[Severe soy allergy in adults. Is there a role for specific immunotherapy?]

An increasing number of immediate type allergies after consumption of soy products have been reported during the last years. Due to cross reactions between the main birch pollen allergen Bet v 1 and soy allergen Gly m 4, patients sensitized to birch are at special risk for soy allergy. Severe immediate type reactions to soy have also been associated with sensitizations to storage proteins Gly m 5 and Gly m 6. Therapy should include avoidance of soy products with high protein content (i.e. drinks). A limited number of studies has investigated specific immunotherapy (SIT) against birch in patients with birch-associated food allergy, namely to apple or hazel. A therapeutic effect on birch- associated food allergy was shown in some of these trials. Results are discussed controversially with regard to number of patients, study design and investigational products. A multicenter trial (BASALIT) is currently investigating the effect of SIT with 80 µg of the folded variant of recombinant Bet v 1 on birch-associated soy allergy.