tomato paste substitute for people allergic to tomatoes

#Tomato paste substitute for people allergic to tomatoes skin

Reactions to nsLTP can occur in combination with or only when cofactors such as exercise and intake of non-steroidal anti-inflammatory drugs (NSAIDs) are present.

1 These proteins, present in native, cooked or processed foods, are an important cause of IgE-mediated food-allergic reactions to plant-derived foods. Non-specific lipid transfer proteins (nsLTPs) are ubiquitous in the plant kingdom, and there is a high degree of structural homology between nsLTP allergens, even from plants with a distant taxonomic relationship.

Immunotherapy can be effective, but it is not commonly available, and the success of the treatment might depend on the primary sensitizing allergen.

The main management for those sensitized and symptomatic is the avoidance of known trigger foods it is difficult to predict whether more foods are likely to provoke reactions over time, and also whether all forms of the food need to be avoided.Those sensitized to nsLTP in a given food without reactions to that food may not need to avoid it although this can vary depending on the individual case.

#Tomato paste substitute for people allergic to tomatoes skin

However, OFC cannot determine whether nsLTP is the definitive cause of a reaction, especially in those with a positive skin prick test or specific IgE test to the whole food.

Oral food challenge (OFC) performed in a clinical setting may be useful for determining whether, in an individual sensitized to nsLTP, all foods that test positive need to be excluded especially if there is no history of reactions to those foods.

The diagnostic pathway should include taking a detailed clinical history, establishing sensitization to the suspected food(s) and testing for sensitization to relevant nsLTP allergens such as Pru p 3 (peach).

Cofactors are a common feature of reactions, usually exercise, NSAID or alcohol but can include a wide range, with some experiencing food-allergic reactions only when a cofactor is present.

Clinical reactions to foods in those sensitized to nsLTP may vary from mild oral symptoms or urticaria to life-threatening anaphylaxis.

Future research should focus on the mechanisms of cofactors, improving diagnostic accuracy and establishing the efficacy of immunotherapy. Studies on immunotherapy are promising, but it is unknown whether such treatments will be useful in populations where Pru p 3 is not the primary sensitizing allergen.

The avoidance of known trigger foods and advice on cofactors is currently the main management for this condition. Testing on suspected food triggers should also establish whether sensitization to nsLTP is present, using purified or recombinant nsLTP allergens such as Pru p 3. The variability in the food and cofactor triggers makes it essential to include an allergy-focused diet and clinical history in the diagnostic workup. A frequent feature of reactions is the requirement for a cofactor (exercise, alcohol, non-steroidal anti-inflammatory drugs, Cannabis sativa) to be present for a food to elicit a reaction. The peach nsLTP allergen Pru p 3 is a dominant sensitizing allergen and peaches a common food trigger, although multiple foods can be involved. Sensitization to one or more non-specific lipid transfer proteins (nsLTPs), initially thought to exist mainly in southern Europe, is becoming accepted as a cause of allergic reactions to plant foods across Europe and beyond.