Rosaceae food allergy: a review

Abstract

This review provides a global overview on Rosaceae allergy and details the particularities of each fruit allergy induced by ten Rosaceae species: almond/peach/cherry/apricot/plum (Amygdaleae), apple/pear (Maleae), and raspberry/blackberry/strawberry (Rosoideae). Data on clinical symptoms, prevalence, diagnosis, and immunotherapies for the treatment of Rosaceae allergy are herein stated. Allergen molecular characterization, cross-reactivity/co-sensitization phenomena, the impact of food processing and digestibility, and the methods currently available for the Rosaceae detection/quantification in foods are also described. Rosaceae allergy has a major impact in context to pollen-food allergy syndrome (PFAS) and lipid transfer protein (LTP) allergies, being greatly influenced by geography, environment, and presence of cofactors. Peach, apple, and almond allergies are probably the ones most affecting the quality of life of the allergic-patients, although allergies to other Rosaceae fruits cannot be overlooked. From patients’ perspective, self-allergy management and an efficient avoidance of multiple fruits are often difficult to achieve, which might raise the risk for cross-reactivity and co-sensitization phenomena and increase the severity of the induced allergic responses with time. At this point, the absence of effective allergy diagnosis (lack of specific molecular markers) and studies advancing potential immunotherapies are some gaps that certainly will prompt the progress on novel strategies to manage Rosaceae food allergies.

Keywords:

• Clinical relevance
• cross-reactivity/co-sensitization phenomena
• detection methods
• diagnosis
• food allergens
• food processing and digestibility
• LTP allergy
• pollen-food allergy syndrome

Authors’ contributions

Joana Costa and Isabel Mafra contributed to the study’s conception, design, data collection, and analysis. The first draft of the manuscript was written by Joana Costa and carefully revised by Joana Costa and Isabel Mafra. Both authors read and approved the final manuscript.

Disclosure statement

No potential competing interest was reported by the authors.

Additional information

Funding

This work was funded by national funds (FCT, Fundação para a Ciência e Tecnologia) through the projects AlleRiskAssess and Hypoallergen (PTDC/BAA-AGR/31720/2017 and PTDC/BAA-AGR/4005/2021, respectively) and the strategic funding of LAQV-REQUIMTE (UID/QUI/50006/2020). This study was also supported by the European Union through FEDER funds (POCI-01-0145-FEDER-031720 and NORTE-01-0145-FEDER-000052). J. Costa thanks FCT for funding through program DL 57/2016—Norma Transitória (SFRH/BPD/102404/2014).