Skip to main content

Apple allergens as an effective option for treating apple allergy

All News

(Vienna, 20 November 2017) The food allergy, which is related to birch pollen, is a very common attendant phenomenon associated with birch pollen allergy – indeed around 70% of those with a birch pollen allergy are also allergic to apples. That amounts to around 280,000 people in Austria. In those affected, eating apples leads to swelling and rashes or itching in the mouth and gullet, as well as in the ear area, and even to blistering.  Working in close collaboration with Tamar Kinaciyan at MedUni Vienna's Department of Dermatology, a research group led by Barbara Bohle at the Institute of Pathophysiology and Allergy Research has now proven in a Phase II trial (funded by FWF) that the apple allergen "Mal d 1" significantly reduces the symptoms of apple allergy and is therefore an effective and safe treatment option.

Of the 60 volunteers with birch pollen-related apple allergy, 20 were treated with placebo, 20 with a birch pollen allergen and with the recombinant apple allergen Mal d 1, that is to say genetically manufactured, reproducible, very stable and therefore easily stored.

The volunteers were administered Mal d 1 once a day in the form of sublingual drops. The results are very promising: "In 6 out of 20 volunteers, the allergy or symptoms did not manifest at all. Following the treatment, they were able to eat two apples a day without any symptoms. In all the others, the symptoms were significantly reduced, so that even they no longer needed to avoid eating healthy, native apples," says lead investigator Bohle.

The results of the Phase II trial now have to be verified in a (multi-centre) clinical Phase III trial – as soon as this trial has been successfully completed and a partner has been found from the pharmaceutical industry, this immunotherapy could be available in a few years for treating apple allergy.

Around 400,000 Austrians suffer from a birch pollen allergy. The symptoms triggered by pollen are easily treated by immunotherapy but the vaccines that have hitherto been available are not effective against the birch pollen allergen or against various cross-sensitivities. The results of the trial lead us to hope that Mal d 1 can be used to reduce the symptoms of cross-sensitivities with apples and might even be effective for other fruit allergies.

Annual meeting of the ÖGAI
The annual meeting of the ÖGAI (Austrian Society for Allergology and Immunology) will take place at the Austrian Ministry for Health and Women from 23 to 25 November 2017. ÖGAI President Barbara Bohle is on the organising committee, together with Winfried Ellmeier, Karin Hoffmann-Sommergruber, Tamar Kinaciyan, Johannes Schmid, Georg Stary, Gerhard Zlabinger and Zsolt Szépfalusi (all from MedUni Vienna). The lectures given by international experts (although interested members of the public may also attend) cover topics such as "Immunotherapy in Rheumatology", "Allergen-specific immunotherapy – quo vadis?" through to "Immunotherapy in Multiple Sclerosis". Link:

Service: American Academy of Allergy, Asthma & Immunology
„Efficacy and safety of 4 months of sublingual immunotherapy with recombinant Mal d 1 and Bet v 1 in patients with birch pollen–related apple allergy.“ Tamar Kinaciyan, Birgit Nagl, Sandra Faustmann, Florian Frommlet, Stephan Kopp, Martin Wolkersdorfer, Stefan Wöhrl, Katharina Bastl, Hans Huber, Uwe Berger and Barbara Bohle. J Allergy Clin Immunol. 2017 Sep 1. pii: S0091-6749(17)31359-3. doi:10.1016/j.jaci.2017.07.036. [Epub ahead of print].