{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T02:59:35Z","timestamp":1792119575281,"version":"4.4.0"},"reference-count":43,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T00:00:00Z","timestamp":1688428800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Kiwifruit allergy is an emerging pathological condition in both general and pediatric populations with a wide range of symptoms linked to variable molecular patterns, justifying systemic and cross-reactions with other allergens (i.e., latex, pollen, and fruit). Skin prick test (SPT), specific serum IgE (Act d 1, Act d 2, Act d 5, Act d 8, and Act d 10) directed against five out of thirteen molecular allergens described in the literature, and oral test challenge with kiwifruit are available for defining diagnosis. The management is similar to that of other food allergies, mostly based on an elimination diet. Although kiwi allergy has been on the rise in recent years, few studies have evaluated the clinical characteristics and methods of investigating this form of allergy. Data collected so far show severe allergic reaction to be more frequent in children compared to adults. Therefore, the aim of this review is to collect the reported clinical features and the available association with specific molecular patterns of recognition to better understand how to manage these patients and improve daily clinical practice.<\/jats:p>","DOI":"10.3390\/nu15133030","type":"journal-article","created":{"date-parts":[[2023,7,5]],"date-time":"2023-07-05T00:37:28Z","timestamp":1688517448000},"page":"3030","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Kiwifruit\u2019s Allergy in Children: What Do We Know?"],"prefix":"10.3390","volume":"15","author":[{"given":"Ivana","family":"Bringheli","sequence":"first","affiliation":[{"name":"Department of Maternal Infantile and Urological Science, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5059-6082","authenticated-orcid":false,"given":"Giulia","family":"Brindisi","sequence":"additional","affiliation":[{"name":"Department of Maternal Infantile and Urological Science, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8441-0451","authenticated-orcid":false,"given":"Rebecca","family":"Morelli","sequence":"additional","affiliation":[{"name":"Department of Maternal Infantile and Urological Science, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lavinia","family":"Marchetti","sequence":"additional","affiliation":[{"name":"Department of Maternal Infantile and Urological Science, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludovica","family":"Cela","sequence":"additional","affiliation":[{"name":"Department of Maternal Infantile and Urological Science, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Gravina","sequence":"additional","affiliation":[{"name":"Department of Maternal Infantile and Urological Science, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Pastore","sequence":"additional","affiliation":[{"name":"Department of Maternal Infantile and Urological Science, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Semeraro","sequence":"additional","affiliation":[{"name":"Department of Maternal Infantile and Urological Science, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1268-5038","authenticated-orcid":false,"given":"Bianca","family":"Cinicola","sequence":"additional","affiliation":[{"name":"Department of Maternal Infantile and Urological Science, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Capponi","sequence":"additional","affiliation":[{"name":"Department of Maternal Infantile and Urological Science, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Gori","sequence":"additional","affiliation":[{"name":"Department of Maternal Infantile and Urological Science, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elia","family":"Pignataro","sequence":"additional","affiliation":[{"name":"Department of Maternal Infantile and Urological Science, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Grazia","family":"Piccioni","sequence":"additional","affiliation":[{"name":"Department of Maternal Infantile and Urological Science, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Maria","family":"Zicari","sequence":"additional","affiliation":[{"name":"Department of Maternal Infantile and Urological Science, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Anania","sequence":"additional","affiliation":[{"name":"Department of Maternal Infantile and Urological Science, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/0091-6749(81)90189-5","article-title":"Hypersensitivity reaction to kiwi fruit (Chinese gooseberry, Actinidia chinensis)","volume":"68","author":"Fine","year":"1981","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_2","unstructured":"U.S. Department of Agriculture (2023, April 17). Agricultural Research Service, Available online: https:\/\/fdc.nal.usda.gov\/fdc-app.html#\/food-details\/168153\/nutrients."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/S1043-4526(06)52006-6","article-title":"Fruits of the actinidia genus","volume":"52","author":"Nishiyama","year":"2007","journal-title":"Adv. Food Nutr. