Old Apple (Malus domestica L. Borkh) Varieties with Hypoallergenic Properties: An Integrated Approach for Studying Apple Allergenicity

Analyzing Bioaccessibility of Polyphenols in Six Commercial and Six Traditional Apples (Malus domestica Borkh.) during In Vitro and Ex Vivo Oral Digestion

SCOPE

Apples are an important polyphenol (PP) source. To compare the health benefits of traditional and commercial varieties, the phenolic contents and profiles as well as their release from the matrix (bioaccessibility) during oral digestion are determined. Furthermore, based on these data the proposed beneficial effect of PP on the variety specific allergenicity is discussed.

METHODS AND RESULTS

Phenolics are quantified by HPLC-DAD. Total phenolic contents (TPC) are in the range of 111-645 and 343-1950 mg 100 g-1 dry weight for flesh and peel, respectively. Matrix release during oral digestion is investigated ex vivo, with centrifuged and non-centrifuged human saliva and in vitro with simulated saliva fluid (SSF). The overall bioaccessibility is similar in all digestion media, ranging between 40-80% and 39-65% of the TPC in flesh and peel, respectively. Analyzing the correlation among Mal-d 1-allergen-content, unoxidized PP, and the allergenic potential for the samples reveals a negligible effect of phenolics.

CONCLUSION

Due to higher phenolic contents in combination with a similar release, increased PP concentrations in the oral phase and an improved uptake of PP from traditional varieties are assumed. However, the proposed beneficial effect of phenolics on allergenicity cannot be confirmed.

Antioxidant, Antidiabetic, and Anti-Obesity Properties of Apple Pulp Extracts (Malus domestica Bork): A Comparative Study of 15 Local and Commercial Cultivars from Spain

Apples (Malus domestica Borkh.) have a great agricultural and economic impact worldwide; they also present an interesting nutritional value, and their consumption has been associated with beneficial health effects. In this study, 15 apple varieties (three commercial, 12 autochthonous genotypes) were collected from mountainous areas in Spain and were evaluated for their phenolic content, antioxidant, anti-obesity and antidiabetic activities. Quercetin was tested as the reference substance in bioassays due to its role as one of the most common flavonoids in apples and other vegetables. Total Phenolic Content (TPC) of apple pulp extracts was quantified using the Folin-Ciocalteu method. The antioxidant activity was determined by using 1,1-diphenyl-2-picrylhydrazyl (DPPH) scavenging and xanthine/xanthine oxidase (X/XO) scavenging assays. Antidiabetic and anti-obesity potential were evaluated by inhibition of alpha-glucosidase (α-GLU), advance glycation end products (AGEs) formation and pancreatic lipase. The results showed in general higher phenol content in autochthonous varieties than in commercial apple pulp extracts. Phenolic-rich extracts showed better antioxidant profiles and significantly inhibited AGEs production and the α-glucosidase enzyme in a dose-dependent manner. None of them showed pancreatic lipase inhibitory effects but in general, the genotype known as "Amarilla de Octubre" was the best in terms of TPC and bioactive properties.

Covalent polyphenol modification of a reactive cysteine in the major apple allergen Mal d 1

Naturally occurring polyphenols can modify the molecular properties of food allergens. For the major apple allergen Mal d 1 it has been postulated that chemical reactions with polyphenols cause permanent changes in the tertiary structure, causing a loss of conformational IgE epitopes and reducing allergenicity. In our study, we investigated the effect that reactions with oxidized polyphenols have on the structure of Mal d 1 by mass spectrometry and NMR spectroscopy. We showed that a surface-exposed cysteine residue in this allergen spontaneously reacts with oxidized polyphenols under formation of a defined covalent adduct. Chemical modification of Mal d 1 did not destabilize or perturb the three-dimensional fold, nor did it interfere with ligand binding to its internal pocket. A structural model of the chemically modified apple allergen is presented, which reveals that the bound polyphenol partially covers a conformational IgE epitope on the protein surface.

