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The major birch pollen allergen, Bet v 1, is a 17.5 kDa acidic protein from Betula verrucosa whose structure features a unique cavity linked to its allergenic properties. It is the principal protein responsible for birch pollen allergies affecting millions globally, associated with cross-reactivity to pollen from related species (hazel, alder, hornbeam) as well as specific foods. Minor birch pollen allergens (e.g., Bet v 2 [profilin], Bet v 4 [polcalcin], Bet v 5 [isoflavone reductase-like]) contribute to the allergenicity and diversity of clinical presentations. These allergens are used as molecular targets for diagnostics and immunotherapy, but clinical management is challenged by cross-reactivity and the risk of severe allergic reactions.
Immunotherapy: Induces tolerance by repeated exposure, shifts immune response from Th2/IgE to Th1 or regulatory T cell profile. Monoclonal anti-IgE: Prevents IgE-allergen interaction by neutralizing circulating IgE
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