Clinical Management of Plant Food Allergy in Patients Sensitized to Lipid Transfer Proteins Is Heterogeneous: Identifying the Gaps.

Autor:	García BE; Department of Allergology, Hospital Universitario de Navarra, Pamplona, Spain.; Health Research Institute (IDISNA, Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain.; CIBER de Enfermedades Respiratorias (CIBERES), Spain., Mateo-Borrega MB; Allergy Department, Hospital Universitario de Guadalajara, Guadalajara, Spain.; RICORS Red de Enfermedades Inflamatorias (REI) - RD21/0002/0028, Madrid, Spain., Garrido S; Department of Allergology, Hospital Universitario de Navarra, Pamplona, Spain., D Amelio CM; Health Research Institute (IDISNA, Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain.; RICORS Red de Enfermedades Inflamatorias (REI) - RD21/0002/0028, Madrid, Spain.; Department of Allergy and Clinical Immunology, Clínica Universidad de Navarra, Pamplona, Spain., Compés E; Allergy Unit, Royo Villanova Hospital, Zaragoza, Spain., Villarreal O; Allergy Unit, Hospital Universitario de Álava, Vitoria, Spain., García-Núñez I; Allergy Unit, Quirón Salud Córdoba, Córdoba, Spain.; Allergy Service Quirón Salud Campo de Gibraltar, Palmones, Spain., Goikoetxea MJ; Health Research Institute (IDISNA, Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain.; RICORS Red de Enfermedades Inflamatorias (REI) - RD21/0002/0028, Madrid, Spain.; Department of Allergy and Clinical Immunology, Clínica Universidad de Navarra, Pamplona, Spain.
Jazyk:	angličtina
Zdroj:	Journal of investigational allergology & clinical immunology [J Investig Allergol Clin Immunol] 2024 Dec 03; Vol. 34 (6), pp. 395-403. Date of Electronic Publication: 2023 Oct 18.
DOI:	10.18176/jiaci.0947
Abstrakt:	Background and Objectives: Patients sensitized to lipid transfer protein (LTP) are characterized by wide clinical variability. The lack of practical diagnostic and therapeutic guidelines complicates their management. The aim of the study was to describe the clinical approach of Spanish allergists to sensitization to LTP. Methods: We used a survey designed following the PICO method and subsequent validation using the Delphi approach. Results: The survey was completed by 224 allergists (75% women; 57.1% with >20 years of professional experience). Clinical practice for the main points of diagnosis of LTP allergy was homogeneous, except for patients with suspected hypersensitivity to nonsteroidal anti-inflammatory drugs (44.6% frequently included skin testing with LTP). Oral food challenges were not frequently performed (63.6% occasionally to never) and were generally (75.5%) used to confirm tolerance. It was common to recommend fruit skin avoidance (77.2%) and to maintain consumption of foods to which patients were sensitized but tolerant (99.1%). The results were heterogeneous for other dietary indications, modifications due to cofactors, and trace avoidance. Peach sublingual immunotherapy (SLIT) was considered very/quite effective by 55.9% of allergists. Most (79.5%) consider SLIT indicated in <25% of LTP-allergic patients based on severity (95.2%), frequency of reactions (99.4%), allergy to multiple food families (97.4%), and impairment of quality of life/nutrition (91.5%). Practice with respect to prescription of SLIT varied based on cofactor involvement. Conclusions: These data suggest that there is a need to increase evidence to reduce heterogeneity in the clinical management of LTP allergy.
Databáze:	MEDLINE
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