Fruit and Vegetable Allergy
Fruit and Vegetable Allergy
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DOI：
10.1159/000375469
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发表时间：
2015-01-01
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影响因子：
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通讯作者：
Fernandez-Rivas, Montserrat
中科院分区：
文献类型：
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作者：
Fernandez-Rivas, Montserrat
水果和蔬菜过敏是青少年和成人中最常见的食物过敏。鉴定所涉及的过敏原并阐明其内在特性和交叉反应模式有助于理解致敏机制以及过敏原谱如何决定不同的表型。最常见的水果和蔬菜过敏是花粉食物综合征（PFS）和脂质转移蛋白（LTP）综合征。在PFS中，水果和蔬菜过敏是由对不稳定的花粉过敏原（如Bet v 1或profilin）的原发性致敏引起的，并且所产生的表型主要是轻度的，由局部口咽反应组成。相比之下，LTP综合征是由对LTP的初级致敏引起的，LTP是稳定的植物性食物过敏原，诱导频繁的全身反应甚至过敏反应。虽然不那么普遍，但严重的水果过敏可能与乳胶有关（乳胶-水果综合征）。分子诊断对于指导这些患者的管理和风险评估至关重要。目前的管理策略包括避免和补救药物，包括肾上腺素，严重的LTP过敏。花粉特异性免疫疗法不适用于治疗花粉-食物综合征，但LTP舌下免疫疗法似乎是LTP综合征的一种有前途的治疗方法。(C)2015 S. Karger AG，巴塞尔
Fruit and vegetable allergies are the most prevalent food allergies in adolescents and adults. The identification of the allergens involved and the elucidation of their intrinsic properties and cross-reactivity patterns has helped in the understanding of the mechanisms of sensitisation and how the allergen profiles determine the different phenotypes. The most frequent yet contrasting fruit and vegetable allergies are pollen-food syndrome (PFS) and lipid transfer protein (LTP) syndrome. In PFS, fruit and vegetable allergies result from a primary sensitisation to labile pollen allergens, such as Bet v 1 or profilin, and the resulting phenotype is mainly mild, consisting of local oropharyngeal reactions. In contrast, LTP syndrome results from a primary sensitisation to LTPs, which are stable plant food allergens, inducing frequent systemic reactions and even anaphylaxis. Although much less prevalent, severe fruit allergies may be associated with latex (latex-fruit syndrome). Molecular diagnosis is essential in guiding the management and risk assessment of these patients. Current management strategies comprise avoidance and rescue medication, including adrenaline, for severe LTP allergies. Specific immunotherapy with pollen is not indicated to treat pollen-food syndrome, but sublingual immunotherapy with LTPs seems to be a promising therapy for LTP syndrome. (C) 2015 S. Karger AG, Basel