THE SHINSHU MEDICAL JOURNAL
Online ISSN : 1884-6580
Print ISSN : 0037-3826
ISSN-L : 0037-3826
Original
Clinical Study of Pollen-food Allergy Syndrome Estimated by Double-blind, Placebo-controlled Food Challenges of Ten Apple Cultivars
Yumi KOIKENaoko OKISHIMAMai TOKUNAGAKatsuhiko KOBAYASHIYuji INABA
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2023 Volume 71 Issue 2 Pages 99-107

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Abstract

Background : The number of patients with pollen-food allergy syndrome (PFAS) has increased globally. Apples are a major causative food for PFAS. Varied reports have demonstrated the usefulness of skin prick test (SPT) for the diagnosis of PFAS, besides differences in symptom expression among apple cultivars, thus the diagnosis of PFAS remains unclear.
Purpose : To investigate the clinical features of apple-induced PFAS by performing a double-blind placebocontrolled food challenge (DBPCFC) using different apple cultivars on patients with apple-induced PFAS.
Method : DBPCFC was performed for six patients with apple-induced PFAS using 10 apple cultivars. We measured the degree of symptoms using the Visual Analog Scale (VAS). Further, we assessed the correlations of Mal d 1 and Bet v 1-specific IgE levels and SPT findings to the VAS.
Results : Three of six patients (50%) were VAS-positive for two apple cultivars, one patient each (17%) was positive for three, four, and five apple cultivars. The correlation between SPT findings and VAS was insignificant (p=0.103). The VAS displayed a positive relationship with Mal d 1 and Bet v 1 (r=0.5 and r=0.84, respectively).
Conclusion : It is necessary to perform DBPCFC with multiple apple cultivars to diagnose PFAS. The SPT was not useful in diagnosing PFAS ; however, Bet v 1-specific IgE levels may be advantageous. This novel clinical study of PFAS assessed multiple Japanese apple varieties, therefore, our findings can serve as a baseline for future studies.

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© 2023 Shinshu Medical Society
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