Low-temperature, acetone powder extracts were prepared from mature fruit of 16 apple strains. SDS-PAGE and immunoblot analysis revealed great variation in the relative amounts of the 18-kDa apple allergen in these extracts. EAST (RAST) scores, measured with individual and pool sera from patients allergic to birch pollen and apples, ranged from 0.2 to 4.0 and were related to the relative amount of the 18-kDa protein. These findings were confirmed by ELISA-inhibition assays, dose-related histamine release, semiquantitative evaluation of immunoblots by absorption/reflection densitometry, and skin prick tests with extracts of Golden Delicious, Boskoop, and Jamba apples (corresponding to a high, low, and very low 18-kDa allergen content). Additional open oral challenge tests were performed with two apple-allergic patients and 15 and 16 apple strains. With all methods, the deduced allergenic potency decreased in the following order: Golden Delicious > Boskoop > Jamba. Therefore, we concluded that the IgE-binding potency of apple strains depends on the occurrence of the 18-kDa allergen.