Improving In Vitro Detection of Sensitization to Lipid Transfer Proteins: A New Molecular Multiplex IgE Assay

Abstract

ScopeLTP‐syndrome is characterized by sensitization (IgE) to multiple non‐specific lipid transfer proteins (nsLTPs) with a variable clinical outcome. The treatment is primarily based on offending food avoidance. However, the determination of Pru p 3‐specific IgE is currently the main diagnostic tool to assess sensitization to nsLTPs. Herein, the study evaluates improvement of LTP‐syndrome diagnosis and clinical management using a new IgE multiplex‐immunoblot assay with a high diversity of food nsLTPs.Methods and resultsAn EUROLINE‐LTP strip with 28 recombinant nsLTPs from 18 allergenic sources is designed. In total the study investigates 38 patients with LTP‐syndrome and compares results from the nsLTPs (LTP‐strip) with the respective food extracts of Prick‐by‐prick (PbP) testing. The agreement exceeds 70% for most nsLTPs, e.g., Pru p 3 (100%), Mal d 3 (97%), Pru av 3 (89%), Pha v 3 isoforms (87%/84%), Ara h 9 (82%), Cor a 8 (82%), and Jug r 3 (82%). The functionality and allergenic relevance of nine recombinant nsLTPs are proven by Basophil activation testing (BAT).ConclusionsThe new IgE multiplex‐immunoblot nsLTP assay shows a good diagnostic performance allowing culprit food assessment. Negative results from LTP‐strip may indicate potentially tolerable foods, improving diet intervention and patients’ quality of life.