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Review article: safe amounts of gluten for patients with wheat allergy or coeliac disease

  1. C. HISCHENHUBER1,†,
  2. R. CREVEL2,
  3. B. JARRY3,
  4. M. MÄKI4,
  5. D. A. MONERET-VAUTRIN5,
  6. A. ROMANO6,
  7. R. TRONCONE7,
  8. R. WARD8

Article first published online: 14 FEB 2006

DOI: 10.1111/j.1365-2036.2006.02768.x

Issue

Alimentary Pharmacology & Therapeutics

Alimentary Pharmacology & Therapeutics

Volume 23, Issue 5, pages 559–575, March 2006

Additional Information

How to Cite

HISCHENHUBER, C., CREVEL, R., JARRY, B., MÄKI, M., MONERET-VAUTRIN, D. A., ROMANO, A., TRONCONE, R. and WARD, R. (2006), Review article: safe amounts of gluten for patients with wheat allergy or coeliac disease. Alimentary Pharmacology & Therapeutics, 23: 559–575. doi: 10.1111/j.1365-2036.2006.02768.x

Author Information

  1. 1

    Nestlé, Nestec Quality Management, Vevey, Switzerland

  2. 2

    Safety & Environmental Assurance Centre, Unilever, Colworth House, Sharnbrook, Bedford, UK

  3. 3

    ACS Partners, Paris, France

  4. 4

    Paediatric Research Centre, University of Tampere Medical School and Tampere University Hospital, Tampere, Finland

  5. 5

    Université de Nancy – Hôpital Central, Medicine Interne, Immunologie Clinique et Allergologie, Nancy, France

  6. 6

    Università Cattolica del Sacro Cuore C.I. Columbus, Rome and Oasi Maria SS, Troina, Italy

  7. 7

    Department of Paediatrics and European Laboratory for the investigation of food induced diseases, University ‘Federico II’, Naples, Italy

  8. 8

    PepsiCo International, Thurmaston, Leicester, UK

  1. †

    All authors contributed equally to this study.

*ILSI Europe, a.i.s.b.l. Avenue E. Mounier 83, Box 6, B-1200 Brussels, Belgium. E-mail: publications@ilsieurope.be

  • †

    All authors contributed equally to this study.

Publication History

  1. Issue published online: 14 FEB 2006
  2. Article first published online: 14 FEB 2006
  3. Publication data Submitted 23 May 2005 First decision 15 June 2005 Resubmitted 16 November 2005 Accepted 16 November 2005

