title: IgE detection to α/β/γ-gliadin and its clinical relevance in wheat-dependent exercise-induced anaphylaxis.
abstract: Wheat-dependent exercise-induced anaphylaxis (WDEIA) is characterized by anaphylactic reactions after wheat ingestion and physical exercise. IgE antibodies to recombinant ω(5) -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 ω(5) -gliadin was detectable in 14/17 patients (82%), to α/β/γ-gliadin in 82% including the three patients lacking IgE to ω(5) -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 ω(5) -gliadin-negative patients in the diagnosis of WDEIA.
authors.affiliation: Allergy Research Group, Department of Dermatology, University Medical Center, Freiburg, Germany.
authors.forename: S C
authors.initials: SC
authors.lastname: Hofmann
authors.forename: J
authors.initials: J
authors.lastname: Fischer
authors.forename: C
authors.initials: C
authors.lastname: Eriksson
authors.forename: O
authors.initials: O
authors.lastname: Bengtsson Gref
authors.forename: T
authors.initials: T
authors.lastname: Biedermann
authors.forename: T
authors.initials: T
authors.lastname: Jakob
mesh_terms: D000293:Adolescent; D000328:Adult; D000707:Anaphylaxis / Q000209:etiology*; D015444:Exercise; D005260:Female; D005512:Food Hypersensitivity / Q000209:etiology*; D005903:Gliadin / Q000276:immunology*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D008297:Male; D008875:Middle Aged; D014908:Triticum / Q000276:immunology*
chemical_list: D007073:Immunoglobulin E; D005903:Gliadin