Cooking birch pollen–related food: Divergent consequences for IgE- and T cell–mediated reactivity in vitro and in vivo

Bohle, Barbara; Zwölfer, Bettina; Heratizadeh, Annice; Jahn-Schmid, Beatrice; Antonia, Yuliya Dall; Alter, Mareike; Keller, Walter; Zuidmeer, Laurian; van Ree, Ronald; Werfel, Thomas; Ebner, Christof

doi:10.1016/j.jaci.2006.03.011

Cited by 157Food Allergy and Anaphylaxis ResearchAllergic Rhinitis and SensitizationAsthma and respiratory diseases

Cooking birch pollen–related food: Divergent consequences for IgE- and T cell–mediated reactivity in vitro and in vivo

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Bohle, Barbara, Zwölfer, Bettina, Heratizadeh, Annice, Jahn-Schmid, Beatrice, Antonia, Yuliya Dall, Alter, Mareike, Keller, Walter, Zuidmeer, Laurian +3 more·2006·Journal of Allergy and Clinical Immunology

DOI 10.1016/j.jaci.2006.03.011

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Abstract

Background The major birch pollen allergen Bet v 1 cross-reacts with homologous food allergens, resulting in IgE-mediated oral allergy syndromes (OASs). To avoid this food, allergy allergologists and guidebooks advise patients to consume birch pollen-related foods after heating.Objective We sought to evaluate whether cooked Bet v 1-related food allergens induce IgE- and T cell-mediated reactions in vitro and in vivo.Methods Recombinant Bet v 1, Mal d 1 (apple), Api g 1 (celery), and Dau c 1 (carrot) were incubated at increasing temperatures. Protein structures were determined by means of circular dichroism. Mediator release was tested in basophil activation assays. PBMCs and Bet v 1-specific T-cell lines with known epitope specificity were stimulated with native and cooked food allergens. Patients with birch pollen allergy who experienced OAS and the exacerbation of atopic dermatitis (AD) on ingestion of fresh apple, celery, or carrot were retested in double-blind, placebo-controlled food challenges with the respective foods in cooked form.Results In vitro, cooked food allergens lost the capacity to bind IgE and to induce mediator release but had the same potency to activate Bet v 1-specific T cells as native proteins. In vivo, ingestion of cooked birch pollen-related foods did not induce OAS but caused atopic eczema to worsen.Conclusion T-cell cross-reactivity between Bet v 1 and related food allergens occurs independently of IgE cross-reactivity in vitro and in vivo. In patients with AD, the resulting immune reaction can even manifest as late eczematous skin reactions. Therefore the view that cooked pollen-related foods can be consumed without allergologic consequences should be reconsidered.Clinical implications Symptom-free consumed pollen-related food allergens might cause T cell-mediated late-phase skin reactions in patients with pollen allergy and AD.

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Some patients in that study manifested a late eczematous skin reaction, likely T-cell-mediated.
“However, some patients did manifest a late eczematous skin reaction, which was likely T-cell–mediated (Table X.E-2).”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [1922]
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In one study, cooked apple, carrot, or celery did not cause oral allergy symptoms in patients with atopic dermatitis and birch pollen allergy who had oral allergy syndrome and dermatologic symptoms upon ingestion of the raw foods.
“Cooked versions of the offending foods did not cause oral allergy symptoms.1922”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [1922]

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Authors: Bohle, B., Zwölfer, B., Heratizadeh, A., Jahn-Schmid, B., Antonia, Y. D., Alter, M., Keller, W., Zuidmeer, L., van Ree, R., Werfel, T., & Ebner, C.
Affiliations: Medical University of Vienna (AT)
Medizinische Hochschule Hannover (DE)
University of Graz (AT)
Amsterdam University Medical Centers (NL)
Corresponding author: Bohle, Barbara
ORCID: Bohle, Barbara
Heratizadeh, Annice
Keller, Walter
Zuidmeer, Laurian
Werfel, Thomas
Venue: Journal of Allergy and Clinical Immunology
Publisher: Elsevier BV
Published: 2006-07
Volume: 118
Issue: 1
Pages: 242-249
ISSN: 0091-6749 (ISSN-L)
DOI: 10.1016/j.jaci.2006.03.011
OpenAlex: W2116708464
Cited by: 157
References: 38
Citations by year: 2026: 1 · 2025: 3 · 2024: 4 · 2023: 4 · 2022: 8 · 2021: 8 · 2020: 11 · 2019: 10 · 2018: 13 · 2017: 4 · 2016: 4 · 2015: 11 · 2014: 6 · 2013: 11 · 2012: 8
FWCI: 7.34
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Journal of Allergy and Clinical Immunology (publishedVersion)
PubMed (publishedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Pure Amsterdam UMC (submittedVersion)
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 › Physiology › Asthma and respiratory diseases
Keywords: Bet v 1, birch pollen allergy, food allergy, oral allergy syndrome, T cell cross-reactivity, IgE cross-reactivity, Mal d 1, atopic dermatitis, basophil activation, double-blind food challenge, thermal denaturation
MeSH terms: Allergens, Cross Reactions, Food Hypersensitivity, Hot Temperature, Humans, Immunoglobulin E, T-Lymphocytes, Epitopes, T-Lymphocyte, Betula, Antigens, Plant

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Cooking birch pollen–related food: Divergent consequences for IgE- and T cell–mediated reactivity in vitro and in vivo

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