Apples have several allergens which, when eaten, lead to symptoms in the mouth within 5-10 min-and therefore cannot be eaten by those suffering from apple allergies. In Germany around 7.5 million people have developed specific antibodies against the main allergen (Mal d 1) in apples and are thus sensitized. At least 3.5 million of them develop the sometimes-considerable allergic symptoms as an expression of an Oral Allergy Syndrome. So far there is no drug therapy for this allergy. Apple allergy sufferers can therefore only do without apples entirely, or eat apples that have been heated beforehand or look for varieties that contain few allergens and can therefore be described as "allergy-friendly" apple varieties. Solely determinations of allergens in the laboratory cannot predict whether an apple can be eaten by apple allergy sufferers without allergic symptoms; clinical trials are required for this. We describe a standardized clinical, oral provocation test that can be used to characterize a low-allergen, allergy-friendly apple or apple variety. The results of such at least three-year tests can be used to award the ECARF seal for allergy-friendly products.
