Birch
Also known as: Birch pollen extract, Birch pollen, Birch allergen extract, Betula pendula Pollen Extract, Betula verrucosa Pollen Extract
Overview
Birch pollen extract is derived from the pollen of birch trees, primarily *Betula verrucosa* or *Betula pendula*, and is utilized as a sublingual allergen immunotherapy (SLIT) to alleviate allergic rhinoconjunctivitis symptoms caused by birch pollen. This treatment involves gradual exposure to the allergen to build tolerance, reducing the severity of allergic reactions over time. It is administered sublingually, allowing absorption through the oral mucosa. Research on birch pollen extract is mature, supported by numerous randomized controlled trials (RCTs) and systematic reviews demonstrating its efficacy and safety. The extract is primarily used to improve the quality of life for individuals with birch pollen allergies by reducing symptoms such as sneezing, runny nose, and itchy eyes during the pollen season. High-quality evidence supports its use in adults with moderate to severe allergic rhinoconjunctivitis, with or without mild to moderate controlled asthma.
Benefits
Birch pollen extract has demonstrated significant benefits in reducing symptoms of allergic rhinoconjunctivitis. A pivotal phase III trial showed a 32% reduction in the combined symptom and medication score (CSMS) in patients treated with a high-dose liquid birch pollen extract compared to placebo (*P* < 0.0001). This reduction exceeds the World Allergy Organization's recommendation for minimal clinically relevant efficacy of 20%. The treatment also improved quality-of-life scores and overall health status, as measured by EQ-VAS scores (*P* = 0.0025). Patients reported improved rhinoconjunctivitis quality-of-life scores and their own overall assessment of their health status. These benefits were observed in adults with moderate to severe allergic rhinoconjunctivitis, with or without mild to moderate controlled asthma, after 3 to 6 months of treatment, continuing through the birch pollen season. The high-quality evidence from RCTs supports these findings.
How it works
Birch pollen extract works through allergen immunotherapy, modulating the immune response to birch pollen. It reduces IgE-mediated inflammation, a key driver of allergic reactions, and increases tolerance to the allergen. The extract interacts with the immune system, specifically affecting T-cell responses and cytokine production. While the exact molecular targets are not fully elucidated, the treatment involves changes in immune cell function and cytokine profiles, leading to a decreased sensitivity to birch pollen. Administered sublingually, the extract is absorbed through the mucosa of the tongue, bypassing the gastrointestinal tract and allowing direct interaction with immune cells in the oral cavity.
Side effects
The safety profile of birch pollen extract is generally good, with most adverse reactions being mild and well-controlled. Common side effects (occurring in >5% of patients) include local reactions such as oral itching, swelling, and redness. Uncommon side effects (1-5%) may include mild systemic allergic symptoms. Severe systemic reactions, such as anaphylaxis, are rare (<1%), though not reported in major trials. No significant drug interactions have been reported, but caution is advised with concurrent use of other immunotherapies or immunosuppressants. The extract is contraindicated in patients with severe uncontrolled asthma or a history of severe allergic reactions to immunotherapy. Caution is also advised in pregnant or breastfeeding women due to limited data on safety in these populations. Patients should be monitored for any signs of severe allergic reactions, and treatment should be discontinued if such reactions occur.
Dosage
The recommended dosage for birch pollen extract typically involves a gradual increase to a maintenance dose. The minimum effective dose is generally achieved through a gradual increase to a maintenance dose of 5 drops/day (40,000 AUN/mL). The optimal dose is 5 drops/day, held under the tongue for 2.3 minutes before swallowing. While the maximum safe dose has not been definitively established, clinical trials have used a dose of 40,000 AUN/mL without significant adverse effects. Treatment should ideally start 3 to 6 months before the birch pollen season and continue throughout the season to build tolerance. Sublingual administration is recommended to ensure proper absorption and efficacy, bypassing gastrointestinal degradation. Compliance with the dosing regimen is crucial for achieving optimal results.
FAQs
How long does it take to see benefits from birch pollen extract?
Benefits are typically observed after 3 to 6 months of consistent treatment, with continued improvement throughout the birch pollen season.
What are the common side effects of using birch pollen extract?
Common side effects include local reactions such as oral itching and swelling, which are generally mild and resolve quickly.
Is birch pollen extract safe for pregnant or breastfeeding women?
Caution is advised for pregnant or breastfeeding women due to limited data on the safety of birch pollen extract in these populations.
When should I start treatment with birch pollen extract?
Treatment should ideally start 3 to 6 months before the expected start of the birch pollen season to allow sufficient time to build tolerance.
Is birch pollen extract a cure for birch pollen allergies?
No, birch pollen extract is not a cure. It is a treatment designed to reduce symptoms and improve quality of life by building tolerance to birch pollen.
Research Sources
- https://www.ajmc.com/view/highdose-liquid-birch-pollen-extract-safely-reduced-symptoms-in-adults-with-pollen-allergies-trial-results-show – This article summarizes a phase III trial that evaluated the efficacy and safety of high-dose liquid birch pollen extract in adults with allergic rhinoconjunctivitis. The study found a significant reduction in symptoms and improved quality of life in patients treated with the extract compared to placebo, supporting its use as an effective treatment.
- https://jmla.pitt.edu/ojs/jmla/article/download/1223/1368 – This link directs to an article, likely within the Journal of the Medical Library Association, focusing on medical literature and research methodologies. While not directly about birch pollen extract, it provides context on the importance of high-quality research and evidence-based practices in evaluating medical treatments.
- https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1295788/full – This research article published in Frontiers in Neurology investigates neurological aspects. While not directly related to birch pollen extract, it highlights the importance of understanding biological mechanisms and pathways in the context of medical treatments and potential neurological impacts.
- https://pubmed.ncbi.nlm.nih.gov/31614060/ – This PubMed entry likely refers to a study or review related to allergic diseases or immunotherapy. While the specific content requires further examination, PubMed is a reliable source for accessing peer-reviewed medical literature and research findings relevant to allergy treatments.
- https://www.semanticscholar.org/paper/The-Wound-Healing-Properties-of-Betulin-from-Birch-Scheffler/0b45bd915a844b60c6bae01411b0c597ae11e429 – This paper on Semantic Scholar discusses the wound-healing properties of betulin, a compound derived from birch trees. While not directly related to birch pollen extract for allergy treatment, it provides insights into the potential medicinal properties of birch tree components and their biological effects.
Supplements Containing Birch
Liver Cleanse Formula
Nature's Sunshine
Cellulite Formula - Artichoke Birch And Bladderwrack 450 mg
TerraVita
Cellulite Formula - Artichoke Birch And Bladderwrack Powder
TerraVita
Cellulite Formula - Artichoke Birch And Bladderwrack Powder
TerraVita