The clinical spectrum of omega‐5‐gliadin allergy

Le, Thanh-Thao Adriana; Kindi, Mahmood Al; Tan, Ju; Smith, Anthony; Heddle, Richard; Kette, Frank; Hissaria, Pravin; Smith, William B.

doi:10.1111/imj.13091

Cited by 36 publications

(27 citation statements)

References 25 publications

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“…Although WDEIA is the most important manifestation of allergy to Tri a 19, sensitization can manifest itself also with symptoms of mild urticaria or anaphylaxis without exercise. 1,3 Omega-5-gliadyn is one of the allergen components included in ImmunoCAP ISAC micro-array assay and the level was not elevated in the case of the described patient. The patient had elevated levels of wheat LTPs (rTri a 14), as well as LTP from other allergen sources (peach, walnut, plane tree).…”

Section: Discussionmentioning

confidence: 72%

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Food-dependent, exercise-induced anaphylaxis in a patient allergic to peach

Ukleja-Sokołowska

Zacniewski

Gawrońska-Ukleja

et al. 2018

Int J Immunopathol Pharmacol

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Determining the single factor that triggered anaphylactic shock can be challenging. We present an interesting case of a 25-year-old female patient with recurrent anaphylactic reactions developing after eating various foods, particularly in presence of co-factors of allergic reactions. Symptoms occurred after consumption of various kinds of foods – peach, pancakes with cottage cheese and fruit, a meal from a Chinese restaurant – all eaten on other occasions without symptoms. During diagnosis, skin prick tests were negative for all tested allergen extracts (both inhalatory and food) from Allergopharma. Prick by prick tests were positive for the peach – wheal diameter – 6 mm, nectarine – 4 mm (histamine 4 mm, negative control 0 mm). Increased levels of asIgE were found for allergens of peach (0.55 kU/L).Open challenge test with one mid-size peach combined with the physical exercise challenge test was positive. ImmunoCAP ISAC test indicated increased levels of IgE specific for the lipid transfer protein (LTP) for walnut (nJug r 3), peach (Pru p 3), wheat (rTri a 14) and plane tree (rPla a 3). The patient was diagnosed with food-dependent, exercise-induced anaphylaxis associated with an allergy to lipid transport proteins (LTPs).

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Section: Discussionmentioning

confidence: 72%

“…Although WDEIA is the most important manifestation of allergy to Tri a 19, sensitization can manifest itself also with symptoms of mild urticaria or anaphylaxis without exercise. 1 , 3 …”

Section: Discussionmentioning

confidence: 99%

Food-dependent, exercise-induced anaphylaxis in a patient allergic to peach

Ukleja-Sokołowska

Zacniewski

Gawrońska-Ukleja

et al. 2018

Int J Immunopathol Pharmacol

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“…Alternatively, measurement of serum specific IgE to ω5 gliadin is a safe and reliable test for WDEIA, using the cut-off value of ≥0.35 kU/L. The sensitivity and specificity of ω5 gliadin IgE testing were shown to reach 76.7-91% and 92-98.5% respectively, and similar results could be reproduced in patients with different ethnic origins [11][12][13]. The case in this report showed high serum specific IgE to ω5 gliadin but a relatively low serum specific IgE to wheat and negative skin prick test.…”

Section: Discussionmentioning

confidence: 80%

A Case of Wheat-Dependent Exercise Induced Anaphylaxis (WDEIA)

Yeung

Park

2019

Journal of Clinical Rheumatology and Immunology

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Wheat dependent exercised induced anaphylaxis (WDEIA) is common in Asian adult populations especially in northern China and Korea. A classical WDEIA case is presented with detailed histories, investigations and management plans. Serum specific IgE to omega-5 gliadin is critical for the diagnosis of WDEIA. Avoidance from wheat and exercise are the keys for prevention of anaphylaxis. Omalizumab, a monoclonal antibody against IgE, is reserved for cases with recurrent anaphylaxis and active physical activity status and it is an off-label treatment.

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“…Gliadins have been implicated in baker's asthma . Omega‐5 gliadin is implicated in severe immediate‐type reactions in children and wheat‐dependent, exercise‐induced anaphylaxis (WDEIA) . Glutenins are multimeric aggregates and are categorized into low and high molecular weight fractions (LMW, HMW).…”

Section: Classification Of Wheat Proteinsmentioning

confidence: 99%

Gluten sensitivities and the allergist: Threshing the grain from the husks

Burkhardt

Chapa-Rodríguez

Bahna

2017

Allergy

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Abstract"Gluten sensitivity" has become commonplace among the public. Wheat allergy (WA) and celiac disease (CD) are well-defined entities, but are becoming a fraction of individuals following a gluten-free diet (GFD). Wheat allergy has a prevalence of <0.5%. Wheat, specifically its omega-5 gliadin fraction, is the most common allergen implicated in food-dependent, exercise-induced anaphylaxis. CD is a non-IgE hypersensitivity to certain cereal proteins: gluten in wheat, secalin in rye, hordein in barley, and to a lesser extent avenin in oat. It is a rare disease, with an estimated prevalence that varied widely geographically, being higher in Northern Europe and the African Saharawi region than in South-East Asia. In addition to suggestive symptoms, serologic testing has high diagnostic reliability and biopsy is a confirmatory procedure. Patients with CD have extra-intestinal autoimmune comorbid conditions more frequently than expected. A third entity is nonceliac gluten sensitivity, which has been created because of the increasing number of subjects who claim a better quality of life or improvement of their variety of symptoms on switching to a GFD.The phenomenon is being fueled by the media and exploited by the industry. The lack of a specific objective test has been raising substantial controversy about this entity. Allergists and gastroenterologists need to pay attention to the multitudes of individuals who elect to follow a GFD. Many such subjects might have WA, CD, or another illness. Providing them with appropriate evaluation and specific management would be of great advantages, medically and economically. K E Y W O R D Sceliac disease, gluten sensitivity, gluten-free diet, nonceliac gluten sensitivity, wheat allergy 1 | INTRODUCTION "Gluten" has become part of everyday vocabulary by the public, a popular topic by the media, and is being exploited by the food industry. Three wheat-related disorders have been described, namely wheat allergy (WA), celiac disease (CD), and the new entity nonceliac gluten sensitivity (NCGS). The objective of this paper was to differentiate between these 3 disorders regarding epidemiology, manifestations, pathogenesis, diagnosis, and management. As a timely topic, "gluten sensitivity" stimulated the publication of multiple reviews, mainly in the gastroenterology and nutrition literatures, but not so in the allergy literature. Fueled by the media and the food industry's promotion of gluten-free products, the number of subjects claiming gluten-related illnesses has been exponentially increasing and they are seeking or referred for allergy evaluation.

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The clinical spectrum of omega‐5‐gliadin allergy

Cited by 36 publications

References 25 publications

Food-dependent, exercise-induced anaphylaxis in a patient allergic to peach

Food-dependent, exercise-induced anaphylaxis in a patient allergic to peach

A Case of Wheat-Dependent Exercise Induced Anaphylaxis (WDEIA)

Gluten sensitivities and the allergist: Threshing the grain from the husks

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