RUBRICA SPECIALISTULUI

Proteine reglate de gibereline – relevanţa clinică

 Clinical relevance of gibberellin-regulated protein

First published: 31 octombrie 2023

Editorial Group: MEDICHUB MEDIA

DOI: 10.26416/Aler.7.3.2023.8788

Abstract

Since 2013, a total of nine allergenic sources of gibberellin-regulated protein (GRP) have been described in the literature. The first gibberellin-regulated protein considered to be an allergen was extracted from peach (Prunus persica) and was named Pru p 7. This article aims to provide an overview of the GRP’s characteristics, to emphasize their importance and relevance in clinical practice, and to bring to attention the methods of diagnosis and treatment proposed in the literature published to date. After certain fruit consumption in patients sensitized to GRP, it has been described the occurrence of allergic reactions of various degrees (oral allergy syndrome, up to severe anaphylactic reactions). This fact raises a series of questions regarding the clinical expression of this sensitization, but also confers a change of perspective in relation to fruit allergy. At this moment, it is not clear if the sensitization to food GRP is always a primary sensitization or if the sensitization to food GRP appears subsequent to sensitization to Cupresaceae pollen’s GRP. Pru p 7 is considered to be a potential marker of severity in case of sensitization to peach allergens. Furthermore, the presence of cofactors in GRP sensitized patients may induce systemic allergic reactions. The diagnosis of this type of allergy might be difficult, and the personalized treatment is not yet available.
 

Keywords
gibberellin, diagnosis, food allergen, oral allergy syndrome, peach

Rezumat

Începând cu 2013, în literatura de specialitate au fost descrise în total nouă surse alergenice de proteine reglate de gibereline (GRP) Prima proteină reglată de gibereline considerată ca fiind un alergen a fost extrasă din piersică (Prunus persica) şi a fost denumită Pru p 7. Acest articol îşi propune să ofere o imagine de ansamblu asupra caracteristicilor GRP, să sublinieze importanţa şi relevanţa lor în practica clinică şi să aducă în prim-plan metodele de diagnostic şi tratament propuse în literatura publicată până la momentul actual. A fost descrisă apariţia reacţiilor alergice de diferite grade (sindrom de alergie orală, până la reacţii anafilactice severe) după consumul de fructe la pacienţi sensibilizaţi la GRP, acest fapt ridicând o serie de întrebări cu privire la expresia clinică a acestei sensibilizări în cazul acestor pacienţi, dar conferind în acelaşi timp şi o schimbare de perspectivă asupra alergiei la fructe. În acest moment nu se cunoaşte încă dacă sensibilizarea la GRP din alimente este întotdeauna sensibilizare primară sau dacă sensibilizarea la GRP din alimente este obligatoriu consecutivă sensibilizării la GRP din polenul de Cupresacee. Pru p 7 este considerat ca potenţial marker de severitate în cazul sensibilizării la alergenele din piersică. De asemenea, prezenţa unor cofactori poate induce reacţii alergice sistemice. Diagnosticul acestui tip de alergie poate pune medicul în dificultate, iar tratamentul personalizat nu este încă disponibil. 
 

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