Apples have several allergens that cause symptoms in the mouth area within 5 to 10 minutes of ingestion and therefore cannot be eaten by people with an apple allergy. About 7.5 million people in Germany have developed IgE antibodies to the main allergen (Mal d 1) in apples and are sensitised as a result. At least 3.5 million of those people go on to develop allergy symptoms characteristic of oral allergy syndrome, some of which can be significant. There is no effective drug therapy for this allergy.
Apple allergy sufferers must therefore avoid apples altogether, eat cooked or baked apples, or look for varieties that contain fewer allergens and can therefore be described as allergy-friendly apple varieties. It cannot be predicted just by identifying the allergens in an apple in a laboratory whether an apple can be eaten without triggering apple allergy symptoms; clinical testing is required for this. A standardised clinical, oral provocation test is used to characterise a low- allergen, allergy-friendly apple or apple variety. The results of such tests, which are conducted over a period of at least three years, will be used to determine whether the ECARF Seal of Quality can be granted for allergy-friendly apples.
However, complete safety from allergen exposure cannot be guaranteed even with a certified allergy-friendly apple.