Skin Testing With Peach Peel Extract Versus Serum IgE to Pru p 3 as a Stronger Predictor of Peach-Induced Anaphylaxis

• Published in: Allergy, asthma & immunology research 2021, Asthma & Immunology Research, 13(6), , pp.922-932
• Main Authors: Somoza, Maria Luisa, Prieto-Moreno Pfeifer, Ana, Martín-Pedraza, Laura, Victorio Puche, Laura, Esteban Rodríguez, Angel, Blanca-López, Natalia, Eva Fernández González, Abel, Fernández-Caldas, Enrique, Morán Morales, Miriam, Fernández-Sánchez, Francisco Javier, López Sánchez, José Damián, Garrido-Lestache, José Luis Subiza, Canto, Gabriela, Blanca, Miguel
• Format: Article
• Language: English
• Subjects: Allergens; Anaphylaxis; Artemisia vulgaris; Brief Communication; Confidence intervals; Food; Food allergies; Food selection; Fruits; Immunoglobulin E; Olea europaea; Peanuts; Plant extracts; Platanus acerifolia; Prunus persica; Skin tests; Tomatoes; 내과학
• ISSN: 2092-7355; 2092-7363
• DOI: 10.4168/aair.2021.13.6.922

The most important peach fruit allergen is Pru p 3, followed by Pru p 1, Pru p 4, and Pru p 7. We aimed to assess their role in subjects with peach fruit-induced allergy (anaphylaxis and OAS) and compare skin prick tests (SPT) vs. specific immunoglobulin E (sIgE) for predicting anaphylaxis. We also selected a control group. SPT included prevalent inhalant and plant food allergens plus peach peel extract. The sIgE to Pru p 1, Pru p 3, Pru p 4, and Pru p 7 were quantified. Compared with controls (n = 42), cases (n = 41) were younger (P = 0.003), more frequently female (P < 0.05) and had higher SPT positivity to peach peel (44% vs. 2.4%, P < 0.0001). There were significant differences in sensitization to several pollens: Olea europaea, Artemisia vulgaris, Prunus persica, Platanus acerifolia (all P < 0.001); and fruits: apple (P < 0.04), peanut (P < 0.002), tomato (P < 0.005), and melon (P < 0.05). Pru p 3 sIgE was detected in 61% of all cases (85% anaphylaxis and 38% OAS; P < 0.01 each) and 5% of controls (P < 0.001). Pru p 4 sIgE was present in 19% of cases and 7% of controls. The sIgE to Pru p 1 and Pru p 7 were not found. The odds ratio to predict anaphylaxis for peach peel SPT was 113 (confidence interval [CI], 20–613; P < 0.0001); for sIgE to Pru p 3, 22 (CI, 5.3–93; P < 0.0001); and for SPT positivity to selected plant food allergens, 5 (CI, 1–19; P < 0.05). In our study group, SPT with peel peach extract was a better predictor of anaphylaxis than Pru p 3 sIgE or other variables considered. The role of sIgE to Pru p 1, Pru p 4, and Pru p 7 seemed negligible.