Specific IgE to gliadin was proposed as a marker for wheat dependent exercise induced anaphylaxis, while Tri a 14 was found to induce IgE response in baker's asthma. We evaluated whether these components could be used for discriminating phenotypes of wheat allergy. Twenty-nine patients who were wheat-induced anaphylaxis and/or urticaria (n=21, group I) and baker's asthma (n=8, group II) were enrolled. The prevalence of serum specific IgE to Tri a 14 was higher in group II (25%) than in group I (4.8%), while the serum specific IgE to gliadin was significantly higher in group I (70%) than in group II (12.5%). The cutoff value for predicting the baker's asthma using the ratio of serum specific IgE to Tri a 14 to gliadin was 742.8 optical densityx1,000/(kU/L) with high sensitivity and specificity. These findings suggest that Tri a 14/gliadin may be a potential marker for predicting baker's asthma.
Adult ; Anaphylaxis/immunology ; Antigens, Plant/*immunology ; Asthma/blood/diagnosis/immunology ; Biological Markers/blood ; Carrier Proteins/*immunology ; Female ; Gliadin/*immunology ; Humans ; Immunoglobulin E/*blood/immunology ; Male ; Phenotype ; Triticum/immunology ; Urticaria/immunology ; Wheat Hypersensitivity/*diagnosis/*immunology

BACKGROUNDWheat-dependent exercise-induced anaphylaxis (WDEIA) is a complex disease resulting from interaction of environmental and genetic factors. The aim of this study was to investigate the association of three single nucleotide polymorphisms (SNPs) (IL-4-C590T, IL-4RA A1727G and IL-10-A627C) with WDEIA.

METHODSSNP genotyping was conducted among the case subset composing 51 patients with WDEIA and four control subsets by sequencing DNA yielded from polymerase chain reaction (PCR). Statistical analysis of genotype/allele's frequencies between cases and controls were carried out through Fisher's exact test with the software of SPSS16.0.

RESULTSFor IL-4-C590T, there were statistically significant differences of genotype frequencies in case-control 1 (P = 0.03) and case-control 4 (P = 0.001) and statistically significant differences of allele frequencies in three case-control models (case-control 1: OR = 4.27 (95%CI = 1.40 - 13.07), P = 0.009; case-control 3: OR = 1.99 (95%CI = 1.13 - 3.50), P = 0.02; case-control 4: OR = 2.39 (95%CI = 1.49 - 3.84), P = 0.001). All other association studies showed no statistically significant (P > 0.05).

CONCLUSIONSIL-4-C590T may be related to the susceptibility of WDEIA, and the minor allele C might be a potential risk factor accounting for WDEIA. IL-4RA A1727G and IL-10-A627C might not be involved in the occurrence of WDEIA.

Adolescent ; Adult ; Aged ; Anaphylaxis ; genetics ; Asian Continental Ancestry Group ; genetics ; Child ; Child, Preschool ; Exercise ; physiology ; Female ; Gene Frequency ; genetics ; Genotype ; Gliadin ; immunology ; Glutens ; immunology ; Humans ; Immunoglobulin E ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; genetics ; Triticum ; immunology ; Young Adult

Wheat dependent exercise-induced anaphylaxis (WDEIA) is a rare but potentially severe food allergy caused by the combination of wheat ingestion and physical exercise. The impact of WDEIA on quality of life (QOL) is unclear. This study characterized the clinical and laboratory features and investigated the QOL in WDEIA patients from Central China. Twenty-eight WDEIA patients were analyzed, and QOL was measured by validated Chinese version Food Allergy Quality of Life Questionnaire-Adult Form (FAQLQ-AF) and Food Allergy Independent Measure (FAIM) after obtaining the diagnosis. The results showed that half of the patients were females. The median onset age was 37 years old. The symptoms occurred within 1 h after wheat ingestion (26/28). Symptoms of anaphylaxis included cutaneous (26/28), respiratory (11/28), gastro-intestinal (5/28) and cardiovascular manifestations (27/28). Skin prick tests were positive to salt soluble (89.3%) and salt insoluble wheat allergen extracts (100%). Positive rate to wheat, gluten and omega-5 gliadin specific IgE was 64.3%, 92.9% and 92.9% respectively. Specific IgE to omega-5 gliadin with a cut-off value 0.83 KU/L offered highly efficient diagnostic criterion for WDEIA (sensitivity: 89.3%; and specificity: 88.9%). The mean scores of FAQLQ-AF and FAIM were 4.70 and 4.98 respectively and level of anti-omega-5 gliadin IgE had positive correlations with FAQLQ scores. Thereby, WDEIA is commonly found in mid-age adults. In most cases, multi-organs especially skin and cardiovascular systems are involved. Salt insoluble wheat allergen skin test and serum specific IgE to gluten and omega-5 gliadin help to diagnose WDEIA. QOL in WDEIA patients is severely impaired.
Adolescent ; Adult ; Aged ; Allergens ; administration & dosage ; chemistry ; immunology ; Anaphylaxis ; diagnosis ; immunology ; physiopathology ; psychology ; China ; Exercise ; Female ; Gastrointestinal Tract ; immunology ; physiopathology ; Gliadin ; administration & dosage ; chemistry ; immunology ; Heart ; physiopathology ; Humans ; Immunoglobulin E ; blood ; Lung ; immunology ; physiopathology ; Male ; Middle Aged ; Quality of Life ; Skin ; immunology ; physiopathology ; Skin Tests ; Surveys and Questionnaires ; Triticum ; chemistry ; immunology ; Wheat Hypersensitivity ; diagnosis ; immunology ; physiopathology ; psychology