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1111\/j.1365-2222.2005.02162.x","article-title":"Prevalence and main characteristics of schoolchildren diagnosed with food allergies in France","volume":"35","author":"Grandmottet","year":"2005","journal-title":"Clin. Exp. Allergy"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/0091-6749(94)90073-6","article-title":"Kiwi fruit allergy: A new birch pollen-associated food allergy","volume":"94","author":"Gall","year":"1994","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1016\/S0091-6749(96)70094-5","article-title":"Identification of the allergenic components of kiwi fruit and evaluation of their cross-reactivity with timothy and birch pollens","volume":"98","author":"Pastorello","year":"1996","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.jaci.2012.09.009","article-title":"Kiwifruit allergy across Europe: Clinical manifestation and IgE recognition patterns to kiwifruit allergens","volume":"131","author":"Le","year":"2013","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1111\/j.1365-2222.2004.01982.x","article-title":"Kiwi fruit is a significant allergen and is associated with differing patterns of reactivity in children and adults","volume":"34","author":"Lucas","year":"2004","journal-title":"Clin. Exp. Allergy"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"424","DOI":"10.3390\/children2040424","article-title":"Kiwifruit Allergy in Children: Characterization of Main Allergens and Patterns of Recognition","volume":"2","author":"Sexto","year":"2015","journal-title":"Children"},{"key":"ref_10","unstructured":"(2023, May 04). Allergen Nomenclature WHO\/IUIS Allergen Nomenclature Sub-Committee. Available online: www.allergen.org."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/S0091-6749(98)70360-4","article-title":"Identification of actinidin as the major allergen of kiwi fruit","volume":"101","author":"Pastorello","year":"1998","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1016\/j.bbagen.2015.12.005","article-title":"Kiwifruit cysteine protease actinidin compromises the intestinal barrier by disruptingtight junctions","volume":"1860","author":"Grozdanovic","year":"2016","journal-title":"Biochim. Biophys. Acta"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1111\/j.1439-0507.2006.01195.x","article-title":"The major allergen of Alternaria alternata (Alt a 1) is expressed in other members of the Pleosporaceae family","volume":"49","author":"Postigo","year":"2006","journal-title":"Mycoses"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.reval.2015.11.003","article-title":"L\u2019association Alt a 1 (Alternaria)\u2013Act d 2 (kiwi): Origine et pertinence clinique possible","volume":"56","author":"Barre","year":"2016","journal-title":"Rev. Fran\u00e7aise D\u2019allergologie"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.1111\/j.1365-2222.2007.02927.x","article-title":"Immunoglobulin E recognition patterns to purified kiwifruit (Actinidia deliciosa) allergens in patients sensitized to kiwi with different clinical symptoms","volume":"38","author":"Palacin","year":"2008","journal-title":"Clin. Exp. Allergy"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1016\/j.jaci.2009.10.017","article-title":"Component-resolved diagnosis of kiwifruit allergy with purified natural and recombinant kiwifruit allergens","volume":"125","author":"Bublin","year":"2010","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1007\/s10930-005-7638-7","article-title":"Kiwellin, a novel protein from kiwi fruit. Purification, biochemical characterization and identification as an allergen","volume":"24","author":"Tamburrini","year":"2005","journal-title":"Protein J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1111\/j.1365-2222.2010.03619.x","article-title":"The performance of a component-based allergen microarray for the diagnosis of kiwifruit allergy","volume":"41","author":"Bublin","year":"2011","journal-title":"Clin. Exp. Allergy."},{"key":"ref_19","first-page":"S230","article-title":"Characterization of Bet v 1-related allergens from kiwifruit relevant for patients with combined kiwifruit and birch pollen allergy","volume":"52","author":"Oberhuber","year":"2008","journal-title":"Mol. Nutr. Food Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1111\/j.1398-9995.2011.02555.x","article-title":"Kiwifruit Act d 11 is the first member of the ripening-related protein family identified as an allergen","volume":"66","author":"Bernardi","year":"2011","journal-title":"Allergy"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1111\/all.12486","article-title":"Detailed characterization of Act d 12 and Act d 13 from kiwi seeds: Implication in IgE cross-reactivity with peanut and tree nuts","volume":"69","author":"Sirvent","year":"2014","journal-title":"Allergy"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1111\/pai.12700","article-title":"Negative Act d 8 indicates systemic kiwifruit allergy among kiwifruit-sensitized children","volume":"28","author":"Asaumi","year":"2017","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.biopha.2006.11.003","article-title":"Initiating mechanisms of food allergy: Oral tolerance versus allergic sensitization","volume":"61","author":"Knippels","year":"2007","journal-title":"Biomed. Pharmacother."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"159","DOI":"10.3109\/02770909509083238","article-title":"Anaphylaxis to kiwi fruit in a 12-year-old boy","volume":"32","author":"Shimizu","year":"1995","journal-title":"J. Asthma."