Apples are in the Rosaceae family of plants. Other plants in this family are pears, apricots, plums, cherries, peaches, raspberries, strawberries and almonds.

The most studied proteins in apple allergy are called Mal d 1, Mal d 2, Mal d 3 and Mal d 4.

87% of people suffering from this allergy are thought to be sensitised to the protein Mal d 1, this is a Bet v 1 protein. These proteins are panallergens which cause oral allergy type symptoms.

Mal d 3 is a Lipid Transfer Protein (LTP), which is considered a panallergen - if allergic to this particular allergen you may have reactions to other foods containing LTPs.

Mal d 2 is a is a thaumatin protein, this is made by plants to inhibit fungal growth.

Mal d 4 is a profilin protein, these are plant panallergens, proteins which have the potential to cause allergies across large groups of seemingly unrelated foods.

Apple cider vinegar is highly processed. Intolerance or allergy to vinegar is most likely a histamine sensitivity, a salicylate sensitivity or an intolerance to sulphites.

You may have Pollen-Food Allergy Syndrome if you suffer from apple allergy with oral allergy symptoms to 3 or more of the foods mentioned in cross reactivity section.

You may have LTP Syndrome if you react to multiple foods in the cross reactivity section.

Allergy to apple is sometimes linked to Celery-Mugwort-Spice Syndrome as the sensitising allergen is a profilin protein called Art v 4, these proteins are also sometimes also called Bet v 2 proteins.

There is a link between apple and Latex Food Syndrome. The plant involved in latex allergy Hevea brasiliensis, the rubber tree plant, has an allergen called Hev b 8 which is a profilin protein. Those very sensitised to latex may have a contact allergic reaction from other foods or plants containing profilin proteins, there is less evidence of this than sensitisation to other latex linked proteins like hevein and chitinases.

If sensitised to Alder pollen you may have Pollen Food Allergy Syndrome and may also react to cherry, peach, pear, parsley, celery, almonds and hazelnuts.

If sensitised to Birch pollen you may have Pollen Food Allergy Syndrome and may also react to kiwi, pear, peach, plum, nectarine, apricots, cherries, tomato, celery, carrot, potato, parsnip, pepper, dill, cumin, peas, coriander, fennel, hazelnut, walnut, almonds, peanuts, lentils and green beans.

If sensited to Mugwort pollen you may have Pollen Food Allergy Syndrome and may also react to celery, carrots, dill, parsley, fennel, coriander, cumin and sunflower seeds.

Proteins with similar protein structures are strawberry, raspberry, asparagus and mango.

Other foods containing thaumatin proteins are kiwi, chilli, peppers, apple, banana, cherry and peach.

If sensitised to LTP proteins you may also react to kiwi, strawberries, sunflower seeds, walnut, apple, mulberry, banana, pea, apricot, cherry, plum, almond, peach pomegranate, raspberry, tomato, grape, celery, peanut, asparagus, cabbage, broccoli, chestnut, lemon, tangerine, orange, hazelnut, lettuce, lentils, lupin, green bean, pear, mustard, wheat and maize.

Apple is broadly linked to other fruit profilin allergies. Allergy to celery, peanut, lychee, soyabeans, walnut, lupin, almonds, mustard, hazelnut, kiwi, pineapple, chilli, melon, orange, strawberry, apple, banana, aubergine (eggplant), peach, pear, tomato, dates, cherry, carrot, barley and wheat. Allergic reactions to some of these foods may be considered a marker of profilin hypersensitivity.

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