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Wise et al.

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Author Manuscript Author Manuscript Author Manuscript Author Manuscript TABLE X.E-2. Study

Evidence for the role of pollen allergy in pollen-food allergy syndrome Study Year LOE Bohle et al. 1922 2006 2b Case Bolhaar et al. 1925 2004 2b RCT Patients with PFAS (birch-apple, n = 25) randomized to: 1 AIT; 2 Pharmacologic intervention Skamstrup Asero 1927 2003 2b Case control design Study groups Clinical endpoint Conclusion Inuo et al. 1916 2015 2b Cohort Children with AR to JCP and tomato sensitization (n = 23, age 6–17 Basophil activation by tomato and JCP extract, IgE and IgG4 levels against tomato and JCP antigens Tomato-specific basophil activation decreases after JCP-based SCIT, suggesting efficacy in treating PFAS symptoms in patients with JCP AR. control Patients with birch pollen allergy and OAS Oral challenge and basophil activation assays Double-blind placebo controlled food challenge and SPT T-cell cross-reactivity occurs independently of IgE cross-reactivity. The view that cooked pollen related foods can be consumed without allergologic consequences should be reconsidered. Birch pollen AIT decreases allergy to foods containing homologous allergens (apple). Hansen et al. 1921 2004 2b RCT Patients with birch reactivity (n = 74) randomized to: 1 SLIT; 2 SCIT; 3 Placebo control 1 AIT; Oral challenge with apple before and after treatment AIT was not accompanied by a significant decrease in the severity of reactivity to apple compared with placebo. Prevalence of apple allergy at 30 months by symptoms or SPT

Most patients have propensity for apple re sensitization. No significant difference between in prevalence of PFAS between test group and controls at 30 months. In some patients, pollen AIT can exert a long-lasting effect on PFAS.

AIT with birch pollen extracts effectively reduces clinical apple sensitivity and skin reactivity in most cases after 1 year of treatment.

There is a high prevalence of food specific IgE in pollen allergic patients, but not in non–pollen allergic patients.

Oral apple challenge and SPT at 12, 24, and 36 months of AIT

Presence of IgE for 6 pollen associated foods

1 Birch pollen allergic patients with apple tolerance after completing injection AIT (n = 30); 2 No intervention

2 Birch pollen allergic patients without apple allergy (n = 57)

1 Patients with pollen allergy (n = 274);

2 Patients with cat allergy (no pollen allergy, n = 36); 3 Patients with no allergies (n = 55)

Patients with PFAS (birch-apple, n = 75) assigned to: Serum samples from:

control

Asero 1924 1998 2b Case

Bircher et al. 1929 1994 2b Case

Int Forum Allergy Rhinol . Author manuscript; available in PMC 2020 June 10.