Pollen Food Allergy Syndrome in Japanese Children and Adolescents: Risk Factors and Pollen Sensitisation

Abstract

Pollen food allergy syndrome (PFAS) is caused by cross-reactivity with pollen; however, not all-pollen-sensitised individuals develop PFAS, and studies on the characteristics of PFAS development are limited in Japan. We investigated the prevalence and risk factors for the development of PFAS in Japanese children and adolescents sensitised to pollen and their association with pollen-specific IgE levels. The characteristics of PFAS were investigated in patients with allergies aged 3–18 years who visited Dokkyo Medical University Hospital between January 2016 and December 2019. Specific IgE levels for alder, Japanese cedar, ragweed, and orchard grass were measured in patients sensitised to any of the pollens. Patients were categorised into preschool (G1), elementary school (G2), and middle-high school (G3) groups. Overall, 600 patients were enrolled. The prevalence of PFAS was 8.5% in G1, 20% in G2, and 36.3% in G3. Multivariate logistic regression analysis demonstrated strong associations between the risk of developing PFAS and older age (odds ratio (OR), 1.12; 95% confidence interval (CI), 1.06–1.19; P < 0.001 ), seasonal allergy rhinitis (OR, 6.93; 95% CI, 1.59–30.34; P = 0.010 ), and alder sensitisation (OR, 6.20; 95% CI, 2.66–14.49; P < 0.001 ). Spearman’s correlation revealed statistically significant positive correlation between each pollen-specific IgE level; high pollen-specific IgE levels were also a risk factor. The OR for being sensitised to all four species was 36.83 (95% CI, 8.93–151.83, P < 0.001 ) when compared with Japanese cedar alone. Alder was most relevant, with an alder-specific IgE level cutoff value of 2.54 UA/mL. The sensitivity was 78.9%, and the specificity was 70.9%. In conclusion, preschool children develop PFAS with alder sensitisation, and higher pollen-specific IgE levels and increased number of pollen sensitisations are risk factors for developing PFAS.

Profiles of Birch Allergen Component Sensitization and Its Association with Pollen Food Allergy Syndrome in Northern China

“…Food allergy due to birch pollen-related cross-reactivity was common in Central-Northern Europe and Asia. 8,9,34,35 In our study, the prevalence of PFAS in birch pollen allergy subjects was 75.9%, which is comparable to that observed in Europe. 36 Bet v 1 frequently cross-reacts with several proteins in Rosaceae fruits, such as apple (Mal d 1), pear (Pyr c 1), apricot (Pru ar 1), cherry (Pru av 1).…”

Nine-Year Trend in the Prevalence of Allergic Diseases and Their Associated Factors in Young Adults

“…The incidence of SAR was elevated outside Hokkaido, whereas that of other allergic diseases was elevated in Hokkaido. Notably, most pollinosis in Hokkaido is caused by white birch, and food allergy was elevated due to the pollen food allergy syndrome caused by the Rosaceae family [27, 28]. The high prevalence of asthma and PAR in Hokkaido could be due to increased exposure to HDM or low endotoxin levels; however, no definitive cause was found in this study [29].…”