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Key Allergens

There are 3 allergens associated with strawberry allergy, Fra a 1, Fra a 3 and Fra a 4.

Fra a 1 is a Bet v 1 like protein. This is a protein found in birch pollen which can cause cross reactions with other fruit.

Fra a 3 is a Lipid Transfer Protein (LTP), these proteins are resistant to heat and are found in many types of plants. Patients suffering from a more severe allergy to cooked fruit may be sensitised to this group of proteins.

Fra a 4 is a profilin protein, this is considered to be another panallergen, causing issues across multiple types of foods.

A study in 2017 showed different varieties of white strawberries, although looking different, were not hypoallergenic and very variable in their allergenicity.

Strawberries are high in natural Vitamin C (also known as ascorbic acid) and is acidic, so can cause a rash on the face especially in babies and toddlers. Small children have a very low requirement of daily Vitamin C, so it can be easy for them to have more than the recommended intake if they eat a lot of fruit. This can cause gastrointestinal problems and looks like a food intolerance.

Associated Syndromes

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

You may be suffering from LTP Syndrome if you have reactions to various fruits, vegetables and nuts and your reactions continue to be severe after you have discarded the peel and have cooked the food.

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

Common foods involved in LTP allergy include 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.

Profilin proteins are also found in pineapple, celery, peanut, chilli, watermelon, orange, hazelnut, carrot, strawberry, soya, barley, walnut, lychee, lupin, apple, banana, dates, cherry, kiwi, peach, pear, mustard, tomato, aubergine and wheat.

There may be cross reactivity with other plants in the Rosaceae family. This includes apples, cherries, almonds, peaches, plums, apricots, pears and raspberries.



Allergen Encyclopedia - Strawberry

Anaphylaxis Campaign - Allergy to fruit

Allergy UK - Oral Allergy Syndrome

Patient UK - Oral Allergy Syndrome

Lipid Transfer Proteins (LTP Syndrome)

Allergy information for: Strawberry (Fragaria ananassa)

Articles and Journals

Allergy to Strawberry in Children From the Mediterranean Area: Is It Really Allergy? 2020

Lipid Transfer Protein allergy in the United Kingdom: Characterization and comparison with a matched Italian cohort, 2019

White-fruited strawberry genotypes are not per se hypoallergenic, 2017

Cloning and sequencing of the Bet v 1-homologous allergen Fra a 1 in strawberry (Fragaria ananassa) shows the presence of an intron and little variability in amino acid sequence, 2007

The role of profilin and lipid transfer protein in strawberry allergy in the Mediterranean area, 2006

Bet v 1 homologues in strawberry identified as IgE-binding proteins and presumptive allergens, 2004

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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