Key Allergens

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.

Associated Syndromes

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.

Cross Reactivity

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.



Apple Allergies

Thermofisher - Apple Allergens

Allergy information for: Apple (Malus domestica)

Allergy UK - Oral Allergy Syndrome Factsheet

Patient (UK) - Oral Allergy Syndrome

Articles and Journals

Oral birch pollen immunotherapy with apples: Results of a phase II clinical pilot study, 2021

Restriction polymorphism of Mal d 1 allergen promotor in apple varieties, 2021

Apple Allergy—Development of Tolerance Through Regular Consumption of Low-Allergen Apples. An Observational Study, 2020

The Effect of Birch Pollen Immunotherapy on Apple and rMal d 1 Challenges in Adults with Apple Allergy, 2020

Allergen‐specific immunotherapy with apples: selected cultivars could be a promising tool for birch pollen allergy, 2020

Possibilities of Interlinking the Genomic Data and Allergenic Potential of Apples, 2019

Allergenicity of apple allergen Mal d 1 as effected by polyphenols and polyphenol oxidase due to enzymatic browning, 2019

Immunological characterization of recombinant Mal d 1, the main allergen from apple (Malus x domestica L. Borkh), 2019

The EuroPrevall outpatient clinic study on food allergy: Background and methodology, 2015

Let me know if you found any of these interesting or useful. If you spot an article or research that you think is interesting you can message me or tag me on Facebook or Twitter - links at the bottom of the page.

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