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We studied the capacity of peach fruit\/Pru p 1, Pru p 3, Pru p 4, Pru p 7 and peach pollen\/Pru p 9 for inducing symptoms following oral or respiratory exposure in a large group of subjects. We included 716 adults (aged 21 to 83 y.o.) exposed to peach tree pollen and fruit intake in the study population. Participants completed a questionnaire and were skin tested with a panel of inhalant and food allergens, including peach tree pollen, Pru p 9 and peach fruit skin extract. Immunoglobulin E antibodies (SIgE) to Pru p 1, Pru p 3, Pru p 4 and Pru p 7 were quantified. Sensitised subjects underwent oral food challenge with peach fruit and nasal provocation test with peach tree pollen and Pru p 9. The prevalence of sensitisation to peach fruit was 5% and most of these had SIgE to Pru p 3, with a very low proportion to Pru p 4 SIgE and no SIgE to Pru p 1 and Pru p 7. In only 1.8%, anaphylaxis was the clinical entity induced. Cases with positive skin tests to peach and SIgE to Pru p 3 presented a good tolerance after oral challenge with peach fruit. The prevalence of skin sensitisation to peach tree pollen was 22%, with almost half recognising Pru p 9. This induced respiratory symptoms in those evaluated by nasal provocation. In a large population group exposed to peach fruit and peach tree pollen, most individuals were tolerant, even in those with SIgE to Pru p 3. A positive response to Pru p 9 was associated with respiratory allergy.<\/jats:p>","DOI":"10.1371\/journal.pone.0255305","type":"journal-article","created":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T18:57:49Z","timestamp":1629399469000},"page":"e0255305","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Subjects develop tolerance to Pru p 3 but respiratory allergy to Pru p 9: A large study group from a peach exposed population"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0141-8914","authenticated-orcid":true,"given":"Maria Luisa","family":"Somoza","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalia","family":"P\u00e9rez-S\u00e1nchez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Victorio-Puche","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Mart\u00edn-Pedraza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angel","family":"Esteban Rodr\u00edguez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalia","family":"Blanca-L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5309-2434","authenticated-orcid":true,"given":"Eva","family":"Abel Fern\u00e1ndez Gonz\u00e1lez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5847-7480","authenticated-orcid":true,"given":"Mar\u00eda","family":"Ruano-Zaragoza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Prieto-Moreno Pfeifer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrique","family":"Fern\u00e1ndez Caldas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam","family":"Mor\u00e1n Morales","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1065-7199","authenticated-orcid":true,"given":"Francisco Javier","family":"Fern\u00e1ndez S\u00e1nchez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Dami\u00e1n","family":"L\u00f3pez S\u00e1nchez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teodorikez Wilfox","family":"Jim\u00e9nez Rodr\u00edguez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Luis","family":"Subiza Garrido-Lestache","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriela","family":"Canto D\u00edez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel","family":"Blanca G\u00f3mez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3465-8735","authenticated-orcid":true,"given":"Jos\u00e9 Antonio","family":"Cornejo-Garc\u00eda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,8,19]]},"reference":[{"key":"pone.0255305.ref001","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1111\/all.13758","article-title":"Birch pollen allergy in Europe","volume":"74","author":"T Biedermann","year":"2019","journal-title":"Allergy"},{"key":"pone.0255305.ref002","first-page":"180","article-title":"An overview of fruit allergy and the causative allergens","volume":"47","author":"AKG Hassan","year":"2015","journal-title":"Eur Ann Allergy Clin Immunol"},{"key":"pone.0255305.ref003","doi-asserted-by":"crossref","first-page":"1587","DOI":"10.1016\/j.jaci.2017.04.006","article-title":"Prevalence of food allergies and intolerances documented in electronic health records","volume":"140","author":"WW Acker","year":"2017","journal-title":"J Allergy Clin Immunol"},{"key":"pone.0255305.ref004","first-page":"37","article-title":"Food Allergy in Alergol\u00f3gica-2005","volume":"19","author":"M Fernandez-Rivas","year":"2009","journal-title":"J Investig Allergol Clin Immunol"},{"key":"pone.0255305.ref005","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1159\/000371647","volume-title":"Food Allergy: Molecular Basis and Clinical Practice. 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