Clinical Characterization and IgE Profiling of Birch (Betula verrucosa)–Allergic Individuals Suffering from Allergic Reactions to Raw Fruits and Vegetables

High correlation of specific IgE sensitization between birch pollen, soy and apple allergens indicates pollen-food allergy syndrome among birch pollen allergic patients in northern China

“…The first food allergen extract reported to show cross-reactivity to birch pollen was apple extract (Lahti et al, 1980) and it has been shown that around 28% patients with allergic rhinitis and monosensitized to birch pollen experience symptoms of pollen-food allergy upon consumption of apple (Tolkki et al, 2013). The amino acid sequences of the major allergens Bet v 1 and the homologous apple allergen Mal d 1 are close to 50% identical (Holm et al, 2001).…”

“…However, severe systemic effects have been reported and can occur upon food consumption outside the pollen season (Katelaris, 2010;Rashid et al, 2011). The immunologic basis for the clinical reactions is considered to be due to cross-reacting IgE antibodies that are specific to birch pollen allergens, in particular Bet v 1, but that can also recognize Bet v 1-homologous allergens from fruits and vegetables (Holm et al, 2001;Mittag et al, 2004;Tolkki et al, 2013). In a study evaluating severe oral allergy syndrome and anaphylactic reactions caused by a Bet v 1-related protein in soy bean (Glycine max), Gly m 4/SAM22, immediate-type allergic symptoms in patients with birch pollen allergy after ingestion of soy proteincontaining food items were reported to occur (KleineTebbe et al, 2002).…”

Component‐resolved diagnostics demonstrates that most peanut‐allergic individuals could potentially introduce tree nuts to their diet

“…Sensitization rate to birch pollen increases with age until young adulthood and is as high as 25% in northern Europe . Bet v 1 drives sensitizations to other PR‐10 proteins and is a major cause of cross‐reactivity . This easily leads to suspicion of severe nut allergy and prescription of precautionary avoidance diets.…”

Oral Allergy Syndrome

“…70 Another group reported improved sensitivity of CRD with individual celeriac allergens compared with extract-based ImmunoCAP diagnosis (88% for CRD vs 67% for extract). While component resolved diagnosis (CRD) has been shown to be useful to distinguish between phenotypes of allergy for some foods such as peanut and hazelnut, 32,33 the utility of CRD for other plant-derived food allergies is variable.…”