The rosaceae (rose) botanical family is a large family of plants consisting of approximately 3000 species. Allergies occur with exposure to plants in, and as a result of ingestion of fruits of, this family. Fruits in the rosaceae family include blackberry, raspberry, strawberry, apple, plum, peach, almond, cherry, and apricot. Studies into allergy cross-reaction within the same family suggest a sufferer may also experience reactions to non-food plants in this family, such as birch pollen (and vice-versa).
The effects of rosaceae allergy are typically mild and focused around the oral area. Rarer are more severe reactions including anaphylaxis.
A response is caused by ingestion or skin contact with rosaceae fruit proteins. Reactions in sufferers are common after eating fresh, unpeeled fruit. The peel of rosaceae fruits has been reported to have a higher allergenicity than the pulp. In most cases the proteins that cause the reaction will be destroyed during a cooking or pasteurization process.
Studies of allergy cross-reaction have shown that if an allergy is experienced with one member of the rosaceae family, there is a greater than 50% chance that an allergy will also be experienced with another member of that botanical family. This includes non-fruits: rosaceae allergy is often associated with birch pollinosis in Central and Northern Europe and with grass pollen allergy in Central Spain. An allergy to apple has also been associated with kiwifruit allergy.
Management of rosaceae allergy consists primarily of avoidance of fruits in the rosaceae family, and in certain cases avoidance of all plants in the rosaceae family. Some sufferers cite herbal/complementary remedies to minimize the effects of the allergy.
Anaphylaxis – Rarer
Angioedema (swelling) of the face – After eating
Angioedema (swelling) of the gums – After eating
Angioedema (swelling) of the lips – After eating
Diarrhoea / diarrhea – After eating
Pruritus (itch) of the mouth – After eating
Rhinitis (nasal congestion) – After eating and occasionally with only skin contact
Sneezing – After eating and occasionally with only skin contact
Watery eyes – After eating and occasionally with only skin contact
Potential high risk
Apple – Golden Delicious Apples have been shown to have the greatest amount of allergen (compared with Macintosh Red Delicious and Granny Smith). Apples in stores have been shown to have higher levels of allergen than freshly picked fruit.
Birch pollen – Birch is a member of the rosaceae plant family and patients allergic to Birch pollen often display allergy symptoms after ingesting or handling raw fruits from the same family due to cross-reactivity between allergens
Unknown / suspected risk
Fruit tea infusions – One study found that fruit tea infusions may contain different ingredients from the Rosaceae family and they continue to be allergenic after boiling resulting in anaphylaxis.
Rose (flower) – Contact with cut roses may result in a similar allergic reaction to contact with fruit from other parts of the rosaceae botanical family