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Pollen-related food allergy: an update

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Abstract

Background

The vast majority of IgE-mediated food allergies in adults are based on sensitization to pollen, followed by reactions to structurally related, often unstable allergens, in particular in fruit (including edible nuts), vegetables, and spices.

Materials and methods

This article provides an up-to-date overview of selected scientific works on pollen-related food allergy and has been drawn-up on the basis of PubMed research, the German Study on Adult Health (Studie zur Gesundheit Erwachsener in Deutschland, DEGS) conducted by the Robert Koch Institute, as well as the national and international guideline registries.

Results

Birch pollen-related symptoms are generally the commonest form of pollen-related allergy observed in Northern Europe. The types of fruit that most frequently cause symptoms belong to the Rosaceae (e. g., apple, cherry) and Fagales families (hazelnut). Reactions to legumes (e. g., peanut, soy) and vegetables, including celery, carrot, tomato, and bell pepper, are also worthy of note. In addition to oropharyngeal contact urticaria, the clinical symptoms of pollen-related food allergy can range from the involvement of other organ systems to anaphylactic shock. The main plant food allergens belong to a handful of protein families: Bet v 1 homologs, profilins, lipid transfer proteins, storage proteins, and thaumatin-like proteins.

Conclusion

The diagnosis of pollen-related food allergy has seen significant advances in recent years in the wake of component-resolved/molecular allergology, thereby, enabling reliable identification. Treatment comprises dietary counseling and the prescription of emergency medication. In addition, allergen-specific immunotherapy for cross-reactive pollen allergens appears to positively affect concomitant food allergies in some patients.

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Abbreviations

ASIT:

Allergen-specific immunotherapy

CCD:

Cross-reactive carbohydrate determinants

DEGS:

Study on Adult Health in Germany Studie zur Gesundheit Erwachsener in Deutschland

FAQL:

Food allergy quality of life (questionnaire)

SPT:

Skin prick test

IgE:

Immunoglobulin E

IgG:

Immunoglobulin G

CRD:

Component-resolved diagnosis

KDa:

Kilodalton

LTP:

Lipid transfer proteins

FA:

Food allergy

OAS:

Oropharyngeal contact urticaria (formerly oral allergy syndrome)

PR:

Family of pathogenesis-related proteins

SIgE:

Specific immunoglobulin E

TLP:

Thaumatin-like proteins

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  1. Department of Dermatology, Venereology and Allergology, Leipzig University Hospital, Leipzig Interdisciplinary Center for Allergology (LICA), Philipp-Rosenthal-Straße 23, 04103, Leipzig, Germany

    Regina Treudler &  Jan-Christoph Simon

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Correspondence to Regina Treudler.

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R. Treudler has received fees for consultancy and lectures, as well as travel expenses or study grants, from the following companies: Allergopharma J. Ganzer KG, ALK-Abello, Novartis, Shire. J.-C. Simon declares that he has no competing interests.

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Treudler, R., Simon, JC. Pollen-related food allergy: an update. Allergo J Int 26, 273–282 (2017). https://doi.org/10.1007/s40629-017-0022-2

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