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Profilin, a change in the paradigm

Rodríguez del Río P1,2, Díaz-Perales A3,4, Sánchez-García S1,2, Escudero C1,2, Ibáñez MD1,2, Méndez-Brea P1,2,5, Barber D6

1Allergy Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
2Health Research Institute Princesa, Madrid, Spain
3Centre for Plant Biotechnology and Genomics (UPM-INIA), Pozuelo de Alarcon, Madrid, Spain
4Department of Biotechnology and Plant Biology, ETSIAAB, Technical University of Madrid, Spain
5Allergy Department, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
6IMMA. Facultad de Medicina. Universidad CEU San Pablo, Madrid, Spain

J Investig Allergol Clin Immunol 2018; Vol. 28(1)
doi: 10.18176/jiaci.0193

Profilin is a protein present in all eukaryotic cells, and is responsible for the cross-reactivity between pollen, latex and plant foods. It has been classically acknowledged as a minor or nearly irrelevant allergen, although recent data are changing this conception. The objective of this manuscript is to comprehensively review the published data on the role of this ubiquitous allergen in pollen, latex and plant food allergy.
The patterns of recognition of this minor allergen follow a north-south gradient, and although present in all pollens and vegetables, it is significantly associated with grass pollen and Cucurbitaceae fruits. Heb v 8, the latex profilin, is usually a marker of profilin allergy in plant food allergic patients, but has no clinical relevance in latex allergy. Profilin sensitization jeopardizes pollen allergy diagnosis and immunotherapy selection, and although component resolved diagnosis can identify its impact, there are no tailored treatments available. In recent years, several new publications have shown how profilin should be taken into account and, under certain circumstances, considered as a severity marker, an allergen capable of inducing respiratory symptoms and, in its natural purified form, a potential candidate for etiological food allergy treatment.
Current data on profilin strongly support the need for a shift in the previously accepted concept of this allergen. More research should be done to assess the real clinical impact of this sensitization in specific populations and to develop therapeutic strategies. 

Key words: Profilin, Phl p 12, Bet v 2, Allergy, Food Allergy, Asthma, Immunotherapy, Allergen