Efficacy and safety of allergen immunotherapy in lipid transfer protein food allergy: an updated systematic review.

Authors

Magdalena Rydzyńska, Tomasz Rosada, Bernadetta Kosztulska, Magdalena Grześk-Kaczyńska, Natalia Ukleja-Sokołowska

Published in

Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology. Aug 02, 2026. Epub Aug 02, 2026.

Abstract

Lipid transfer protein (LTP) allergy is a clinically relevant phenotype of IgE-mediated food allergy, particularly prevalent in Mediterranean populations and frequently associated with systemic and cofactor-dependent reactions. Therapeutic options remain limited, and the role of allergen immunotherapy is not well established.
To provide an updated systematic review of the efficacy and safety of Pru p 3-based immunotherapy in LTP-mediated food allergy.
A systematic literature search was conducted to identify studies published up to March 2026 evaluating sublingual (SLIT) or oral immunotherapy (OIT) in patients with LTP allergy. Eligible studies were analyzed qualitatively with respect to clinical outcomes, immunological parameters, and safety.
Fifteen studies were included, the majority observational and conducted in Mediterranean countries. Available data suggest that SLIT and, less frequently, OIT may increase the threshold of clinical reactivity to peach and, in some patients, improve tolerance to other LTP-containing foods. These effects are accompanied by changes in Pru p 3-specific IgE and IgG4 levels. However, substantial heterogeneity in study design, outcome assessment, and immunotherapy protocols, as well as the limited number of controlled trials, restrict the strength of the evidence.
Pru p 3-based immunotherapy appears promising for selected patients with LTP allergy; however, the overall certainty of evidence remains low. Well-designed randomized controlled trials with standardized outcome measures are needed to define its role in clinical practice.

PMID:
42543147
Bibliographic data and abstract were imported from PubMed on 03 Aug 2026.

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