Pear allergy under the microscope - Strefa Alergii
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Pear allergy under the microscope

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The pear is not often allergenic. For some of us, however, it can become a dangerous allergen. How, then, can a pear allergy manifest itself?

A few words about the pear


Alergia na gruszkę

The pear is a fruit that is frequently associated with its delicate taste, juicy flesh and high vitamin C content [1]. This valuable fruit also contains numerous micronutrients such as phosphorus, calcium, magnesium, sodium, copper, or iron [2]. In kitchens all over the world, we can find the pear in both desserts and main dishes. Unfortunately, despite its nutritional value, the fruit can also be a source of allergic problems.

The pear is a fruit with extremely versatile uses in the kitchen. It can be found in salads, jams, compotes and as part of many desserts. Its sweet flavour combines perfectly with cheese and nuts, making it a popular appetiser ingredient in Western Europe. In main courses, the pear is used to add a sweet flavour to meat dishes.

Pear allergy

According to recent studies, between 6 and 8% of children and about 3% of adults struggle with food allergy [3]. Most patients suffer from an allergy to one of the so-called “Big Eight” allergens. These include cow’s milk, eggs, fish, shellfish, molluscs, nuts, peanuts, soya, and wheat. In contrast, a primary allergy to pear is quite rare. This means that only a  some people have a direct allergy to pear proteins as a primary allergen. In contrast, it is much more common for symptoms to appear after eating this fruit in people with an allergy to birch pollen. Such a phenomenon is known as pollen food allergy syndrome (PFAS). This occurs as a result of cross-reactions between food and pollen from plants or trees. This is due to the similar chemical structure of many allergens. Therefore, in these patients, after eating a pear, the immune system mistakenly identifies it as a birch-related allergen. Therefore, people with pollen-food syndrome should avoid eating foods that cause cross-reactions with inhalant allergens.

Pear allergy – symptoms

stół, na stole ciasto z gruszką, alergia na gruszkę

Symptoms of a pear allergy can take many forms. They can manifest themselves both in the digestive system and in other parts of the body. One of the most common complaints is the so-called allergic rhinitis. It is characterised by a watery discharge that gives a feeling of a blocked nose.  Patients sometimes also report coughing or itching around the eyes and nose. [4]

Another common complaint is the so-called oral allergy syndrome (OAS). It appears within minutes of contact with the allergen. The first symptoms are itchy mouth and scratchy throat. In addition, swelling of the lips, tongue, or throat and an itching sensation in the ears may occur.

  • In addition, researchers have noted that pear allergens can cause contact dermatitis [5]. Symptoms can occur both in the oral cavity and on other parts of the body. The most common symptom is an itching sensation, but erythema and vesicles that may peel are also among the symptoms.
  • Some patients have also observed signs of an allergic reaction from the gastrointestinal tract, e.g. abdominal pain or nausea.
  • The most severe allergic reactions include anaphylactic shock. This is quite rare in the case of pear allergy. However, it is characterised by severe breathing problems, a rapid drop in blood pressure, and an increased heart rate. Anaphylactic shock is a condition that can pose a serious risk to health and life [6], [7].

Methods for diagnosing pear allergy

If you suspect that you have a pear allergy, it is worth consulting an allergologist. The doctor, to establish the diagnosis, usually carries out a detailed history and allergy tests. The use of molecular diagnostics is also becoming more frequent. Its use allows a more effective and precise diagnosis of allergies. In addition, it helps to better understand the causes of symptoms and to identify possible cross-reactions [8].

Pear allergens

To this day, around five pear allergens have been identified, the name of which comes from the Latin term Pyrus communis, which means common pear tree. Scientists have noted that most allergens are found in fresh fruit. Cooking or baking pears can reduce their ability to cause allergies. In addition, it was noted that many more allergenic proteins are found in the peel than in the flesh. People suffering from an allergy to pears should exercise caution. Before consuming the fruit in any form, an allergologist should be consulted.

