The allergen-specific IgE antibody test is a crucial tool for diagnosing gluten allergies. It quantifies an individual's IgE response to gluten, an essential protein in wheat, and is conducted as an in vitro quantitative assay. This test should be used alongside other clinical information to aid in food allergy diagnosis. While similar in many respects to skin testing, organizations like the American Academy of Allergy, Asthma, and Immunology and the American College of Allergy, Asthma, and Immunology recognize certain situations where serum IgE testing is preferred. These include cases of widespread skin disease, recent antihistamine use, uncooperative patients, or where skin testing poses a significant risk of a serious allergic reaction.
Food-specific IgE tests, while sensitive, only indicate sensitization and don't confirm an allergy; many sensitized individuals don't develop symptoms upon ingestion. Therefore, a trained medical provider should make a food allergy diagnosis after a comprehensive clinical evaluation. Detection of food-specific IgE in serum is evidence of IgE sensitization, but clinical reactivity history to the food is essential for an IgE-mediated food allergy diagnosis. Some forms of food hypersensitivity don't involve food-specific IgE in serum.
Gluten, the main storage protein in wheat, is a major food allergen affecting an estimated 0.4% of the global population. Symptoms of wheat allergy can range from gastrointestinal issues to skin and respiratory reactions, and even systemic anaphylactic responses. These can occur quickly after ingestion or exposure to wheat products.
Wheat kernel contains 8-15% protein, primarily gluten, composed of gliadins and glutenins. Gluten is heat stable and often used as an additive in processed foods. Gluten or similar proteins are also found in other grains like rye, barley, and oats. Gluten is the trigger for immune-mediated disorders like celiac disease. Wheat allergy, including Baker's asthma/rhinitis, is often linked to the albumin/globulin protein group in wheat, with omega-5 gliadin being a common allergen in exercise-induced anaphylaxis.
Worldwide, wheat allergy prevalence varies but is most common in children, many of whom outgrow the allergy by age 6. The prevalence of wheat allergy varies globally and is associated with atopic disorders like dermatitis, asthma, and allergic rhinitis in children. Environmental factors may influence the development of wheat allergy, though findings are inconclusive.
For wheat allergy management, the main approach is dietary avoidance, with the ability to tolerate other cereal grains generally. Epinephrine auto-injectors are prescribed for systemic reactions, and specific measures are recommended for occupational exposures. Oral immunotherapy with vital wheat gluten has shown varying degrees of desensitization, but adverse reactions are possible.
Gluten (f79) IgE
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