Can we help people with Oral Allergy Syndrome eat fresh fruit?

Abstract

The major birch allergen Betulae verrucosa 1, (Bet v 1), belongs to the proteinase 10 (PR-10) family of panallergens that are common to many fruits, nuts and vegetables. A high proportion of birch-sensitised individuals experience oral symptoms upon consumption of such foods. This has been termed 'oral allergy syndrome (OAS),' or 'pollen-food syndrome.' Birch pollen specific immunotherapy (BP-SIT) can successfully treat birchsensitive rhinitis; it has been postulated that BP-SIT might also reduce oral allergy symptoms. Previous studies have been small and contradictory, using differing methodology and primary outcome measures.We designed a placebo controlled, double blind, randomised study aiming to establish definitively whether BP-SIT can effectively treat the pollen-food However, a total of eight patients were noted to have an apple threshold of 100g or more at baseline, despite reacting to only 20g during screening. The clinical trial is on going and remains blinded; it is therefore impossible to draw any firm conclusions regarding the efficacy of BP-SIT to treat OAS at this time.However, the study has raised questions concerning the validity of DBPCFC as the gold standard test in oral allergy syndrome, something not previously reported.II II