Oral Allergy Syndrome

Objectives To review oral allergy syndrome (OAS). Methods We searched several medical literature data bases with the following key words: “oral allergy syndrome,” “OAS,” “pollen-food allergy syndrome,” “PFAS,” “allergy,” “diagnosis,” “treatment.” Results Oral allergy syndrome (OAS), also called “pollen-food allergy syndrome,” is a type of food allergy brought about by flavors, nuts, raw fruit, and vegetables. The most well-known symptoms are mouth and throat itching, which starts rapidly after a food is placed in the mouth, and that, as a rule, continues for just a couple of minutes after the food has been swallowed. The frequency of OAS with pollen allergy has been reported as 5–8%; 1–2% of patients with OAS with pollen allergy show extreme responses, e.g., anaphylaxis. Birch tree pollen, ragweed pollen, and grass pollen hypersensitivity cause the symptoms. The diagnosis of OAS is confirmed by a positive history and positive skin-prick test result triggered by the food's fresh extract. Oral challenge result is normally positive with the raw food and negative with the similar cooked food. Conclusion Patients with grass allergy may have a response to peaches, oranges, celery, tomatoes, and melons. Patients with ragweed allergy may show OAS symptoms with melon, cucumber, banana, and zucchini. Physicians should be aware of OAS and know the appropriate treatment.

[1]  Andrew A. White,et al.  Differential skin test reactivity to pollens in pollen food allergy syndrome versus allergic rhinitis. , 2015, Allergy and asthma proceedings.

[2]  C. Katelaris,et al.  The prevalence of the oral allergy syndrome and pollen‐food syndrome in an atopic paediatric population in south‐west Sydney , 2014, Journal of paediatrics and child health.

[3]  D. Dorward,et al.  Middleton’s Allergy: Principles and Practice , 2013 .

[4]  W. Busse,et al.  Middleton's Allergy: Principles and Practice , 2013 .

[5]  C. Webber,et al.  Oral allergy syndrome: a clinical, diagnostic, and therapeutic challenge. , 2010, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[6]  D. Ebo,et al.  Sensitization profiles in birch pollen‐allergic patients with and without oral allergy syndrome to apple: lessons from multiplexed component‐resolved allergy diagnosis , 2010, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[7]  S. Reda Gastrointestinal manifestations of food allergy , 2009 .

[8]  T. Himi,et al.  [Clustering of food causing oral allergy syndrome in patients with birch pollen allergy]. , 2008, Nihon Jibiinkoka Gakkai kaiho.

[9]  B. Bohle,et al.  Successful sublingual immunotherapy with birch pollen has limited effects on concomitant food allergy to apple and the immune response to the Bet v 1 homolog Mal d 1. , 2007, The Journal of allergy and clinical immunology.

[10]  A. Assa’ad,et al.  Gastrointestinal food allergy and intolerance. , 2006, Pediatric annals.

[11]  P. Briza,et al.  Pollen‐food syndromes associated with weed pollinosis: an update from the molecular point of view , 2006, Allergy.

[12]  G. Berry,et al.  TIM-1 induces T cell activation and inhibits the development of peripheral tolerance , 2005, Nature Immunology.

[13]  D. Hepner,et al.  Symposium on the definition and management of anaphylaxis: summary report. , 2005, The Journal of allergy and clinical immunology.

[14]  W. Pichler,et al.  Effect of tree pollen specific, subcutaneous immunotherapy on the oral allergy syndrome to apple and hazelnut , 2004, Allergy.

[15]  H. Malling,et al.  Food allergy to apple and specific immunotherapy with birch pollen. , 2004, Molecular nutrition & food research.

[16]  K. Nékám,et al.  Standardization of food challenges in patients with immediate reactions to foods – position paper from the European Academy of Allergology and Clinical Immunology , 2004, Allergy.

[17]  L. Zuidmeer,et al.  Efficacy of birch‐pollen immunotherapy on cross‐reactive food allergy confirmed by skin tests and double‐blind food challenges , 2004, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[18]  D. Ebo,et al.  Sensitization to cross‐reactive carbohydrate determinants and the ubiquitous protein profilin: mimickers of allergy , 2004, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[19]  A. Nowak‐Wegrzyn,et al.  A survey on the management of pollen-food allergy syndrome in allergy practices. , 2003, The Journal of allergy and clinical immunology.

[20]  C. Bindslev‐Jensen,et al.  Diagnostic value of scratch‐chamber test, skin prick test, histamine release and specific IgE in birch‐allergic patients with oral allergy syndrome to apple , 2003, Allergy.

[21]  J. Bernstein,et al.  The -159 C-->T polymorphism of CD14 is associated with nonatopic asthma and food allergy. , 2003, The Journal of allergy and clinical immunology.

[22]  Hugh A Sampson,et al.  9. Food allergy. , 2003, The Journal of allergy and clinical immunology.

[23]  T. Ogawa Plant-Derived Food Allergens , 2002 .

