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Original Article


Sublingual Immunotherapy in Peach Allergy: Monitoring Molecular Sensitizations and Reactivity to Apple Fruit and Platanus Pollen


BE García,1 E González-Mancebo,2* D Barber,3 S Martín,3 AI Tabar,1 MªD Alonso Díaz de Durana,2 S Garrido-Fernández,1† G Salcedo,4 P Rico,3 M Fernández-Rivas2†

1Servicio de Alergia, Hospital Virgen del Camino, Pamplona, Spain
2Unidad de Alergia, Fundación Hospital Alcorcón, Alcorcón, Spain
3ALK-Abelló, S.A., Madrid, Spain
4Unidad de Bioquímica, Departamento de Biotecnología, ETS Ingenieros Agrónomos, Madrid, Spain
*Present address: Unidad de Alergia, Hospital de Fuenlabrada, Fuenlabrada, Spain
†Present address: Servicio de Alergia, Hospital Clínico San Carlos, Madrid, Spain

J Investig Allergol Clin Immunol 2010; Vol. 20(6): 514-520



Background: Peach allergy is prevalent, persistent, and potentially severe and as such is a target for immunotherapy. Our aims were to evaluate the profile of sensitization to Rosaceae allergens and the effects of sublingual peach immunotherapy on immunoglobulin (Ig) E levels to these allergens, to monitor for neosensitizations, and to check if this treatment modified other Rosaceae fruit and pollen-related sensitizations.

Methods: A double-blind placebo-controlled trial was conducted on 56 peach-allergic patients who received, sublingually, a standardized peach extract quantifi ed in mass units of Pru p 3, or placebo for 6 months. IgE to recombinant (r) Mal d 1, rMal d 4, rPru p 3, and natural (n) Art v 3 and skin prick test (SPT) reactivity to Platanus pollen and apple extracts evaluated before treatment (T0), after 1 month (T1) and after and 6 months (T6) were recorded.

Results: In total, 18.5% of patients recognized rMal d 1, 83.3%, rPru p 3, 24.1%, rMal d 4, and 25.9% nArt v 3. IgE to Pru p 3 rose from T0 to T1 in both the active group (P=.003) and the placebo group (P=.022), and remained elevated at T6 in the active group (P=.001).
IgE to other purified allergens did not change significantly and no relevant neosensitizations were detected. SPT reactions to peach decreased from T0 to T6 in the active group (P<0.05). Reactivity to peach (T1 and T6) and apple (T6) was lower in the active group than in the control group.

Conclusions: The main allergen was Pru p 3. Changes in rPru p 3 IgE levels and in peach and apple extract SPT were induced by sublingual immunotherapy.

Key words: Food allergy. Immunotherapy. Sublingual immunotherapy. Food allergens. Peach. Food immunotherapy. Molecular allergens.