Food and Drug Reactions and AnaphylaxisWheat ω-5 gliadin is a major allergen in children with immediate allergy to ingested wheat☆,☆☆
Section snippets
Patients
Serum samples were collected from 40 children (mean age, 2.5 years; range, 0.7-8.2 years) who had been referred to the Helsinki University Hospital for Skin and Allergic Diseases (n = 29) or to the Tampere University Hospital (n = 11) for evaluation of suspected food allergy. The clinical histories of all 40 children were suggestive of wheat allergy, and at initial examination 23 of them had a positive skin prick test (SPT) result to wheat (1:10 w/v 0.9% NaCl, prepared as previously described8)
Oral wheat challenge
Nineteen children (48%) reacted with immediate hypersensitivity symptoms, including urticaria, erythema, and upper and lower respiratory and abdominal symptoms (Table I). One child experienced an anaphylactic reaction requiring emergency treatment. Eight children (20%) reacted with delayed symptoms, showing flare-up AD and/or diarrhea (Table I). Thirteen children (32%) remained challenge-negative.
IgE antibodies to ω-5 gliadin in ELISA
Sixteen children (84%) with immediate challenge symptoms had IgE antibodies to ω-5 gliadin in ELISA
Discussion
The results of this study show that the presence of IgE antibodies to ω-5 gliadin, a major allergen in wheat-dependent, exercise-induced anaphylaxis, associates strongly with immediate symptoms on oral wheat challenge in young children with food allergy symptoms. On the contrary, IgE antibodies to ω-5 gliadin were not detected in children with delayed or no symptoms in oral wheat challenge. This suggests that ω-5 gliadin is a potent sensitizer not only in adults with exercise-induced anaphylaxis
Acknowledgements
We thank Mrs Leena Petman for expert skin prick testing and Mrs Sari Tillander for technical assistance. We are grateful to Laura Linkosalo, MD, for the control sera.
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Cited by (0)
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Supported by grants from the Finnish Allergy Research Foundation, the Finnish Medical Society, and the Finnish Society of Allergology and Immunology.
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Reprint requests: Kati Palosuo, MD, Laboratory of Immunotoxicology, Finnish Institute of Occupational Health, Topeliuksenkatu 41 b, 00250 Helsinki, Finland.