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. 2022 Apr 5:3:868267.
doi: 10.3389/falgy.2022.868267. eCollection 2022.

Low Levels Matter: Clinical Relevance of Low Pru p 3 sIgE in Patients With Peach Allergy

Sara Balsells-Vives  1 , Clara San Bartolomé  1   2 , Rocío Casas-Saucedo  1   3   4 , María Ruano-Zaragoza  1   3   4 , Josefina Rius  2 , Maria Torradeflot  2 , Joan Bartra  1   3   4 , Rosa Munoz-Cano  1   3   4 , Mariona Pascal  1   2   4
Affiliations

Low Levels Matter: Clinical Relevance of Low Pru p 3 sIgE in Patients With Peach Allergy

Sara Balsells-Vives et al. Front Allergy. .

Abstract

Many clinical lab settings still use 0.35 KUA/L as the cut-off for serum specific-IgE (sIgE) immunoassays, while the detection limit is 0.1 KUA/L. The clinical relevance of -low-level sIgE (0.1-0.35 KUA/L) remains controversial. Pru p 3 sIgE is considered to be the main routine tool for assessing lipid transfer protein (LTP) sensitization. We aimed to evaluate the clinical relevance of Pru p 3 sIgE low levels in a population diagnosed with LTP allergy. Adults diagnosed with LTP allergy and Pru p 3 sIgE ≥ 0.1 KUA/L between 2012 and 2019 were included. Clinical data were reviewed. nPru p 3 basophil activation test (BAT) was performed and basophil reactivity (BR) and sensitivity (BS) correlated with the peach allergy symptoms. Pru p 3 sIgE from 496 subjects was recorded, 114 (23.0%) between 0.1 and 0.34 KUA/L (grLOW), the rest ≥ 0.35 KUA/L (grB). A total of 44.7% in grLOW and 59.9% in grB were allergic. Urticaria was more frequent in grLOW. In grLOW, Pru p 3 sIgE was higher in patients with local compared with systemic symptoms. In grB, Pru p 3 sIgE was higher in allergic patients. Pru p 3/Total IgE ratios were higher in allergic vs. tolerant in both groups. In BAT, BR was similar in both groups. In grLOW, it was higher on allergic compared with tolerant (p = 0.0286), and on those having systemic vs. local symptoms (p = 0.0286). BS showed no significant difference between groups. Patients with low levels represent a non-negligible fraction and around 45% are peach allergic. BAT showed functional sIgE in them. Pru p 3 sensitizations should be carefully evaluated even when sIgE levels are low.

Keywords: BAT; clinical relevance; lipid transfer protein; low levels; serum specific-IgE.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Levels of Pru p 3 sIgE per group. Pru p 3 sIgE distribution, median, and IQR (interquartile range) values from grLOW (A) and grB (B) according to symptom classification (tolerance vs. allergy, local vs. systemic). The Mann–Whitney test was used to test p (*0.01 to 0.05, ***0.0001 to 0.001).
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References

    1. Frischmeyer-Guerrerio PA, Rasooly M, Gu W, Levin S, Jhamnani RD, Milner JD, et al. . IgE testing can predict food allergy status in patients with moderate to severe atopic dermatitis. Ann Allergy Asthma Immunol. (2019) 122:393–400.e2. 10.1016/j.anai.2019.01.001 - DOI - PMC - PubMed
    1. Nilsson SF, Lilja G, Järnbert-Pettersson H, Alm J. Relevance of low specific IgE levels to egg, milk and peanut in infancy. Clin Exp Allergy. (2019) 49:308–16. 10.1111/cea.13273 - DOI - PubMed
    1. Cuomo B, Indirli GC, Bianchi A, Arasi S, Caimmi D, Dondi A, et al. . Specific IgE and skin prick tests to diagnose allergy to fresh and baked cow's milk according to age: a systematic review. Ital J Pediatr. (2017) 43:93. 10.1186/s13052-017-0410-8 - DOI - PMC - PubMed
    1. Pastorello EA, Farioli L, Pravettoni V, Scibilia J, Mascheri A, Borgonovo L, et al. . Pru p 3-sensitised Italian Peach-allergic patients are less likely to develop severe symptoms when also presenting IgE antibodies to Pru p 1 and Pru p 4. Int Arch Allergy Immunol. (2011) 156:362–72. 10.1159/000324440 - DOI - PubMed
    1. Skypala IJ, Bartra J, Ebo DG, Antje Faber M, Fernández-Rivas M, Gomez F, et al. . The diagnosis and management of allergic reactions in patients sensitized to non-specific lipid transfer proteins. Allergy. (2021) 76:2433–46. 10.1111/all.14797 - DOI - PubMed