Efectividad, tolerabilidad, evolución de parámetros in vitro y calidad de vida en pacientes sensibilizados a proteínas transportadoras de lípidos (LTPs) tras 3 años de tratamiento con inmunoterapia específica

Abstract

INTRODUCTION: Lipid transporter proteins (LTPs) are currently one of the most important causes of severe food allergy induced by plant foods, which is included within what is known as LTP syndrome. The clinical variability that the LTP syndrome presents and its great molecular heterogeneity, make this pathology a wide field of study. The LTP syndrome is an increasingly prevalent disease, especially in the young population in which their quality of life is affected by the importance of the condition and the related symptoms. Since 2015 there has been a specific treatment for LTP syndrome (SLIT-peach®) but until now there were no long-term effectiveness studies or controls on the quality of life of patients, so this study has been carried out where the clinical evolution of patients has been related with analytical parameters and with specific food allergy quality of life tests. OBJECTIVES: The main objective of this study is to assess the long-term effectiveness of SLIT-peach® and to relate the clinical evolution of the patients with specific analytical parameters and quality of life tests. MATERIAL AND METHODS: It is an observational and ambispective study during a period of 3 years of treatment and a subsequent year of follow-up. 25 patients from the Allergology Service of the Reina Sofía General Hospital of Murcia diagnosed with LTP syndrome have been selected, who received treatment with SLIT-peach® for 3 years. They were performed a provocation test the first year and reintroduced foods that had previously produced symptoms. Analytical determinations of specific IgE to Pru p 3 and IgG4 specific to Pru p 3 were also performed at the beginning, one year of initiation and at the end of the treatment and specific quality of life tests for food allergies (S-FAQLQ-AF) at the beginning, at the end and one year after stopping treatment. All these data were compared with the control group, made up of 14 patients with LTP syndrome who had not received treatment. RESULTS: The patients in the active group were performed a provocation test one year after treatment, with negative results for all of them, being able to reintroduce foods that previously produced symptoms, without problems. A statistically significant decrease in Pru p 3 specific IgE and an increase Pru p 3 specific IgG4 were also observed in the active group, in relation to tolerance to foods with LTP. The patients in the active group also presented a significant improvement in the quality of life test score after treatment, progressive one year after the end of treatment, with no such improvement being observed in the control group. CONCLUSION: Treatment with SLIT-peach® for 3 years is effective for patients with LTP syndrome, preventing the evolution of the disease, allowing patients to restart a diet with plant foods with which they previously had severe symptoms of food allergy and in consequently improving their quality of life globally.