Food-Dependent Exercise-Induced Wheals, Angioedema, and Anaphylaxis: A Systematic Review

Kulthanan, Kanokvalai; Ungprasert, Patompong; Jirapongsananuruk, Orathai; Rujitharanawong, Chuda; Munprom, Kanyalak; Trakanwittayarak, Suphattra; Pochanapan, Oraya; Panjapakkul, Waratchaya; Maurer, Marcus

doi:10.1016/j.jaip.2022.06.008

Cited by 21 publications

(17 citation statements)

References 157 publications

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“… 20 Wheat has been reported as the most common food trigger of anaphylaxis in China and the most common trigger for food-dependent exercise-induced anaphylaxis (FDEIA). 3 , 21 , 22 Studies in Japan, 23 , 24 Korea, 25 and Europe 6 have reported similar results. It may partly be because of the high consumption, and high processing of wheat products, which results in a higher level of gluten and immunogenic epitopes.…”

Section: Discussionmentioning

confidence: 59%

Clinical profiles of patients with wheat-induced anaphylaxis at various ages of onset

Du¹,

Li²,

Liu³

et al. 2023

World Allergy Organization Journal

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Section: Discussionmentioning

confidence: 59%

Clinical profiles of patients with wheat-induced anaphylaxis at various ages of onset

Du¹,

Li²,

Liu³

et al. 2023

World Allergy Organization Journal

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“…It has been reported worldwide and most commonly affects adolescents and young adults with a prevalence of approximately 0.02% although the exact number might probably be higher due to underdiagnosis [ 1 ]. It has a slight male predominance (55%) with the median age at onset of 21 years (range 4–82 years) [ 5 , 6 ]. Contrary to its term, not all patients diagnosed with FDEIA present with anaphylaxis.…”

Section: Discussionmentioning

confidence: 99%

“…Contrary to its term, not all patients diagnosed with FDEIA present with anaphylaxis. According to the recent meta-analysis of 722 patients, 3 different phenotypes were identified including anaphylaxis with wheals and/or angioedema (80%), wheals, angioedema, or both without anaphylaxis (17%), and anaphylaxis without wheals or angioedema (4%) [ 5 ]. However, the clinical significance of differentiating the phenotype for FDEIA remains to be further explored.…”

Section: Discussionmentioning

confidence: 99%

Preprandial food-dependent exercise-induced anaphylaxis to banana

Kampitak

2023

Asia Pacific Allergy

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Food-dependent exercise-induced anaphylaxis is a disorder in which a reaction develops only in association with physical exertion that generally takes place postprandially. The reaction that occurs following food intake after exercise is uncommon. Banana is an infrequent cause of anaphylaxis, which has been previously reported in combination with postprandial exercise in only 1 patient. A probable case of preprandial food-dependent exercise-induced anaphylaxis to banana is described herein together with a brief review of recent related literature.

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“…The alternative explanation is that orally ingested glycoprotein forms of alpha-gal, which clearly can be allergenic in vitro and in vivo when introduced parenterally, are absorbed, processed and presented to IgE-bound mast cells with a delay of 3-5 h. 37 This is clearly different from classic IgE-mediated food allergy, such as peanut allergy, but has parallels with some forms of wheat allergy, where co-factors are important and there is often a substantial delay between ingestion and symptom onset. 133 Whether the relevant source of alpha-gal is in glycolipid and/or glycoprotein form, there is now good in vivo evidence that peak levels of alpha-gal require two or more hours to reach the systemic circulation after challenge with a mammalian meal. 134 The recent development of models of semi-humanized pigs (i.e.…”

Section: Patho Phy S Io Log Ic Cons Ider Ationsmentioning

confidence: 99%

Tick bites, IgE to galactose‐alpha‐1,3‐galactose and urticarial or anaphylactic reactions to mammalian meat: The alpha‐gal syndrome

Wilson,

Erickson,

Levin

et al. 2024

Allergy

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The recent recognition of a syndrome of tick‐acquired mammalian meat allergy has transformed the previously held view that mammalian meat is an uncommon allergen. The syndrome, mediated by IgE antibodies against the oligosaccharide galactose‐alpha‐1,3‐galactose (alpha‐gal), can also involve reactions to visceral organs, dairy, gelatin and other products, including medications sourced from non‐primate mammals. Thus, fittingly, this allergic disorder is now called the alpha‐gal syndrome (AGS). The syndrome is strikingly regional, reflecting the important role of tick bites in sensitization, and is more common in demographic groups at risk of tick exposure. Reactions in AGS are delayed, often by 2–6 h after ingestion of mammalian meat. In addition to classic allergic symptomatology such as urticaria and anaphylaxis, AGS is increasingly recognized as a cause of isolated gastrointestinal morbidity and alpha‐gal sensitization has also been linked with cardiovascular disease. The unusual link with tick bites may be explained by the fact that allergic cells and mediators are mobilized to the site of tick bites and play a role in resistance against ticks and tick‐borne infections. IgE directed to alpha‐gal is likely an incidental consequence of what is otherwise an adaptive immune strategy for host defense against endo‐ and ectoparasites, including ticks.

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Food-Dependent Exercise-Induced Wheals, Angioedema, and Anaphylaxis: A Systematic Review

Cited by 21 publications

References 157 publications

Clinical profiles of patients with wheat-induced anaphylaxis at various ages of onset

Clinical profiles of patients with wheat-induced anaphylaxis at various ages of onset

Preprandial food-dependent exercise-induced anaphylaxis to banana

Tick bites, IgE to galactose‐alpha‐1,3‐galactose and urticarial or anaphylactic reactions to mammalian meat: The alpha‐gal syndrome

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