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Sensitization to Gibberellin-Regulated Protein (Peamaclein) Among Italian Cypress Pollen–Sensitized Patients

Asero R1, Abbadessa S2, Aruanno A3, Barilaro G4, Barzaghi C4, Bignardi D5, Bilò MB6, Borro M7, Bresciani M8, Busa M9,10, Buzzulini F11, Cavaliere C12, Cecchi L13, Ciccarelli A14, Cortellini G15, Cucinelli F16, Deleonardi G17, Emiliani F18, Farsi A13, Ferrarini E19, Franchini M20, Ingrassia A21, Lippolis D15, Losappio L22, Marra AM4, Martini M23, Masieri S24, Mauro M25, Mazzolini M26, Muratore L27, Murzilli F16, Nucera E3, Pastorello EA22, Pinter E28, Polillo BR29, Pravettoni V30, Quercia O18, Rizzi A3, Russello M25, Sacerdoti C31, Scala E32, Scala G14, Scarpa A10, Schroeder J22, Uasuf CG33, Villalta D11, Yang B28, Mistrello G34, Amato S34, Lidholm J35

1Ambulatorio di Allergologia, Clinica San Carlo, Paderno Dugnano (MI), Italy
2Scuola di Medicina, Dipartimento di Medicina di Precisione, Università degli Studi della Campania "Luigi Vanvitelli", Napoli, Italy
3Fondazione Policlinico Universitario A. Gemelli-IRCCS, Roma, Italy
4Ambulatorio di Allergologia e Immunologia Clinica, ASST-Rhodense, PO Rho, Rho (MI), Italy
5UOC Allergologia, Ospedale Policlinico San Martino, Genova, Italy
6Unità di Allergologia, Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche – Dipartimento di Medicina Interna, Ospedali Riuniti, Ancona, Italy
7Unità di Immunologia Clinica, Dipartimento di Medicina Interna, Università di Genova –Ospedale Policlinico San Martino, Genova, Italy
8Ambulatorio di Allergologia, Asl RM 4, Ospedale S. Paolo, Civitavecchia (RM), Italy
9U.O Dermatologia, Ospedale di Mirano (VE), Italy
10Ambulatorio di Allergologia Ospedale di Bassano del Grappa (VI), Italy
11SSD di Immunologia e Allergologia, Presidio Ospedaliero S. Maria degli Angeli, Pordenone, Italy
12Dipartimento di scienze orali e maxillo-facciali, Università la Sapienza Roma, Italy
13SOS Allergologia e Immunologia, Prato - Azienda USL Toscana Centro, Prato (FI), Italy
14UOSD di Allergologia, Loreto Crispi, ASL Napoli 1 Centro, Napoli, Italy
15Unità Operativa di Allergologia della Romagna, Dipartimento Internistico di Rimini, Rimini, Italy
16U.O.S.D. di Allergologia, Ospedale S.S. Filippo e Nicola, Avezzano (AQ), Italy
17Laboratorio Unico Metropolitano, AUSL Bologna, Italy
18S.S. Interdipartimentale di Allergologia, Ospedale di Faenza, Italy
19OUS Allergologia, Ospedale Umberto I, Siracusa, Italy
20UOC Medicina Interna, Ospedale di Jesolo, Italy
21UO Allergologia, Distretto di Marsala, ASP 9 Trapani, Italy
22Struttura Complessa di Allergologia e Immunologia, ASST GOM Niguarda, Milano, Italy
23Università Politecnica delle Marche, Scuola di Allergologia e Immunologia Clinica, Ancona, Italy
24Dipartimento organi di senso, Università Sapienza Roma, Italy
25UO Allergologia, ASST Lariana Como, Italy
26Scuola di Allergia e Immunologia Clinica, Alma Mater Studiorum, Bologna, Italy
27UOC Allergologia e Immunologia Clinica, PO “Fazzi”, Lecce, Italy
28UOC Immunologia Clinica, Policlinico Umberto Primo, Roma, Italy
29UOS di allergologia, PTP Nuo vo Regina Margerita, Roma, Italy
30IRCCS Foundation Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy
31Private Practice, Napoli, Italy
32Istituto Dermopatico dell'Immacolata - IDI-IRCCS, Roma, Italy
33Ambulatorio di Allergologia, Centro malattie respiratorie “Giovanni Bonsignore”, Istituto per la Ricerca e l'Innovazione Biomedica (IRIB), Consiglio Nazionale delle Ricerche (CNR), Palermo, Italy
34Lofarma R & D, Milano, Italy
35Thermo Fisher Scientific, Uppsala, Sweden

J Investig Allergol Clin Immunol 2022; Vol 32(1) : 40-47
doi: 10.18176/jiaci.0542

Background: Peach gibberellin-regulated protein (peamaclein) has recently emerged as a relevant food allergen in cypress pollen–hypersensitive patients.
Objective: We investigated monosensitization to peamaclein among Italian cypress pollen–allergic patients.
Patients: A total of 835 cypress pollen–hypersensitive patients from 28 Italian allergy centers underwent a thorough work-up to determine food-allergic reactions and performed skin prick testing with a commercial peach extract containing peamaclein. IgE to rPru p 3 was measured in peach reactors, and those with negative results were enrolled as potentially monosensitized to peamaclein. IgE reactivity to rPru p 7 was evaluated using immunoblot and an experimental ImmunoCAP with rPru p 7.
Results: Skin prick tests were positive to peach in 163 patients (19.5%); however, 127 (77.9%) were excluded because they reacted to Pru p 3. Twenty-four patients (14.7%) corresponding to 2.8% of the entire study population) were considered potentially monosensitized to peamaclein. No geographic preference was observed. Seventeen of the 24 patients (70.8%) had a history of food allergy, mainly to peach (n=15). Additional offending foods included other Rosaceae, citrus fruits, fig, melon, tree nuts, and kiwi. On peach immunoblot, only 3 of 18 putative peamaclein–allergic patients reacted to a band at about 7 kDa; an additional 4 patients reacted at about 50-60 kDa. Ten of 18 patients (56%) had a positive result for Pru p 7 on ImmunoCAP.
Conclusion: Allergy and sensitization to peamaclein seem rare in Italy. Most patients react to peach, although other Rosaceae fruits and several citrus fruits may also be offending foods. Peach and cypress pollen probably also share cross-reacting allergens other than peamaclein.

Key words: Food allergy, Pollen-food syndrome, Peamaclein, Peach, Cypress pollen allergy