The clinical relevance of sensitization to pollen-related fruits and vegetables in unselected pollen-sensitized adults.
BACKGROUND
Previous studies have described cross-reactivity between fresh fruits, vegetables and pollen. However, no data demonstrates the clinical relevance of sensitization to pollen-related fruits and vegetables in unselected pollen-sensitized adults with and without symptoms in the pollen season.


OBJECTIVE
The aim of this study was to estimate the clinical relevance of sensitization to pollen-related fruits and vegetables in unselected pollen-sensitized adults and to examine the diagnostic value of skin-prick test (SPT), histamine release and specific IgE compared with the outcome of oral challenge.


METHODS
In total, 936 unselected adults (female : male 479 : 457, median age 33.7 years) were examined for pollen sensitization and clinical cross-reactivity with pollen-related fruits and vegetables by questionnaire, SPT, histamine release, specific IgE and oral challenge.


RESULTS
The prevalence of pollen sensitization was 23.8% (n = 223). The probability of a clinical reaction to pollen-related foods in the respective pollen-sensitized groups was: 24% (birch), 4% (grass), 10% (mugwort), 35% (birch + grass), 8% (grass + mugwort) and 52% (birch + grass + mugwort). The odds ratio of a clinical reaction to pollen-related fruits and vegetables in symptomatic pollen-sensitized adults was as high as four times (birch + grass) the odds ratio of a clinical reaction in asymptomatic pollen-sensitized adults.


CONCLUSIONS
This study not only demonstrates a high prevalence of clinical reactions to fruits and vegetables in pollen-sensitized adults, but also a discrepancy between the prevalence of sensitization to fruits and vegetables and the clinical relevance in different pollen-sensitized groups with symptoms in the pollen season as a significant factor.
Osterballe
M
M
Allergy Center, Department of Dermatology, Odense University Hospital, Odense, Denmark.
Hansen
T K
TK
Mortz
C G
CG
Bindslev-Jensen
C
C
D000328:Adult; D029662:Betula; D003429:Cross Reactions; D004311:Double-Blind Method; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology* / Q000378:metabolism; D005638:Fruit / Q000276:immunology*; D006636:Histamine Release; D006801:Humans; D006967:Hypersensitivity / Q000276:immunology*; D007073:Immunoglobulin E / Q000032:analysis; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D006109:Poaceae; D011058:Pollen / Q000276:immunology*; D015995:Prevalence; D012882:Skin Tests; D014675:Vegetables / Q000276:immunology*
D007073:Immunoglobulin E