STRAWBERRY ALLERGY
Key Allergens
Strawberries are in the
Rosaceae family of plants. Other plants in this family include almonds, apple, apricot, blackberry, cherry, peaches and plums.
Strawberries contain a
Bet v 1 like protein. This is a protein found in birch pollen which can cause cross reactions with other fruit.
They also contain
Lipid Transfer Proteins (LTPs), 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.
Strawberries contain 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.
Food Intolerances
Strawberries are a low FODMAP food.
FODMAP stands for
Fermentable
oligosaccharides,
disaccharides,
monosaccharides
and
polyols. Foods high in FODMAPs can cause symptoms of food intolerance, affecting the gastro intestinal system and this can be mistaken for a true IgE food allergy.
Strawberries are very high in
salicylates. Salicylates have the potential to cause worsening of asthma, swelling, itching and hives as well as food intolerance symptoms in people who are sensitive to salicylates.
You can read more about
Food Intolerances on the dedicated Food Intolerance Page.
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.
Please note that these food lists are not exhaustive, the most up to date information is on the Cross Reactivity Tool.
Resources
Websites
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)
Histamine Food List
ATP Science - Salicylate Food List
Healthline - Low FODMAP foods
Articles and Journals
Food allergy outside the eight big foods in Europe: A systematic review and meta-analysis, 2024
Characteristics of major allergen Fra a 1 in cultivated strawberry, 2023
Generalized allergic reaction in response to exercise due to strawberry gibberellin-regulated protein: a case report, 2022
Allergen Tests of Fruit Sensitization Involving Children with Allergic Diseases, 2022
Analysis of Protein Sequence Identity, Binding Sites, and 3D Structures Identifies Eight Pollen Species and Ten Fruit Species with High Risk of Cross-Reactive Allergies, 2022
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
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