Evidence map›Paper›PMID 38903704›Full record

ReviewFrontiers in allergy2024

The effect of subcutaneous and sublingual birch pollen immunotherapy on birch pollen-related food allergy: a systematic review.

E J J Kallen, P M J Welsing, J M Löwik, R Van Ree, A C Knulst, T M Le

Abstract readReview
In one paragraph

Review in Frontiers in allergy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Birch Pollen-Related Food Allergy: Occasionally Severe, Yet Home-Based Oral Food Challenges Are Safe.Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology · 2026
    Article
  2. MUW researcher of the month.Wiener klinische Wochenschrift · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

E J J KallenDepartment of Dermatology/Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.
P M J WelsingDepartment of Dermatology/Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.
J M LöwikDepartment of Dermatology/Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.
R Van ReeDepartments of Experimental Immunology and Otorhinolaryngology, Amsterdam University Medical Centers, Amsterdam, Netherlands.
A C KnulstDepartment of Dermatology/Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.
T M LeDepartment of Dermatology/Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Birch pollen-related food allergy (BPFA) is the most common type of food allergy in birch-endemic areas such as Western and Central Europe. Currently, there is no treatment available for BPFA. Due to the cross-reactivity between birch pollen and a range of implicated plant foods, birch pollen allergen immunotherapy (AIT) may be effective in the treatment of BPFA. In this study, we systematically evaluate the effectiveness of birch pollen-specific subcutaneous or sublingual immunotherapy in treating BPFA. Methods: A search was performed in the PubMed, Embase, and Cochrane libraries. Studies were independently screened by two reviewers against predefined eligibility criteria. The outcomes of interest were changes in (1) severity of symptoms during food challenge, (2) eliciting dose (ED), and (3) food allergy quality of life (FA-QoL). The validity of the selected articles was assessed using the revised Cochrane risk of bias tool. We focused on studies with the lowest risk of bias and considered studies with a high risk of bias as supportive. Data were descriptively summarized. Results: Ten studies were selected that included 475 patients in total. Seven studies were categorized into "high risk of bias" and three into "moderate risk of bias." The three moderate risk of bias studies, with a total of 98 patients, reported on severity of symptoms during challenge and on the ED. All three studies had a control group. Compared to the control group, improvement in severity of symptoms was observed during challenge in two out of the three studies and on the eliciting dose in one out of three. Only one study investigated the effect of birch pollen AIT on FA-QoL, showing that there was no significant difference between patients receiving subcutaneous immunotherapy or a placebo. Of the seven supportive studies, four had a control group and of those, three showed improvement on both severity of symptoms and ED. None of the supportive studies investigated the effect of the therapy on FA-QoL. Conclusion: This systematic review shows that there is not enough evidence to draw firm conclusions about the effect of AIT on BPFA. Future research is warranted that uses robust clinical studies that include long-term effects, QoL, and multiple BPFA-related foods.

Indexed as

allergen immune therapy (AIT)birch pollen allergyBPFAfood allergypollen food allergy syndrome (PFAS)subcutaneous immunotherapy (SCIT)sublingual immunotherapy (SLIT)systematic review

Identifiers

PMID38903704
PMCPMC11187334

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.