Tomato allergy: clinical features and usefulness of current routinely available diagnostic methods

J Investig Allergol Clin Immunol. 2013;23(1):37-42.


Background: Tomato contains many allergens but their clinical relevance is poorly defined and the usefulness of available diagnostic methods is unknown.

Objective: To assess the clinical usefulness of current diagnostic methods for tomato allergy.

Methods: Ninety-six adults with plant food allergy were grouped based on their reactivity to PR-10, profilin, and lipid transfer protein (LTP). Tomato allergy was ascertained by history and a positive skin prick test (SPT) to fresh tomato. SPT with a commercial extract and immunoglobulin (Ig) E measurements were carried out.

Results: In total, 36%, 8%, 28%, 18%, 8%, and 1% of patients were sensitized to PR-10, profilin, both PR-10 and profilin, LTP alone, LTP plus PR-10 or profilin, and genuine tomato allergens, respectively. Tomato allergy was detected in 32 (33%) of the 96 patients and was significantly associated with profilin hypersensitivity (P < .001). The sensitivity of SPT was good in all subgroups, but specificity was poor in many cases. ImmunoCAP sensitivity was acceptable in profilin reactors, but very poor in PR-10 reactors. IgE levels were not associated with tomato allergy in any of the subgroups. Similarly, birch and peach-specific IgE levels were not associated with tomato allergy in PR-10/profilin or in LTP reactors, respectively. Both SPT and ImmunoCAP worked well in the only patients with true tomato allergy. Birch- and tomato-specific IgE levels were not associated in patients monosensitized to PR-10, but they were correlated in profilin groups (P < .005). Peach- and tomato-specific IgE levels were correlated (P < .001) in LTP-allergic patients.

Conclusions: Tomato allergy occurs via sensitization towards different proteins. Component-resolved diagnosis helps to define clinical subgroups with different risk levels.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Algorithms
  • Allergens* / immunology
  • Antibody Specificity / immunology
  • Antigens, Plant / immunology
  • Child
  • Female
  • Food Hypersensitivity / diagnosis*
  • Food Hypersensitivity / immunology
  • Humans
  • Immunoglobulin E / blood
  • Immunoglobulin E / immunology
  • Male
  • Middle Aged
  • Sensitivity and Specificity
  • Skin Tests
  • Solanum lycopersicum / adverse effects*
  • Solanum lycopersicum / immunology
  • Young Adult


  • Allergens
  • Antigens, Plant
  • Immunoglobulin E