Allergy Asthma Immunol Res.  2018 Nov;10(6):648-661. 10.4168/aair.2018.10.6.648.

Pollen-Food Allergy Syndrome in Korean Pollinosis Patients: A Nationwide Survey

• Kim MA
• Kim DK
• Yang HJ
• Yoo Y
• Ahn Y
• Park HS
• Lee HJ
• Jeong YY
• Kim BS
• Bae WY
• Jang AS
• Park Y
• Koh YI
• Lee J
• Lim DH
• Kim JH
• Lee SM
• Kim YM
• Jun YJ
• Kim HY
• Kim Y
• Choi JH
• Work Group for Rhinitis, the Korean Academy of Asthma, Allergy and Clinical Immunology

• KMID: 2441814
• DOI: http://doi.org/10.4168/aair.2018.10.6.648

Abstract

PURPOSE
Pollen-food allergy syndrome (PFAS) is an immunoglobulin E (IgE)-mediated allergy in pollinosis patients caused by raw fruits and vegetables and is the most common food allergy in adults. However, there has been no nationwide study on PFAS in Korea. In this study, we investigated the prevalence and clinical characteristics of PFAS in Korea.
METHODS
Twenty-two investigators participated in this study, in which patients with allergic rhinoconjunctivitis and/or bronchial asthma with pollen allergy were enrolled. The questionnaires included demographic characteristics, a list of fruits and vegetables, and clinical manifestations of food allergy. Pollen allergy was diagnosed by skin prick test and/or measurement of the serum level of specific IgE.
RESULTS
A total of 648 pollinosis patients were enrolled. The prevalence of PFAS was 41.7% (n = 270). PFAS patients exhibited cutaneous (43.0%), respiratory (20.0%), cardiovascular (3.7%) or neurologic symptoms (4.8%) in addition to oropharyngeal symptoms. Anaphylaxis was noted in 8.9% of the PFAS patients. Seventy types of foods were linked to PFAS; e.g., peach (48.5%), apple (46.7%), kiwi (30.4%), peanut (17.4%), plum (16.3%), chestnut (14.8%), pineapple (13.7%), walnut (14.1%), Korean melon (12.6%), tomato (11.9%), melon (11.5%) and apricot (10.7%). Korean foods such as taro/taro stem (8.9%), ginseong (8.2%), perilla leaf (4.4%), bellflower root (4.4%), crown daisy (3.0%), deodeok (3.3%), kudzu root (3.0%) and lotus root (2.6%) were also linked to PFAS.
CONCLUSIONS
This was the first nationwide study of PFAS in Korea. The prevalence of PFAS was 41.7%, and 8.9% of the PFAS patients had anaphylaxis. These results will provide clinically useful information to physicians.

Keyword

Pollen-food allergy syndrome; pollen; food allergy

MeSH Terms

Adult
Ananas
Anaphylaxis
Arachis
Asthma
Codonopsis
Crowns
Cucurbitaceae
Food Hypersensitivity
Fruit
Humans
Hypersensitivity*
Immunoglobulin E
Immunoglobulins
Juglans
Korea
Lotus
Lycopersicon esculentum
Neurologic Manifestations
Perilla
Pollen
Prevalence
Prunus armeniaca
Prunus domestica
Prunus persica
Pueraria
Research Personnel
Rhinitis, Allergic, Seasonal*
Skin
Vegetables
Immunoglobulin E
Immunoglobulins

Figure

• 

  Fig. 1 Prevalence of PFAS in various age groups. The prevalence of PFAS did not differ according to age, with the exception of patients less than 5 or more than 60 years of age. PFAS, pollen-food allergy syndrome.

• 

  Fig. 2 Sensitization rate to inhalant allergens according to PFAS. Patients with PFAS had a higher rate of sensitization to alder, birch, beech, hazel, oak, mugwort and cat dander than those without. PFAS, pollen-food allergy syndrome.

• 

  Fig. 3 Prevalence of PFAS according to strength of sensitization in each pollen. The prevalence of PFAS increased with increasing strength of sensitization. X-axis, strength of sensitization (A/H ratio); Y-axis, prevalence of PFAS (%). PFAS, pollen-food allergy syndrome.

• 

  Fig. 4 Correlations among inhalant allergens and causative foods of PFAS. Significant correlations were found among Chinese yam, taro, ginseong, jujube and chest nut; pine nut, peanut and walnut; pear, apricot, plum, cherry, apple and peach; and Korean melon, watermelon, melon, kiwi and pineapple. PFAS, pollen-food allergy syndrome.

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