Molecular Profiles of Sensitization to Non-Specific Lipid Transfer Proteins in Lithuania: Single Center Experience

Abstract

Non-specific Lipid Transfer proteins (nsLTPs) are relevant allergens of several pollens and plant foods. Sensitization to nsLTPs is not typical in our region. Still, it has become an increasingly common cause of IgE-mediated food allergies and food-induced anaphylaxis in Northern Europe in recent decades. No in-depth studies describe the prevalence of sensitization of molecular components to nsLTPs in Lithuania. This study aimed to determine the sensitization profile of atopic patients at the Immunology and Allergy Department of Kauno Klinikos to the components of nsLTPs, using molecular allergen component analysis. Sixty Lithuanian adults with symptoms of allergic rhinitis and/or allergic asthma and/or food allergies were included into the study. Specific immunoglobulin E (IgE) levels were measured using two in vitro techniques: allergen extract and molecular component analysis. Results showed that 25% of subjects were sensitized to nsLTP-containing allergen sources, mostly to Zea m 14, Mal d 3, Vit v 1, and Art v 3. The median amount of total IgE was higher in nsLTP-sensitized patients than in nsLTP-nonsensitized patients. Based on Cohen's Kappa and McNemar tests, the results of allergen extract and component analysis tests do not always agree, especially when we determine the sensitization to allergen sources containing nsLTPs. Molecular allergen component analysis could be the first choice in determining detailed sensitization to nsLTPs in patients who experienced anaphylaxis of unknown origin.

Keywords: allergen extracts; anaphylaxis; food allergy; molecular allergy diagnostics; nsLTP; sensitization; systemic reactions.

Figure 1

The prevalence of sensitization of the whole allergen source (a) and their separate molecular components (b) in studied group. Cases of sensitization indicated in both parts—%.

Figure 2

The prevalence of sensitization to nsLTP-containing allergen sources (a) and to different nsLTPs (b). Data presented as percentage of the whole group (a) and percentage of nsLTP-sensitized subjects (b).

Figure 3

The amount of total IgE in nsLTP-sensitized subjects or without sensitization to nsLTPs (minimum data value, lower quartile value, median value, upper quartile value, maximum data value, outliers).

Figure 4

The sensitization profiles to nsLTP components. Different patients indicated as (A–O). The concentration of sIgE up to 5 kUA/L (A–I), up to 15 kUA/L (J–L), and up to 50 (M–O).