Comprehensive review of pollen-food allergy syndrome: Pathogenesis, epidemiology, and treatment approaches

Pollen-food allergy syndrome (PFAS) is caused by cross-reaction of a specific pollen antigen with the corresponding food allergen in sensitized individuals. The manifestations are usually limited to oral symptoms; however, sometimes, rhinitis, respiratory and skin symptoms, and anaphylactic shock ma...

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Main Authors: Yukinori Kato, Taiyo Morikawa, Shigeharu Fujieda
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Allergology International
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Online Access:http://www.sciencedirect.com/science/article/pii/S1323893024000893
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author Yukinori Kato
Taiyo Morikawa
Shigeharu Fujieda
author_facet Yukinori Kato
Taiyo Morikawa
Shigeharu Fujieda
author_sort Yukinori Kato
collection DOAJ
description Pollen-food allergy syndrome (PFAS) is caused by cross-reaction of a specific pollen antigen with the corresponding food allergen in sensitized individuals. The manifestations are usually limited to oral symptoms; however, sometimes, rhinitis, respiratory and skin symptoms, and anaphylactic shock may occur. In PFAS pathogenesis, when food containing protein antigens (pan-allergens) with high homology to pollen antigens is ingested, mast cells bound to pollen antigen-specific IgE distributed in the oral mucosa cross-react with the food antigen, causing a local type I allergic reaction. The prevalence of PFAS depends on the geographic conditions, such as the type and amount of pollen in the area. PFAS is prevalent in all regions owing to the wide variety of pollen antigens implicated in the disease, such as alder and grass pollen, even outside of the birch habitat area. Basic research on PFAS is expected to significantly contribute to elucidating the pathogenesis and development of therapeutic strategies for PFAS. Currently, effective treatment for patients with PFAS that allows safe consumption of raw foods is lacking, and avoiding the intake of causative foods is the basis of prevention. Furthermore, allergen immunotherapy for PFAS has not yet been established, but various attempts are underway to develop it into a novel treatment strategy. This review highlights the current research landscape on the pathophysiology, epidemiology, and clinical aspects of PFAS. We outline the research gaps that should be addressed to improve the outcomes of patients with PFAS.
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spelling doaj-art-e0b64c6b8c84415d8c7af44fc89915212025-08-20T02:45:56ZengElsevierAllergology International1323-89302025-01-01741425010.1016/j.alit.2024.08.007Comprehensive review of pollen-food allergy syndrome: Pathogenesis, epidemiology, and treatment approachesYukinori Kato0Taiyo Morikawa1Shigeharu Fujieda2Corresponding author. Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medical Science, University of Fukui, 23-3, Shimoaizuki, Matsuoka Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan.; Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medical Science, University of Fukui, Fukui, JapanDepartment of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medical Science, University of Fukui, Fukui, JapanDepartment of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medical Science, University of Fukui, Fukui, JapanPollen-food allergy syndrome (PFAS) is caused by cross-reaction of a specific pollen antigen with the corresponding food allergen in sensitized individuals. The manifestations are usually limited to oral symptoms; however, sometimes, rhinitis, respiratory and skin symptoms, and anaphylactic shock may occur. In PFAS pathogenesis, when food containing protein antigens (pan-allergens) with high homology to pollen antigens is ingested, mast cells bound to pollen antigen-specific IgE distributed in the oral mucosa cross-react with the food antigen, causing a local type I allergic reaction. The prevalence of PFAS depends on the geographic conditions, such as the type and amount of pollen in the area. PFAS is prevalent in all regions owing to the wide variety of pollen antigens implicated in the disease, such as alder and grass pollen, even outside of the birch habitat area. Basic research on PFAS is expected to significantly contribute to elucidating the pathogenesis and development of therapeutic strategies for PFAS. Currently, effective treatment for patients with PFAS that allows safe consumption of raw foods is lacking, and avoiding the intake of causative foods is the basis of prevention. Furthermore, allergen immunotherapy for PFAS has not yet been established, but various attempts are underway to develop it into a novel treatment strategy. This review highlights the current research landscape on the pathophysiology, epidemiology, and clinical aspects of PFAS. We outline the research gaps that should be addressed to improve the outcomes of patients with PFAS.http://www.sciencedirect.com/science/article/pii/S1323893024000893Allergic rhinitisCross-reactionOral symptomsPan-allergensPollen-food allergy syndrome
spellingShingle Yukinori Kato
Taiyo Morikawa
Shigeharu Fujieda
Comprehensive review of pollen-food allergy syndrome: Pathogenesis, epidemiology, and treatment approaches
Allergology International
Allergic rhinitis
Cross-reaction
Oral symptoms
Pan-allergens
Pollen-food allergy syndrome
title Comprehensive review of pollen-food allergy syndrome: Pathogenesis, epidemiology, and treatment approaches
title_full Comprehensive review of pollen-food allergy syndrome: Pathogenesis, epidemiology, and treatment approaches
title_fullStr Comprehensive review of pollen-food allergy syndrome: Pathogenesis, epidemiology, and treatment approaches
title_full_unstemmed Comprehensive review of pollen-food allergy syndrome: Pathogenesis, epidemiology, and treatment approaches
title_short Comprehensive review of pollen-food allergy syndrome: Pathogenesis, epidemiology, and treatment approaches
title_sort comprehensive review of pollen food allergy syndrome pathogenesis epidemiology and treatment approaches
topic Allergic rhinitis
Cross-reaction
Oral symptoms
Pan-allergens
Pollen-food allergy syndrome
url http://www.sciencedirect.com/science/article/pii/S1323893024000893
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AT taiyomorikawa comprehensivereviewofpollenfoodallergysyndromepathogenesisepidemiologyandtreatmentapproaches
AT shigeharufujieda comprehensivereviewofpollenfoodallergysyndromepathogenesisepidemiologyandtreatmentapproaches