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Food allergens
Published in Richard F. Lockey, Dennis K. Ledford, Allergens and Allergen Immunotherapy, 2020
Wheat and other cereal grains are common food allergens, particularly in children. The proteins of wheat include the water-soluble albumins, the saline-soluble globulins, the aqueous ethanol-soluble prolamines (i.e., gliadins), and the glutelins. Subjects with wheat allergy have specific IgE to wheat fractions of 47 kDa and 20 kDa, proteins not recognized by specific-IgE from subjects with grass allergy [47]. Wheat α-amylase inhibitor (15 kDa) is also a major wheat allergen. This protein does not bind IgE from wheat-tolerant control subjects, including those with grass allergy. Battais et al. [48] identified major wheat allergens by IgE-binding studies. IgE from subjects with wheat-dependent exercise-induced anaphylaxis and urticaria react with sequential epitopes (QQX1PX2QQ) in the repetitive domain of gliadins, whereas IgE from atopic dermatitis subjects recognizes conformational epitopes [49].
Lactic Acid Bacteria Application to Decrease Food Allergies
Published in Marcela Albuquerque Cavalcanti de Albuquerque, Alejandra de Moreno de LeBlanc, Jean Guy LeBlanc, Raquel Bedani, Lactic Acid Bacteria, 2020
Vanessa Biscola, Marcela Albuquerque Cavalcanti de Albuquerque, Tatiana Pacheco Nunes, Antonio Diogo Silva Vieira, Bernadette Dora Gombossy de Melo Franco
Wheat allergy is an adverse immunologic reaction to proteins contained in wheat and related grains. Depending on the route of exposure, it presents different clinical manifestations. Food allergy symptoms affect the skin, the gastrointestinal tract or the respiratory tract. Other reactions are linked to occupational asthma and rhinitis; wheat-dependent exercise-induced anaphylaxis; and contact urticaria. The clinical manifestations are the result of inflammatory responses, triggered by the activation of specific IgE, and are related with different antigenic proteins, including gliadins and HMW glutenins. This type of allergic reaction affects mainly children and is related to genetic aspects, environmental conditions, diet and modulation of the gut microbiota (Elli et al. 2015, Czaja-Bulsa and Bulsa 2017).
Gastroenterology
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Wheat sensitive enteropathy and atopy-associated wheat allergy are not autoimmune diseases and have a very different immunological pathology to coeliac disease. Both are transient. They are commonest in infants and preschool children (see ‘Food sensitive enteropathy’).
Gluten-free diet attenuates the impact of exogenous vitamin D on thyroid autoimmunity in young women with autoimmune thyroiditis: a pilot study
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2022
Robert Krysiak, Karolina Kowalcze, Bogusław Okopień
The study population consisted of two groups of patients. Group A included 31 women who, because of non-celiac gluten sensitivity, were on a gluten-free diet for at least 12 months preceding the study. Non-celiac gluten sensitivity was defined as self-reported gluten intolerance, a rapid resolution of symptoms on a gluten-free diet and exclusion of celiac disease and IgE-mediated wheat allergy. Celiac disease was considered adequately excluded if tissue transglutaminase antibodies and endomysial antibodies were negative (based upon IgA testing or IgG testing in individuals with IgA deficiency), and there was no villous atrophy on biopsy. IgE-mediated wheat allergy was ruled out based on the lack of an immediate reaction after wheat ingestion combined with a negative skin prick test and levels of specific IgE below the threshold value. The gluten-free diet was defined as the consumption of gluten-free natural and processed products containing no more than 20 mg of gluten per 1 kg of product. In turn, group B included 31 women without gluten-related disorders. They were unaffected sisters of women with non-celiac gluten sensitivity and did not follow dietary interventions. To limit the impact of seasonal variations in the outcome variables and seasonal confounds, participants were recruited between December and January, and between July and August. The flow of patients through the study is shown in Figure 1.
Exercise-induced anaphylaxis: causes, consequences, and management recommendations
Published in Expert Review of Clinical Immunology, 2019
Morten J. Christensen, Esben Eller, Henrik F. Kjaer, Sigurd Broesby-Olsen, Charlotte G. Mortz, Carsten Bindslev-Jensen
Challenging patients with high amounts of purified gluten, meaning ingestion of an unphysiological high amount of wheat will not give the patient guidelines of what can be tolerated in a daily life setting. The corresponding amount of 80 g of gluten is approximately 800 g of regular wheat flour or 55 slices of wheat-toast bread. This challenge method should be regarded as a confirmatory test, but also indicates that WDEIA is a regular (non-exercise-dependent) wheat allergy where the threshold is very high in a daily life setting without co-factors. We demonstrated that WDEIA could be elicited in 55% (26/47) of the challenges with gluten and in absence of exercise or another co-factor [52]. Theoretically, if gluten doses were further increased, all patients would potentially react with objective symptoms. Challenges performed with a very high amount of the causative allergen is not uncommon, it is routinely performed in conjunctival challenges with pollen [80].
Allergen immunotherapy for food allergy from the Asian perspective: key challenges and opportunities
Published in Expert Review of Clinical Immunology, 2019
Agnes Sze Yin Leung, Nicki Yat Hin Leung, Christine Yee Yan Wai, Ting Fan Leung, Gary Wing Kin Wong
The prevalence of wheat allergy has been reported to be very low 0.08–0.37% [60], but it is one of the major triggers of anaphylaxis in Asia [61,62]. Wheat and buckwheat are major allergens in Korean children (after egg and milk) and adults [43,63,64]. Wheat is also the second commonest food allergic trigger in a major teaching hospital in Thailand [40], and the third commonest food allergen in Japanese children after the egg and milk [44]. In northern China, cereals and wheat are the top food allergens implicated in anaphylaxis, especially in adolescents and adults [39]. In Asia, wheat is a common cause of food-dependent, exercise-induced anaphylaxis [65–67]. An increase in the incidence of wheat-dependent, exercise-induced anaphylaxis in association with the use of a new brand of hydrolyzed wheat protein (HWP)-containing soap was reported in Japan [68]. Such phenomenon was suspected to be induced by sensitization through the percutaneous and/or rhinoconjunctival route [68]. Buckwheat is considered as one of the most important food allergens in Korea with a sensitization rate up to 5% by skin prick test in Korean children [69]. Buckwheat chaff-stuffed pillows were implicated to induce nocturnal asthma in three Korean children [48]. In these children, asthmatic symptoms completely recovered during seven days of pillow elimination and were followed by provocation of asthmatic symptoms by bronchial challenge with buckwheat extract.