Evaluation of the Efficacy of Oral Immunotherapy with Raw Apple in Patients Allergic to Birch Pollen and Apple: Prospective, Multicenter, Comparative Phase III Study

Inclusion Criteria: * Patient with allergic rhinitis to birch pollen. * Patient with an oral syndrome within 15 minutes of consuming at least one of the first 3 doses of raw apple in the V0 or V1 raw apple oral challenge test. * Evidence of sensitization to PR10 proteins in birch pollen and apple: positive prick tests to birch pollen and raw Golden apple and/or positive Bet v 1 and Mal d 1 specific IgE assays. * Subject affiliated to a social health insurance scheme * Subject able to understand the aims and risks of the research and to give dated and signed informed consent * For women of childbearing age: negative urine pregnancy test at inclusion visit Exclusion Criteria: * Severe or uncontrolled asthma * Severe obstructive syndrome * Active neoplastic disease * Active autoimmune disease * Eosinophilic esophagitis or other active eosinophilic gastrointestinal pathologies * History of bariatric surgery * History of anaphylaxis to apples * Allergy to cooked apples * Contraindication to anti-histamines, corticoids, salbutamol, adrenaline * Other contraindication to an oral challenge test * Allergy to placebo ingredients * Presence of oral syndrome during consumption of placebo in the first oral challenge test * Allergenic immunotherapy to birch pollen in progress or completed less than 5 years ago * Current treatment with anti-IgE, anti-IL4/13, anti-IL5 or anti-TSLP biotherapy. * Impossibility of giving the subject informed information * Subject under court protection * Sub…