panallergens

Panallergens are families of allergenic proteins that occur in many different plant-derived foods and pollens, producing cross-reactive allergic responses in sensitized individuals. The term highlights how a single protein family can trigger reactions to a wide range of seemingly unrelated foods or pollens due to shared molecular epitopes.

The main pan allergen families are profilins, PR-10 proteins, and non-specific lipid transfer proteins (nsLTPs). Profilins (eg, Bet v 2) and PR-10 proteins (Bet v 1-like) tend to be heat-labile and are commonly associated with pollen-food allergy syndrome, often causing oral symptoms when raw fruits and vegetables are eaten, with cooking sometimes reducing reactivity. nsLTPs (such as Pru p 3 from peach and Mal d 3 from apple) are more heat-stable and can provoke more serious reactions, including systemic symptoms, and are a prominent concern in some regions, notably the Mediterranean.

Cross-reactivity arises because these panallergens are widely conserved across plant species, leading a person sensitized to one pollen or food to react to many others. Geographic patterns influence which panallergen groups predominate in clinical presentations.

Diagnosis relies on component-resolved diagnostics to detect IgE specific to individual panallergen components, helping distinguish cross-reactivity from primary sensitization. Skin tests and, when necessary, oral food challenges support assessment.

Management focuses on avoiding or limiting exposure to trigger foods, with consideration of whether processed or cooked forms are tolerated. In some cases, treatment of the primary pollen allergy may alleviate related food symptoms. Education on label reading and individualized dietary planning is essential.