Peels of Rosaceae fruits have a higher allergenicity than pulps

Background It is not uncommon that patients allergic to fruits such as appl e, pear, and peach, refer adverse reactions after the ingestion of the whol e fruit, but subsequently tolerate the pulp. Objective This study aimed to compare the allergenicity of peels and pulps of apple, peach, and pear in 33 patients allergic to these fruits. Methods Clinical reactivity to the ingestion of whole fruit (peel + pulp) a nd pulp was established by medical history. Peels and pulps were tested sep arately in skin prick tests (SPTs), histamine release tests (HRTs) and RAST s. Cross-allergenicity between peel and pulp of apple and peach was studied by PAST inhibition. Results Adverse reactions appeared more frequently and were more severe whe n the whole fruit was eaten. More than 40% of patients allergic to apple an d pear tolerated the ingestion of the gulp of these fruits, and reactions w ere only elicited by the intake of the whole fruit. Peels induced higher SP Ts, HRTs and RASTs than pulps. An important cross-allergenicity was found b etween the peel and pulp of apple and peach, although the amount of the sha red allergenic epitopes seemed to be higher in peels. Conclusion Our results suggest that peels of Rosaceae fruits such as apple, peach, and pear, have a higher allergenicity than pulps, which is clinical ly relevant. This aspect should be considered in the evaluation of patients allergic to Rosaceae fruits, and in the production of diagnostic materials .