Identification of low allergenic apple cultivars and assessment of proper chain conditions in view of apple allergy

Apple allergy freqently occurs among older children and adults in the Dutch
population. The prevalenc of apple allergy in Nothern and Central Europe is up
to 2%.
Apple allergy causes Oral Allergy symptoms (OAS) which is clinically presented
by mild symptoms in the oral cavity immediately following consumption of fresh,
unprocessed apple.
Apple allergy occurs in concordance with birch pollen allergy ( e.g. in the
Netherlands), which can be explained by cross-reactivity of IgE-antibodies
between birch pollen allergens (Bet v 1) and apple allergens (Mal d 1).
In patients suffering from severe OAS symptoms almost all fresh fruits cause
allergic symptoms. This may affect the nutritious value of the diet and health
of patients suffering from OAS symptoms in a negative way.
Low allergenic apple cultivars could be an alternative for apple allergic
people
The study from Bolhaar et al, and previously performed research in the UMCG
showed that the allergenicity of apple cultivars differs strongly.
The ISAFRUIT project is an integrated research project, which is initiated and
funded by the European Union, aiming at increasing fruit consumption among
europeans.
This project is part of ISAFRUIT.

Identification of low allergenic apple cultivars and breeding germplasm
Identification of chains in which low allergenicity is preserved and of the
critical steps in the chain for preserving low allergenicity.

Interventie onderzoek onder appel-allergische proefpersonen, waarbij gebruik
wordt gemaakt van huidtests en open voedselprovocatie onderzoek

Intervention study in apple allergic patients, using skin prick tests by prick
to prick tests, and open food challenge tests.

year 1:
apple cultivars are tests by SPT (prick to prick)
year 2:
oral challenge tests using least allergenic apple cultivars as well as 1
allergenic cultivar.
breeding germplasms tested by SPT (prick to prick)
year 3:
least allergenic applel cultivars coming from different chains are tested by
SPT (prick to prick)
year 4:
GMO Mal d 1 knocked down apple cultivars are tested by SPT
oral challenge tests using GMO Mal d 1 knocked down apple cultivars as well as
1 allergenic cultivar

Burden of the patient:

Assuming the patients participate in all parts of the study, the extent of the
participation is, divided over 4 years:

16 x skin prick tests (lasting 1,5 uur) = 24 hours
3 x oral food challenge (lasting 4 uur) = 12 hours
total: 36 hours

The patients come to the outpatient clinic of the UMCG during 19 times

The number of hours spent on this research project by the patient decreases
along with a decreasing participation in the project.

Possible benefits for the patient:
Identification of ow allergenic apple cultivars allows for adding new fruits
into the diet of patients.