Characterization and Quantification of Mal d 1 Isoallergen Profiles and Contents in Traditional and Commercial Apple Varieties by Mass Spectrometry

The apple allergy in Northern Europe is a cross-reaction to the birch pollen allergy. No correlation between the allergenicity of an apple variety and the content of the major apple allergen Mal d 1, a homologue to the Bet v 1 allergen in birch, could be found using ELISA, so far. Therefore, an impact of polyphenols and/or differences in the isoallergen profile are discussed. To allow a more detailed analysis of the Mal d 1 content and the isoallergen profile, a mass spectrometric method was applied to investigate differences in the flesh and peel of 10 traditional varieties and 10 commercial breeds. The data revealed often, but not always, lower Mal d 1 contents in traditional varieties grown in orchard meadows, which was more obvious in the flesh. Differences among the peels were less pronounced. A closer look at the individual isoallergens 1.01, 1.02, 1.03, and 1.06 reveals an increased impact of the minor isoallergens 1.03 and 1.06 on the allergenic potential, since commercial breeds like Braeburn, Santana, and Holstein Cox, which are considered to have reduced allergenic potentials, were characterized by low levels of these isoallergens.

New Mass Spectrometric Approach to Quantify the Major Isoallergens of the Apple Allergen Mal d 1

Patients who suffer from birch pollinosis often develop adverse reactions to the consumption of fresh apples due to the structural similarity of the allergens Bet v 1 and Mal d 1 from birch and apples, respectively. A different allergenic potential for Mal d 1 isoallergens is postulated, but approaches to quantify the Mal d 1 isoallergen-specific are missing. Therefore, a bottom-up proteomics approach was developed to quantify Mal d 1 by stable isotope dilution and microHPLC-QTOF analyses. Marker peptides for individual isoallergens (Mal d 1.01-Mal d 1.03 and Mal d 1.06), combinations thereof (Mal d 1.01 + 1.02, Mal d 1.02 + 1.06, and Mal d 1.04 + 1.05), and two global marker peptides, comprising Mal d 1.01 + 1.02 + 1.04 + 1.05 and Mal d 1.03 + 1.06 + 1.07 + 1.08 + 1.09, were identified. By the use of an extraction standard (r-Mal d 1_mut), an optimized protocol for extraction and tryptic digestion of apple proteins was developed, and the variety-specific extraction efficiency was monitored for the flesh and peel of apples. The Mal d 1 contents in flesh and peel of five commercial apple breeds and four apple varieties from orchard meadows were quantified isoallergen-specific.

Ascorbylation of a Reactive Cysteine in the Major Apple Allergen Mal d 1

The protein Mal d 1 is responsible for most allergic reactions to apples (Malus domestica) in the northern hemisphere. Mal d 1 contains a cysteine residue on its surface, with its reactive side chain thiol exposed to the surrounding food matrix. We show that, in vitro, this cysteine residue is prone to spontaneous chemical modification by ascorbic acid (vitamin C). Using NMR spectroscopy and mass spectrometry, we characterize the chemical structure of the cysteine adduct and provide a three-dimensional structural model of the modified apple allergen. The S-ascorbylated cysteine partially masks a major IgE antibody binding site on the surface of Mal d 1, which attenuates IgE binding in sera of apple-allergic patients. Our results illustrate, from a structural perspective, the role that chemical modifications of allergens with components of the natural food matrix can play.

Identification of apple cultivars hypoallergenic for birch pollen-allergic individuals by a multidisciplinary in vitro and in vivo approach

BACKGROUND

Birch pollen-related apple allergy is the most frequent IgE-mediated food allergy in Central-Northern Europe with Mal d 1 as major allergen. Its concentration in apples varies with the cultivar and storage time. Year-round appealing, hypoallergenic cultivars still are needed to satisfy the nutritional needs of affected individuals. We characterized three promising cultivars by multidisciplinary in vitro assays including long-term storage and by clinical challenges of allergic individuals before and after the birch pollen season.

METHODS

Proteins were extracted from fruits of 'Santana', 'Golden Delicious' (GD), and three genuine cultivars in November 2018 and April 2019. Mal d 1-levels were analysed by mass spectrometry, SDS-PAGE, immunoblotting, competitive ELISA, and basophil activation tests. Twenty-eight allergic individuals underwent single-blinded open food challenges and skin testing with the cultivars and birch pollen in November 2018 and May 2019. Allergen-specific IgE-levels were determined.

