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Omega-5-Gliadin Specific IgE as a Predictor of Wheat Allergy in Children

2007; Elsevier BV; Volume: 119; Issue: 1 Linguagem: Inglês

10.1016/j.jaci.2006.12.116

1097-6825

Kiyonori Ito, Yuri Takaoka, Masaki Futamura, Tatsuo Sakamoto, Kunie Kohno, Eishin Morita, Hiroaki Matsuo, Akira Tanaka,

Food Allergy and Anaphylaxis Research

RATIONALE: Wheat is the third-most common food allergen in Japanese children, but detection of wheat-specific IgE antibody is insufficient to diagnose wheat allergy because of low clinical specificity. Omega-5-gliadin is known to represent a major allergen in wheat-dependent exercise-induced anaphylaxis, but levels in immediate-type wheat allergy in children remain unclear. METHODS: IgE antibody to omega-5-gliadin was detected by ImmunmoCAP in sera from patients with wheat allergy (n=44; mean age, 3.4 years) diagnosed according to positive wheat challenge or apparent clinical history. Control patients (n=44; mean age, 4.9 years) with positive IgE for wheat (>=3.5 UA/ml) but without clinical symptoms after ingestion of wheat products were also recruited. RESULTS: Levels of wheat-specific IgE (mean ±SD) were 44.52 ±36.37 UA/ml in patients and 12.57 ±11.81 UA/ml in controls. Omega-5-gliadin-specific IgE was positive (>0.34 UA/ml) in 37 patients with wheat allergy (84.1%) and 12 controls(27.3%). Mean IgE titer in positive sera was 7.25 UA/ml in patients (range, 0.40-81.0 UA/ml) and 1.08 UA/ml in controls (0.35-4.80 UA/ml). Although only 1 control patient showed a level of 4.80 UA/ml (all others were 5.0 UA/ml. Patients with high IgE titer to omega-5-gliadin tended to display severe reactions including respiratory symptoms or anaphylaxis. CONCLUSIONS: Detection of omega-5-gliadin-specific IgE is useful for the diagnosis of immediate-type wheat allergy in children comparing to that of wheat.