Clinical relevance of gibberellin-regulated protein

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.