{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T02:59:26Z","timestamp":1792119566117,"version":"4.4.0"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,11,1]],"date-time":"2020-11-01T00:00:00Z","timestamp":1604188800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Heat\u2010and\u2010pepsin\u2010sensitive plant food allergens (PR\u201010 and profilin) sometimes cause systemic reaction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To detect the risk factors for systemic reactions induced by labile food allergens.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective multicenter study was performed on patients with a documented history of systemic allergic reaction to labile plant food allergens and on age\u2010matched controls with a history of oral allergy syndrome (OAS) induced by the same foods. Offending foods, their amount, and state (solid or liquid), and potential cofactors (nonsteroidal anti\u2010inflammatory drugs, protonic pump inhibitors, exercise, alcohol, and fasting) were considered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We studied 89 patients and 81 controls. Sensitization to PR\u201010 or profilin, IgE to Bet v 1 and\/or Bet v 2, and foods causing OAS were similar in the two groups. Twenty patients experienced &gt;1 systemic allergic reaction. Tree nuts, Rosaceae, Apiaceae, and soymilk were the main offending foods. Seventeen (19%) patients were taking a PPI when the systemic reaction occurred (vs 5% in controls; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.025). The ingestion of the offending food in liquid form (soymilk) was frequent among patients (15%) but unusual among controls (2%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.025). Soy milk\u2010induced systemic reactions were independent of PPI treatment. Fasting and excess of allergen, but not NSAID and exercise, were other relevant cofactors for systemic reactions. Systemic reactions occurred without any identifiable cofactor in 39 (44%) cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>PR\u201010\u2010 and profilin\u2010induced systemic reactions are facilitated by PPI, ingestion of large amounts of unprocessed foods, and fasting. Soybean beverages represent a risk for PR\u201010 hypersensitive patients and should be avoided.<\/jats:p><\/jats:sec>","DOI":"10.1111\/all.14634","type":"journal-article","created":{"date-parts":[[2020,10,20]],"date-time":"2020-10-20T17:10:39Z","timestamp":1603213839000},"page":"1473-1479","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Systemic allergic reactions induced by labile plant\u2010food allergens: Seeking potential cofactors. A multicenter study"],"prefix":"10.1111","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8277-1700","authenticated-orcid":false,"given":"Riccardo","family":"Asero","sequence":"first","affiliation":[{"name":"Ambulatorio di Allergologia Clinica san Carlo Paderno Dugnano (MI) Italia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renato","family":"Ariano","sequence":"additional","affiliation":[{"name":"Private Practice Liguria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"Aruanno","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario A. Gemelli\u2010 IRCCS Universit\u00e0 Cattolica del Sacro Cuore Roma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Barzaghi","sequence":"additional","affiliation":[{"name":"Ambulatorio di Allergologia UOC Medicina ASST Rhodenese, P.O Rho Rho Italia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Borrelli","sequence":"additional","affiliation":[{"name":"SSD Dermatologia e Allergologia \u2010 Ospedale Beauregard Aosta Italia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moira","family":"Busa","sequence":"additional","affiliation":[{"name":"Ambulatorio di Allergologia U.O.S. 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