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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

1
Allergy Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
2Health Research Institute Princesa, Madrid, Spain
3Center 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) : 1-12
doi: 10.18176/jiaci.0193

Profilin is a protein that is present in all eukaryotic cells and is responsible for 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 provide a comprehensive review of 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. Although present in all pollens and vegetables, profilin is significantly associated with allergy to grass pollen and to Cucurbitaceae fruits. Heb v 8, the latex profilin, is usually a marker of profilin allergy in plant food–allergic patients, although it has no clinical relevance in latex allergy. Sensitization to profilin jeopardizes the diagnosis of pollen allergy and selection of immunotherapy, 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 a marker of severity, an allergen capable of inducing respiratory symptoms, and, in its natural purified form, a potential candidate for etiological treatment of food allergy.
Current data on profilin strongly support the need for a shift in the previously accepted paradigm for this allergen. More research should be done to assess the real clinical impact of sensitization in specific populations and to develop therapeutic strategies.

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