RESULTS

After storage all cultivars except 'Santana' were of appealing appearance and taste. Their Mal d 1 content had increased, also reflected by significantly amplified basophil activation and stronger reactions in clinical challenges. Besides, individuals showed boosted reactivity after pollen exposure indicated by enhanced allergen-specific IgE-levels and skin reactions to birch pollen. Still, all cultivars remained significantly less allergenic than GD and comparable to Santana in November 2018 in all assessments except for skin testing.

CONCLUSIONS

Combined expertise in pomology and allergology identified promising new cultivars for allergic consumers. The evaluation of hypoallergenic apples should incorporate long-term storage and birch pollen exposure. Basophil activation tests may be suitable in the selection of promising cultivars for oral challenges.

Identification of allergenomic signatures in allergic and well-tolerated apple genotypes using LC-MS/MS

The apple fruit (Malus domestica L. Borkh) is one of the most popular fruits worldwide. Beyond their beneficial properties, apples contain proteins that trigger allergic reactions in susceptible consumers. Mal d1 to d4 are allergens present in a variety of different isoforms in apples. In this study, we used proteomics to quantify all four Mal d proteins in 52 apple genotypes with varying allergenic potentials. A total of 195, 17, 14, and 18 peptides were found to be related to Mal d1, d2, d3, and d4 proteins, respectively of which 25 different Mal d proteins could be unambiguously identified. The allergenic potential of the Mal d isoforms was characterized by comparing the isoform abundance with the allergenic score of genotypes from oral challenge tests. The detected Mal d peptides presumably have different IgE binding properties and could be used as potential molecular markers to discriminate between hypoallergenic and hyperallergenic cultivars.

Apple allergy: Causes and factors influencing fruits allergenic properties-Review

BACKGROUND

Apple tree fruits (Malus × domestica Borkh.) are a rich source of nutrients and nutraceuticals and are recommended as a part of the healthy, staple diet. However, apples could be also the cause of allergies including severe reactions. Allergies to fruits like apples are predominantly associated with pollinosis. In North and Central Europe, sensitisation to apples is caused mainly by cross-reactive birch pollen aeroallergen, whereas in the Mediterranean area of Europe, apple allergy is mostly associated with allergies to peach. The allergenicity of apples differ across cultivars but only a few varieties were studied. Some factors changing apples allergenicity were identified, including unmodifiable and potentially modifiable factors for example cultivation method, ripening stage and storage conditions.

AIM

This review presents current knowledge about the molecular basis of apple allergenicity and factors influencing its level.

CONCLUSIONS

Selecting cultivars with low potential of allergenicity, removing apple peel and heat treatment could reduce the risk of severe allergy reaction incidence and presumably can be used in birch pollen immunotherapy.

The Perspective of Croatian Old Apple Cultivars in Extensive Farming for the Production of Functional Foods

The Republic of Croatia has a long tradition of fruit growing due to its geographical location, climatic conditions, and high quality of fruit crops, especially apple fruits. Apples can be used for the formulation of functional foods either in processed form (e.g., juice), or as a by-product (e.g., apple pomace). However, there is a growing demand for functional foods derived from ancient and traditional plant sources as they are recognized as a very valuable source of health-promoting bioactive ingredients. Similarly, old apple cultivars (Malus domestica Borkh.) are characterized by good morphological and pomological properties, less need for chemicals during cultivation and the higher share of biologically active compounds (BACs) with better sensory acceptability compared to commercial cultivars. However, their nutritional and biological potential is underestimated, as is their ability to be processed into functional food. The importance in preserving old apple cultivars can also be seen in their significance for improving the nutritional composition of other apple cultivars through innovative cultivation strategies, and therefore old local apple cultivars could be of great importance in future breeding programs.

Oral birch pollen immunotherapy with apples: Results of a phase II clinical pilot study

BACKGROUND

Seventy percent of patients suffering from birch pollen allergy (BPA) develop a pollen-related food allergy (prFA), especially to apples, due to a clinically relevant cross-reactivity between the major allergen in birch Bet v 1 and Mal d 1 in apples. Therefore allergen-specific immunotherapy with fresh apples (AITA) could be a promising natural treatment of both BPA and prFA.

OBJECTIVE

To assess the clinical efficacy of immunotherapy by daily apple consumption for patients with BPA and prFA.

