D1.96 - Assessment of sensitivity to Lipid Transfer Proteins in allergic patients in the Republic of Moldova

Lipid transfer proteins (LTPs) are panallergens, highly stable molecules that cause cross-reactivity reactions commonly found in plants, nuts, vegetables, and fruits, and are the main allergen in the Rosaceae family. There is a high rate of heterogeneity among the types of reactions that patients allergic to LTPs can develop, ranging from mild reactions such as oral allergy syndrome to severe reactions such as anaphylactic shock. They may also experience reactions upon contact with only one source of LTPs or may experience the same reaction but triggered by multiple sources.

The aim of the study was the description of the characteristics of LTP sensitization in patients with allergic pathologies in the Republic of Moldova, consulted in the allergology outpatient clinic.The study included 1,265 patients who presented with allergic rhinitis and asthma at the allergy clinic between 2020 and 2025. The LTPs tested were: Pla a3, Art v3, Can s3, Par j2, Ara h9, Tri a14, Zea m14, Act d10, Mal d3, Pru p3, Vit v1,  Api g2, Api g6, Sola l6, Cor a8, Jug r3, Fra a1+3, Mal d2 (using the ImmunoCAP assay).

LTPs are widely distributed and are found mainly in food sources such as peanuts, grapes, kiwi, apples, tomatoes, walnuts, and celery, but also in plants such as plane trees pollen or Artemisia. Important properties of LTPs are their ability to promote lipid transfer between membranes in vitro, their high denaturation temperature, and their resistance to proteolysis, which is important in the digestion of these proteins. Their high level of stability can contribute significantly to their role in triggering hypersensitivity reactions.

Of the 1,265 patients tested, 50.3% are women and 49.7% are men. The average age constuies 29,3 years. Of the total number of patients, 15% (191/1265) are sensitized to LTPs. The most common sensitization is to strawberry LTPs Fra a 1+3: 44,5%. Other LTP molecules to which patients are sensitized are Par j2 (30,4), peach Pru p3 (21,5%), and Artemisia Art v3 (19,4%).

Sensitivity to LTP is common in patients with allergic conditions in the Republic of Moldova, confirming their role as relevant panallergens. Diagnosis of these proteins is essential for personalizing treatment and improving the clinical management of allergic disease.