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References

  • 1
    Codex Alimentarius Commission. Codex General Standard for the Labelling of Prepackaged Foods (Codex Stan 1 – 1985, Rev. 1 – 1991, Amended 1999). Rome, Italy: FAO/WHO, 1999.
  • 2
    Sicherer SH. Determinants of systemic manifestations of food allergy. J Allergy Clin Immunol 2000; 106 (Suppl. 5): S251–7.
  • 3
    Niggemann B. The role of the atopy patch test (APT) in diagnosis of food allergy in infants and children with atopic dermatitis. Pediatr Allergy Immunol 2001; 14 (Suppl. 12): 37–40.
    Direct Link:
  • 4
    Imai T, Iikura Y. The national survey of immediate type of food allergy. Arerugi 2003; 52: 1006–13.
  • 5
    Moneret-Vautrin DA, Kanny G, Morisset M, Rancé F, Fardeau MF, Beaudouin E. Severe food anaphylaxis: 107 cases registered in 2002 by the Allergy Vigilance Network. Allerg Immunol 2004; 36: 46–51.
  • 6
    Codex Alimentarius Commission. Codex Standard for ‘Gluten-free Foods’ (Codex Stan 118 – 1981, Amended 1983). Rome, Italy: FAO/WHO, 1983.
  • 7
    Skerritt JH, Hill AS. How ‘free’ is ‘gluten free'? Relationship between Kjeldahl nitrogen values and gluten protein content for wheat starches. Cereal Chem 1992; 69: 110–2.
  • 8
    Taylor SL, Hefle SL, Bindslev-Jensen C, et al. Factors affecting the determination of threshold doses for allergenic foods: how much is too much? J Allergy Clin Immunol 2002; 109: 24–30.
  • 9
    Codex Alimentarius Commission. Codex Committee on Nutrition and Foods for Special Dietary Uses: Proposed Draft Revised Standard for Gluten-free Foods (At Step 7 of the Procedure). Rome, Italy: FAO/WHO, 2003.
  • 10
    Sollid LM. Coeliac disease: dissecting a complex inflammatory disorder. Nat Rev Immunol 2002; 2: 647–55.
  • 11
    Mowat AM. Coeliac disease: a meeting point for genetics, immunology, and protein chemistry. Lancet 2003; 361: 1290–2.
  • 12
    Janatuinen EK, Pikkarainem PH, Kemppainen TA, et al. A comparison of diets with and without oats in adults with celiac disease. N Engl J Med 1995; 333: 1033–7.
  • 13
    Srinivasan U, Leonard N, Jones E, et al. Absence of oat toxicity in adult coeliac disease. Br Med J 1996; 313: 1300–1.
  • 14
    Janatuinen EK, Kemppainen TA, Julkunen RJK, et al. No harm from five year ingestion of oats in coeliac disease. Gut 2002; 50: 332–5.
  • 15
    Lundin KEA, Nilsen EM, Scott HG, et al. Oats induced villous atrophy in coeliac disease. Gut 2003; 52: 1649–52.
  • 16
    Walker-Smith JA, Guandalini S, Schmitz J, Shmerling DH, Visakorpi JK. Revised criteria for diagnosis of coeliac disease. Report of Working Group of European Society of Paediatric Gastroenterology and Nutrition. Arch Dis Child 1990; 65: 909–11.
  • 17
    Dicke WK. Coeliakie. MD thesis. Utrecht, the Netherlands, 1950.
  • 18
    Logan RFA, Tucker G, Rifkind EA, Heading RC, Ferguson A. Changes in clinical features of coeliac disease in adults in Edinburgh and the Lothians 1960–79. Br Med J 1983; 285: 95–7.
  • 19
    Bottaro G, Cataldo F, Rotolo N, Spina M, Corazza GR. The clinical pattern of subclinical/silent celiac disease: an analysis on 1026 consecutive cases. Am J Gastroenterol 1999; 94: 691–6.
  • 20
    Collin P, Reunala T, Pukkala E, Laippala P, Keyriläinen O, Pasternack A. Coeliac disease – associated disorders and survival. Gut 1994; 35: 1215–8.
  • 21
    Collin P, Kaukinen K, Mäki M. Clinical features of coeliac disease today. Dig Dis 1999; 17: 100–6.
  • 22
    Aine L, Mäki M, Collin P, Keyrilainen O. Dental enamel defects in coeliac disease. J Oral Pathol Med 1990; 19: 241–5.
    Direct Link:
  • 23
    Gobbi G, Bouquet F, Greco L, et al. Coeliac disease, epilepsy and cerebral calcifications. Lancet 1992; 340: 439–43.
  • 24
    Volta U, De Franceschi L, Lari F, Molinaro N, Zoli M, Bianchi FB. Coeliac disease hidden by cryptogenic hypertransaminasaemia. Lancet 1998; 352: 26–9.
  • 25
    Kaukinen K, Halme L, Collin P, et al. Coeliac disease in patients with severe liver disease: gluten-free diet may reverse hepatic failure. Gastroenterology 2002; 122: 881–8.
  • 26
    Mazure R, Vazquez H, Gonzales D, et al. Bone mineral affection in asymptomatic adult patients with coeliac disease. Am J Gastroenterol 1994; 89: 2130–4.
  • 27
