Objective: To determine the relationship between peanut allergy and Fagales tree pollen. And identify the clinical features of oral allergy syndrome (OAS) in Korea.
Methods: Eighty-four birch-sensitized patients were classified as with (n = 48) and without OAS (n = 36). Peanut anaphylaxis patients (n = 4) were included to compare peanut allergen components. Skin prick tests and specific immunoglobulin E (sIgE) titers to birch, oak, and peanuts were compared. In addition to total allergen levels, we also measured component allergens (Bet v 1, Bet v 2, Ara h 1, Ara h 2, Ara h 3, Ara h 8, and Ara h 9). Clinical manifestations of OAS were also studied.
Results: Birch, oak, Bet v 1 sIgE were higher in the OAS group than in the non-OAS group. Approximately one-third of OAS patients experienced oral symptoms after peanut consumption, symptoms were not correlated with the peanut sIgE titers. All the peanut anaphylaxis patients showed Ara h 2 positivity. Total peanut, Ara h 2, and 3 sIgE were increased as the allergic symptom severity was increased. Reactions to Ara h 2 were not observed in OAS patients. Approximately 83.3% of the OAS group had positive Ara h 8, which was significantly different from non-OAS group.
Conclusion: The higher incidence of peanut allergy in Korea was associated with the increase in birch sensitization, which is cross-reactive to peanuts. Furthermore, component diagnosis of peanut allergies can be used to predict symptom severity.