The most important pear allergens:

  • Pyr c 1 is the main allergen of the pear. This means that it sensitises more than 50% of patients with an allergy to this fruit. It often cross-reacts with other proteins of similar structure, especially with the inhaled birch pollen allergen Bet v 1 and the food protein Mal d 1 in apple.
  • Pyr c 3 is an allergen that belongs to the lipid transport protein (LTP) group. This protein is mainly found in the skin of pears.
  • Pyr c 4 belongs to the profilin family. It cross-reacts very frequently with the birch inhalant allergen Bet v 2 and the mango food protein Man i 3.
  • Pyr c 5 is an allergen belonging to the reductase group and quite rarely sensitises patients with pear allergy.
  • Pyr py 2 belongs to the thaumatin family. It is also a fairly rare sensitising allergen.

How to deal with a pear allergy?

  • Monitor your diet carefully.
  • Be aware of your diet and avoid foods that may trigger allergic reactions.
  • Regularly check the labels of the products you eat to ensure that they do not contain pear or other ingredients to which you are allergic.
  • If signs of allergy appear, react immediately. If you notice mild symptoms such as a runny nose, rash or itching, reach for antihistamines. Remember to take the dosage as recommended by your allergist. On the other hand, when more severe symptoms occur, such as difficulty breathing, a sharp drop in blood pressure, accelerated heart rate and loss of consciousness, use adrenaline. This medication is given using an auto-injector or ampoule-syringe. Make sure your family and colleagues are familiar with how to administer adrenaline in emergencies . Failure to administer the drug can lead to a risk to health or life.

    Pear allergy is a fairly rare health problem that can significantly affect patients’ quality of life. It manifests itself with a wide spectrum of complaints, from allergic rhinitis to anaphylactic shock. Therefore, correct diagnosis and treatment is the key to health and wellbeing. Patients with symptoms of a pear allergy should take care of their diet and apply the correct treatment if symptoms arise. Knowledge of pear allergy allows you to avoid risks and safely enjoy a variety of foods.

Weronika Gromek

translation: Julia Majsiak

[1] H. Reiland and J. Slavin, “Systematic review of pears and health,” Nutr Today, vol. 50, no. 6, pp. 301–305, 2015, doi: 10.1097/NT.0000000000000112.
[2] J. L. Chen, J. H. Wu, Y. Jiang, and X. S. Hu, “Determination of mineral elements in eight pear varieties by ICP-MS after microwave-assisted digestion,” Guang Pu Xue Yu Guang Pu Fen Xi/Spectroscopy and Spectral Analysis, vol. 29, no. 2, 2009, doi: 10.3964/j.issn.1000-0593(2009)02-0496-03.
[3] K. Willits, M. A. Park, M. F. Hartz, C. D. Schleck, A. L. Weaver, and A. Y. Joshi, “Food Allergy: A Comprehensive Population-Based Cohort Study,” Mayo Clin Proc, vol. 93, no. 10, pp. 1423–1430, Oct. 2018, doi: 10.1016/j.mayocp.2018.05.031.
[4]       A. Emeryk and P. Rapiejko, “Alergiczny nieżyt nosa,” Lekarz POZ, vol. 5, no. 2, pp. 165–169, 2019.
[5] C. Amaro and A. Goossens, “Immunological occupational contact urticaria and contact dermatitis from proteins: a review,” Contact Dermatitis, vol. 58, no. 2, pp. 67–75, Feb. 2008, doi: 10.1111/J.1600-0536.2007.01267.X.
[6] M. Fernandez-Rivas, R. Van Ree, M. Cuevas, A. Madrid, and A. Spain, “Allergy to Rosaceae fruits without related poliinosis,” 1997.
[7] S. M. Salter, R. Loh, F. M. Sanfilippo, and R. M. Clifford, “Anaphylactic shock,” Lekarz POZ, vol. 3, no. 2, pp. 98–103, Sep. 2017, doi: 10.1186/1710-1492-10-49.
[8] M. Wanda Balińska-Miśkiewicz, K. Pediatrii, K. Alergologii, and U. Kardiologii, “Diagnostyka molekularna alergii pokarmowej-czy wiemy więcej?”, Accessed: Nov. 09, 2023. [Online]. Available: