| Author/Editor | Kopač, P; Rudin, M; Gentinetta, T; Gerber, R; Pichler, C; Hausmann, O; Schnyder, B; Pichler, WJ | |
| Title | Continuous apple consumption induces oral tolerance in birch-pollen-associated apple allergy | |
| Type | članek | |
| Source | Allergy | |
| Vol. and No. | Letnik 67, št. 2 | |
| Publication year | 2012 | |
| Volume | str. 280-5 | |
| Language | eng | |
| Abstract | To cite this article: Kopac P, Rudin M, Gentinetta T, Gerber R, Pichler C, Hausmann O, Schnyder B, Pichler WJ. Continuous apple consumption induces oral tolerance in birch-pollen-associated apple allergy. Allergy 2011; DOI: 10.1111/j.1398-9995.2011.02744.x. ABSTRACT: Background: Patients with birch pollen allergy (major allergen: Bet v 1) have often an associated oral allergy syndrome (OAS) to apple, which contains the cross-reactive allergen Mal d 1. As successful birch pollen immunotherapy does not consistently improve apple related OAS symptoms, we evaluated whether regular apple consumption has an effect on OAS and immune parameters of Mal d 1 or Bet v 1 allergy. Methods: A total of 40 patients with a clear history of birch pollen rhinoconjunctivitis and associated OAS to apple were included in an open, randomized, controlled clinical trial: 27 patients consumed daily defined amount of apple (1-128 g), doubling the amount every two to three weeks, while 13 patients remained untreated. Primary endpoint was the proportion of patients that achieved tolerance to at least 128 g of apple at the end of the study after 8 months. Exploratory endpoints were questionnaire about cross-reactive food and pollen allergy symptoms, conjunctival provocation test with birch pollen and Bet v 1, and in vitro tests (tIgE, sIgE, and IgG4 to Mal d 1 and Bet v 1; basophil activation test with both allergens). Results: Seventeen of 27 patients in active group and none of 13 patients in control group (P = 0.0001) could tolerate a whole apple after the intervention. However, differences in endpoints reflecting systemic immune reactivity did not reach statistical significance. Conclusion: In patients with OAS to apple, tolerance can be safely induced with slowly, gradually increasing consumption of apple. (Abs. trunc. at 2000 ch.) | |
| Descriptors | POLLEN TREES HAY FEVER CROSS REACTIONS FRUIT NUTRITION INTRADERMAL TESTS IMMUNE TOLERANCE IGG IGE |