Efficacy and safety of allergen immunotherapy in lipid transfer protein food allergy: An updated systematic review.
Magdalena Rydzyńska, Tomasz Rosada, Bernadetta Kosztulska et al.
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In 30 seconds
This updated systematic review assessed sublingual and oral Pru p 3-based immunotherapy for patients with lipid transfer protein (LTP)-mediated food allergy. It included 15 studies, most observational and conducted in Mediterranean countries. The available evidence suggests immunotherapy may raise the threshold for clinical reactions to peach and may improve tolerance to other LTP-containing foods in some patients, alongside changes in Pru p 3-specific IgE and IgG4. The review did not report a pooled quantitative effect; heterogeneity and few controlled trials limit confidence in these findings.
Key findings
- The review included 15 studies; most were observational and conducted in Mediterranean countries.
- Sublingual and, less often, oral immunotherapy may increase the clinical reactivity threshold to peach.
- Some patients may improve tolerance to other LTP-containing foods, with accompanying changes in Pru p 3-specific IgE and IgG4.
Why it matters
LTP allergy can involve systemic and cofactor-dependent reactions, while therapeutic options are limited. This review brings together evidence suggesting a possible immunotherapy benefit, but its low certainty means the findings do not establish efficacy or define which patients are most likely to benefit.
What to keep in mind
Study designs, outcome assessments, and immunotherapy protocols varied substantially, and controlled trials were limited, restricting the strength of the evidence.