In sensitized individuals, when a particular pollen allergen interacts with a related food allergen, it triggers pollen-food allergy syndrome (PFAS). While oral symptoms are the most common manifestation, some individuals may experience additional symptoms such as nasal congestion, skin reactions, respiratory issues, or even life-threatening anaphylactic shock. The development of pollen-food allergy syndrome (PFAS) involves mast cells in the oral mucosa, which are sensitized to specific pollen antigens bound to IgE. These mast cells then cross-react with food antigens, triggering a localized type I allergic response when ingesting foods containing protein antigens (panallergens) that share structural similarities with pollen antigens. The prevalence of PFAS is influenced by regional variations in pollen type and abundance. Due to the widespread presence of various pollen allergens, such as alder and grass, linked to this condition, research on per- and polyfluoroalkyl substances (PFAS) is a global endeavor. This review examines the latest findings on the pathophysiology, epidemiology, and clinical manifestations of PFAS. We also highlight crucial research gaps that must be addressed to improve patient outcomes for those affected by PFAS.

Pollen-food allergy, ethiology, pathogenesis, cross-reaction, clinical types

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