Art v 3 sensitization is associated with increased immunological complexity but not clinical severity in lipid transfer protein syndrome

SUMMARY

Background. Lipid transfer protein (LTP)–mediated food allergy represents one of the most severe and heterogeneous forms of IgE-mediated food allergy in Mediterranean populations. Although Pru p 3 is the main marker of LTP sensitization, the clinical relevance of pollen-derived LTPs such as Art v 3 remains incompletely defined. Methods. We conducted a retrospective observational study including 241 adult patients with LTP-mediated food allergy and confirmed sensitization to Pru p 3. Art v 3–specific IgE was determined using component-resolved diagnostics. Clinical severity was assessed using the Food Allergy Severity Score (FASS). Profilin sensitization was analyzed when available. Correlations were evaluated using Spearman’s coefficient. Results. Art v 3 sensitization was detected in 124 patients (51.5%). A higher proportion of moderate-to-severe reactions (FASS ≥ 3) was observed in Art v 3–sensitized patients compared with non-sensitized patients (64.0% vs 56.3%), although this difference did not reach statistical significance (OR = 1.38; 95% CI: 0.82–2.31). A statistically significant but low positive correlation was observed between Art v 3– and Pru p 3–specific IgE levels (Spearman’s ρ = 0.46). Profilin sensitization was not associated with clinical severity (p = 0.36). Conclusions. Art v 3 sensitization is associated with a more complex immunological profile rather than acting as an independent predictor of clinical severity. Its clinical value may lie in risk stratification. Prospective studies are needed.

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