Abstract：
BACKGROUND: Allergy to peanuts and tree nuts is a common cause of food allergy in Spain, with lipid transfer proteins (LTP) being the most frequently recognized panallergen. LTP sensitization often leads to multiple food group sensitivities, resulting in overly restrictive diets that hinder patient\'s quality of life. This study aimed to assess the tolerance of peanuts and tree nuts (hazelnuts and walnuts) in children sensitized to LTP, potentially mitigating the need for such diets.
METHODS: This prospective study enrolled individuals diagnosed with allergy to peanuts, hazelnuts, or walnuts. Data were collected from medical records, including demographics and clinical history. Allergological assessment comprised skin prick tests using commercial extracts and the nuts in question, alongside measurements of total and specific IgE to nuts and their primary molecular components. Participants showing positive LTP sensitization without sensitization to seed storage proteins underwent open oral nut challenges.
RESULTS: A total of 75 individuals labeled as allergic to peanuts, 44 to hazelnuts, and 51 to walnuts were included. All of them underwent an open oral provocation test with the incriminated nut, showing a high tolerance rate. Peanut was tolerated by 98.6% of patients, 97.72% tolerated hazelnut, and 84.3% tolerated walnut.
CONCLUSIONS: The findings suggest that the majority of patients allergic to peanuts, hazelnuts, or walnuts, due to LTP sensitization and lacking IgE reactivity to seed storage proteins, can tolerate these nuts. This supports the need for personalized nut tolerance assessments to avoid unnecessary dietary restrictions.
METHODS: This prospective study enrolled individuals diagnosed with allergy to peanuts, hazelnuts, or walnuts. Data were collected from medical records, including demographics and clinical history. Allergological assessment comprised skin prick tests using commercial extracts and the nuts in question, alongside measurements of total and specific IgE to nuts and their primary molecular components. Participants showing positive LTP sensitization without sensitization to seed storage proteins underwent open oral nut challenges.
RESULTS: A total of 75 individuals labeled as allergic to peanuts, 44 to hazelnuts, and 51 to walnuts were included. All of them underwent an open oral provocation test with the incriminated nut, showing a high tolerance rate. Peanut was tolerated by 98.6% of patients, 97.72% tolerated hazelnut, and 84.3% tolerated walnut.
CONCLUSIONS: The findings suggest that the majority of patients allergic to peanuts, hazelnuts, or walnuts, due to LTP sensitization and lacking IgE reactivity to seed storage proteins, can tolerate these nuts. This supports the need for personalized nut tolerance assessments to avoid unnecessary dietary restrictions.
摘要：
背景：对花生和树坚果的过敏是西班牙食物过敏的常见原因，脂质转移蛋白（LTP）是最常见的全变应原。LTP致敏通常导致多种食物组敏感性，导致过度限制饮食，阻碍患者的生活质量。这项研究旨在评估对LTP敏感的儿童对花生和坚果（榛子和核桃）的耐受性，有可能减轻对这种饮食的需求。
方法：这项前瞻性研究招募了被诊断为对花生过敏的个体，榛子,或者核桃.数据是从医疗记录中收集的，包括人口统计学和临床病史。过敏评估包括使用商业提取物和相关坚果的皮肤点刺测试，以及对坚果及其主要分子成分的总IgE和特异性IgE的测量。表现出积极的LTP致敏而没有对种子储存蛋白致敏的参与者接受了开放的口服坚果挑战。
结果：共有75人被标记为对花生过敏，44到榛子，包括51个核桃。他们都接受了与有罪的坚果的公开口头挑衅测试，表现出较高的容忍率。98.6%的患者对花生耐受,97.72%耐受榛子，84.3%耐受核桃。
结论：研究结果表明，大多数对花生过敏的患者，榛子,或者核桃,由于LTP致敏和缺乏对种子储存蛋白的IgE反应性，可以忍受这些坚果。这支持需要个性化的坚果耐受性评估，以避免不必要的饮食限制。
方法：这项前瞻性研究招募了被诊断为对花生过敏的个体，榛子,或者核桃.数据是从医疗记录中收集的，包括人口统计学和临床病史。过敏评估包括使用商业提取物和相关坚果的皮肤点刺测试，以及对坚果及其主要分子成分的总IgE和特异性IgE的测量。表现出积极的LTP致敏而没有对种子储存蛋白致敏的参与者接受了开放的口服坚果挑战。
结果：共有75人被标记为对花生过敏，44到榛子，包括51个核桃。他们都接受了与有罪的坚果的公开口头挑衅测试，表现出较高的容忍率。98.6%的患者对花生耐受,97.72%耐受榛子，84.3%耐受核桃。
结论：研究结果表明，大多数对花生过敏的患者，榛子,或者核桃,由于LTP致敏和缺乏对种子储存蛋白的IgE反应性，可以忍受这些坚果。这支持需要个性化的坚果耐受性评估，以避免不必要的饮食限制。
