IgE detection to α/β/γ-gliadin and its clinical relevance in wheat-dependent exercise-induced anaphylaxis

• Published in: Allergy (Copenhagen) 2012-11, Vol.67 (11), p.1457-1460
• Main Authors: Hofmann, S. C., Fischer, J., Eriksson, C., Bengtsson Gref, O., Biedermann, T., Jakob, T.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Anaphylaxis - etiology; Biological and medical sciences; Dermatology; Exercise; Female; Food Hypersensitivity - etiology; Fundamental and applied biological sciences. Psychology; Fundamental immunology; gliadin; Gliadin - immunology; Humans; IgE; Immunoglobulin E - blood; Male; Medical sciences; Middle Aged; recombinant allergens; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Triticum - immunology; wheat allergy; wheat-dependent exercise-induced anaphylaxis
• ISSN: 0105-4538; 1398-9995
• DOI: 10.1111/all.12020

Wheat‐dependent exercise‐induced anaphylaxis (WDEIA) is characterized by anaphylactic reactions after wheat ingestion and physical exercise. IgE antibodies to recombinant ω5‐gliadin are detectable in a majority of WDEIA patients, but other wheat allergens may also play a role in elicitation of WDEIA. Here, we performed a comprehensive analysis of IgE reactivity to different wheat proteins in 17 patients with confirmed WDEIA by ImmunoCAP research prototypes and a semi‐quantitative microarray immunoassay with α/β/γ‐gliadin, high‐molecular‐weight (HMW) glutenin, alpha‐amylase inhibitor (AAI) dimer, and wheat lipid transfer protein (LTP). By ImmunoCAP, IgE to recombinant ω5‐gliadin was detectable in 14/17 patients (82%), to α/β/γ‐gliadin in 82% including the three patients lacking IgE to ω5‐gliadin, and to HMW glutenin in 59%. The microarray revealed specifically γ‐gliadin as the second most important allergen. These results demonstrate the additional diagnostic value of α/β‐ and γ‐gliadin in particular in ω5‐gliadin‐negative patients in the diagnosis of WDEIA.