@article{2999817,
    title = "The diagnosis and management of allergic reactions in patients sensitized to non-specific lipid transfer proteins",
    author = "Skypala, I.J. and Bartra, J. and Ebo, D.G. and Antje Faber, M. and Fernández-Rivas, M. and Gomez, F. and Luengo, O. and Till, S.J. and Asero, R. and Barber, D. and Cecchi, L. and Diaz Perales, A. and Hoffmann-Sommergruber, K. and Anna Pastorello, E. and Swoboda, I. and Konstantinopoulos, A.P. and van Ree, R. and Scala, E. and European Academy of Allergy & Clinical Immunology (EAACI) Task Force: Non-specific Lipid Transfer Protein Allergy Across Europe",
    journal = "Allergy: European Journal of Allergy and Clinical Immunology",
    year = "2021",
    volume = "76",
    number = "8",
    pages = "2433-2446",
    publisher = "John Wiley and Sons Inc",
    doi = "10.1111/all.14797",
    keywords = "alcohol;  food allergen;  nonsteroid antiinflammatory agent;  recombinant allergen;  sterol carrier protein 2;  allergen;  immunoglobulin E;  lipid;  plant antigen;  plant protein, allergic reaction;  Cannabis sativa;  diagnostic accuracy;  diet therapy;  disease severity;  exercise;  food allergy;  human;  immunotherapy;  peach;  pollen allergy;  Review;  risk factor;  sensitization;  symptom;  cross reaction;  food allergy, Allergens;  Antigens, Plant;  Cross Reactions;  Food Hypersensitivity;  Humans;  Immunoglobulin E;  Lipids;  Plant Proteins",
    abstract = "Sensitization to one or more non-specific lipid transfer proteins (nsLTPs), initially thought to exist mainly in southern Europe, is becoming accepted as a cause of allergic reactions to plant foods across Europe and beyond. The peach nsLTP allergen Pru p 3 is a dominant sensitizing allergen and peaches a common food trigger, although multiple foods can be involved. A frequent feature of reactions is the requirement for a cofactor (exercise, alcohol, non-steroidal anti-inflammatory drugs, Cannabis sativa) to be present for a food to elicit a reaction. The variability in the food and cofactor triggers makes it essential to include an allergy-focused diet and clinical history in the diagnostic workup. Testing on suspected food triggers should also establish whether sensitization to nsLTP is present, using purified or recombinant nsLTP allergens such as Pru p 3. The avoidance of known trigger foods and advice on cofactors is currently the main management for this condition. Studies on immunotherapy are promising, but it is unknown whether such treatments will be useful in populations where Pru p 3 is not the primary sensitizing allergen. Future research should focus on the mechanisms of cofactors, improving diagnostic accuracy and establishing the efficacy of immunotherapy. © 2021 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd."
}