title: [The inhibition effect of a synthetic analogue of prostaglandin E1 to the provocation by aspirin in the patients of WDEIA].
abstract: BACKGROUND
  Exercise or aspirin intake enhances symptoms by increasing blood gliadin levels in patients with wheat-dependent exercise-induced anaphylaxis (WDEIA). Misoprostol, a synthetic analogue of prostaglandin E1 (PGE1) compensates prostagrandins of which synthesis is inhibited by aspirin and protect the gastrointestinal mucosa. We projected to examine the effect of misoprostol in suppression the allergic symptom and elevation of blood gliadin levels in WDEIA induced by aspirin.
  
  
  METHODS
  Two patients with a history of recurrent anaphylaxis associated with wheat ingestion accompanied with exercise, positive specific IgE and/or skin test were enrolled in the provocation test. On the provocation test of WDEIA, wheat ingestion, exercise, aspirin intake were combined on various ways. During the test, the patients' symptom and serum gliadins levels were monitored.
  
  
  RESULTS
  Although wheat with exercise did not induce any symptoms, addition of aspirin induced urticaria and elevation of blood gliadin levels in both cases. In case 1, premedication of misoprostol suppressed the urticaria and elevation of blood gliadin levels which were induced by exercise, wheat and aspirin intake. In case 2, premedication of misoprostol suppressed the urticaria and elevation of blood gliadin levels which were induced by wheat and aspirin intake.
  
  
  CONCLUSIONS
  These findings suggest that a synthetic analogue of PGE1 may suppresses the absorption of the allergen levels and outbreak the allergic symptom induced by aspirin in the patients with WDEIA.
authors.affiliation: Department of Dermatology, Hyogo Prefectural Kakogawa Hospital, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Inoue
authors.forename: Atsuko
authors.initials: A
authors.lastname: Adachi
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Ueno
authors.forename: Takeshi
authors.initials: T
authors.lastname: Fukumoto
authors.forename: Nao
authors.initials: N
authors.lastname: Nishitani
authors.forename: Norihiro
authors.initials: N
authors.lastname: Fujiwara
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Matsuo
authors.forename: Kunie
authors.initials: K
authors.lastname: Kohno
authors.forename: Eishin
authors.initials: E
authors.lastname: Morita
mesh_terms: D000328:Adult; D000527:Alprostadil / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D000707:Anaphylaxis / Q000209:etiology* / Q000517:prevention & control*; D001241:Aspirin / Q000009:adverse effects*; D015444:Exercise; D005260:Female; D005903:Gliadin / Q000097:blood; D006801:Humans; D008875:Middle Aged; D016595:Misoprostol / Q000627:therapeutic use*; D011292:Premedication; D021182:Wheat Hypersensitivity / Q000517:prevention & control*
chemical_list: D016595:Misoprostol; D005903:Gliadin; D000527:Alprostadil; D001241:Aspirin