Plant Profiler

Birch (Betula pendula)

Birch (Betula pendula) Image
Synonyms / Common Names / Related Terms
Bet v 1, Bet v 1-fragments, Bet v 1-trimer, Betula, Betula 30c, Betula davurica Pall., Betula ermanii Cham., Betula grossa Sieb. et Zucc., Betula maximowicziana, Betula maximowicziana Regel, Betula nana, Betula nana L., Betula occidentalis, Betula pendula, Betula pendula Roth., Betula papyrifera Marsh., Betula platyphylla var. japonica, Betula platyphylla Sukatchev var. japonica (Miq.) Hara, Betula pubescens Ehrh., Betula verrucosa, Betulaceae (family), betulin, betulinic acid, birch pollen allergen (Bet v 1), downy birch, dwarf birch, Japanese white birch, lupeol, mountain birch, natural birch pollen extract, oleanolic acid, paper birch, rBet v 1, rBet v 2, rBet v 4, recombinant Betula verrucosa (rBet v 1), silver birch, white birch.

Note: This monograph does not cover birch immunotherapy. For more information on immunotherapy, please see the Natural Standard allergy database.

Mechanism of Action


  • Constituents: Birch contains betulinic acid, betulin, oleanolic acid, and lupeol.2
  • Diuretic effects: Birch may have diuretic effects, according to secondary sources.
  • Immunologic effects: Birch pollen is a common allergen, causing symptoms ranging from atopic dermatitis to rhinitis to asthma.1 In fact, binding of birch allergens to IgE on mast cells and basophils releases inflammatory mediators in nasal secretions.4 Because it is such a common allergen, birch pollen is frequently used in immunotherapy, although the mechanism of action is currently poorly understood. In conventional birch pollen immunotherapy, the cytokine profile of the circulating pool of allergen-specific T-cells is not changed during birch-pollen season.5 However, part of the mechanism of immunotherapy may involve the induction of peripheral T-cell tolerance and the increased production of specific IgG and IgG4. Early in immunotherapy treatment, stimulation by allergens may lead to systemic changes in Th2-like cytokine production and the early increase in allergen-specific IgE is a consequence of enhanced IL-4 production.6 In addition, birch pollen immunotherapy may inhibit the serum IgE-facilitated allergen presentation needed to obtain optimal T cell activation at the low allergen concentrations present in vivo, thereby reducing immunological response to allergens.7 Sublingual immunotherapy also reduces eosinophil infiltration in nasal mucosa, thereby reducing inflammation and significantly improving pulmonary function.8 In a study, patients with birch allergy had a significantly increased eotaxin concentration compared to controls, and immunotherapy significantly reduced the levels of eotaxin.9 Immunotherapy also reduces leukotriene release of peripheral leukocytes.10 Using genetically modified birch allergens reduces immediate skin reactions11 and induces IgG antibody responses against birch pollen in serum and mucosal fluids, possibly abrogating allergen-induced inflammation12. Interestingly, the mechanisms supporting bronchial hyperresponsiveness during allergic rhinitis may be different from those in asthma.3 As an aside, the birch pollen allergens show ribonuclease activity in vitro.13


  • Insufficient available evidence.


  1. Bergmann, R. L., Edenharter, G., Bergmann, K. E., Forster, J., Bauer, C. P., Wahn, V., Zepp, F., and Wahn, U. Atopic dermatitis in early infancy predicts allergic airway disease at 5 years. Clin Exp Allergy 1998;28(8):965-970. 9756200
  2. Huyke, C., Laszczyk, M., Scheffler, A., Ernst, R., and Schempp, C. M. [Treatment of actinic keratoses with birch bark extract: a pilot study]. J Dtsch Dermatol Ges 2006;4(2):132-136. 16503940
  3. Rak, S., Heinrich, C., Jacobsen, L., Scheynius, A., and Venge, P. A double-blinded, comparative study of the effects of short preseason specific immunotherapy and topical steroids in patients with allergic rhinoconjunctivitis and asthma. J Allergy Clin Immunol 2001;108(6):921-928. 11742269
  4. Bez, C., Schubert, R., Kopp, M., Ersfeld, Y., Rosewich, M., Kuehr, J., Kamin, W., Berg, A. V., Wahu, U., and Zielen, S. Effect of anti-immunoglobulin E on nasal inflammation in patients with seasonal allergic rhinoconjunctivitis. Clin Exp Allergy 2004;34(7):1079-1085. 15248853
  5. Moverare, R., Elfman, L., Bjornsson, E., and Stalenheim, G. Cytokine production by peripheral blood mononuclear cells following birch-pollen immunotherapy. Immunol Lett 7-3-2000;73(1):51-56. 10963811
  6. Moverare, R., Elfman, L., Bjornsson, E., and Stalenheim, G. Changes in cytokine production in vitro during the early phase of birch-pollen immunotherapy. Scand J Immunol 2000;52(2):200-206. 10931388
  7. van Neerven, R. J., Arvidsson, M., Ipsen, H., Sparholt, S. H., Rak, S., and Wurtzen, P. A. A double-blind, placebo-controlled birch allergy vaccination study: inhibition of CD23-mediated serum-immunoglobulin E-facilitated allergen presentation. Clin Exp Allergy 2004;34(3):420-428. 15005736
  8. Marogna, M., Spadolini, I., Massolo, A., Canonica, G. W., and Passalacqua, G. Clinical, functional, and immunologic effects of sublingual immunotherapy in birch pollinosis: a 3-year randomized controlled study. J Allergy Clin Immunol 2005;115(6):1184-1188. 15940132
  9. Jahnz-Rozyk, K., Glodzinska-Wyszogrodzka, E., Rozynska-Polanska, R., Paluchowska, E., and Zabielski, L. S. [The effect of specific immunotherapy on serum eotaxin level in patients with pollinosis: preliminary studies]. Pol Merkur Lekarski 2001;11(63):244-246. 11761820
  10. Kopp, M. V., Brauburger, J., Riedinger, F., Beischer, D., Ihorst, G., Kamin, W., Zielen, S., Bez, Friedrichs, F., Von Berg, A., Gerhold, K., Hamelmann, E., Hultsch, and Kuehr, J. The effect of anti-IgE treatment on in vitro leukotriene release in children with seasonal allergic rhinitis. J Allergy Clin Immunol 2002;110(5):728-735. 12417881
  11. Pauli, G., Purohit, A., Oster, J. P., de Blay, F., Vrtala, S., Niederberger, V., Kraft, D., and Valenta, R. Comparison of genetically engineered hypoallergenic rBet v 1 derivatives with rBet v 1 wild-type by skin prick and intradermal testing: results obtained in a French population. Clin Exp Allergy 2000;30(8):1076-1084. 10931114
  12. Reisinger, J., Horak, F., Pauli, G., van Hage, M., Cromwell, O., Konig, F., Valenta, R., and Niederberger, V. Allergen-specific nasal IgG antibodies induced by vaccination with genetically modified allergens are associated with reduced nasal allergen sensitivity. J Allergy Clin Immunol 2005;116(2):347-354. 16083789
  13. Swoboda, I., Hoffmann-Sommergruber, K., O'Raiodajin, G., Scheiner, O., Heberle-Bors, E., and Vicente, O. Bet v 1 proteins, the major birch pollen allergens and members of a family of conserved pathogenesis-related proteins, show ribonuclease activity in vitro. Physiologia Plantarum 1996;96(3):433-438.

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