Efficacy of oral tolerance induction to raw apple using an ultra-rush protocol in 28 patients allergic to rosaceae fruits: RAAP study

Abstract

BackgroundThe aim of this study was to describe an ultra-rush (UR) protocol of Raw Golden Apple (RGA) in 28 patients with Oral Allergy Syndrome (OAS) which resulted in avoidance of raw rosaceaes fruits, in order to demonstrate the safety of the protocol and follow-up of patients at 2 months and 1 year. MethodsThe UR protocol was administered with RGA in a daycare hospital starting with 1 gram (g) of RGA, then by regularly doubling the dose until 128g, to reach a 255g cumulative dose in a 3-hours’ period. During the post-hospitalization period, patients had to eat half of a RGA a day during one month, then 1 RGA a day during one month. An assessment consultation was performed at two months follow-up and a telephone interview at one year. ResultsDuration of OAS to raw rosacea ranged from 6 months to 20 years. All 28 patients received the 255g cumulative dose. Tolerance was very good in 25 of the 28 patients. No major allergic incident was recorded. After two months, all the patients were eating a RGA. After one year, 21 patients continued eating all types of raw rosacea fruits. ConclusionThis study shows that resumption of RGA intake by patients with OAS to raw rosacea fruits, part of a cross-allergy with birch pollen is possible within 3 hours’ after use of an UR protocol. This protocol is simple, safe and easy to administer. Follow-up at 2 months and at one year was positive.