[24]  J. James,et al.  Reactivity to potential cross‐reactive foods in fruit‐allergic patients: implications for prescribing food avoidance , 2002, Allergy.

[25]  F. Rancé,et al.  Asthme et allergies alimentaires : propos de 163 observations pdiatriques , 2002 .

[26]  M. Neurath,et al.  The role of Th1/Th2 polarization in mucosal immunity , 2002, Nature Medicine.

[27]  S. Sicherer,et al.  Clinical implications of cross-reactive food allergens. , 2001, The Journal of allergy and clinical immunology.

[28]  A. Sheffer,et al.  Oral allergy syndrome. , 2001, Allergy and asthma proceedings.

[29]  V. Backer,et al.  Diagnostic evaluation of grass‐ and birch‐allergic patients with oral allergy syndrome , 2001, Allergy.

[30]  H. Sampson Immunological approaches to the treatment of food allergy , 2001, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology.

[31]  T. Macdonald,et al.  IL-12 and Th1 immune responses in human Peyer's patches. , 2001, Trends in immunology.

[32]  H. Sampson Utility of food-specific IgE concentrations in predicting symptomatic food allergy. , 2001, The Journal of allergy and clinical immunology.

[33]  B. Niggemann,et al.  Atopy patch tests, together with determination of specific IgE levels, reduce the need for oral food challenges in children with atopic dermatitis. , 2001, The Journal of allergy and clinical immunology.

[34]  W. Burks,et al.  Randomized, double-blind, crossover challenge study in 53 subjects reporting adverse reactions to melon (Cucumis melo). , 2000, The Journal of allergy and clinical immunology.

[35]  S. Vieths,et al.  Celery allergens in patients with positive double-blind placebo-controlled food challenge. , 2000, The Journal of allergy and clinical immunology.

[36]  P. Heuschmann,et al.  Celery allergy confirmed by double-blind, placebo-controlled food challenge: a clinical study in 32 subjects with a history of adverse reactions to celery root. , 2000, The Journal of allergy and clinical immunology.

[37]  A. López-Rubio,et al.  Clinical cross-reactivity among foods of the Rosaceae family. , 2000, The Journal of allergy and clinical immunology.

[38]  H. Breiteneder,et al.  Molecular and biochemical classification of plant-derived food allergens. , 2000, The Journal of allergy and clinical immunology.

[39]  R. Van Ree,et al.  Lipid Transfer Protein: A Pan-Allergen in Plant-Derived Foods That Is Highly Resistant to Pepsin Digestion , 2000, International Archives of Allergy and Immunology.

[40]  R. Asero Fennel, cucumber, and melon allergy successfully treated with pollen-specific injection immunotherapy. , 2000, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[41]  S. Romagnani The role of lymphocytes in allergic disease. , 2000, The Journal of allergy and clinical immunology.

[42]  J. Lamb,et al.  Serrate1-induced notch signalling regulates the decision between immunity and tolerance made by peripheral CD4(+) T cells. , 2000, International immunology.

[43]  J. Cuesta-Herranz,et al.  Pollen allergy in peach-allergic patients: sensitization and cross-reactivity to taxonomically unrelated pollens. , 1999, The Journal of allergy and clinical immunology.

[44]  A. Mari,et al.  Specific IgE to cross-reactive carbohydrate determinants strongly affect the in vitro diagnosis of allergic diseases. , 1999, The Journal of allergy and clinical immunology.

[45]  C. Baroglio,et al.  The major allergen of peach (Prunus persica) is a lipid transfer protein. , 1999, The Journal of allergy and clinical immunology.

[46]  Asero Effects of birch pollen‐specific immunotherapy on apple allergy in birch pollen‐hypersensitive patients , 1998, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[47]  D. Umetsu,et al.  Heat-killed Listeria monocytogenes as an adjuvant converts established murine Th2-dominated immune responses into Th1-dominated responses. , 1998, Journal of immunology.

[48]  Y. Cho,et al.  Oral allergy syndrome in pollen - sensitized patients , 1998 .

[49]  R. Van Ree,et al.  Allergy to Rosaceae fruits without related pollinosis. , 1997, The Journal of allergy and clinical immunology.

[50]  K. Tanaka,et al.  The requirement of intestinal bacterial flora for the development of an IgE production system fully susceptible to oral tolerance induction. , 1997, Journal of immunology.

[51]  H. Nelson,et al.  Treatment of anaphylactic sensitivity to peanuts by immunotherapy with injections of aqueous peanut extract. , 1997, The Journal of allergy and clinical immunology.

[52]  P. Sly,et al.  Atopic versus infectious diseases in childhood: a question of balance? , 1997, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology.

[53]  R. Valenta,et al.  Type 1 allergic reactions to plant-derived food: a consequence of primary sensitization to pollen allergens. , 1996, The Journal of allergy and clinical immunology.

