Yukihiro Ohya

BACKGROUND: Allergic rhinitis and pollen sensitization typically increase with age; however, longitudinal data on the prevalence of pollen-food allergy syndrome (PFAS) among Japanese adolescents are limited. OBJECTIVE: We assessed the prevalence, causal foods, and sensitization status of PFAS among 17-year-olds and explored its association with comorbid allergic conditions. METHODS: This study was conducted as part of the Tokyo Child Health, Disease, and Development Research, a prospective birth cohort study involving the general population. Adolescents aged 17 (range, 16-18) years participated in a cross-sectional survey that included a medical history and health questionnaire, alongside serum IgE testing by ImmunoCAP ISAC. Statistical analyses were performed by descriptive statistics. RESULTS: Among 458 participants, 54.4% had current pollen allergy and 11.2% had PFAS. The most common causal foods were apples (45.1%), kiwis (41.2%), and pineapples (39.2%). Sensitization rates were high for Cry j 1 (96.1%), Bet v 1 (70.6%), Mal d 1 (64.7%), and Pru p 1 (62.7%). Additionally, 43.1% of adolescents with PFAS had a history of atopic dermatitis, suggesting a link between PFAS and the concept of the allergic march. Rhinitis symptoms peaked in spring, with 79.8% reporting symptoms, particularly in March and April. CONCLUSION: This study examined the prevalence and sensitization status of PFAS among Japanese adolescents. PFAS was common in those with pollen allergies and was associated with atopic dermatitis, supporting the allergic march hypothesis. Apples, kiwis, and pineapples were the most frequently implicated foods. These findings underscore the importance of recognizing PFAS in managing adolescent allergic conditions.