METHODS

A daily defined increasing amount of selected cultivars (Red Moon®, Pink Lady®, Topaz, Golden Delicious) was continuously consumed by 16 patients (12 female; median age; 50; range, 23-68 years), leading to increased intake of allergen over a period of at least 8 months. Specific IgE and IgG₄ to Bet v 1 and Mal d 1, conjunctival and oral provocation tests, skin reactivity, and the average daily rhinoconjunctivitis combined symptom and medication score (CSMS) were measured during the peak birch pollen season.

RESULTS

After 8 months of therapy, patients showed increased tolerance to apples (p < .001) and a decreased skin reactivity to apples. Oral allergy syndrome to other birch prFA than apple also decreased (p < .05). Moreover, daily rhinoconjunctivitis CSMS declined by 34% (p < .001), as did conjunctival reactivity to birch pollen extract by 27% (p < .01), while specific IgG₄ to Mal d 1 and Bet v 1 increased (p < .01).

Evaluation of the phenolic profile and immunoreactivity of Mal d 3 allergen in ancient apple cultivars from Italy

BACKGROUND

Since the second half of the 20th century, the cultivation of ancient and local apple cultivars has almost disappeared from orchards in Italy. Some of these ancient apple cultivars often possess high nutraceutical values and display lower allergenicity than the modern ones, supporting the so-called 'green revolution' theory.

RESULTS

In this study, the phenolic composition and the antioxidant activity of five ancient apple cultivars ('Belfiore', 'Pomella Genovese', 'Gravenstein', 'Bella del Bosco', and 'Piatlin') were compared with a 'Golden Delicious' commercial cultivar. Additionally, apples were tested for their potential allergenicity by detecting the presence of Mal d 3, a non-specific lipid transfer protein that represents the main apples' allergen. All apples came from northern Italy (Trentino Region) and were organically produced. Results showed that, for all cultivars, the skins contained more polyphenols than the pulps. 'Bella del Bosco' had the highest amount of polyphenols and antioxidant activity, whereas 'Piatlin' had the lowest phenolic content. All ancient cultivars presented a higher amount of pulp phenolic compounds than 'Golden Delicious'. Immunoblotting techniques showed that 'Bella del Bosco' and 'Piatlin' had very low quantities of Mal d 3 allergen; hence, they can be considered hypoallergenic cultivars.

CONCLUSIONS

The preservation of ancient apple cultivars would be of great importance, not only to maintain the biodiversity but also for their nutritional properties. The hypoallergenic activity of some of these cultivars could be of interest also for the preparation of different apple-based products. © 2020 Society of Chemical Industry.

Polyphenols of Traditional Apple Varieties in Interaction with Barley β-Glucan: A Study of the Adsorption Process

Apple polyphenols have been studied for various beneficial bioactivities. Especially interesting are traditional, old varieties of apples for which some initial studies have suggested significant bioactivities, but they are still not completely understood. Polyphenol bioactivities can be affected by interactions with dietary fibers such as β-glucans. The aim of this study was to investigate for the first time interactions between individual polyphenols from traditional, old apple varieties (“Božićnica” and “Batulenka”) and β-glucans by studying the adsorption process. Polyphenols were extracted from the peel and flesh of traditional apples by using an ultrasonic bath and characterized with high-performance liquid chromatography. The amounts of adsorbed (q_e) and un-adsorbed (c_e) polyphenols were modeled with adsorption isotherms (Langmuir, Dubinin–Radushkevich, and Hill) by using improved non-linear fitting in a novel R algorithm, developed specifically for the modeling of adsorption isotherms. Polyphenols adsorbed onto β-glucan from 9 to 203 (peel, “Božićnica”), 1 to 484 (peel, “Batulenka”), 5 to 160 (flesh, “Božićnica”), and 19 to 28 mg g⁻¹ (flesh, “Batulenka”). The adsorption was concentration dependent (polyphenols present in higher amount adsorbed in higher amounts). Physical sorption can be suggested. Polyphenols from traditional apples adsorb onto β-glucan and should be further studied.

