Abstract：
Oral allergy syndrome or pollen food allergy syndrome (PFAS) represents a common clinical conundrum when the reported trigger food is a tree nut (usually almond or hazelnut) or peanut. The PFAS may give rise to uncertainty about the potential severity of the future reactions, indications for prescribing epinephrine, and the extent of the necessary dietary avoidance. As a food allergy, secondary to cross-reactivity with airborne pollen, PFAS usually manifests toward the end of the first decade of life as contact urticaria of the oropharyngeal mucous membranes. Molecular allergology facilitates diagnosis and risk stratification by establishing the profile of sensitization. Exclusive sensitization to pathogenesis-related proteins family 10 (PR10) and profilins indicates that signs and symptoms are due to PFAS, whereas sensitization to seed storage proteins with or without sensitization to PR10 and profilins may indicate a more severe primary nut allergy phenotype. Management relies on avoidance of the specific nut trigger, advice on the likelihood of more severe local or systemic symptoms, and treatment of reactions according to the severity. Future studies are needed to better delineate the risk of systemic reactions in individuals with nut PFAS and to establish the role of food or pollen allergen immunotherapy for the prevention or moderation of this condition.
摘要：
当报告的触发食物是树坚果（通常是杏仁或榛子）或花生时，口腔过敏综合征或花粉食物过敏综合征（PFAS）代表了常见的临床难题。PFAS可能会对未来反应的潜在严重程度产生不确定性，处方肾上腺素的适应症，以及必要的饮食避免的程度。作为食物过敏，继发于与空气传播的花粉的交叉反应，PFAS通常在生命的第一个十年结束时表现为口咽粘膜的接触性荨麻疹。分子变态反应学通过建立致敏的概况来促进诊断和风险分层。对发病相关蛋白家族10（PR10）和profilins的独家致敏表明体征和症状是由于PFAS，而对种子贮藏蛋白的致敏或不对PR10和profilins致敏可能表明更严重的原发性坚果过敏表型。管理依赖于避免特定的坚果触发因素，关于更严重的局部或全身症状的可能性的建议，并根据严重程度治疗反应。需要进一步的研究来更好地描述坚果PFAS患者的全身反应风险，并确定食物或花粉过敏原免疫疗法在预防或缓解这种情况中的作用。
