*Review* **Phenotypes and Endotypes of Peach Allergy: What Is New?**

**Simona Barni <sup>1</sup> , Davide Caimmi 2,3, Fernanda Chiera <sup>4</sup> , Pasquale Comberiati 5,6,\*, Carla Mastrorilli <sup>7</sup> , Umberto Pelosi <sup>8</sup> , Francesco Paravati <sup>4</sup> , Gian Luigi Marseglia <sup>9</sup> and Stefania Arasi <sup>10</sup>**

	- <sup>5</sup> Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, 56126 Pisa, Italy <sup>6</sup> Department of Clinical Immunology and Allergology, I.M. Sechenov First Moscow State Medical University,
	- 119991 Moscow, Russia
	- <sup>7</sup> Department of Pediatrics, University Hospital Consortium Corporation Polyclinic of Bari, Pediatric Hospital Giovanni XXIII, 70124 Bari, Italy; carla.mastrorilli@icloud.com
	- <sup>8</sup> Pediatric Unit, Santa Barbara Hospital, 09016 Iglesias, Italy; umberto.pelosi@gmail.com
	- <sup>9</sup> Department of Pediatrics, University of Pavia, San Matteo Foundation IRCCS Policlinico, 27100 Pavia, Italy; gl.marseglia@smatteo.pv.it
	- <sup>10</sup> Area of Translational Research in Pediatric Specialities, Allergy Unit, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy; stefania.arasi@opbg.net
	- **\*** Correspondence: pasquale.comberiati@gmail.com

**Abstract:** Peach allergy is emerging as a common type of fresh-fruit allergy in Europe, especially in the Mediterranean area. The clinical manifestations of peach allergy tend to have a peculiar geographical distribution and can range from mild oral symptoms to anaphylaxis, depending on the allergic sensitization profile. The peach allergen Pru p 7, also known as peamaclein, has recently been identified as a marker of peach allergy severity and as being responsible for peculiar clinical features in areas with high exposure to cypress pollen. This review addresses the latest findings on molecular allergens for the diagnosis of peach allergy, the clinical phenotypes and endotypes of peach allergy in adults and children, and management strategies, including immunotherapy, for peach allergy.

**Keywords:** peach allergy; food allergy; molecular allergy; Pru p 3; Pru p 7; peamaclein; anaphylaxis; oral allergy syndrome; pollen-food allergy syndrome; oral immunotherapy