    Mustalahti K, Collin P, Sievanen H, Salmi J, Mäki M. Osteopenia in patients with clinically silent coeliac disease warrants screening. Lancet 1999; 354: 744–5.
  • 28
    Hadjivassiliou M, Grunewald RA, Chattopadhyay AK, et al. Clinical, radiological, neurophysiological, and neuropathological characteristics of gluten ataxia. Lancet 1998; 352: 1582–5.
  • 29
    Collin P, Vilska S, Heinonen PK, Hallstrom O, Pikkarainen P. Infertility and coeliac disease. Gut 1996; 39: 382–4.
  • 30
    Catassi C, Fabiani E, Corrao G, et al. Risk of non-Hodgkin lymphoma in coeliac disease. JAMA 2002; 287: 1413–9.
  • 31
    Curione M, Barbato M, De Biase L, Viola F, Lo Russo L, Cardi E. Prevalence of coeliac disease in idiopathic dilated cardiomyopathy. Lancet 1999; 354: 222–3.
  • 32
    Korponay-Szabo IR, Dahlbom I, Laurila K, et al. Elevation of IgG antibodies against tissue transglutaminase as a diagnostic tool for coeliac disease in selective IgA deficiency. Gut 2003; 52: 1567–71.
  • 33
    Carlsson A, Axelsson I, Borulf S, et al. Prevalence of IgA-antigliadin antibodies and IgA-antiendomysium antibodies related to coeliac disease in children with Down syndrome. Pediatrics 1998; 101: 272–5.
  • 34
    Collin P, Kaukinen K, Välimäki M, Salmi J. Endocrinological disorders and coeliac disease. Endocr Rev 2002; 23: 464–83.
  • 35
    Holmes GK. Coeliac disease and type 1 diabetes mellitus – the case for screening. Diabet Med 2001; 18: 169–77.
    Direct Link:
  • 36
    Csizmadia C, Mearin M, von Blomberg B, Brand R, Verloove-Vanhorick S. An iceberg of childhood coeliac disease in the Netherlands. Lancet 1999; 353: 813–4.
  • 37
    Fasano A, Berti I, Gerarduzzi T, et al. Prevalence of celiac disease in at-risk and not-at-risk groups in the United States: a large multicenter study. Arch Intern Med 2003; 163: 286–92.
  • 38
    Gomez JC, Selvaggio G, Pizarro B, et al. Value of a screening algorithm for coeliac disease using tissue transglutaminase antibodies as first level in a population-based study. Am J Gastroenterol 2002; 97: 2785–90.
    Direct Link:
  • 39
    Ivarsson A, Persson LA, Juto P, Peltonen M, Suhr O, Hernell O. High prevalence of undiagnosed coeliac disease in adults: a Swedish population-based study. J Intern Med 1999; 245: 63–8.
    Direct Link:
  • 40
    Korponay-Szabo IR, Kovacs J, Czinner A, Goracz G, Vamos A, Szabo T. High prevalence of silent coeliac disease in preschool children screened with IgA/IgG anti-endomysium antibodies. J Pediatr Gastroenterol Nutr 1999; 28: 26–30.
  • 41
    Mäki M, Mustalahti K, Kokkonen J, et al. Prevalence of coeliac disease among children in Finland. N Engl J Med 2003; 348: 2517–24.
  • 42
    West J, Logan RF, Hill PG, et al. Seroprevalence, correlates and characteristics of undetected coeliac disease in England. Gut 2003; 52: 960–5.
  • 43
    Nilsen EM, Jahnsen FL, Lundin KE, et al. Gluten induces an intestinal cytokine response strongly dominated by interferon gamma in patients with celiac disease. Gastroenterology 1998; 115: 551–63.
  • 44
    Salvati VM, MacDonald TT, Bajaj-Elliott M, et al. Interleukin 18 and associated markers of T helper cell type 1 activity in coeliac disease. Gut 2002; 50: 186–90.
  • 45
    Maiuri L, Ciacci C, Ricciardelli I, et al. Association between innate response to gliadin and activation of pathogenic T cell in coeliac disease. Lancet 2003; 362: 30–7.
  • 46
    Dieterich W, Ehnis T, Bauer M, et al. Identification of tissue transglutaminase as the autoantigen of celiac disease. Nat Med 1997; 3: 797–801.
  • 47
    Korponay-Szabo IR, Halttunen T, Szalai Z, et al. In vivo targeting of intestinal and extraintestinal transglutaminase 2 by coeliac autoantibodies. Gut 2004; 53: 641–8.
  • 48
    Molberg O, McAdam S, Korner R, et al. Tissue transglutaminase selectively modifies gliadin peptides that are recognized by gut-derived T cells in celiac disease. Nat Med 1998; 4: 713–7.
  • 49
    Schuppan D. Current concepts of coeliac disease pathogenesis. Gastroenterology 2000; 119: 234–42.
  • 50
    Maiuri L, Ciacci C, Raia V, et al. FAS engagement drives apoptosis of enterocytes of coeliac patients. Gut 2001; 48: 418–24.
  • 51
    Meresse B, Chen Z, Ciszewski C, et al. Coordinated induction by IL15 of a TCR-independent NKG2D signaling pathway converts CTL into lymphokine-activated killer cells in celiac disease. Immunity 2004; 21: 357–66.
