Oral allergy syndrome by fruit and vegetable PR-10 allergy: Accuracy of in vivo diagnosis

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Cristina De Rose
Maria Letitzia Patti
Alessadro Gambacorta
Federica Brancato
Stefano Miceli Sopo


Component-resolved diagnosis, oral allergy syndrome, prick by prick, PR-10 allergy, skin prick test


Routine diagnostic methods for allergies to plant-derived foods are based on skin prick test (SPT) with commercial extracts, prick-by-prick (PbP) with fresh food, serum-specific IgE measurement, and oral food challenge.
We discuss the possibility and the advantages of performing, in patients with oral allergy syn-drome (OAS) by fruit and vegetables (excluding nuts) PR-10 allergy, component-resolved diag-nosis (CRD) by SPT and PbP with raw and cooked vegetables, rather than performing a CRD with in vitro tests by drawing blood.
Based on our clinical experience and the studies published in the literature, we believe that, at least for the OAS by fruit and vegetables (excluding nuts) PR-10 allergy, the search for sensitizing allergens and related cross-reactive allergens with SPT and PbP can be performed routinely in clinical practice, even at the primary-care level.

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1. Asero R, Jimeno L, Barber D. Component-resolved diagnosis of plant food allergy by SPT. Eur Ann Allergy Clin Immunol. 2008;40(N4):115–121.

2. Asero R, Mistrello G, Roncarolo D, de Vries SC, Gautier MF, Ciurana CL, et al. Lipid transfer protein: A pan-allergen in plant-derived foods that is highly resistant to pepsin digestion. Int Arch Allergy Immunol. 2000;122:20–32. https://doi.org/10.1159/000024355

3. Lehmann K, Schweimer K, Reese G, Randow S, Suhr M, Becker WM, et al. Structure and stability of 2S albumin-type peanut allergens: Implications to the severity of peanut allergic reactions. Biochem J. 2006;395:463–72. https://doi.org/10.1042/ BJ20051728

4. Ebisawa M, Ballmer-Weber BK, Vieths S, Wood RA (eds). Food allergy: Molecular basis and clinical practice. Chem Immunol Allergy. 2015;101:162–70. https://doi.org/10.1159/isbn.978-3-318-02341-1

5. Asero R. Plant food allergies: A suggested approach to allergen-resolved diagnosis in the clinical practice by identifying easily available sensitization markers. Int Arch Allergy Immunol. 2005;138:1–11. https://doi.org/10.1159/000087352

6. Asero R, Celi G, Scala E. Labile plant food allergens: Really so harmless? Case series and literature review. Allergy. 2020 Jun;75(6):1517-1518. https://doi.org/10.1111/all.14184

7. Alessandri C, Ferrara R, Bernardi ML, Zennaro D, Tuppo L, Giangrieco I. Diagnosing allergic sensitizations in the third millennium: Why clinicians should know allergen molecule structures. Clin Transl Allergy. 2017;17(7):21. https://doi. org/10.1186/s13601-017-0158-7

8. Tuppo L, Giangrieco I, Alessandri C, Ricciardi T, Rafaiani C, Ciancamerla M, et al. Pomegranate chitinase III: Identification of a new allergen and analysis of sensitization patterns to chitinases. Mol Immunol. 2018;103:89–95. https://doi.org/ 10.1016/j.molimm.2018.09.009

9. Asero R, Monsalvew R, Barber D. Profilin sensitization detected in the office by skin prick test: A study of prevalence and clinical relevance of profilin as a plant food allergen. Clin Experim Allergy. 2008;38:1033–7. https://doi.org/10.1111/j.1365-2222.2008.02980.x

10. Webber CM, Enland RW. Oral allergy syndrome: A clinical, diagnostic and therapeutic challenge. Ann Allergy Asthma Immunol. 2010;104:101–8. https://doi.org/10.1016/j.anai.2009.11.007