[54]  H. Sampson,et al.  Immunologic cross-reactivity among cereal grains and grasses in children with food hypersensitivity. , 1995, The Journal of allergy and clinical immunology.

[55]  L. Jäger,et al.  Effect of hyposensitization for tree pollinosis on associated apple allergy. , 1995, Journal of investigational allergology & clinical immunology.

[56]  C. Bindslev‐Jensen,et al.  Adverse reactions to food * , 1995 .

[57]  H. Weiner,et al.  Peripheral deletion of antigen-reactive T cells in oral tolerance , 1995, Nature.

[58]  J. Kelso,et al.  Oral allergy syndrome successfully treated with pollen immunotherapy. , 1995, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[59]  E. Pastorello,et al.  Allergenic cross-reactivity among peach, apricot, plum, and cherry in patients with oral allergy syndrome: an in vivo and in vitro study. , 1994, The Journal of allergy and clinical immunology.

[60]  A. Bircher,et al.  IgE to food allergens are highly prevalent in patients allergic to pollens, with and without symptoms of food allergy , 1994, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[61]  E. Pastorello,et al.  IgE-mediated allergy from vegetable allergens. , 1993, Annals of allergy.

[62]  T. Mosmann,et al.  Bidirectional cytokine interactions in the maternal-fetal relationship: is successful pregnancy a TH2 phenomenon? , 1993, Immunology today.

[63]  R. Valenta,et al.  Common epitopes of birch pollen and apples--studies by western and northern blot. , 1991, The Journal of allergy and clinical immunology.

[64]  A. Reiss,et al.  Syndrome , 1990, Biological Psychiatry.

[65]  D. P. Strachan,et al.  Hay fever, hygiene, and household size. , 1989, BMJ.

[66]  C. Möller Effect of pollen immunotherapy on food hypersensitivity in children with birch pollinosis. , 1989, Annals of allergy.

[67]  E. Pastorello,et al.  Comparison of results of skin prick tests (with fresh foods and commercial food extracts) and RAST in 100 patients with oral allergy syndrome. , 1989, The Journal of allergy and clinical immunology.

[68]  J. Zwetchkenbaum,et al.  The oral allergy syndrome. , 1988 .

[69]  D. Kemeny,et al.  Oral allergy syndrome (OAS): symptoms of IgE‐mediated hypersensitivity to foods , 1987, Clinical allergy.

[70]  H. Sampson,et al.  Comparison of results of skin tests, RAST, and double-blind, placebo-controlled food challenges in children with atopic dermatitis. , 1984, The Journal of allergy and clinical immunology.

[71]  N. Eriksson,et al.  Birch Pollen‐Related Food Hypersensitivity: Influence of Total and Specific IgE Levels , 1983, Allergy.

[72]  N. Eriksson,et al.  Food Hypersensitivity in Patients with Pollen Allergy , 1982, Allergy.

[73]  Lloyd B. Anderson,et al.  Melon and banana sensitivity coincident with ragweed pollinosis. , 1970, The Journal of allergy.

[74]  L. Tuft,et al.  Studies in food allergy , 1940 .

[75]  M. Mussap,et al.  Birch allergy and oral allergy syndrome: The practical relevance of serum immunoglobulin E to Bet v 1. , 2016, Allergy and asthma proceedings.

[76]  Z. Bartuzi,et al.  [Food hypersensitivity in patients with pollen allergy]. , 2016, Przeglad lekarski.

[77]  E. Pastorello,et al.  Food allergies and food intolerances. , 2006, Best practice & research. Clinical gastroenterology.

[78]  Sam Griffiths-Jones,et al.  Structural relatedness of plant food allergens with specific reference to cross-reactive allergens: an in silico analysis. , 2005, The Journal of allergy and clinical immunology.

[79]  H. Sampson,et al.  New approaches for the treatment of anaphylaxis. , 2004, Novartis Foundation symposium.

[80]  S. Vieths,et al.  Soybean allergy in patients allergic to birch pollen: clinical investigation and molecular characterization of allergens. , 2004, The Journal of allergy and clinical immunology.

[81]  F. Martín-Muñoz,et al.  Specific IgE levels in the diagnosis of immediate hypersensitivity to cows' milk protein in the infant. , 2001, The Journal of allergy and clinical immunology.

[82]  K. Hoffmann‐Sommergruber,et al.  Quantitative IgE inhibition experiments with purified recombinant allergens indicate pollen-derived allergens as the sensitizing agents responsible for many forms of plant food allergy. , 2000, The Journal of allergy and clinical immunology.

[83]  J. Crespo,et al.  IgE-binding and histamine-release capabilities of the main carbohydrate component isolated from the major allergen of olive tree pollen, Ole e 1. , 1999, The Journal of allergy and clinical immunology.

[84]  K. Turjanmaa,et al.  Combined skin prick and patch testing enhances identification of food allergy in infants with atopic dermatitis. , 1996, The Journal of allergy and clinical immunology.