Tiered approach for the identification of Mal d 1 reduced, well tolerated apple genotypes

A rising proportion of the world population suffers from food-related allergies, including incompatibilities to apples. Although several allergenic proteins have been found in apples, the most important proteins that cause allergic reactions to apples in Central-Northern Europe, and North America are the Mal d 1 proteins, which are homologues of the birch pollen allergen Bet v 1. As the demand for hypoallergenic fruits is constantly increasing, we selected apple genotypes with a low total content of Mal d 1 by enzyme-linked immunosorbent assay analysis from segregating populations and tested the tolerability of these fruits through a human provocation study. This tiered approach, which exploited the natural diversity of apples, led to the identification of fruits, which were tolerated by allergic patients. In addition, we found a significant correlation (coefficient >0.76) between the total Mal d 1 content and flavan-3-ol amount and show that the isoform composition of the Mal d 1 proteins, which was determined by LC-MS/MS has a decisive effect on the tolerability of apple genotypes. The approach presented can be applied to other types of fruit and to other allergenic proteins. Therefore, the strategy can be used to reduce the allergen content of other plant foods, thereby improving food safety for allergy subjects.

Allergen-specific immunotherapy with apples: selected cultivars could be a promising tool for birch pollen allergy

Background

Most birch pollen‐allergic patients develop allergic cross‐reactions to the major allergen found in apples Mal d1, known as pollen‐related food allergy (prFA). This is due to a strong clinically relevant homology between the major allergen in birch Bet v 1 and Mal d 1. Daily apple consumption induces oral tolerance in prFA, but its effect on the inhalational allergy has not been investigated.

Objectives

As continuous apple consumption might also mitigate the inhalational allergy, this study aimed to uncover apple cultivars suitable for treatment of birch pollen rhinoconjunctivitis and apple allergy in a controlled and established dosage.

Methods

Patients (n = 52) with birch pollen allergy and prFA to apples were subjected to a prick‐to‐prick test (SPT) with 23 cultivars (red‐fleshed, old traditional and new commercial). By SPT, the apple parts flesh, peel equatorial and peel apical near the stalk were compared for their reactivity. One apple cultivar of each allergenicity class (low, middle and high) was subsequently tested in an oral provocation test (OPT).

Results

According to the SPTs, we provide a ranking of all 23 cultivars. Red‐fleshed apples displayed the lowest reactivity, followed by old and new cultivars. Four cultivars showed disagreement from their allergenicity class: Santana and Pink Lady®, new cultivars that provoked only low to moderate. In contrast, White Rosemary and Goldparmäne, two old cultivars, induced strong reactions. Skin reactivity increased from flesh to peel to stalk, and SPT results could predict the severity of prFA of each allergenicity class.

Conclusions

Herein, we propose a treatment protocol for allergen immunotherapy to birch pollen and prFA with daily apple consumption. Red‐fleshed, old and the new cultivars Santana and Pink Lady® provoke less allergic reactions and are suitable for initial induction. After a controlled and well‐tolerated increase of intake, also moderate and finally high allergenic apple cultivars should be integrated into treatment of birch pollen allergenic patients.

Linked Commentary: K.‐C. Bergmann. J Eur Acad Dermatol Venereol 2020; 34: 1130–1130. https://doi.org/10.1111/jdv.16556.

Traditional, Indigenous Apple Varieties, a Fruit with Potential for Beneficial Effects: Their Quality Traits and Bioactive Polyphenol Contents

Earlier studies suggested that traditional apple varieties have quality traits well accepted by consumers and beneficial effects on human health. The aim was to collect 25 traditional apple varieties grown in Croatia and to determine, for the first time in so many details, their external (weight, height, width, shape, color), internal quality traits (firmness, starch decomposition index, maturity index, soluble solid concentration, total acids, soluble solid/total acids ratio, pH), and seed characteristics. In addition, individual polyphenols were determined in the flesh and peel, by using RP-HPLC. All was compared to the commercial variety ‘Idared’. Quality parameters of these varieties were similar to those of the commercial variety. The flesh and peel contained flavan-3-ols, dihydrochalcones, phenolic acids, and flavonols, while anthocyanins were additionally found in the peel. Total polyphenols in the peel (536–3801 mg kg⁻¹ fresh weight (FW)) and in the flesh (79–1294 mg kg⁻¹ FW) of the majority of varieties were higher than in the commercial variety. Principal component analysis showed possible clustering according to polyphenol amounts. According to the observed diversity of quality traits and bioactive polyphenol contents, the traditional varieties have potential for consumer acceptance and increased cultivation.

