Pollen-Food Allergy Syndrome in China: Current Knowledge and Future Research Needs

Background: Pollen-food allergy syndrome (PFAS) is a distinct form of IgE-mediated food allergy that occurs in individuals sensitized to pollen. The characteristics of PFAS vary across regions and exhibit significant heterogeneity due to differing pollen sensitization profiles. Summary: Research on PFAS in China has primarily focused on Northern regions, where weed and tree pollen allergy, particularly to Artemisia, are prevalent. PFAS is more commonly observed in China among patients allergic to Artemisia pollen, nsLTPs (e.g., Art v 3) derived from Artemisia pollen is regarded as a biomarker for severe food-pollen allergies in China. Other cross-reactive components, including PR-10, profilins, and recently identified GRP, also contribute to PFAS. Diagnosis mainly relies on clinical history, supported by specific IgE, skin prick testing, and component-resolved diagnostics (CRD), while management includes dietary modifications, allergen avoidance, and epinephrine for anaphylaxis. Although allergen immunotherapy and biologics have been explored, their efficacy remains limited, highlighting unmet needs for further research. Critical knowledge gaps persist in understanding PFAS epidemiology, risk factors, and regional variations in China. Future priorities include large-scale epidemiological studies, validation of diagnostic tools, and the development of tailored management guidelines for China's diverse population. Key Messages: This review aimed to provide a comprehensive overview of PFAS and its management to enhance understanding of the existing knowledge gaps and future research needs in China.