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IgE antibodies to ω‐5 gliadin associate with immediate symptoms on oral wheat challenge in Japanese children

2008; Wiley; Volume: 63; Issue: 11 Linguagem: Inglês

10.1111/j.1398-9995.2008.01753.x

1398-9995

Komei Ito, Masaki Futamura, Magnus P. Borres, Yuri Takaoka, Jörgen Dahlström, Tatsuo Sakamoto, Akira Tanaka, Kunie Kohno, Hiroaki Matsuo, Eishin Morita,

Occupational exposure and asthma

Background: Gliadins have been implicated in immunoglobulin E (IgE)‐mediated allergy to ingested wheat and ω‐5‐gliadin is known to represent a major allergen in wheat‐dependent exercise‐induced anaphylaxis. Less known is whether ω‐5‐gliadin is a clinically relevant allergen in children with immediate allergy to ingested wheat. This study investigates whether specific IgE antibodies to ω‐5‐gliadin (sIgE‐ω‐5‐gliadin‐ab) could be used as a marker for oral wheat challenge outcome in wheat‐sensitized children. A secondary objective was to study whether the level of sIgE‐ω‐5‐gliadin was related to symptom severity in children with a positive challenge test. Methods: Serum samples from 88 children sensitized to wheat, of whom 35 underwent wheat challenge, were collected consecutively. sIgE‐ω‐5‐gliadin‐ab was related to a physician’s diagnosis of wheat allergy and challenge symptoms. Results: The mean concentration of sIgE‐ω‐5‐gliadin‐ab was 7.25 kU A /l in patients with wheat allergy and 1.08 kU A /l in patients with no wheat allergy ( P < 0.01). sIgE‐ω‐5‐gliadin‐ab was only detected in 12 of the non‐wheat allergic children and 11 of them had a specific IgE to wheat below 1.30 kU A /l. Children reacting with severe symptoms upon challenge ( n = 8) had increased levels of sIgE‐ω‐5‐gliadin‐ab compared to children with moderate, mild or no symptoms ( P < 0.001). Conclusions: The presence of sIgE‐ω‐5‐gliadin‐ab is related to the reaction level to wheat challenge outcome in wheat‐sensitized children. The sIgE‐ω‐5‐gliadin‐ab was found to be associated with a strong convincing history of wheat allergy also in those cases when oral food challenge was avoided. The sIgE‐ω‐5‐gliadin‐ab level may serve as a marker for clinical reactivity in wheat‐sensitized individuals.