Allergen Sublingual Tablet Immunotherapy: Is it Possible to Induce nsLTPs Tolerance?

Background: Fruit and vegetable allergies related to non-specific Lipid Transfer Proteins (nsLTPS), are quite frequent in Mediterranean countries, with a geographical difference in sensitization. NsLTPs are major and minor allergens in various trees and weed pollens and can induce mild or severe allergic reactions. Objective: We report our experience on 10 patients with grass respiratory pollen allergy and nsLTP sensitization. All ten patients had presented only oral symptoms after ingestion of fruit and/or vegetable known to contain nsLTPs. During the evaluation and management of these patients we investigated whether a common management of grass pollen allergy and nsLTP sensitization is possible. Methods: All ten patients were treated with a 5 Grass pollen sublingual tablet immunotherapy and compared with 10 patients with the same sensitization and clinical pattern but who had never performed immunotherapy for pollen allergy at the time of the study. Results: After 2 years of 5 Grass pollen sublingual tablet immunotherapy, an improvement of pollen allergy symptoms, reduced use of symptomatic drugs and major tolerance to the ingestion of nsLTPs containing foods was observed. According to these results, we suggest that a personalized approach, investigating patients not only for respiratory allergies but also for food sensitization and the use of specific sublingual tablet immunotherapy with extracts registered as drugs, could be the right approach for a specific but at the same time comprehensive desensitization.