Wheat allergy : Current Opinion in Allergy and Clinical Immunology (original) (raw)

Food allergy: Edited by Alessandro Fiocchi and Anna Nowak-Wegrzyn

Department of Dermatology, Yokohama City University Hospital, Yokohama, Japan

Correspondence to Naoko Inomata, MD, PhD, Department of Dermatology, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan Tel: +81 45 787 2675; fax: +81 45 786 0243; e-mail: [email protected]

Current Opinion in Allergy and Clinical Immunology 9(3):p 238-243, June 2009. | DOI: 10.1097/ACI.0b013e32832aa5bc

Abstract

Purpose of review

This review describes the diverse clinical manifestations of IgE-mediated allergy to ingested wheat and summarizes recent advances in characterization of clinically significant allergens and diagnostic workup.

Recent findings

Recent population-based studies have shown the prevalence of wheat allergy and sensitization more precisely than past studies among small populations and in hospital settings. Intensive research has demonstrated the diverse profile of both water/salt-soluble and insoluble allergens involved in clinical types of wheat allergies determined depending on the patient age, the sensitization route, and the protein state during the exposure. Consequently, some new allergens, including nonspecific lipid transfer protein (Tri a 14), have been identified. For diagnosis, the role of water/salt-insoluble gliadins, particularly ω-5 gliadin, a major allergen of wheat-dependent, exercise-induced anaphylaxis, was assessed as compared with the results of oral challenges. The mechanisms of eliciting anaphylactic symptoms by exercise in wheat-dependent, exercise-induced anaphylaxis were speculated upon; one is the allergenicity strengthened by activated tissue transglutaminase and another is the increased absorption of allergens through the gastrointestinal tract.

Summary

Findings of the recent studies show potential for more precise diagnosis in each clinical type of wheat allergies.