Outcome and safety of double-blind, placebo-controlled food challenges in 111 patients sensitized to lipid transfer proteins

摘要

Fruits are the foods most frequently involved in allergic reactions in adults and older children in the Mediterranean area.1'2 In this area, Rosacea fruits, and especially peach, are the fruits most commonly involved,2 and their major allergens are the lipid transfer proteins (LTPs).3 These proteins have a molecular weight of 9 kd and a compact structure stabilized by 4 disulfide bridges that confer a high stability, a characteristic thought to be essential to induce systemic symptoms on oral in-gestion.4 Indeed, sensitization to Mai d 3, the apple LTP, has been shown to be a risk factor for systemic reactions.5 For these reasons, although food challenges, particularly the double-blind placebo-controlled food challenges (DBPCFCs), are the gold standard for diagnosing food allergy, their performance in patients with food allergy sensitized to LTPs has been considered too hazardous, and it has even been recommended to avoid them.