  • 52
    Hüe S, Mention JJ, Monteiro RC, et al. A direct role for NKG2D/MICA interaction in villous atrophy during celiac disease. Immunity 2004; 21: 367–77.
  • 53
    Ciclitira PJ, Evans DJ, Fagg NL, Lennox ES, Dowling RH. Clinical testing of gliadin fractions in coeliac patients. Clin Sci 1984; 66: 357–64.
  • 54
    Ciclitira PJ, Ellis HJ, Fagg NL. Evaluation of a gluten free product containing wheat gliadin in patients with coeliac disease. Br Med J 1984; 289: 83.
  • 55
    Howdle PD, Ciclitira PJ, Simpson FG, Losowsky MS. Are all gliadins toxic in coeliac disease? An in vitro study of α,β,γ and ω-gliadins. Scand J Gastroenterol 1984; 19: 41–7.
  • 56
    Arentz-Hansen H, Korner R, Molberg O, et al. The intestinal T-cell response to alpha-gliadin in adult celiac disease is focussed on a single deamidated glutamine targeted by tissue transglutaminase. J Exp Med 2000; 191: 603–12.
  • 57
    Anderson RP, Degano P, Godkin AJ, Jewell DP, Hill AV. In vivo antigen challenge in celiac disease identifies a single transglutaminase-modified peptide as the dominant A-gliadin T-cell determinant. Nat Med 2000; 6: 337–42.
  • 58
    Arentz-Hansen H, McAdam SN, Molberg O, et al. Celiac lesion T-cells recognize determinants that cluster in regions of gliadins rich in proline residues. Gastroenterology 2002; 123: 803–9.
  • 59
    Shan L, Molberg O, Parrot I, et al. Structural basis for gluten intolerance in coeliac sprue. Science 2002; 297: 2275–9.
  • 60
    Ellis HJ, Pollock EL, Engel W, et al. Investigation of the putative immunodominant T cell epitopes in coeliac disease. Gut 2003; 52: 212–7.
  • 61
    Vader W, Kooy Y, Van Veelen P, et al. The gluten response in children with celiac disease is directed toward multiple gliadin and glutenin peptides. Gastroenterology 2002; 122: 1729–37.
  • 62
    Molberg O, Solheim Flaete N, Jensen T, et al. Intestinal T-cell responses to high-molecular-weight glutenins in celiac disease. Gastroenterology 2003; 125: 337–44.
  • 63
    Stern M, Ciclitira PJ, van Eckert R, et al. Analysis and clinical effects of gluten in coeliac disease. Eur J Gastroenterol Hepatol 2001; 13: 741–7.
  • 64
    Catassi C, Rossini M, Rätsch I-M, et al. Dose dependent effects of protracted ingestion of small amounts of gliadin in coeliac disease children: clinical and jejunal morphometric study. Gut 1993; 34: 1515–9.
  • 65
    Catassi C, Fabiani E, Iacono G, et al. Toxicity of Gluten Traces in Patients on Treatment for Celiac Disease. Results of a Prospective, Placebo-controlled, Double-blind, Randomized Study (Abstract). Digestive Disease Week, 14–19 May 2005, McCormick Place, Chicago, IL, USA. Bethesda, MD: American Gastrointestinal Association, 2005.
  • 66
    Ejderhamn J, Veress B, Strandvik B. The long-term effect of continual ingestion of wheat starch-containing gluten-free products in coeliac patients. In: Kumar, PJ, ed. Coeliac Disease: One Hundred Years. Leeds, UK: Leeds University Press, 1988: 294–7.
  • 67
    Collin P, Pukkala E, Reunala T. Malignancy and survival in dermatitis herpetiformis: a comparison with coeliac disease. Gut 1996; 38: 528–30.
  • 68
    Selby WS, Painter D, Collins A, Faulkner-Hogg KB, Loblay RH. Persistent mucosal abnormalities in coeliac disease are not related to the ingestion of trace amounts of gluten. Scand J Gastroenterol 1999; 34: 909–14.
  • 69
    Kaukinen K, Collin P, Holm K, et al. Wheat starch-containing gluten-free products in the treatment of coeliac disease and dermatitis herpetiformis: a long-term follow-up study. Scand J Gastroenterol 1999; 34: 163–9.
  • 70
    Lohiniemi S, Mäki M, Kaukinen K, Laippala P, Collin P. Gastrointestinal symptoms rating scale in coeliac disease patients on wheat starch-based gluten-free diets. Scand J Gastroenterol 2000; 35: 947–9.
  • 71
    Peräaho M, Kaukinen K, Paasikivi K, Sievänen H, Lohiniemi S, Mäki M. Wheat-starch-based gluten-free products in the treatment of newly detected coeliac disease: prospective and randomised study. Aliment Pharmacol Ther 2003; 17: 587–94.
    Direct Link:
  • 72
    Collin P, Thorell L, Kaukinen K, Mäki M. The safe threshold for gluten contamination in gluten-free products. Can trace amounts be accepted in the treatment of coeliac disease? Aliment Pharmacol Ther 2004; 19: 1277–83.
