Patients with birch pollen allergy often develop allergic reactions to plant foods - a condition often called oral allergy syndrome, or pollen-food allergy syndrome.
In this study from Austria, food-induced symptoms were evaluated in 200 patients with birch pollen allergy.
IgE and IgG(4) levels were quantified by ImmunoCAP specific for:
- major birch pollen allergen Bet v 1
- birch profilin Bet v 2
- Bet v 1 homologs in apple (Mal d 1) and hazelnut (Cor a 1)
73% of the patients experienced food allergy, which was perennial in 86% of them.
The oral allergy syndrome was the main clinical manifestation. More than 58% of the patients also had food-induced rhinoconjunctivitis.
Apples and hazelnuts were identified as the most frequent triggers.
Food allergy correlated with IgE reactivity to Bet v 1. Birch pollen-related food allergy is highly prevalent and often perennial.
Typical cross-reactive associations:
BIRCH - Apple, peach, apricot, hazelnut, potato, carrot, celery
RAGWEED - Banana, cucumber, cantaloupe, watermelon, zucchini, cucumber
MUGWORT - Celery, onion, mustard, cabbage
Cross-reactivity in Pollen-Food Allergy Syndrome (PFAS) or Oral Allergy Syndrome (OAS) (click to enlarge the image).
Birch pollen-related food allergy: Clinical aspects and the role of allergen-specific IgE and IgG(4) antibodies. Geroldinger-Simic M, Zelniker T, Aberer W, Ebner C, Egger C, Greiderer A, Prem Md N, Lidholm J, Ballmer-Weber BK, Vieths S, Bohle B. J Allergy Clin Immunol. 2011 Jan 19. PMID: 21251701
Oral allergy syndrome