title: Assessment of the reduced allergenic properties of the Santana apple.
abstract: BACKGROUND
  Approximately 2% of the Northern and Central European population is allergic to apples. Because of symptoms of oral allergy syndrome, many individuals avoid eating fresh apples. A strategy to allow apple allergic individuals to eat apples is the development of hypoallergenic apple varieties.
  
  
  OBJECTIVE
  To investigate the allergenicity of a putatively hypoallergenic apple cultivar, the Santana apple, on apple allergic individuals using a method of challenge in which loss of allergenicity is minimized.
  
  
  METHODS
  The study population consisted of 15 apple allergic individuals, who underwent an open oral challenge with 3 different apple cultivars: Santana, Golden Delicious, and Topaz. Food challenges were performed between February 1 and May 31, 2005, during the birch tree pollen season. Sensory perception during challenges was minimized by use of a blindfold and nose clip and randomization of challenge order. Subjective symptoms were scored by a visual analog scale.
  
  
  RESULTS
  After challenge with the Santana apple, 8 of 15 study participants (53%) developed no symptoms, which was a significantly greater proportion than after challenge with the Topaz apple (1 participant) and Golden Delicious apple (1 participant) (P = .002). The visual analog scale scores for the Santana apple (dose 1) were significantly lower than that for the Golden Delicious and Topaz apples. A total of 73% of the participants stated they would eat Santana apples in the future.
  
  
  CONCLUSIONS
  The Santana apple caused significantly fewer allergic symptoms in apple allergic individuals than the Golden Delicious and Topaz apples. The Santana apple may be a good choice for most apple allergic individuals who want to eat apples.
authors.affiliation: Beatrix Children's Hospital, University Medical Centre Groningen, University of Groningen, the Netherlands.
authors.forename: Helmi S
authors.initials: HS
authors.lastname: Kootstra
authors.forename: Berber J
authors.initials: BJ
authors.lastname: Vlieg-Boerstra
authors.forename: Anthony E J
authors.initials: AE
authors.lastname: Dubois
mesh_terms: D000328:Adult; D005512:Food Hypersensitivity / Q000209:etiology / Q000276:immunology*; D006801:Humans; D027845:Malus / Q000276:immunology*; D012882:Skin Tests; D018709:Statistics, Nonparametric