    Direct Link:
  • 73
    Dissanayake AS, Truelove SC, Whitehead R. Jejunal mucosal recovery in coeliac disease in relation to the degree of adherence to a gluten-free diet. Q J Med 1974; 170: 161–85.
  • 74
    Baker PG, Barry RE, Read AE. Detection of continuing gluten ingestion in treated coeliac patients. BMJ 1975; 1: 486–8.
  • 75
    Kumar PJ, Walker-Smith J, Milla P, Harris G, Coyler J, Halliday R. The teenage coeliac: follow up study of 102 patients. Arch Dis Child 1988; 63: 916–20.
  • 76
    Mayer M, Greco L, Troncone R, Auricchio S, Marsh MN. Compliance of adolescents with coeliac disease with a gluten free diet. Gut 1991; 32: 881–5.
  • 77
    Troncone R, Mayer M, Spagnuolo F, Maiuri L, Greco L. Endomysial antibodies as unreliable markers for slight dietary transgressions in adolescents with coeliac disease. J Pediatr Gastroenterol Nutr 1995; 21: 69–72.
  • 78
    Ciclitira PJ, Cerio R, Ellis HJ, Maxton D, Nelufer JM, Macartney JM. Evaluation of a gliadin-containing gluten-free product in coeliac patients. Hum Nutr Clin Nutr 1985; 39: 303–8.
  • 79
    Montgomery AM, Goka AK, Kumar PJ, Farthing MJ, Clark ML. Low gluten diet in the treatment of adult coeliac disease: effect on jejunal morphology and serum anti-gluten antibodies. Gut 1988; 29: 1564–8.
  • 80
    Chartrand LC, Russo PA, Duhaime AG, Seidman EG. Wheat starch intolerance in patients with celiac disease. J Am Diet Assoc 1997; 97: 612–8.
  • 81
    Räsänen L, Lehto M, Turjanmaa K, Savolainen J, Reunala T. Allergy to ingested cereals in atopic children. Allergy 1994; 49: 871–6.
    Direct Link:
  • 82
    Rancé F, Kanny G, Dutau G, Moneret-Vautrin DA. Aspects cliniques de l'allergie alimentaire. Rev Fr Allergol 1998; 38: 900–5.
  • 83
    Moneret-Vautrin DA, Kanny G, Perrier P, et al. Etude prospective 1999–2002 de l'allergie alimentaire à la farine de blé chez l'enfant et chez l'adulte, comparée à la maladie coeliaque. Alim Inter 2003; 8: 2–8.
  • 84
    Bock AS, Atkins FM. Patterns of food hypersensitivity during sixteen years of double-blind placebo-controlled food challenges. J Pediatr 1990; 117: 561–7.
  • 85
    Sampson HA. Food allergy: Part 2. Diagnosis and management. J Allergy Clin Immunol 1999; 103: 981–9.
  • 86
    Roehr CC, Reibel S, Ziegert M, Sommerfeld C, Wahn U, Niggemann B. Atopy patch tests, together with determination of specific IgE levels, reduce the need for oral food challenges in children with atopic dermatitis. J Allergy Clin Immunol 2001; 107: 548–53.
  • 87
    Strömberg L. Diagnostic accuracy of the atopy patch test and the skin-prick test for the diagnosis of food allergy in young children with atopic eczema/dermatitis syndrome. Acta Paediatr 2002; 91: 1044–9.
  • 88
    Järvinen K-M, Turpeinen M, Suomalainen H. Concurrent cereal allergy in children with cow's milk allergy manifested with atopic dermatitis. Clin Exp Allergy 2003; 33: 1060–6.
    Direct Link:
  • 89
    Breuer K, Heratizadeh A, Wulf A, et al. Late eczematous reactions to food in children with atopic dermatitis. Clin Exp Allergy 2004; 34: 817–24.
    Direct Link:
  • 90
    Sutton R, Hill DJ, Baldo BA, Wrigley CW. Immunoglobulin E antibodies to ingested cereal flour components: studies with sera from subjects with asthma and eczema. Clin Allergy 1982; 12: 63–74.
    Direct Link:
  • 91
    Isolauri E, Turjanmaa K. Combined skin prick and patch testing enhances identification of food allergy in infants with atopic dermatitis. J Allergy Clin Immunol 1996; 97: 9–15.
  • 92
    Majamaa H, Moisio P, Holm K, Turjanmaa K. Wheat allergy: diagnostic accuracy of skin prick and patch test and specific IgE. Allergy 1999; 54: 851–6.
    Direct Link:
  • 93
    Moneret-Vautrin DA, Kanny G, Guerin L, Flabbee J, Lemerdy P. The multifood allergy syndrome. Allerg Immunol (Paris) 2000; 32: 12–5.
  • 94
    Varjonen E, Vainio E, Kalimo K. Antigliadin IgE-indicator of wheat allergy in atopic dermatitis. Allergy 2000; 55: 386–91.
    Direct Link:
  • 95
    Guinnepain M, Eloit C, Raffard M, Brunet-Moret M, Rassemont R, Laurent J. Exercise-induced anaphylaxis: useful screening of food sensitization. Ann Allergy Asthma Immunol 1996; 77: 491–6.
  • 96
