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IgE detection to α/β/γ-gliadin and its clinical relevance in wheat-dependent exercise-induced anaphylaxis

Authors

  • S. C. Hofmann,

    1. Allergy Research Group, Department of Dermatology, University Medical Center, Freiburg, Germany
    Current affiliation:
    1. Department of Dermatology and Allergy, University of Witten/Herdecke, Helios-Klinikum Wuppertal, Germany
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    • SCH and JF contributed equally.

  • J. Fischer,

    1. Allergy Unit, Department of Dermatology, University Hospital Tübingen, Tübingen, Germany
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    • SCH and JF contributed equally.

  • C. Eriksson,

    1. Thermo Fisher Scientific, Uppsala, Sweden
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  • O. Bengtsson Gref,

    1. Thermo Fisher Scientific, Uppsala, Sweden
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  • T. Biedermann,

    Corresponding author
    1. Allergy Unit, Department of Dermatology, University Hospital Tübingen, Tübingen, Germany
    • Allergy Research Group, Department of Dermatology, University Medical Center, Freiburg, Germany
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    • TB and TJ contributed equally.

  • T. Jakob

    Corresponding author
    • Allergy Research Group, Department of Dermatology, University Medical Center, Freiburg, Germany
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    • TB and TJ contributed equally.


  • Edited by: Antonella Muraro

Correspondence

Thilo Jakob, Allergy Research Group, Department of Dermatology, University Medical Center Freiburg, Hauptstrasse 7, D-79104 Freiburg, Germany.

Tel.: +49-761-270-67140

Fax: +49-761-270-66550

E-mail: thilo.jakob@uniklinik-freiburg.de

Tilo Biedermann, Department of Dermatology, University Hospital Tuebingen, Liebermeisterstr. 25, D-72076 Tuebingen, Germany.

Tel.: +49-7071-29-85119

Fax: +49-7071-29-4117

E-mail: tilo.biedermann@med.uni-tuebingen.de

Abstract

Wheat-dependent exercise-induced anaphylaxis (WDEIA) is characterized by anaphylactic reactions after wheat ingestion and physical exercise. IgE antibodies to recombinant ω5-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 ω5-gliadin was detectable in 14/17 patients (82%), to α/β/γ-gliadin in 82% including the three patients lacking IgE to ω5-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 ω5-gliadin-negative patients in the diagnosis of WDEIA.

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