The DOI matches its Crossref record; 88 of the 88 references it cites were found in a registry or an index.
Comprehensive review of pollen-food allergy syndrome: Pathogenesis, epidemiology, and treatment approaches
Open accessAbstract
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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In the citing paper
“For example, birch pollen-related PFAS is more common in Northern and Central Europe [31,47].”
From Pollen–Food Allergy Syndrome: Allergens, Clinical Insights, Diagnostic and Therapeutic Challenges (2024) · cites this paper as [31]
In the citing paper
“This syndrome arises from immunological cross-reactivity between pollen allergens and structurally similar proteins found in various fruits, vegetables, and nuts.”
From Pollen–Food Allergy Syndrome: Allergens, Clinical Insights, Diagnostic and Therapeutic Challenges (2024) · cites this paper as [31]
In the citing paper
“However, OAS can occur as the initial symptom of both class I and class II food allergies [31].”
From Pollen–Food Allergy Syndrome: Allergens, Clinical Insights, Diagnostic and Therapeutic Challenges (2024) · cites this paper as [31]
In the citing paper
“Advances in molecular allergology and component-resolved diagnostics have further enhanced the ability to distinguish between cross-reactive and primary food allergens, providing better tools for predicting symptom severity and guiding patient care, and offering promising avenues for managing these conditions [31].”
From Pollen–Food Allergy Syndrome: Allergens, Clinical Insights, Diagnostic and Therapeutic Challenges (2024) · cites this paper as [31]
In the citing paper
“Key panallergen families involved in PFAS include pathogenesis-related protein class 10 (PR-10) proteins, profilins, lipid transfer proteins (LTPs), and gibberellinregulated proteins (GRPs), each contributing to distinct patterns of cross-reactivity [31].”
From Pollen–Food Allergy Syndrome: Allergens, Clinical Insights, Diagnostic and Therapeutic Challenges (2024) · cites this paper as [31]
In the citing paper
“Cross-reactivity between pollen allergens and plant-derived foods is a key mechanism driving PFAS, as this phenomenon occurs due to structural similarities between proteins found in pollens and those present in certain fruits, vegetables, nuts, and seeds [31].”
From Pollen–Food Allergy Syndrome: Allergens, Clinical Insights, Diagnostic and Therapeutic Challenges (2024) · cites this paper as [31]
In the citing paper
“Most patients experience pruritus and paresthesia in the mouth, lips, tongue, and throat shortly after ingesting raw fruits, vegetables, nuts, seeds, or legumes.”
From Pollen–Food Allergy Syndrome: Allergens, Clinical Insights, Diagnostic and Therapeutic Challenges (2024) · cites this paper as [31]
In the citing paper
“These symptoms are often accompanied by mild swelling (angioedema) of the oral mucosa, lips, or tongue [31].”
From Pollen–Food Allergy Syndrome: Allergens, Clinical Insights, Diagnostic and Therapeutic Challenges (2024) · cites this paper as [31]
In the citing paper
“In cases where cross-reactivity between pollens and foods results in systemic reactions or chronic symptoms, omalizumab may help by dampening the overall allergic response.”
From Pollen–Food Allergy Syndrome: Allergens, Clinical Insights, Diagnostic and Therapeutic Challenges (2024) · cites this paper as [31]
In the citing paper
“Non-sedating second-generation antihistamines, such as loratadine, cetirizine, or fexofenadine, are preferred due to their favorable side effect profiles [31].”
From Pollen–Food Allergy Syndrome: Allergens, Clinical Insights, Diagnostic and Therapeutic Challenges (2024) · cites this paper as [31]
Citations
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Cited by
Sorted by citations
Global Burden of Allergies: Mechanisms of Development, Challenges in Diagnosis, and Treatment
Alska, E., Doligalska, A., Napiórkowska-Baran, K., Dolina, M., Osińska, K., Pilichowicz, A., Wojtkiewicz, A., Kaczor, J., Szymczak, B., & Bartuzi, Z. (2025) · Life · doi:10.3390/life15060878 · Cited by 33
Pollen–Food Allergy Syndrome: Allergens, Clinical Insights, Diagnostic and Therapeutic Challenges
Haidar, L., Bănărescu, C. F., Uța, C., Moldovan, S. I., Zimbru, E.-L., Zimbru, R.-I., Ciurariu, E., Georgescu, M., & Panaitescu, C. (2024) · Applied Sciences · doi:10.3390/app15010066 · Cited by 21
The impact of climate change in pollen food allergy syndrome
Skypala, I. J. (2025) · Current Opinion in Allergy and Clinical Immunology · doi:10.1097/aci.0000000000001064 · Cited by 8
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Berghea, E. C., Feketea, G. M., Cosoreanu, M.-T., Popa, O. M., Ionescu, M. D., Porr, C., Berghea, F., & Vassilopoulou, Ε. (2025) · Frontiers in Allergy · doi:10.3389/falgy.2025.1698559 · Cited by 6
Metadata
- Authors
- Kato, Y., Morikawa, T., & Fujieda, S.
- Affiliations
- University of Fukui (JP)
- Corresponding author
- Kato, Yukinori
- Venue
- Allergology International
- Publisher
- Elsevier BV
- Published
- 2025-01
- Volume
- 74
- Issue
- 1
- Pages
- 42-50
- ISSN
- 1323-8930 (ISSN-L)
- OpenAlex
- W4402542501
- Cited by
- 45
- References
- 88
- Citations by year
- 2026: 27 · 2025: 16
- FWCI
- 2.48
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Allergology International (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
- Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Asthma and respiratory diseases
- Keywords
- oral allergy syndrome, cross-reactivity, panallergens, pollen allergens, food allergens, mast cells, immediate hypersensitivity, alder pollen, grass pollen, birch pollen, allergen immunotherapy, epidemiology, food avoidance, anaphylaxis
- MeSH terms
- Allergens, Animals, Cross Reactions, Desensitization, Immunologic, Food Hypersensitivity, Rhinitis, Allergic, Seasonal, Humans, Pollen, Prevalence
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- The paper
- Kato, Y., Morikawa, T., & Fujieda, S. (2025). Comprehensive review of pollen-food allergy syndrome: Pathogenesis, epidemiology, and treatment approaches. Allergology International. https://doi.org/10.1016/j.alit.2024.08.007
