F004-IgE Wheat

The Wheat Allergy test looks for IgE antibodies which the body develops in response to proteins found in wheat. 

Today almost a half of the calories consumed by the human population worldwide come from cereals, with wheat being the most popular grain in Europe and the Americas. Its use is so widespread that people suffering from gluten-related disorders have great difficulty in avoiding it. Flour and bran are used in the production of bread, muesli, breakfast cereals, pasta, bulgur, couscous, and pastries. Being a binding agent, wheat is added to cold cuts, desserts, ice cream, and cream. Starch is used for coating pills, pralines, and roasted coffee grains, as well as in cosmetic, paper, and chemical industries.

It is important to note that a wheat allergy is not the same as Celiac Disease.

What are typical symptomsm of a wheat allergy?

Typical symptoms of wheat allergy include swelling, itching or irritation around the mouth or throat, headache, nasal congestion, itchy or watery eyes, hives or rash, stomach cramps, nausea, diarrhea, vomiting and difficulty breathing. Some people may experience more severe reactions including swelling of the throat, chest pain, rapid heartbeat, dizziness, fainting or severe breathing problems.

A food allergy to wheat is characterized by T helper type 2 activation which can result in immunoglobulin E (IgE) and non-IgE mediated reactions. IgE mediated reactions are immediate, are characterized by the presence of wheat-specific IgE antibodies, and can be life-threatening.

Diagnosis:

The diagnosis of an IgE mediated wheat allergy is based on an accurate history that documents the symptoms specific of IgE mediated food allergy to wheat or occupational respiratory allergies to wheat flour. When these symptoms occur within 1–3 hours of wheat exposure the allergy to wheat needs to be confirmed by measuring IgE specific to wheat. The presence of specific sIgE to wheat without a clear history of symptoms after wheat exposure is not diagnostic as many people can be sensitive to wheat but can tolerate wheat exposure, especially in grass pollen sensitive individuals. Indeed patients with grass pollen sensitivity carry IgE specific for cereal derived allergens and several studies have reported cross-reactivity between wheat flour and grass pollen due to common IgE epitopes in wheat flour and grass pollen proteins. Furthermore, a diagnosis based on wheat flour extract does not allow discrimination between patients suffering from a respiratory allergy and those suffering from a food allergy to wheat.

Treatment / Management:

At the moment, management of IgE mediated wheat allergy is mainly based on avoidance both in food and inhaled wheat allergens.

Patients with a food allergy to wheat must be trained to identify relevant food allergens in the labels, and written instruction should be given to effectively eliminate wheat from their diet.

One promising way for treatment of a food allergy is immunotherapy. Currently, there are three techniques being studied: oral immunotherapy (OIT), sublingual immunotherapy (SLIT), and epicutaneous immunotherapy (EPIT). OIT and SLIT are based on the principle of slowly increasing the amount of food ingested in order to avoid experiencing systemic reactions. OIT is the immunotherapeutic treatment with the largest body of evidence, having a decade-long experience in clinical trials.

References:

Cianferoni A. Wheat allergy: diagnosis and management. J Asthma Allergy. 2016 Jan 29;9:13-25. doi: 10.2147/JAA.S81550. PMID: 26889090; PMCID: PMC4743586.

Czaja-Bulsa G, Bulsa M. What Do We Know Now about IgE-Mediated Wheat Allergy in Children? Nutrients. 2017 Jan 4;9(1):35. doi: 10.3390/nu9010035. PMID: 28054973; PMCID: PMC5295079.