    Hanakawa Y, Tohyama M, Shirakata Y, Murakami S, Hashimoto K. Food-dependent exercise-induced anaphylaxis: a case related to the amount of food allergen ingested. Br J Dermatol 1998; 138: 898–900.
    Direct Link:
  • 97
    Guenard-Bilbault L, Kanny G, Moneret-Vautrin DA. Food allergy to wheat flour in adults. Allerg Immunol (Paris) 1999; 31: 22–5.
  • 98
    Morita E, Yamamura Y, Mihara S, Kameyoshi Y, Yamamoto S. Food-dependent exercise-induced anaphylaxis: a report of two cases and determination of wheat-gamma-gliadin as the presumptive allergen. Br J Dermatol 2000; 143: 1059–63.
    Direct Link:
  • 99
    Lehto M, Palosuo K, Varjonen E, et al. Humoral and cellular responses to gliadin in wheat-dependent, exercise-induced anaphylaxis. Clin Exp Allergy 2003; 33: 90–5.
    Direct Link:
  • 100
    Bengtsson U, Nilsson-Balknas U, Hanson LA, Ahlstedt S. Double blind, placebo controlled food reactions do not correlate to IgE allergy in the diagnosis of staple food related gastrointestinal symptoms. Gut 1996; 39: 130–5.
  • 101
    Bischoff SC, Mayer J, Wedemyer PN, et al. Colonoscopic allergen provocation (COLAP): a new diagnostic approach for gastrointestinal food allergy. Gut 1997; 40: 745–53.
  • 102
    Simonato B, De Lazzari F, Pasini G, et al. IgE binding to soluble and insoluble wheat flour proteins in atopic and non-atopic patients suffering from gastrointestinal symptoms after wheat ingestion. Clin Exp Allergy 2001; 31: 1771–8.
    Direct Link:
  • 103
    Spergel JM, Beausoleil JL, Mascarenhas M, Liacouras CA. The use of skin prick test and patch tests to identify causative foods in eosinophilic esophagitis. J Allergy Clin Immunol 2002; 109: 363–8.
  • 104
    Linna O. Specific IgE antibodies to uningested cereals. Allergy 1996; 51: 849–50.
  • 105
    Chirdo FG, Rumbo M, Anon MC, Fossati CA. Presence of high levels of non-degraded gliadin in breast milk from healthy mothers. Scand J Gastroenterol 1998; 33: 1186–92.
  • 106
    Romano A, Di Fonso M, Giuffreda F, et al. Food-dependent exercise-induced anaphylaxis: clinical and laboratory findings in 54 subjects. Int Arch Allergy Immunol 2001; 125: 264–72.
  • 107
    Aihara M, Miyazawa M, Osuna H, et al. Food-dependent exercise-induced anaphylaxis: influence of concurrent aspirin administration on skin testing and provocation. Br J Dermatol 2002; 146: 466–72.
    Direct Link:
  • 108
    Dohi M, Suko M, Sugiyama H, et al. Food-dependent, exercise-induced anaphylaxis: a study on 11 Japanese cases. J Allergy Clin Immunol 1991; 87: 34–40.
  • 109
    Varjonen E, Vainio E, Kalimo K. Life-threatening, recurrent anaphylaxis caused by allergy to gliadin and exercise. Clin Exp Allergy 1997; 27: 162–6.
    Direct Link:
  • 110
    Palosuo K, Alenius H, Varjonen E, et al. A novel wheat gliadin as a cause of exercise-induced anaphylaxis. J Allergy Clin Immunol 1999; 103: 912–7.
  • 111
    Blands J, Diamant B, Kallos P, Kallos-Deffner L, Lowenstein H. Flour allergy in bakers: I. Identification of allergenic fractions in flour and comparison of diagnostic methods. Int Arch Allergy Appl Immunol 1976; 52: 392–406.
  • 112
    Baldo BA, Wrigley CW. IgE antibodies to wheat flour components. Studies with sera from subjects with baker's asthma or coeliac condition. Clin Allergy 1978; 8: 109–24.
    Direct Link:
  • 113
    Barber D, Sanchez-Monge R, Gomez L, et al. A barley flour inhibitor of insect α-amylase is a major allergen associated with baker's asthma disease. FEBS Lett 1989; 248: 119–22.
  • 114
    Sandiford CP, Tee RD, Newman-Taylor AJ. The role of cereal and fungal amylases in cereal flour hypersensitivity. Clin Exp Allergy 1994; 24: 549–57.
    Direct Link:
  • 115
    Brisman J, Järvholm B, Lillienberg L. Exposure-response relations for self reported asthma and rhinitis in bakers. Occup Environ Med 2000; 57: 335–40.
  • 116
    Cullinan P, Cook A, Nieuwenhuijsen MJ, et al. Allergen and dust exposure as determinants of work-related symptoms and sensitization in a cohort of flour-exposed workers: a case-control analysis. Ann Occup Hyg 2001; 45: 97–103.
  • 117
    Jones SM, Magnolfi CF, Cooke SK, Sampson HA. Immunologic cross-reactivity among cereal grains and grasses in children with food hypersensitivity. J Allergy Clin Immunol 1995; 96: 341–51.
  • 118
