title: Very low prevalence of IgE mediated wheat allergy and high levels of cross-sensitisation between grass and wheat in a UK birth cohort.
abstract: BACKGROUND
  Patients often report adverse reactions to wheat. Interpretation of sensitization to wheat pollen and flour with/without sensitization to grass pollen is a clinical problem.
  
  
  OBJECTIVE
  We set out to determine the prevalence of wheat allergy in a birth cohort (10/11 year olds) and investigate the usefulness of performing skin prick tests (SPT), specific IgE tests and component resolved diagnostics to wheat pollen and flour.
  
  
  METHODS
  The Food Allergy and Intolerance Research (FAIR) birth cohort included babies born on the Isle of Wight (UK) between September 2001-August 2002 (n = 969). Children were followed up at 1, 2, 3 and 10/11 years. 588 children had SPTs to wheat pollen and grass during the 10 year follow-up. 294 children underwent further SPT to wheat flour and 246 had specific IgE testing to wheat and grass.
  
  
  RESULTS
  Eight children underwent oral food challenges (OFC). We diagnosed 0.48 % (4/827; 95 % CI 0-1 %) children with wheat allergy based on OFC. 16.3 % (96/588) were sensitized to grass pollen, 13.4 % (79/588) to wheat pollen; 78 % (75/96) sensitized to both. Only one child was sensitized to wheat flour and wheat pollen, but not grass pollen. For specific IgE, 15.0 % (37/246) and 36.2 % (89/246) were sensitized to wheat and grass pollen, with 40.5 % (36/89) sensitized to both. Of the 37 children sensitized to wheat, 3 (8.1 %) were sensitized to omega 5 gliadin, 1 (2.7 %) to wheat lipid transfer protein and 1 to wheat gliadin.
  
  
  CONCLUSIONS
  Clinicians should be aware of the high level of cross-sensitization when performing tests to wheat and grass pollen i.e. sensitisation to wheat specific IgE and wheat pollen SPT should be assessed in the presence of grass pollen SPT and/or specific IgE.
authors.affiliation: The David Hide Asthma and Allergy Research Centre, St. Mary's Hospital, Newport, Isle of Wight PO30 5TG UK ; School of Health Sciences and Social Work, University of Portsmouth, James Watson West, 2 King Richard 1st Road, Portsmouth, PO1 2FR UK.
authors.forename: Carina
authors.initials: C
authors.lastname: Venter
authors.affiliation: The David Hide Asthma and Allergy Research Centre, St. Mary's Hospital, Newport, Isle of Wight PO30 5TG UK ; School of Health Sciences and Social Work, University of Portsmouth, James Watson West, 2 King Richard 1st Road, Portsmouth, PO1 2FR UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Maslin
authors.affiliation: The David Hide Asthma and Allergy Research Centre, St. Mary's Hospital, Newport, Isle of Wight PO30 5TG UK.
authors.forename: Syed Hasan
authors.initials: SH
authors.lastname: Arshad
authors.affiliation: The David Hide Asthma and Allergy Research Centre, St. Mary's Hospital, Newport, Isle of Wight PO30 5TG UK.
authors.forename: Veeresh
authors.initials: V
authors.lastname: Patil
authors.affiliation: The David Hide Asthma and Allergy Research Centre, St. Mary's Hospital, Newport, Isle of Wight PO30 5TG UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Grundy
authors.affiliation: The David Hide Asthma and Allergy Research Centre, St. Mary's Hospital, Newport, Isle of Wight PO30 5TG UK.
authors.forename: Gillian
authors.initials: G
authors.lastname: Glasbey
authors.affiliation: The David Hide Asthma and Allergy Research Centre, St. Mary's Hospital, Newport, Isle of Wight PO30 5TG UK.
authors.forename: Roger
authors.initials: R
authors.lastname: Twiselton
authors.affiliation: The David Hide Asthma and Allergy Research Centre, St. Mary's Hospital, Newport, Isle of Wight PO30 5TG UK ; School of Health Sciences and Social Work, University of Portsmouth, James Watson West, 2 King Richard 1st Road, Portsmouth, PO1 2FR UK.
authors.forename: Taraneh
authors.initials: T
authors.lastname: Dean
keywords: Cross-reactions; Cross-sensitization; Food allergy; Hay fever; Wheat allergy