-transfer protein (LTP), cross-reactive with Pru p 3, a 15 kDa protein identified as a pathogenesis-related protein 1 of the Bet v 1 family. In conclusion, peach and fennel severe allergic symptoms are significantly related, and LTP is a major fennel allergen. Fennel should be included in the LTP syndrome.

Tomato allergy: impact of genotype and environmental factors on the biological response

BACKGROUND

Food allergies are increasing in the European population. At present the onset of symptoms can be avoided only by elimination of a particular fruit or vegetable from the diet. A new approach is to develop hypoallergenic food products. This study characterises the allergenic potential of tomatoes, considering cultivation conditions, developmental stages and genotypes, in order to identify hypoallergenic fruits.

RESULTS

Patients with a history of tomato allergy were recruited for skin allergy tests. Tomatoes carrying distinct genotypes were grown under various cultivation conditions and harvested at different maturation stages. Cultivation conditions (nitrogen fertilisation, light exposure and plant nutrition) did not affect the skin reactivity in tomato-allergic patients. However, skin reactivity was significantly lower when using green-unripe compared with red-ripe tomatoes and when using landrace cultivars compared with cultivars bred for use in organic horticulture.

CONCLUSION

Depending on their genetic background and maturity level, some tomato cultivars elicit positive reactions in tomato-allergic patients in the skin allergy test. This novel finding should pave the way for the development of tomatoes with reduced allergenicity to relieve sufferers of tomato allergy.

Molecular diagnosis of fruit and vegetable allergy

PURPOSE OF REVIEW

The purpose of this paper is to review and discuss studies on molecular diagnosis in fruit and vegetable allergy.

RECENT FINDINGS

Celeriac, carrot and tomato are the most prevalent allergenic vegetables, whereas fruit allergy is mainly induced by apple, peach and kiwi. Component-resolved molecular diagnosis has been recently applied in two well-defined patient groups with kiwifruit and celeriac allergy, respectively. In kiwifruit allergy Act d 1 and Act d 3 were identified as potential marker allergens for severe symptoms. For celeriac allergy, however, such markers are still missing. In both studies component-resolved molecular diagnosis approach improved in particular sensitivity compared to extract-based diagnostic test assays.

SUMMARY

Food and vegetable allergy can be acquired both via a direct sensitization over the gastrointestinal tract and via a primary sensitization to pollen or latex. The diagnosis of fruit and vegetable allergy in birch pollen-sensitized patients should not be excluded on a negative IgE testing to extracts. Bet v 1-related allergens are often under-represented in extracts. Few recombinant allergens derived from fruits and vegetables are nowadays commercially available and facilitate diagnosis of fruit and vegetable allergies.

Allergenic activity of different tomato cultivars in tomato allergic subjects

BACKGROUND

Tomatoes (Solanum lycopersicum) are consumed worldwide and their amount of consumption is associated with the prevalence of tomato allergy. Therefore, identification of tomato cultivars with reduced allergenicity would potentially increase the quality of life of affected subjects.

OBJECTIVE

In this study, we examined the allergenic and biological activity of two different tomato cultivars in tomato allergic subjects.

METHODS

Twenty-five subjects with tomato allergy were identified using double-blind, placebo-controlled food challenges (DBPCFC). We applied skin prick test (SPT) and further DBPCFC to investigate the clinical differences between two tomato cultivars ('Reisetomate' and 'Matina'). To examine the molecular basis of allergenic activity, immunoblotting and basophil activation test (BAT) were performed.

RESULTS

The cultivar 'Reisetomate' induced significantly less positive skin reactions (P = 0.045) and elicited fewer symptoms after oral challenge compared with 'Matina' (P = 0.047). Molecular assessment revealed that IgE-binding profiles were variable on an interindividual basis, but no major differences between 'Reisetomate' and 'Matina' were detectable. In contrast, BAT underpinned the clinical differences evoked by the different tomato cultivars and showed a left-shift of the dose-response curve obtained for 'Matina' extract (P = 0.046).

CONCLUSIONS AND CLINICAL RELEVANCE

Tomato cultivars promote a distinct clinical reactivity in tomato allergic subjects, demonstrated using SPT, DBPCFC and BAT. The molecular background for these differences could not be clarified, as the IgE-binding profiles did not reveal significant alterations. This might be due to instabilities of physicochemical sensitive proteins and/or different isoform expression of allergens.

The role of lipid transfer proteins in allergic diseases

Nonspecific lipid transfer proteins (LTPs) are important allergens in fruits, vegetables, nuts, pollen, and latex. Despite their wide distribution throughout the plant kingdom, their clinical relevance is largely confined to the Mediterranean area. As they can sensitize via the gastrointestinal tract, LPTs are considered true food allergens, and IgE reactivity to LTPs is often associated with severe systemic symptoms. Although Pru p 3 represents the predominant LTP in terms of patients' IgE recognition, the contribution of pollen LTPs in primary sensitization cannot be ruled out. Due to structural homology, LTPs from different allergen sources are generally IgE cross-reactive. However, sensitization profiles among allergic patients are extremely heterogeneous, and individual cross-reactivity patterns can be restricted to a single LTP or encompass many different LTPs. Molecule-based approaches in allergy research and diagnosis are important for better understanding of LTP allergy and could assist clinicians with providing adequate patient-tailored advice.