    James JM, Sixbey JP, Helm RM, Bannon GA, Burks AW. Wheat alpha-amylase inhibitor: a second route of allergic sensitization. J Allergy Clin Immunol 1997; 99: 239–44.
  • 119
    Kusaba-Nakayama M, Ki M, Iwamoto M, et al. CM3, one of the wheat α-amylase inhibitor subunits, and binding of IgE in sera from Japanese with atopic dermatitis related to wheat. Food Chem Toxicol 2000; 38: 179–85.
  • 120
    Morita E, Kameyoshi Y, Mihara S, Hiragun T, Yamamoto S. Gamma-gliadin: a presumptive allergen causing wheat-dependent exercise-induced anaphylaxis. Br J Dermatol 2001; 145: 182–4.
    Direct Link:
  • 121
    Watanabe M, Tnabe S, Suzuki T, Ikezawa Z, Arai S. Primary structure of an allergenic peptide occurring in the chymotryptic hydrolysate of gluten. Biosci Biotechnol Biochem 1995; 59: 1596–7.
  • 122
    Armentia A, Rodríguez R, Callejo A, et al. Allergy after ingestion or inhalation of cereals involves similar allergens in different ages. Clin Exp Allergy 2002; 32: 1216–22.
    Direct Link:
  • 123
    Battais F, Pineau F, Popineau Y, et al. Food allergy to wheat: identification of immunoglobulin G-binding proteins with sequential extracts and purified proteins from wheat flour. Clin Exp Allergy 2003; 33: 962–70.
    Direct Link:
  • 124
    Battais F, Courcoux P, Popineau Y, et al. Food allergy to wheat: differences in immunoglobulin E-binding proteins as a function of age or symptoms. J Cereal Sci 2005; 42: 109–17.
  • 125
    Daengsuwan T, Palosuo K, Phankingthongkum S, et al. IgE antibodies to ω-gliadin in children with wheat-induced anaphylaxis. Allergy 2005; 60: 506–9.
    Direct Link:
  • 126
    Varjonen E, Savolainen L, Mattila L, Kalimo K. IgE-binding components of wheat, rye, barley and oats recognized by immunoblotting analysis with sera from adult atopic dermatitis patients. Clin Exp Allergy 1994; 24: 481–9.
    Direct Link:
  • 127
    Varjonen E, Vainio E, Kalimo K, Juntunen-Backman K, Savolainen J. Skin-prick test and RAST responses to cereals in children with atopic dermatitis. Characterization of IgE-binding components in wheat and oats by an immunoblotting method. Clin Exp Allergy 1995; 25: 1100–7.
    Direct Link:
  • 128
    Palosuo K, Varjonen E, Kekki OM, et al. Wheat omega-5 gliadin is a major allergen in children with immediate allergy to ingested wheat. J Allergy Clin Immunol 2001; 108: 634–8.
  • 129
    Palosuo K, Varjonen E, Nurkkala J, et al. Transglutaminase-mediated cross-linking of a peptic fraction of omega-5 gliadin enhances IgE reactivity in wheat-dependent, exercise-induced anaphylaxis. J Allergy Clin Immunol 2003; 111: 1386–92.
  • 130
    Leduc V, Moneret-Vautrin DA, Morisset M, Kanny G. Anaphylaxis to wheat isolates: immunochemical study of a case proved by means of double-blind, placebo-controlled food challenge. J Allergy Clin Immunol 2003; 111: 897–9.
  • 131
    Palosuo K, Alenius H, Varjonen E, Kalkkinen N, Reunala T. Rye γ-70 and γ-35 secalins and barley γ-3 hordein cross-react with omega-5 gliadin, a major allergen in wheat-dependent, exercise induced anaphylaxis. Clin Exp Allergy 2001; 31: 466–73.
    Direct Link:
  • 132
    Sampson HA. Utility of food-specific IgE concentrations in predicting symptomatic food allergy. J Allergy Clin Immunol 2001; 107: 891–6.
  • 133
    Spergel JM, Beausoleil JL, Fiedler JM, Ginsberg J, Wagner K, Pawlowski NA. Correlation of initial food reactions to observed reactions on challenges. Ann Allergy Asthma Immunol 2004; 92: 217–24.
  • 134
    Perry TT, Matsui EC, Conover-Walker MK, Wood RA. The relationship of allergen-specific IgE levels and oral food challenge outcome. J Allergy Clin Immunol 2004; 114: 144–9.
  • 135
    Pourpak Z, Mansouri M, Mesdaghi M, Kazemnejad A, Farhoudi A. Wheat allergy: clinical and laboratory findings. Int Arch Allergy Immunol 2004; 133: 168–73.
  • 136
    Sampson HA, Nho DG. Relationship between food-specific IgE concentrations and the risk of positive food challenges in children and adolescents. J Allergy Clin Immunol 1997; 100: 444–51.
  • 137
    Romano A, Di Fonso M, Giuffreda F, et al. Diagnostic work-up for food-dependent, exercise-induced anaphylaxis. Allergy 1995; 50: 817–24.
    Direct Link:
  • 138
    Denery-Papini S, Popineau Y, Quillien L, Van Regenmortel MHV. Specificity of antisera raised against synthetic peptide fragments of high MW glutenin subunits. J Cereal Sci 1996; 23: 133–44.
