xRead - September 2022

Wise et al.

Page 447

Author Manuscript Author Manuscript Author Manuscript Author Manuscript Study design Study groups Clinical endpoint Conclusion

Treatment with antihistamine (astemizole) significantly reduced (but did not eliminate) the severity of local symptoms after ingestion of hazelnuts compared to placebo.

Different doses of birch extract may be necessary to induce apple tolerance amongst patient with birch apple PFAS.

Symptom score (0–5 rating) with hazelnut provocation

before and after 2 weeks of treatment

Oral challenge with apple

before and after treatment

Study Year LOE Bindslev-Jensen et al. 1923 1991 2b RCT Patients with PFAS (birch-hazelnut, n = 30) randomized to: 1 Antihistamine; 2 Placebo

Mauro et al. 1926 2011 4 Cohort Patients with birch allergy (n = 30) randomized to: 1 SLIT; 2 SCIT

AIT = allergen immunotherapy; AR = allergic rhinitis; Ig = immunoglobulin; JCP = Japanese cedar pollen; LOE = level of evidence; OAS = oral allergy syndrome; PFAS = pollen-food allergy syndrome; RCT = randomized controlled trial; SCIT = subcutaneous immunotherapy; SLIT = sublingual immunotherapy; SPT = skin-prick test.

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