},{"key":"ref_25","first-page":"203","article-title":"Allergie alimentaire au kiwi chez l\u2019enfant","volume":"32","author":"Rance","year":"1992","journal-title":"Rev. Fr. D\u2019allergol. D\u2019immunol. Clin."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1007\/s13631-018-00206-3","article-title":"Diagnosi di allergia al kiwi in et\u00e0 pediatrica: Utilit\u00e0 della diagnostica molecolare","volume":"14","author":"Visentini","year":"2018","journal-title":"Riv. Ital. Med. Lab."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1080\/09540109709354941","article-title":"Characterization of allergens in kiwi fruit and detection of cross-reactivities with allergens of birch pollen and related fruit allergens","volume":"9","author":"Moller","year":"1997","journal-title":"Food Agric. Immunol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1111\/j.1398-9995.1997.tb00967.x","article-title":"Allergenic properties of kiwi-fruit extract: Cross-reactivity between kiwi-fruit and birch-pollen allergens","volume":"52","author":"Voitenko","year":"1997","journal-title":"Allergy"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/j.1398-9995.1998.tb03889.x","article-title":"Determination and characterization of cross-reacting allergens in latex, avocado, banana, and kiwi fruit","volume":"53","author":"Kayma","year":"1998","journal-title":"Allergy"},{"key":"ref_30","first-page":"78","article-title":"Kiwi allergens and their cross-reactivity with birch, rye, timothy, and mugwort pollen","volume":"8","author":"Rudeschko","year":"1998","journal-title":"J. Investig. Allergol. Clin. Immunol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1067\/mai.2002.128947","article-title":"Isolation and biochemical characterization of a thaumatin-like kiwi allergen","volume":"110","author":"Petersen","year":"2002","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1046\/j.0905-6157.2003.00095.x","article-title":"Kiwi fruit allergy: A review","volume":"14","author":"Lucas","year":"2003","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1016\/j.jaci.2003.11.043","article-title":"Allergy to kiwi: A double-blind, placebo-controlled food challenge study in patients from a birch-free area","volume":"113","author":"Sastre","year":"2004","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1111\/all.12429","article-title":"EAACI food allergy and anaphylaxis guidelines: Diagnosis and management of food allergy","volume":"69","author":"Muraro","year":"2014","journal-title":"Allergy"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e30","DOI":"10.3346\/jkms.2022.37.e30","article-title":"Clinical Characteristics of Atopic Dermatitis in Korean School-Aged Children and Adolescents According to Onset Age and Severity","volume":"37","author":"Jeon","year":"2022","journal-title":"J. Korean Med. Sci."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1007\/s11882-010-0149-4","article-title":"Diagnosis of food allergy: Epicutaneous skin tests, in vitro tests, and oral food challenge","volume":"11","author":"Lieberman","year":"2011","journal-title":"Curr. Allergy Asthma Rep."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"585","DOI":"10.3949\/ccjm.78a.11023","article-title":"Allergy blood testing: A practical guide for clinicians","volume":"78","author":"Siles","year":"2011","journal-title":"Clevel. Clin. J. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"206","DOI":"10.18176\/jiaci.0691","article-title":"Unraveling the Diagnosis of Kiwifruit Allergy: Usefulness of Current Diagnostic Tests","volume":"32","author":"Bernad","year":"2022","journal-title":"J. Investig. Allergol. Clin. Immunol."},{"key":"ref_39","first-page":"47","article-title":"The oral allergy syndrome","volume":"61","author":"Ortolani","year":"1988","journal-title":"Ann. Allergy"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1159\/000445391","article-title":"Oral Immunotherapy for Food Allergies","volume":"68","author":"Feuille","year":"2016","journal-title":"Ann. Nutr. Metab."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1111\/1541-4337.12426","article-title":"A Comprehensive Review on Kiwifruit Allergy: Pathogenesis, Diagnosis, Management, and Potential Modification of Allergens Through Processing","volume":"18","author":"Wang","year":"2019","journal-title":"Compr. Rev. Food Sci. Food Saf."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1007\/s11882-012-0316-x","article-title":"Use of omalizumab in the treatment of food allergy and anaphylaxis","volume":"13","author":"Lieberman","year":"2013","journal-title":"Curr. Allergy Asthma Rep."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1177\/0009922816664512","article-title":"Cow\u2019s Milk Protein Allergy","volume":"55","author":"Mousan","year":"2016","journal-title":"Clin. Pediatr."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/13\/3030\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:05:45Z","timestamp":1760126745000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/13\/3030"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,4]]},"references-count":43,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["nu15133030"],"URL":"https:\/\/doi.org\/10.3390\/nu15133030","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,4]]}}}