ALLERGENIC CROSS-REACTIVITY, FOOD ALLERGY AND POLLEN

Pollen-allergic patients frequently present oral allergy-like symptoms after ingestion of several kinds of plant foods. The majority of thes e reactions are due to three distinct cross-reactive structures that a re present in birch pollen. Proteins that share common epitopes with B et v 1, the major birch pollen allergen, occur in other kinds of tree pollen, apples, stone fruits, celery, carrots and nuts. Approximately 70% of patients who are allergic to birch pollen may experience sympto ms after consumption of foods from these groups. In contrast to Bet v 1, two minor allergenic structures which sensitise approximate to 10-2 0% of all pollen-allergic patients are also present in grass and weed pollen, namely profilin and cross-reactive carbohydrate determinants. Profilms can induce symptoms to almost all kinds of plant foods, where as the clinical relevance of IgE binding to ubiquitous carbohydrates o f N-glycans from plants remains in doubt. The paper summarises the kno wledge pertaining to the molecular features of these cross-reactive st ructures and the characteristics of the cross-reactivity patterns and discusses aspects of diagnosis, management and routes of sensitisation . (C) 1997 Elsevier Science B.V.