ArticleAllergy2026
Thaumatin-Like Proteins in Molecular Allergy Diagnostics: Uncommon, Co-Sensitized, and Clinically Inconspicuous? Insights From an Italian Cohort.
Article in Allergy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
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9 authors.
Funding
Abstract
backgroundThaumatin-like proteins (TLPs) are conserved plant pathogenesis-related proteins with IgE-binding capacity, but their clinical relevance remains poorly defined. Unlike well-characterized panallergens, TLPs are underrepresented in diagnostic panels, and their role in food allergy is largely unexplored.
objectiveTo assess the prevalence, quantitative IgE levels, co-sensitization patterns, and clinical significance of IgE reactivity to two TLPs-Act d 2 (kiwi) and Mal d 2 (apple)-in a large Italian allergic cohort.
methodsWe conducted a cross-sectional study of 7176 consecutive patients referred to Italian tertiary allergy centers. Specific IgE to TLPs and other plant allergens was measured using ALEX
resultsTLP sensitization occurred in 137 patients (1.9%), predominantly to Act d 2. Isolated TLP sensitization was rare (n = 20) and associated with low IgE levels (mean 0.61 ± 0.98 kUA/L) and minimal symptoms. Co-sensitized patients (n = 117) had higher and more variable IgE levels (mean 1.41 ± 3.49 kUA/L) and experienced more clinically relevant reactions, including oral allergy syndrome and food-dependent exercise-induced anaphylaxis. ROC analyses indicated limited discriminatory power of Act d 2 IgE for predicting reaction severity (AUC 0.51-0.61). Multivariate adjustment confirmed no independent association between TLP-specific IgE and moderate or severe symptoms.
conclusionsTLP sensitization is uncommon and generally clinically silent when isolated. Co-sensitization with other panallergens appears to drive allergic manifestations. Quantitative TLP-specific IgE alone provides limited predictive value, emphasizing the importance of integrating molecular diagnostics with clinical phenotyping in precision allergy management.
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