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Major pollen allergen Bet v 1 is the primary sensitizing protein found in birch (Betula verrucosa) pollen and is the prototypical member of the pathogenesis-related protein family 10 (PR-10) [UniProt: P15494]. It functions biologically as a carrier for hydrophobic ligands, including plant steroids and flavonoids, within its internal cavity [PubMed: 28823055]. In the context of human disease, Bet v 1 is the major trigger for allergic rhinitis, allergic conjunctivitis, and pollen-related asthma in temperate regions, with over 90% of birch pollen-allergic individuals exhibiting IgE reactivity to this specific protein [PubMed: 31152447]. It is also the primary cause of pollen-food allergy syndrome (PFAS) due to structural cross-reactivity with homologous proteins in foods like apples (Mal d 1) and hazelnuts (Cor a 1.04) [PubMed: 25264142]. Therapeutically, Bet v 1 is the central component of allergen-specific immunotherapy (AIT), where controlled exposure to the allergen induces immune tolerance by promoting regulatory T-cell (Treg) activity and the production of protective IgG4 antibodies [PubMed: 30633301]. Modern treatments like Itulazax utilize standardized extracts to target the immune system's response to this specific allergen [ClinicalTrials.gov: NCT02245412].
Allergen-specific immunotherapy (AIT) modulates the immune system by inducing peripheral T-cell tolerance, increasing the production of regulatory cytokines such as IL-10 and TGF-beta, and stimulating the synthesis of allergen-specific IgG4 antibodies that act as blocking antibodies to prevent IgE-mediated mast cell degranulation [PubMed: 30633301, PMID: 28823055].
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