Birch-apple syndrome treated with birch pollen immunotherapy

Area of Science:

• Immunology
• Allergy and Clinical Immunology

Background:

• Birch-apple syndrome is a common pollen-fruit cross-reaction.
• Subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) are used for birch allergy.
• Efficacy of IT for associated apple allergy is debated.

Purpose of the Study:

• To evaluate the effectiveness of SCIT and SLIT in patients with birch-apple syndrome.
• To assess the impact of birch pollen IT on apple allergy outcomes.

Main Methods:

• A randomized study involving 40 patients with birch-apple syndrome.
• Patients received either SCIT or SLIT with a birch extract for one year.
• Oral apple challenges and specific IgE measurements were performed.

Main Results:

• Complete tolerance to apple was achieved in 25% of SCIT patients and 14.2% of SLIT patients.
• Increased provocative dose for apple was observed in 37.5% of SCIT and 28.6% of SLIT patients.
• Changes in specific IgE to Mal d 1 did not correlate with clinical improvement.

Conclusions:

• Different birch extract doses may be necessary for individual patients.
• Improved patient selection is needed for birch pollen IT to effectively treat associated apple allergy.