While pine tree allergy is relatively uncommon, there are two main allergens of concern that come from pine trees: pine nuts and pine pollen. Pine nuts (pignoli) are the edible seeds of certain species of pine trees, and are used in a variety of foods, including Italian pesto. Pine nut consumption has increased due to its use in the Mediterranean Diet. Pine pollen is produced when the trees reproduce in the springtime. It is possible for pollen to travel very long distances in the air.
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Pine pollen allergies are similar to other pollen allergies, and many people with pine pollen allergy are also allergic to grass pollen. Pine nut allergies are similar to other tree nut allergies, and can cause mild, moderate, and severe allergic responses including anaphylaxis. Cross-reactivity has been reported between pine nuts and peanuts and between pine nuts and pine pollen.