Immunoblotting Quantification Approach for Identifying Potential Hypoallergenic Citrus Cultivars

The inherent allergens of citrus fruits, such as Cit s 1, Cit s 2, Cit s 3 can cause allergic reactions. A better understanding of the genetic factors (cultivar to cultivar) affecting the allergenic potential of citrus fruits would be beneficial for further identification of hypoallergenic genotypes. In the present study, an immunoblotting quantification approach was adopted to assess the potential allergenicity of 21 citrus cultivars, including nine subgroups (tangerine, satsuma, orange, pummelo, grapefruit, lemon, kumquat, tangor, and tangelo). To prepare highly sensitive and specific rabbit polyclonal antibodies, antigenicity of purified rCit s 1.01, rCit s 2.01, and rCit s 3.01 peptides were enhanced with high epitope density in a single protein molecule. The data integration of three citrus allergen quantifications demonstrated that the four pummelo cultivars (Kao Phuang Pummelo, Wanbai Pummelo, Shatian Pummelo, and Guanxi Pummelo) were potential hypoallergenic, compared with other 8 subgroups. Moreover, the immunological analyses with sera of allergic subjects revealed that Shatian Pummelo and Guanxi Pummelo showed the lowest immunoreactivity in 8 representative citrus cultivars. These potential hypoallergenic genotypes are of great significance to not only allergic consumers but also citrus breeders in the genetic improvement of hypoallergenic citrus as breeding resources.

The Incidence of Delayed-Type Hypersensitivity Reactions to Apples Among Patients Allergic to Birch Pollen

The major apple allergen Mal d 1 cross-reacts with the homologous birch pollen allergen Bet v 1 and causes immunoglobulin E (IgE)-mediated immediate-type allergic reactions. In some patients, delayed-type hypersensitivity to apples may develop within 72 hours without evidence of specific IgE or a positive skin prick test (SPT). The aim of the study was to evaluate the concomitance of delayed-type hypersensitivity reactions and immediate IgE-mediated reactions against high- and low-allergenic apple cultivars in patients with birch pollen allergy. Data were obtained from 45 adults with clinical symptoms of birch pollen allergy. Patients were exposed to apple pulp via atopy patch tests (APTs) and SPTs. Levels of IgE specific to Bet v 1 and Mal d 1 were measured with a radioallergosorbent test. Patients allergic to birch pollen showed the highest rate of positive SPT responses to Golden Delicious apples and the lowest rate to low-allergenic cultivar Grey French Reinette. Among these patients, 9% developed delayed hypersensitivity reactions to either Golden Delicious or Grey French Reinette apples; these reactions manifested clinically as erythema with papules (class ++). Fifty percent of APT-positive patients were concomitantly SPT-negative. Here, we show for the first time the clinical relevance of T cell-driven allergic reactions to apples. APTs may reveal type IV sensitization in patients who are negative for the corresponding type I sensitization tests. Thus, utilization of the APT procedure with fresh apple appears to be a valuable tool for the diagnosis of apple allergy and may improve the accuracy of food allergy diagnoses.

Comparative analysis of allergen genes and pro-inflammatory factors in pollen and fruit of apple varieties

Allergy to freshly consumed apple fruits is often associated to pollinosis and manifested as oral allergy syndrome (OAS). The allergenic properties of apple varieties differ greatly, spanning from low allergenic to high allergenic varieties. The knowledge of the genetic determinants for allergenicity has been of great interest in scientific community for several years, but the molecular mechanisms involved are still little understood. Here, factors putatively involved in allergenicity were investigated at biochemical and molecular level in pollen and in fruits of apple varieties differing in their allergenic potential. Among putative sensitizing factors, transglutaminase (TGase) and phospholipase A₂ (PLA₂) were considered together with reactive oxygen species (ROS) and known apple allergen genes, with particular attention devoted to the Mal d 1 gene family, the most important one in sensitization. We found that the expression of some allergen genes and the activities of TGase, PLA₂ and ROS producing enzyme are lower in the hypo-allergenic variety 'Durello di Forlì' in comparison with the high-allergenic genotypes 'Gala' and 'Florina'. These results highlight correlations among allergen expressions, enzymatic activities and apple cultivars; these data underline the possibility that some of them could be used in the future as markers for allergenicity.