**1. Epidemiology**

Peach (*Prunus persica*) is the fruit of *Prunus* trees, belonging to the *Rosaceae* family, including 4828 known species in 104 genera [1–3]. In addition to peaches, apples, pears, quinces, apricots, plums, cherries, raspberries, loquats, strawberries, and almonds belong to the *Rosaceae* family [4].

Currently, the peach plant is cultivated in different parts of the world. Peach cultivation is believed to have originated in China and to have been transported, via the silk route, to India, the Middle East, and Persia, before finally spreading towards Europe. China, Italy, Spain, Turkey, and the USA are the leading peach-producing countries [5].

Peach fruit usually ripens between August and September [1]. Peach can be eaten as fresh fruit as well as in treated forms, such as canned, dried, juice, and jam [5].

Peach has been described as a common cause of fresh-fruit allergy in Europe, especially in the Mediterranean area [6]. The prevalence data on fruit allergies are limited, and the available data are derived from scarce studies, especially in children [7–9]. In a systematic review conducted by Zuidmeer et al., the overall perceived prevalence of fruit allergies

**Citation:** Barni, S.; Caimmi, D.; Chiera, F.; Comberiati, P.; Mastrorilli, C.; Pelosi, U.; Paravati, F.; Marseglia, G.L.; Arasi, S. Phenotypes and Endotypes of Peach Allergy: What Is New? *Nutrients* **2022**, *14*, 998. https://doi.org/10.3390/nu14050998

Academic Editor: Margarida Castell

Received: 21 January 2022 Accepted: 25 February 2022 Published: 26 February 2022

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ranged from 0.1% to 4.3% [7]. In particular, 2.2–11.5% of children aged 0–6 years and 0.4–6.6% of adults are affected by fruit allergies, based on self-reported data. One Europeanbased large survey reported the highest and lowest prevalence of allergic sensitization to peach in Germany (11.7%) and Iceland (0.3%), respectively [8]. In another, similar survey, the highest prevalence of peach sensitization was observed in Switzerland (13.4%) and the lowest in Iceland (2.3%) [9]. The overall European prevalence of allergic sensitization to peach increased from 5.4% in 2010 [8] to 7.9% in 2014 [9]. The prevalence data on peach-allergen-specific sensitization have been investigated in Spanish and Italian studies: lipid-transfer protein (LTP) sensitization is predominant in Southern Europe, whereas sensitization to pathogenesis-related 10 (PR-10) is more common in Northern and Central Europe, including areas with Fagales pollen exposure (birch, alder, hazel, hornbeam, oak, beech, and chestnut) [10,11].

Similar to other IgE-mediated food allergies, peach allergy negatively impacts quality of life, causing stress and anxiety. Peach allergy, as with fruit allergies in general, is reported to be associated with less-severe symptoms than food allergies to peanuts and tree nuts; nevertheless, the condition exerts a similar impact on patients' quality of life: 60% of adults are impacted by fruit allergy in their daily life at home and 62% in their life outside the home [12].