  • 139
    Camafeita E, Alfonso P, Mothes T, Méndez E. Matrix-assisted laser desorption/ionisation time-of-flight mass spectrometric micro-analysis: the first non-immunological alternative attempt to quantify gluten gliadins in food samples. J Mass Spectrom 1997; 32: 940–7.
    Direct Link:
  • 140
    Köppel E, Stadler M, Lüthy J, Hübner P. Detection of wheat contamination in oats by polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA). Z Lebensm Unters Forsch 1998; 206: 399–403.
  • 141
    Osborne T. The Proteins of the Wheat Kernel. Washington, DC, USA: Carnegie Inst., 1907: 84.
  • 142
    Hernando A, Valdes I, Garcia E, Méndez E. Proceedings of the 16th Meeting of the Working Group on Prolamin Analysis and Toxicity, 8–11 November 2001. Barcelona: Martin Stern, Verlag Wissenschaftliche Scripten, Zwickau, Germany, 2002.
  • 143
    Skerritt JH, Smith RA. A sensitive monoclonal antibody based test for gluten detection. Studies with cooked or processed foods. J Sci Food Agric 1985; 36: 980–6.
    Direct Link:
  • 144
    Skerritt JH, Hill AS. Enzyme immunoassay for determination of gluten in foods: collaborative study. JAOAC 1991; 74: 257–64.
  • 145
    Fritschy F, Windemann H, Baumgartner E. Quantitative determination of wheat gliadins in foods by enzyme-linked immunosorbent assay. Z Lebensm Unters Forsch 1985; 181: 379–85.
  • 146
    Ellis HJ, Rosen-Bronson S, O'Reilly N, Ciclitira PJ. Measurement of gluten using a monoclonal antibody to a coeliac toxic peptide of A-gliadin. Gut 1998; 43: 190–5.
  • 147
    Wieser H. Investigations on the extractability of gluten protein from wheat bread in comparison with flour. Z Lebensm Unters Forsch 1998; 207: 128–32.
  • 148
    Valdés I, García E, Llorente M, Méndez E. Innovative approach to low-level gluten determination in foods using a novel sandwich enzyme-linked immunosorbent assay protocol. Eur J Gastroenterol Hepatol 2003; 15: 465–74.
  • 149
    Osman AA, Uhlig HH, Valdés I, Amin M, Méndez E, Mothes T. Monoclonal antibody recognizing a potential coeliac toxic repetitive pentapeptide epitope in gliadins. Eur J Gastroenterol Hepatol 2001; 13: 1189–93.
  • 150
    García E, Llorente M, Hernando A, Méndez E. Cocktail Solution versus Aqueous Ethanol for Gluten Extraction in Food Samples. Proceedings of the 17th Meeting of the Prolamin Working Group on Prolamin Analysis and Toxicity, 3–6 October 2002. Martin Stern, Zwickau, Verlag Wissenschaftliche Scripten, London UK, 2003.
  • 151
    López E, Reyes E, Valdés I, Llorente M, Iglesias J, Méndez E. Massive Analysis of Food Samples by a Sandwich ELISA based on a Unique Monoclonal Antibody. Proceedings of the 14th Meeting of the Working Group on Prolamin Analysis and Toxicity, 5–7 November 1999. Martin Stern, Verlag Wissenschaftliche Scripten, Tübingen, Zwickau, 2000.
  • 152
    Immer U, Vela C, Méndez E, Jenssen F. PWG Collaborative Trial of Gluten in Gluten-free Food Through ‘Cocktail ELISA’. Proceedings of the 17th Meeting of the Working Group on Prolamin Analysis and Toxicity, 3–6 October 2002. Martin Stern, Verlag Wissenschaftliche Scripten, Zwickau, Germany, 2003.
  • 153
    Sorell L, Lopez JA, Valdés I, et al. An innovative sandwich ELISA system based on an antibody cocktail for gluten analysis. FEBS Lett 1998; 439: 46–50.
  • 154
    Wieser H, Seilmeier W. Determination of Gliadin and Gluten in Wheat Starch by means of Alcohol Extraction and Gel Permeation Chromatography. Proceedings of the 17th Meeting of the Working Group on Prolamin Analysis and Toxicity, 3–6 October 2002. Martin Stern, Verlag Wissenschaftliche Scripten, Zwickau, Germany, 2003.
  • 155
    Codex Alimentarius Commission. Report of the 25th Session of the Codex Committee on Methods of Analysis and Sampling in Budapest. Rome, Italy: ALINORM 04/27/23, FAO/WHO, 2004.
  • 156
    Ferre S, García E, Méndez E. Measurement of Hydrolysed Gliadins by a Competitive ELISA based on Monoclonal Antibody R5: Analysis of Syrups and Beers. Proceedings of the 18th Meeting of the Working Group on Prolamin Analysis and Toxicity, 2–5 October 2003. Martin Stern, Verlag Wissenschaftliche Scripten, Zwickau, Germany, 2004.
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